VALERIE GROVER, Employee/Respondent, v. HONEYWELL, INC., and SELF-INSURED/SEDGWICK CLAIMS MANAGEMENT SERVS., Employer/Appellant, and ORTHOPEDIC PARTNERS, P.A., MN ORTHOPEDIC SRUGERY CENTER, ALLINA MEDICAL CLINIC/CAMBRIDGE HOSPITAL, AND BLUE CROSS BLUE SHIELD OF MINNESOTA/COMPREHENSIVE HEALTHCARE SERVICES, Intervenors.
WORKERS= COMPENSATION COURT OF APPEALS
APRIL 30, 2003
CAUSATION - SUBSTANTIAL EVIDENCE. Substantial evidence, including records of the employee=s treating physician and the employee=s testimony, supports the compensation judge=s findings that the employee sustained a Gillette injury to her left and right shoulders as a result of her work activities.
Determined by Rykken, J., Stofferahn, J., and Johnson, C.J.
Compensation Judge: Rolf Hagen
MIRIAM P. RYKKEN, Judge
The self-insured employer appeals from the compensation judge=s finding that the employee sustained a Gillette injury to her left and right shoulders as a result of her work activities with the employer, and from the award of temporary disability benefits and payment of medical expenses. We affirm.
Valerie Grover, the employee, began working for Honeywell, Inc., in January 1979. The employee worked in various departments for the employer. Between December 1997 and September 2000, and during part of 2001, the employee worked full-time in the paint department, painting chassis parts for airplane dashboards. Her duties were five-fold: masking parts with tape, spray painting, unmasking the taped parts, scraping residual paint off the parts, and removing the residual scrapped paint with a high pressure air hose. At hearing, while testifying in a manner that the compensation judge specifically found to be credible, the employee testified that all five aspects of her job required her to hold her left arm out at least shoulder level, and frequently and to lift her left arm above shoulder level. The employee also testified that she performed her tasks at a constant, somewhat rushed pace.
On approximately September 2, 2000, the employee noticed a toothache-type feeling in her left shoulder, which became more constant and pronounced in October and November 2000. Eventually her left shoulder Alocked up@ and became more painful by the end of the work week. The employee consulted Dr. Robin Crandall on November 9, 2000, reporting left shoulder symptoms; the employee had treated with Dr. Crandall at various times during the 17 years before November 2000. Dr. Crandall diagnosed degenerative arthritis of the left shoulder AC joint and probable impingement syndrome. He performed cortisone injections to the left shoulder, but the employee=s left shoulder pain and left arm numbness and weakness persisted, so Dr. Crandall referred the employee for an MRI scan of her left shoulder and an EMG of her left upper extremity. The results of the EMG were normal, but the MRI scan showed degenerative changes in the AC joint with osteophytic formation. Dr. Crandall diagnosed degenerative arthritis and subacromial clavicular articulation of the shoulder, and recommended an arthroscopic acromioplasty with a distal clavicle excision, which he performed on January 18, 2001.
The employee remained off work post-surgery, and returned to work, full-time as a painter, by mid-March 2001. The employee testified that she began to favor her left shoulder and used her right arm on an increasing basis, and that she began to notice symptoms in her right arm as a result of her work. By May 4, 2001, the employee reported to Dr. Crandall that she continued to have pain and discomfort in her right shoulder, including pain resulting from range of motion testing. Dr. Crandall recommended an MRI scan of the right shoulder to rule out impingement syndrome or right rotator cuff tear. Upon review of the MRI results, Dr. Crandall diagnosed a probable mild impingement syndrome and treated the employee with a steroid injection. However, the employee=s right shoulder pain persisted, and by September 2001, Dr. Crandall recommended surgery. On October 16, 2001, Dr. Crandall performed right shoulder surgery in the nature of decompression and distal clavicle excision, and restricted the employee from work post-surgery through January 27, 2002. The employee returned to work for the employer, and remained employed there at the time of the hearing in May 2002.
The self-insured employer denied primary liability for the employee=s claimed injuries. By claim petition filed on May 10, 2001, later amended, the employee claimed entitlement to payment of temporary total and temporary partial disability benefits and medical expenses.
On January 31, 2002, Dr. Edward Szalapski examined the employee at the request of the self-insured employer. Dr. Szalapski diagnosed an acromioclavicular joint arthrosis and impingement syndrome in both upper extremities. He provided no opinion in his report concerning the causation of the employee=s upper extremity conditions other than to note that the employee=s medical records or Awork note, the box for work-related was checked yes. This is checked yes on a number of other occasions as well.@ Dr. Szalapski outlined his opinion as follows:
ASSESSMENT: Ms. Grover has had bilateral upper extremity problems. Specifically, she has had acromioclavicular joint arthrosis and impingement syndrome. The symptoms she describes and the symptoms described in the medical records fit very nicely. Furthermore, she has had an excellent response to surgical management of these problems, which is further hard evidence supporting that diagnosis.
At this point, there are no limitations on use of the left upper extremity, either in the work place or at home. For the right, she should refrain from using the arm overhead or from lifting over 10 pounds. This restriction should be eliminated no later than April 1, 2002.
At this point, Ms. Grover can progress to a home exercise program. Further formal physical therapy should not be necessary. She will, however, need a few more visits to Dr. Crandall to monitor her progress.
Maximum Medical Improvement has occurred for the left shoulder. Maximum Medical Improvement for the right shoulder should occur no later than April 1, 2002.
Treatment rendered to date has been appropriate and reasonably necessary to cure and relieve the effects of the above diagnoses.
Dr. Crandall, on the other hand, opined that the employee=s shoulder problems were related to her work for the employer. He stated as follows, in a report dated May 10, 2002:
Most of these shoulder type problems do occur from repetitive overhead use and are very common in industrial type situations. Valerie certainly does have a right to [a] Work Comp claim in this situation. The repetitive motion overhead certainly would have caused this difficulty. I do think this is related to her work situation at Honeywell.
Dr. Crandall addressed the concern voiced by the employer, that is, that he at various times indicated the employee=s condition was work-related and not work-related. Dr. Crandall explained that
with regard to her work ability reports for her left shoulder, these were marked Aundetermined@ due to the fact that she had not filed a first report of injury. The 1-26-01 work ability was marked Ano@ because we had received a denial from Sedgwick. This is where the confusion came with regards to the causation of injury.
Dr. Crandall opined that the employee=s injuries were permanent in nature, and that all of her medical treatment that she received had been reasonable and necessary. He advised that the employee should restrict her overhead motion and avoid repetitive motion overhead and avoid any pushing or pulling.
Following the hearing held on May 24, 2002, and following receipt of postBhearing documents, the compensation judge issued Findings and Order on September 3, 2002, in which he found that the employee sustained a Gillette injury to her left and right shoulders as a result of her work activities for the employer. The compensation judge awarded the employee=s claimed periods of temporary total and temporary partial disability benefits, reimbursement of medical expenses and reimbursement of medical intervention claims. The self-insured employer appeals.
The self-insured employer appeals from the compensation judge=s finding that the employee sustained a Gillette injury to her left and right shoulders as a result of her employment activities. The employer argues that the employee did not sustain her burden of proof and that the compensation judge applied the wrong standard of proof. The employer also argues that the trial judge did not fairly characterize the hearing record and that the evidence of record does not support the compensation judge=s findings concerning causation of the employee=s claimed injuries. We are not persuaded. There is ample evidence in the record to support the compensation judge=s findings.
A Gillette injury is a result of repeated trauma or aggravation of a pre-existing condition which results in a compensable injury when the cumulative effect is sufficiently serious to disable an employee from further work. Gillette v. Harold, Inc., 257 Minn. 313, 321-22, 101 N.W.2d 200, 205-06, 21 W.C.D. 105, 111-13 (1960); Carlson v. Flour City Brush Co., 305 N.W.2d 347, 350, 33 W.C.D. 594, 598 (Minn. 1981). The question of a Gillette injury primarily depends on medical evidence. Marose v. Maislin Transport, 413 N.W.2d 507, 512, 40 W.C.D. 175 (Minn. 1987), and questions of medical causation fall within the province of the compensation judge. Felton v. Anton Chevrolet, 513 N.W.2d 457, 50 W.C.D. 181 (Minn. 1994). The employee "must prove a causal connection between her ordinary work and ensuing disability. . . . Whether given by testimony or written report, an opinion by a medical expert as to the causal link between the claimant's disability and the job must be based on adequate foundation." Steffen v. Target Stores, 517 N.W.2d 579, 582, 50 W.C.D. 464, 467 (Minn. 1994).
The compensation judge relied on Dr. Crandall=s expert medical opinion in concluding that the employee=s work activities resulted in a Gillette injury to her left and right shoulders. At hearing, as on appeal, the employer and insurer argued that Dr. Crandall=s reports lack foundation in that there is little or no mention of the employee=s work activities in his reports. Adequate foundation is necessary for a medical opinion to be afforded evidentiary value. Winkles v. Independent Sch. Dist. No. 625, 46 W.C.D. 44, 58 (W.C.C.A. 1991). Furthermore, the facts upon which the expert relies for his or her opinions must be supported by the evidence. McDonald v MTS Sys. Corp., 43 W.C.D. 83 (W.C.C.A. 1990), summarily aff'd (Minn. July 13, 1990). In this case, the employee=s testimony, which the compensation judge specifically found to be credible, describes in detail the various tasks the employee performed as a painter and includes the employee=s assertions that she discussed these tasks with Dr. Crandall. A videotape offered into evidence by the employer and insurer demonstrated the type of activities the employee performed as a painter. The medical records, specifically those of Dr. Crandall, the employee=s treating physician, reflect the history and development of symptoms reported by the employee. The compensation judge addressed those arguments on foundation in his memorandum, stating that
While it is true Dr. Crandall=s records/reports are lacking in exactly the nature, extent and frequency of the work activities of the employee, it was employee=s credible testimony at hearing that she discussed in detail with Dr. Crandall her job activities. Based upon these verbal representations, Dr. Crandall came to an opinion as to causation, which this Compensation Judge has accepted as having been based upon adequate foundation.
The employee=s testimony describing her work activities and the onset of her symptoms is consistent with and provides adequate support for Dr. Crandall=s conclusion that the employee=s work activities resulted in injuries to her shoulders. Dr. Crandall examined and treated the employee and was familiar with her history and work activities. In view of the evidence in this case, we conclude that Dr. Crandall=s opinions were adequately founded and the compensation judge cold reasonably rely on them. See Grunst v. Immanuel-St. Joseph=s Hosp., 424 N.W.2d 66, 40 W.C.D. 1130 (Minn. 1988).
At hearing, as on appeal, the employer and insurer also argued that the record indicates that the employee=s job was not highly-repetitive and did not require overhead use of the shoulders to any great extent. The compensation judge disagreed with that characterization, stating in his memorandum that he accepted the employee=s testimony credible and that, even though the employer and insurer=s exhibit of job requirements did not indicate a highly repetitive job, Agiven this employee=s age, size and condition (significant arthritis in the shoulder), the repetitive nature of the job was more than sufficient to cause the problems.@
On appeal, the Workers' Compensation Court of Appeals must determine whether "the findings of fact and order [are] clearly erroneous and unsupported by substantial evidence in view of the entire record as submitted." Minn. Stat. ' 176.421, subd. 1 (1992). Substantial evidence supports the findings if, in the context of the entire record, "they are supported by evidence that a reasonable mind might accept as adequate." Hengemuhle v. Long Prairie Jaycees, 358 N.W.2d 54, 59, 37 W.C.D. 235, 239 (Minn. 1984). In this case, the compensation judge reviewed the medical records from the employee=s treating physician as well as the employee=s testimony and other documents in the record, and the videotaped illustration of the type of painting job the employee performed, and determined that Dr. Crandall=s medical opinion supported a conclusion that the employee=s work activities resulted in her left and right shoulder injuries. On appeal, this court will not disturb a compensation judge=s findings of fact "unless they are clearly erroneous in the sense that they are manifestly contrary to the weight of the evidence or not reasonably supported by the evidence as a whole.@ Northern States Power Co. v. Lyon Food Prods., Inc., 304 Minn. 196, 201, 229 N.W.2d 521, 524 (1975). In view of the record as a whole, we believe that the compensation judge=s determinations and award of the employee=s claim are supported by the evidence as a whole and are not clearly erroneous. We therefore affirm.