DORIS A. TRETTEL, Employee/Appellant, v. STATE, CAMBRIDGE REG'L CTR., SELF-INSURED, Employer, and ABBOTT NORTHWESTERN HOSP., TWIN CITIES FLOOR COVERING IND. H&W FUND, and THE INST. FOR LOW BACK CARE, Intervenors.
WORKERS= COMPENSATION COURT OF APPEALS
AUGUST 5, 2004
CAUSATION - SUBSTANTIAL EVIDENCE. Substantial evidence supports the compensation judge=s conclusion that the employee failed to establish her work injury was a substantial contributing factor in her need for treatment.
Determined by Stofferahn, J., Pederson, J., and Johnson, C.J.
Compensation Judge: Carol A. Eckersen
Attorneys: Lorrie L. Bescheinen, Borkon, Ramstead, Mariani, Fishman & Carp, LTD, Minneapolis, MN, for the Appellant. Kenneth H. Chun, Department of Employee Relations, Employee Insurance Division, St. Paul, MN, for the Respondents.
DAVID A. STOFFERAHN, Judge
The employee appeals from the compensation judge=s determination that she failed to prove her work injury was a substantial contributing factor in her need for medical treatment. We affirm.
The employee, Doris Trettel, injured her low back on April 4, 1980, while working at Cambridge Regional Center. The parties dispute whether medical bills incurred by the employee and whether her July 2001 back surgery were causally related to this work injury. This dispute was previously before this court and in our earlier decision we vacated the compensation judge=s Findings and Order, served and filed June 23, 2003, and remanded this matter for further consideration. A detailed recitation of the evidence in this case may be found in that decision.
The compensation judge issued her Findings and Order on Remand on March 16, 2004. She determined that the employee had failed to establish by a preponderance of the evidence that the 1980 work injury was a substantial contributing factor in her need for the medical treatment in dispute. She also found that the July 2001 low back surgery was not causally related to the 1980 injury and was neither reasonable nor necessary. The employee appeals.
The compensation judge determined that the employee failed to establish by a preponderance of the evidence that her 1980 work injury was a substantial contributing factor in the employee=s need for the disputed medical treatment. On appeal, the employee contends that the compensation judge=s decision lacks the support of substantial evidence. Specifically, the employee argues that the medical records show the employee treated on a regular basis for her low back since the date of injury. Further, the employee contends that multiple doctors have concluded that the employee=s low back condition was the result of her work injury. According to the employee, this evidence provided the requisite support for her claim and it was error for the compensation judge to conclude otherwise. We disagree.
As the compensation judge noted in her decision, the employee=s medical history is not as clear as the employee argues. The employee=s initial treatment after the work injury in 1980 was with the Cambridge Clinic, where she was diagnosed with a low back strain. She was released to return to work and, while the employee does not recall whether she had any work restrictions, she returned to her date of injury job and worked in that position until she voluntarily resigned six years later for reasons not connected to her work injury. A CT scan done at the Noran Neurological Clinic on February 28, 1996, showed only mild degenerative changes and no evidence of disc herniation or spinal stenosis. An evaluation on behalf of the employer by Dr. Mark Engasser in 1986 resulted in a diagnosis of chronic myoligamentous strain and a permanent partial disability rating of five percent of the spine.
The employee treated with Dr. Charles Cooley between 1989 and 1992. A CT scan done at his direction in 1990 showed only minimal bulging at L4-5 and L5-S1. At the time of his last consultation in May 1992, there were no objective findings on examination. Dr. Cooley did not indicate that the employee=s condition was due to her work injury. While the employee testified that she treated regularly thereafter for her low back until 1994, there are no such records in evidence. The employee testified that she did not treat for her back between 1994 and 1998.
The employee began extensive treatment for her low back in 2000 when she started making a series of visits to the emergency room in Monticello Big Lake Hospital. There were no objective findings on examination during these visits and no treatment was recommended other than pain medications. Other than noting the employee=s statements that her back problems began after her work injury in 1980, there was no medical opinion in the records of her treatment in 2000 that her ongoing complaints were related to her work injury.
Dr. Engasser saw the employee for treatment on three occasions in 2001. He did not state an opinion that the employee=s back problems were due to her 1980 work injury, but, instead, in his history, noted the employee=s statements that her back problems began in 1980. At the time of his last consultation on June 20, 2001, Dr. Engasser diagnosed lumbar disc syndrome with degenerative disc disease and disc bulging. He concluded that the employee=s symptoms were not serious enough to justify surgery and instead recommended a walking program and a weight loss program.
The employee saw Dr. Sunny Kim one time before he performed surgery on her low back on July 23, 2001. Dr. Kim expressed no opinion in his July 20, 2001, office notes at to whether the employee=s condition was related to her work injury and he appears not to have had any of the employee=s medical records other than a copy of an MRI done in May 2001. The only mention in any of Dr. Kim=s records of the work injury was in his initial chart note when he stated Apatient is a 48 year old woman who states that she has had a work-related injury to her back and she has gotten permanent partial disability.@
The burden is on the employee to prove by a fair preponderance of the evidence that he or she is entitled to workers= compensation benefits. Fisher v. Saga Corp., 463 N.W.2d. 501, 43 W.C.D. 559 (Minn. 1990). The employee must establish that the work injury is a substantial contributing factor in the current disability. Steinhaus v. F.B. Clements, 47 W.C.D. 22 (W.C.C.A. 1992). Given the evidence cited above, we cannot state that the compensation judge erred in concluding that the employee failed to establish that the work injury was a substantial contributing factor in the employee=s need for the medical treatment.
The employee also appeals the compensation judge=s finding that the back surgery of July 2001 was not reasonable or necessary. Since we have affirmed the compensation judge=s determination that the employee=s work injury was not a substantial contributing factor in her need for treatment, the question of whether the 2001 surgery was reasonable or necessary has been rendered moot and will not be considered.
 Trettel v. Cambridge Regional Center, slip op. (W.C.C.A. Dec. 17, 2003).