IRVIN C. HAMM, Employee, v. MARVIN WINDOWS & DOORS, SELF-INSURED/BERKLEY RISK ADM'RS CO., Employer-Insurer/Appellants, and ARCTIC CAT, INC., SELF-INSURED/BERKLEY RISK ADM'RS CO., Employer-Insurer, and MICKELSON CHIROPRACTIC, BLUE CROSS/BLUE SHIELD OF MINN. & BLUE PLUS, MN DEP=T OF ECON. SEC., and MN DEP=T OF HUMAN SERVS., Intervenors.
WORKERS= COMPENSATION COURT OF APPEALS
APRIL 21, 2004
CAUSATION - SUBSTANTIAL EVIDENCE; CAUSATION - INTERVENING CAUSE. Where, prior to the nonwork-related electrical burn injury that resulted in amputation of his nondominant arm, the employee had already been incapable of performing more than light to medium work within his restrictions due to his low back work injury, and where it was not unreasonable for the compensation judge to conclude that the low back disability, in combination with the employee=s age, training, and experience and the type of work available in his community, was substantial, the compensation judge=s conclusions that the employee=s low back work injury was a substantial contributing factor in his permanent total disability and that his nonwork-related electrical burn injury was not a superseding intervening cause of that disability was not clearly erroneous and unsupported by substantial evidence.
Determined by Pederson, J., Rykken, J., and Stofferahn, J.
Compensation Judge: Gary P. Mesna.
Attorneys: James S. Pikala, Arthur, Chapman, Kettering, Smetak & Pikala, Minneapolis, MN, for the Appellants. Jeffrey R. Hannig & Associates, Fargo, ND, for the Respondent.
WILLIAM R. PEDERSON, Judge
Marvin Windows & Doors, the self-insured employer, appeals from the compensation judge=s finding that the employee=s work injury is a substantial contributing factor in the employee=s permanent total disability and from the judge=s related finding that a subsequent nonwork-related electrical burn injury resulting in the amputation of the employee=s right arm is not a superseding intervening cause. We affirm.
Irvin C. Hamm was born on July 14, 1947, near Goodridge, Minnesota, a small town in the northwestern part of the state. Mr. Hamm attended schools in the area but left school after the tenth grade to help out on the family farm. He also worked for other farmers in the region until he entered the army in 1967. After completing his two-year military service obligation, including a year in Vietnam, Mr. Hamm returned to the Goodridge area and worked at a number of laboring jobs, including farming, construction, carpentry, janitor work, maintenance work, and a variety of other jobs. In July of 1986, Mr. Hamm began working at Marvin Windows & Doors [the employer]. Mr. Hamm [the employee] worked at several different jobs for the employer, and on March 15, 1990, while working in the re-work area sorting and salvaging parts, he sustained an injury to his lower back for which liability was accepted. The employee was forty-two years old at the time and was earning a weekly wage of $346.80.
Following the injury, and throughout his tenure with the employer, the employee treated regularly with chiropractor Dr. Thomas Mickelson at the Agassiz Chiropractic Clinic in Thief River Falls. The employee complained primarily of low back pain and stiffness, pain into his hips, and pain and numbness into both legs. Despite his low back problems, the employee continued to work full time at essentially the same light job that he had been performing before his injury.
On July 27, 1994, the employee was seen in consultation for Dr. Mickelson by neurologist Dr. Ross Pettit. Dr. Pettit diagnosed chronic low back pain with intermittent right and left lower extremity pain and ordered an MRI of the lumbar spine, which, conducted on August 11, 1994, revealed degenerative changes at several levels, most prominently at L3-4.
On May 10, 1995, the employee=s attorney referred him for an evaluation by orthopedist Dr. Joseph Flake. Dr. Flake obtained a history from the employee, reviewed pertinent medical records, and performed a physical examination. The employee complained to Dr. Flake of low back pain and leg pain that radiated down to his knees and increasing pain with twisting, bending, and sitting. Dr. Flake diagnosed lumbosacral strain with degenerative disc and joint disease of the lumbar spine. Based on the employee=s examination and MRI findings, the doctor rated the employee=s whole body impairment at 10.5% and recommended that the employee Ashould avoid any heavy lifting, any repetitive bending[,] as well as twisting, stooping, crawling, etc.@
On June 2, 1995, the employee filed a claim petition, seeking compensation for the 10.5% permanent partial disability rated by Dr. Flake. The employer obtained a medical evaluation of the employee by orthopedist Dr. Gary Wyard. In a report dated July 26, 1995, Dr. Wyrad diagnosed low back pain with degenerative lumbar disc disease and concluded that the employee was overweight and deconditioned. Moreover, he concluded that the employee=s low back complaints were related not to his employment or work injuries but to a long-standing unrelated degenerative condition. He restricted the employee from lifting over fifty pounds and from doing any repetitive prolonged bending, stooping, twisting and turning, and he suggested that the employee be given some flexibility in sitting and standing.
About a month later, on August 22, 1995, the employee voluntarily terminated his employment with the employer to begin a job at Arctic Cat in Thief River Falls, a plant at least fifty miles closer to his home. The employee subsequently testified that his low back condition played no role in his decision to change jobs and that he advised Arctic Cat of the restrictions that had been placed on him by his chiropractor.
The employee=s claim for permanent partial disability causally related to his March 15, 1990, work injury came on for a hearing before Compensation Judge Catherine Dallner on August 29, 1996. In an unappealed findings and order issued September 9, 1996, Judge Dallner accepted the opinions of Dr. Flake and found that the employee had sustained a 10.5% whole body impairment as a result of his work injury at the employer.
The employee worked for Arctic Cat for going on four years. According to his later trial testimony, the employee=s jobs at Arctic Cat were initially rather light, but after his transfer to the crating department in 1997, his duties became somewhat more strenuous and included helping another employee carry crates weighing about thirty pounds. The employee testified that he performed this activity about two hundred times a day. Throughout his tenure with Arctic Cat, the employee missed a number of full and partial days from work for a variety of reasons, including a sore back, and as early as January 4, 1996, he was warned of issues related to absenteeism. During this time, the employee continued to receive treatment periodically with Dr. Mickelson for symptoms similar to those that he had experienced at the employer- -low back pain, pain radiating into the legs, and difficulty walking and sleeping. On January 29, 1999, responding to an inquiry from Arctic Cat about the employee=s ability to carry on full-time employment, Dr. Mickelson wrote that the employee was capable of full-time employment if certain accommodations were consistently applied. He recommended no excessive or prolonged bending, no lifting of over twenty-five pounds occasionally or fifteen pounds continuously, and no work requiring twisting or excessive reaching. On April 4, 1999, the employee was terminated for excessive absences.
Following his termination by Arctic Cat, the employee applied for unemployment compensation and looked for other employment without success. On July 14, 1999, the employee applied for social security disability benefits, evidently alleging, at least in part, that he was disabled because of his back. The employee did not look for work after that date.
On August 14, 1999, the employee was assisting a friend who was placing a steeple on a church when the crane owned by the friend came into contact with a high voltage power line. The employee later testified that he had simply been asked to hook a cable onto the crane and was holding the cable when the crane touched the power line. The voltage was conducted through his right hand, resulting in significant burns to his back and buttocks and the amputation of his non-dominant right arm at the shoulder. Following this serious injury, the employee was hospitalized at Hennepin County Medical Center [HCMC] for thirty-two days. About six weeks after his discharge from HCMC, the employee=s doctors noted that he had an elevated blood sugar and diagnosed Type II diabetes, recommended referral to a dietician regarding diabetic education, and placed the employee on medication.
In January of 2000, the employee completed an AActivities of Daily Living Questionnaire@ to supplement his social security application. In response to questions asking him to describe his condition both before and after his impairment, the employee stated that after his impairment he only had one arm and could no longer work, whereas before his impairment he had two arms and was able to work. On June 12, 2000, the Social Security Administration issued a Notice of Award, finding that the employee became disabled under their rules and eligible for disability benefits effective on April 4, 1999, the day he was terminated by Arctic Cat.
Beginning in February of 2000, the employee sought periodic chiropractic treatment for his back with Dr. Steven Keogh at Altra Chiropractic in Thief River Falls. Later that year, on June 28, 2000, the employee=s family doctor referred him for a lumbar MRI scan. The scan was read as showing dehydration at L2-3, dehydration and a mild disc bulge at L3-4, and dehydration and a broad-based midline disc herniation at L4-5 that resulted in mild lateral stenosis. In late August of 2000, the employee was hospitalized for chest pain suggestive of ischemic heart disease or unstable angina. The doctors diagnosed cardiac ischemia without clear evidence of myocardial infarction and placed the employee on additional medication.
On March 19, 2002, the employee was examined by Dr. Seth Rosenbaum at the request of his attorney. Dr. Rosenbaum obtained a history, reviewed medical records, and performed a physical examination. In a report issued April 9, 2002, and in a supplemental report issued July 30, 2003, Dr. Rosenbaum opined that the employee sustained injuries to his lower back while working for the employer and Arctic Cat. He related the injury at Arctic Cat to repetitive activities at work that exceeded the employee=s previously defined restrictions. He attributed a 10.5% whole body impairment to the employee=s March 15, 1990, injury at the employer and an additional 10% whole body impairment to the employee=s injury at Arctic Cat. He stated that both injuries were a substantial contributing factor in the employee=s permanent total disability. He did not believe the employee had a severe cardiac condition and concluded that the employee=s diagnosed diabetes mellitus was a minimally disabling condition.
On May 17, 2003, the employee filed a claim petition for permanent total disability benefits and permanent partial disability benefits allegedly due to low back injuries sustained with both employers. Both the employer and Arctic Cat denied liability for the benefits claimed and arranged for medical evaluations.
Dr. Michael Smith examined the employee on behalf of Arctic Cat on October 17, 2002, and testified to his findings by deposition on August 7, 2003. Dr. Smith obtained a history from the employee, reviewed medical records, and performed a physical examination. He diagnosed lumbar degenerative disc disease at virtually all levels of the lumbar spine and characterized the employee=s numerous exacerbations and remissions of pain specifically any related to incidents at the employer or Arctic Cat, as temporary aggravations. He did not believe that the employee sustained a Gillette injury during his three plus years of employment at Arctic Cat, and he related the employee=s back complaints to the Aage-related consequences of advancing degenerative disc disease.@ Dr. Smith assigned a 10% whole body impairment rating to the employee=s condition but indicated that the rating was unrelated to the employee=s employment. Dr. Smith saw no specific need for restrictions as a result of the employee=s degenerative condition, and he concluded that if only the lumbar spine condition were considered the employee would be capable of engaging in the same type of manufacturing assembly work that he performed over the years at the employer and Arctic Cat.
Dr. Nolan Segal examined the employee on behalf of the employer on October 29, 2002, testified by deposition on July 9, 2003, and issued a supplemental report on August 4, 2003. Dr. Segal diagnosed multilevel degenerative disc disease of the lumbar spine and amputation of the right upper extremity at the shoulder as the employee=s major conditions. He testified that the employee=s back condition was the result of changes that were evidenced as far back as 1975 as well as the result of employee=s weight and age. He did not believe that the employee qualified for any permanent partial disability in excess of the 10.5% previously awarded, but he did agree that the employee=s degenerative disc disease required activity modification or restrictions. Dr. Segal recommended that the employee avoid repetitive bending, lifting, and twisting, that he use proper body mechanics and posture principles with activities, and that he change positions between sitting, standing and walking as needed. He opined that, but for the employee=s amputation, the employee would be capable of engaging in full-time employment. He also testified that the employee=s right arm amputation was a far more limiting factor in his ability to work than was his degenerative low back condition. Dr. Segal stated that the employee was not permanently and totally disabled prior to the 1999 electrical injury but that he was disabled to that effect after that injury. He did not believe that the employee=s work injury in 1990 was a substantial contributing factor in his permanent total disability.
The employee=s claim petition came on for a hearing before Compensation Judge Gary P. Mesna on July 15, 2003, and the record closed on August 14, 2003. Issues at trial included in part the following: (1) whether the employee was entitled to permanent total disability benefits and, if so, whether such disability began on April 4, 1999, or August 14, 1999; (2) whether the employee=s work injury of March 15, 1990, was a substantial contributing factor in the claimed disability; and (3) whether the employee=s nonwork injury of August 14, 1999, was a superseding intervening cause of the employee=s disability. Evidence offered at trial included testimony of the employee, testimony of the employee=s vocational expert Vaughn Thorfinnson, testimony of the employer=s vocational expert Richard VanWagner, the employee=s medical records, and the depositions of Drs. Smith and Segal.
The employee testified that, following his injury at the employer on March 15, 1990, he continued to perform light-duty tasks for the employer until he voluntarily resigned in August of 1995. He also testified that his back gradually worsened during his employment at Arctic Cat and that he missed a number of days from work because of his back. He testified that, after his dismissal by Arctic Cat for absenteeism, he looked for other work but could only recall about three places where he applied. He testified that he applied for social security benefits on the advice of his medical doctor on July 14, 1999, and did not look for work after that date.
Mr. Thorfinnson testified that there were very few transferrable skills to be garnered from the employee=s work history and that, given the employee=s work experience and age, his employment opportunities are much more limited than they would be if he had had a broader background. In his report of January 20, 2003, Mr. Thorfinnson had opined that the employee was Adisabled to a degree that would preclude his returning to the competitive workforce at a level that he could ever be considered to be gainfully employed.@ He testified that the employee=s Aloss of his right arm has not disabled him as much as it would have if he were right had dominant,@ and that A[h]is opportunity to find work is quite limited in the area in which he lives and his physical limitations preclude his working at a competitive level.@
Vocational expert Richard VanWagner testified that, prior to August 14, 1999, the employee was employable in the regional economy in which he lived. Based on the restrictions given by Dr. Mickelson, it was Mr. VanWagner=s opinion that the employee could work full-time at light capacity to modified medium capacity jobs. Using the restrictions offered by Drs. Wyard and Segal, Mr. VanWagner opined that the employee could work full-time at medium capacity jobs. He opined that the employee=s August 14, 1999, electrocution injury and the employee=s subsequent medical problems Ahad a composite devastating effect on [the employee=s] employability@ that rendered him permanently and totally disabled after August 14, 1999. Mr. VanWagner did not believe that the employee was permanently totally disabled before that date or that his back condition was a substantial contributing factor in his total disability after that date.
In a findings and order issued September 15, 2003, the compensation judge found that, prior to August 14, 1999, the employee was able to perform light to medium work within his restrictions. Because the employee did not make a diligent effort to find work within his restrictions between April 4, 1999, and August 14, 1999, the judge denied the employee=s claim for permanent total disability benefits during that period. The judge did find, however, that the employee has been permanently and totally disabled since August 14, 1999, and that the work injury of March 15, 1990, remains a substantial contributing cause of the employee=s disability. The judge concluded that the employee=s electrical burn injury in 1999, which resulted in the amputation of his right arm, was not a superseding intervening cause of the employee=s permanent total disability. The employer appeals.
STANDARD OF REVIEW
In reviewing cases on appeal, the Workers= Compensation Court of Appeals must determine whether Athe 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, Athey 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). Where evidence conflicts or more than one inference may reasonably be drawn from the evidence, the findings are to be affirmed. Id. at 60, 37 W.C.D. at 240. Similarly, A[f]actfindings are clearly erroneous only if the reviewing court on the entire evidence is left with a definite and firm conviction that a mistake has been committed.@ Northern States Power Co. v. Lyon Food Prods., Inc., 304 Minn. 196, 201, 229 N.W.2d 521, 524 (1975). Findings of fact should not be disturbed, even though the reviewing court might disagree with them, Aunless 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.@ Id.
There is no dispute that the employee has been permanently and totally disabled since August 14, 1999, the date of his serious nonwork-related electrical burn injury. The employer first argues that the compensation judge committed an error of law by applying the wrong legal standard for determining whether the employee=s electrical burn injury was a superseding intervening cause. It argues that, while the judge Afound that he should not apply a >but for= standard to this question, [he] did not cite any other standard.@ We disagree.
In Buford v. Ford Motor Co., 52 W.C.D. 723 (W.C.C.A. 1995), this court stated that the proper test to determine whether a subsequent incident or condition is a superseding intervening cause is the Asubstantial contributing cause@ test. A panel of this court explained,
[I]t has long been the law in Minnesota that the employer is liable for all natural consequences flowing from an admitted personal injury unless such consequences are the result of an independent intervening cause. Rohr v. Knutson Constr. Co., 305 Minn. 26 232 N.W.2d 233, 28 W.C.D. 23 (1975). In Roman v. Minneapolis Street Ry., 268 Minn. 367, 129 N.W.2d 550, 23 W.C.D. 573 (1964), the court held that a personal injury need not be the sole cause of disability. It is only necessary for the employee to show that the personal injury was a legal cause of the disability, that is, a substantial contributing cause. Thus, Ford is liable for all disability of which the admitted personal injuries are a substantial contributing cause. It is not, however, liable for disability resulting from a superseding intervening cause. A superseding intervening cause is one which severs the causal link between the original personal injury and the resultant disability such that the original personal injury is no longer a substantial and contributing cause of the resultant disability.
Burford v. Ford Motor Co., 52 W.C.D. 723, 727-28 (W.C.C.A. 1995). Moreover, A[a] disabling, non-work-related medical condition sustained subsequent to a work injury does not automatically constitute an intervening cause where it can be shown that the previous work injury remains a substantial contributing factor in the employee=s disability.@ Leegard v. Mid-City Hotel Assoc., 44 W.C.D. 240, 243 (W.C.C.A. 1990).
At Finding 12, the judge specifically found that the employee=s electrical burn injury was not a superseding intervening cause under the standards set down by this court in Buford. In his memorandum, the judge explained,
To determine liability, the court must determine whether the 1990 work injury remains a substantial contributing cause of the employee=s ongoing disability or whether the 1999 electrical injury was a superseding intervening cause sufficient to break the chain of causation between the 1990 work injury and the ongoing inability to work.
We see no basis for concluding that the judge applied the wrong legal standard. To the contrary, it is evident that the judge properly applied the Asubstantial contributing cause@ test of Roman and Buford in determining the employer=s liability for the employee=s permanent total disability.
At Finding 11, the judge found that the work injury of March 15, 1990, is a substantial contributing factor in the employee=s current disability. The employer argues that the compensation judge failed to provide any real analysis of this issue and that the legal standard for what makes an injury a substantial contributing factor needs to be defined. Neither statute nor case law precisely defines what constitutes a Asubstantial@ or Asignificant@ contributing factor in a workers= compensation setting. Because each case must to a great extent stand on its own facts, no one comprehensive definition can be fashioned. See Flowers v. Consolidated Containers Corp., 336 N.W.2d 255, 36 W.C.D. 39 (Minn. 1983). The term essentially contains its own definition- -that is, a Asubstantial contributing cause@ is a cause that is both Asubstantial and Acontributing@ to the ultimate disability. Stated another way, the cause must be Aappreciable.@ Roman v. Minneapolis Street Ry., 268 Minn. 367, 380, 129 N.W.2d 550, 558, 23 W.C.D. 573, 592 (1964). As this court stated in a different context, A[w]hen a line is drawn, there are always cases very close to each side of the line. No absolute rule can be derived, since there are too many factual variables that could affect the result.@ Bohlin v. St. Louis County/Nopeming Nursing Home, 61 W.C.D. 69, 81 (W.C.C.A. 2000). It is because of the many factual variables peculiar to each case that the issue of whether a work injury is a substantial contributing factor in a claimed disability is a factual question for the compensation judge. The term essentially defies precise definition, and the issue on appeal in this case is whether substantial evidence supports the judge=s decision.
Finally, the employer argues that the compensation judge=s decision is unsupported by substantial evidence, and it lists the following evidence which could support a contrary conclusion. The employee continued to work at the employer at his preinjury job for an additional five years before voluntarily leaving for reasons unrelated to his back. He worked at Arctic Cat in a position that involved manual labor, and he worked at that job without claim of wage loss. He was terminated by Arctic Cat for absenteeism and immediately applied for unemployment compensation benefits, certifying that he was capable of and ready to work. Around this same time, the employee=s treating doctor for his low back condition indicated that the employee was capable of full-time employment. The employee did not conduct a reasonable and diligent job search between April 4, 1999, and August 14, 1999. The judge found that the employee was capable of working prior to August 14, 1999, and that he sustained a Adevastating@ injury on that date, following which the employee became permanently and totally disabled. Considering these facts, and the judge=s essential conclusion that, had the employee not sustained the electrical burn injury, he would not have been permanently and totally disabled, the employer argues that the judge=s conclusion that the work injury was a substantial contributing factor, or that the electrical injury was not a superseding intervening injury, defies common sense and logic. We are not persuaded.
In general, an employee is permanently and totally disabled Aif his physical condition, in combination with his age, training, experience, and the type of work available in his community, causes him to be unable to secure anything more than sporadic employment resulting in insubstantial income.@ Schulte v. C.H. Peterson Constr. Co., 278 Minn. 79, 83, 153 N.W.2d 130, 133-34, 24 W.C.D. 290, 295 (1967). In evaluating permanent total disability, the primary consideration is the employee=s vocational potential rather than his physical condition. McClish v. Pan-O-Gold Baking Co., 336 N.W.2d 538, 542, 36 W.C.D. 133, 139 (Minn. 1983); Boileau v. A-Plus Indus., 58 W.C.D. 549, 558-59 (W.C.C.A. 1998). In the memorandum accompanying his findings and order, the compensation judge stated the following:
The permanent nature of the 1990 low back injury was previously determined by Judge Dallner. The ongoing low back problems and treatment are well documented. He continues to have significant restrictions related to his low back. Even though he did not have an additional injury at Arctic Cat, he had trouble performing the work as a result of his low back condition. Even Richard VanWagner, the employer=s vocational expert, agreed that as a result of the low back problems, the employee was limited to light to medium work just prior to the electrical injury. Considering the employee=s vocational history and the type of jobs available in his community, the physical limitations related to the low back are significant.
We have carefully reviewed the entire record and conclude that substantial evidence supports the judge=s finding that the employee=s work injury is a substantial contributing factor to the employee=s current disability.
At a hearing in 1996, Compensation Judge Dallner concluded that the employee did not have any restrictions or permanent partial disability prior to his work injury of March 15, 1990. She concluded that the 1990 work injury resulted in a permanent aggravation of the employee=s multi-level degenerative disc disease, and she awarded compensation for a 10.5% whole body impairment. Although the employee continued working for the employer at his pre-injury light job for an additional five years, the records of the treating chiropractor, Dr. Mickelson, clearly reflect ongoing problems of low back pain and stiffness, pain in both hips, and pain and numbness into both legs. Dr. Mickelson=s records reflect over two hundred visits to his office by the employee between the date of the work injury and the employee=s voluntary termination from the employer. Although the employee was able to maintain employment at Arctic Cat, and although the judge did not find an additional injury during that employment, the judge did note that the employee continued to work with significant restrictions related to his low back and that he had trouble performing the work. Arctic Cat eventually terminated the employee for excessive absences, but the employee testified and Arctic Cat=s records confirm that he was missing time in part because of his back.
Mr. Thorfinnson testified that the employee possessed few transferrable skills, considering his age, training, and experience, that would translate into significant employment opportunities in his community. Mr. VanWagner agreed that, given the employee=s restrictions, he was limited to light to medium work just prior to the electrical injury and that, in conducting his labor market analysis, he had excluded jobs that he categorized as Aheavier.@ The fact that the employee was able to maintain employment with the employer and Arctic Cat until April of 1999 does not mean that his injury did not impact his employability. Prior to August 14, 1999, the employee was capable of performing only light to medium work within his restrictions. Because of his restrictions, there were a number of jobs that the employee was incapable of performing. Based on the employee=s testimony, including his testimony regarding his application for social security disability benefits in July 1999, the testimony of the vocational experts, and the entire medical record, the compensation judge could reasonably conclude that the employee=s work-related restrictions, in combination with his age, training, experience, and the type of work available in his community were significant and, therefore, a substantial contributing cause of the employee=s current disability. The intervention of a nonwork-related disability as the terminal cause does not relieve an employer and insurer from liability. Dillemuth v. Owatonna Tool Co., 62 W.C.D. 229, 235 (W.C.C.A. 2002), citing Roman, 268 Minn. 367, 129 N.W.2d 550, 23 W.C.D. 573.
Given the devastating nature of the employee=s nonwork injury in 1999, the employee=s general medical condition, and other factors in the record, another factfinder may well have reached a different conclusion on these facts. This is one of those cases that is very close to the Aline.@ In the end, however, we find no grounds to reverse the compensation judge=s implicit decisions to credit the employee=s testimony regarding his back symptoms and to find the employee=s back restrictions substantial. As such, we are compelled under our standard of review to affirm the judge=s conclusion that the employee=s March 15, 1990, work injury is a substantial contributing factor in the employee=s resultant permanent total disability after August 14, 1999. Therefore, the decision of the compensation judge is affirmed in its entirety. Hengemuhle, 358 N.W.2d at 59, 37 W.C.D. at 239.
 Mr. Ham evidently obtained his G.E.D. in 1984, at Northwest Technical Institute in Thief River Falls.
 Mr. Hamm has a service-connected disability related to Agent Orange exposure.
 Dr. Mickelson=s office records reference over 200 office visits by the employee between March 1990 and August 1995.
 Under Minn. R. 5223.0070, subp. 1A(3)(b).
 The judge also determined that, although the employee had experienced pain and problems in his low back prior to his work injury of March 15, 1990, the evidence did not support the employer=s claim for apportionment of the employee=s permanency under Minn. Stat. ' 176.101, subd. 4a(a).
 The record does not contain the employee=s actual application for social security benefits. However, the employee=s testimony and a background letter from the employer=s attorney to medical expert Dr. Nolan Segal reflect that the employee=s claim was based, at least in part, on his low back condition.
 See Gillette v. Harold, Inc., 257 Minn. 313, 101 N.W.2d 200, 21 W.C.D. 105 (1960).
 Also at issue before the judge, though not on appeal to this court, was the employee=s claim for a Gillette injury at Arctic Cat culminating on April 4, 1999, and his claim for additional permanent partial disability. The judge denied the claimed Gillette injury against Arctic Cat, and found the claimed permanency to be duplicative of the 10.5% paid by the employer in 1996.