GONDAH MIANTONA, Employee, v. SAM’S CLUB and AMERICAN HOME ASSURANCE CORP./AIG/CLAIMS MGMT., INC., Employer-Insurer/Appellants, and FAIRVIEW HEALTH SERVS., NORAN NEUROLOGICAL CLINIC, GROUP HEALTH PLAN d/b/a HEALTHPARTNERS, INC., TWIN CITIES ORTHOPAEDICS, and SUMMIT CHIROPRACTIC, Intervenors.
WORKERS’ COMPENSATION COURT OF APPEALS
AUGUST 8, 2012
CAUSATION - SUBSTANTIAL EVIDENCE. Substantial evidence, including expert opinion, supported the compensation judge’s decision that the employee sustained work-related injuries to his neck and left shoulder, as claimed, and that the employee’s work-related low back injury did not resolve for six months, in accordance with the opinion of the employee’s treating physician.
Determined by: Wilson, J., Hall, J. and Johnson, J.
Compensation Judge: John Ellefson
Attorneys: Kirsten M. Tate and Joseph J. Osterbauer, Osterbauer Law Firm, Minneapolis, MN, for the Respondent. Andrew M. Tatge, Gislason & Hunter, Mankato, MN, for the Appellants.
DEBRA A. WILSON, Judge
The employer and insurer appeal from the compensation judge’s decision as to the nature and extent of the employee’s work injury. We affirm.
The employee is a high school graduate who emigrated from Liberia to the United States in 2004. Following his arrival in this country, the employee received some vocational training at Job Corps in St. Paul, and he worked at several different warehouse jobs before obtaining employment at Sam’s Club [the employer] in 2007. The employee worked full time for the employer as an overnight stocker, operating a forklift and lifting products manually onto pallets and shelves.
The employee was involved in two nonwork-related motor vehicle accidents in 2007. He received treatment, including chiropractic care, for low back and neck symptoms following these incidents. He also underwent a lumbar MRI scan. He testified that he was “strong and healthy” and that he was subject to no restrictions when he began his job with the employer. It is apparently undisputed that he received little or no treatment for low back or neck symptoms from late November 2007 to May of 2009.
On May 17, 2009, the employee experienced sharp pain in his back as he was moving bags of rice between pallets at work. He stopped working immediately and completed an injury report indicating that he had hurt his back. Medical records from the following day note that the employee was complaining of left-sided low back pain. The evidence is conflicting as to whether the employee experienced neck and left shoulder pain, as well, while lifting the rice bags at work.
On May 20, 2009, three days after the work incident, the employee sought chiropractic treatment from Dr. Alex Onsomu, complaining of pain in his back, neck, and hip. In the history portion of his notes, Dr. Onsomu indicated that the employee had also experienced left shoulder pain on May 17. Dr. Onsomu treated the employee with manipulation, massage, hot/cold therapy, traction, and home exercises over the next ten months. An x-ray of the employee’s left shoulder, performed on June 14, 2009, was deemed unremarkable.
Dr. Onsomu referred the employee to Noran Neurological Clinic, where he came under the care of Dr. Ana Groeschel. At his July 1, 2009, consultation, the employee was still complaining of low back, neck, mid back, and shoulder pain. A lumbar MRI performed on July 20, 2009, showed no abnormality or change from the scan performed in September of 2007, following the employee’s automobile accidents.
In September 2009, the employee underwent an MRI of his left shoulder. That study disclosed an “edema-like signal within the distal clavicle,” which the radiologist thought could have been due to trauma, degenerative changes, or inflammation. The radiologist also found a greater than normal quantity of fluid in the bicipital tendon sheath and increased signal within the superior labrum, suggestive of a labral tear. Subsequent diagnostic studies of the employee’s cervical spine showed a possible C5 or C6 radiculopathy and mild anterior disc bulging at C5-6.
In March 2011, the employer and insurer had the employee evaluated by Dr. Paul Cederberg. In his March 28, 2011, report, Dr. Cederberg wrote that the employee had sustained a temporary lumbar strain at work on May 17, 2009, which would have resolved by May 28, 2009. Dr. Cederberg also indicated that the employee had no continuing objective findings and that the employee had shown signs of functional overlay on examination.
In January 2012, Dr. Groeschel issued a narrative report expressing the opinion that the employee’s “work injury of May 17, 2009, was a substantial contributing factor for his left shoulder, cervical, and lumbar spine condition and disability.” She found the employee’s lumbar spine injury to be temporary, having lasted about six months, but, in her opinion, the employee had sustained permanent injuries to his cervical spine and left shoulder. Dr. Groeschel also concluded that the employee had a 7% whole body impairment referable to his cervical condition. Dr. Groeschel referred the employee to an orthopedist for evaluation of his shoulder condition; advised the employee to continue anti-inflammatory medication, physical therapy, and chiropractic care; and restricted the employee from overhead work and working more than 40 hours a week.
The matter came on for hearing before a compensation judge on February 1, 2012, for resolution of the employee’s claim for medical expenses and benefits for a 7% whole body impairment. The primary issue was the nature and extent of the May 17, 2009, injury. The employer and insurer admitted that the employee had sustained a temporary low back strain but denied that the employee had injured his neck or left shoulder on that date. Evidence included the employee’s testimony, his medical records, and the opinions of Drs. Cederberg and Groeschel.
In a decision issued on March 6, 2012, the compensation judge concluded that the employee had injured his neck and left shoulder at work on May 17, 2009, that the employee had a 7% whole body impairment due to his work-related cervical condition, and that the employee’s low back injury had not resolved in May of 2009, contrary to the opinion of Dr. Cederberg. The employer and insurer were ordered to pay benefits accordingly. The employer and insurer appeal.
STANDARD OF REVIEW
In reviewing cases 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. 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). 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, “[f]act findings 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 Foods 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, “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.” Id.
In making his decision on causation, the compensation judge expressly accepted the opinion of Dr. Groeschel, the employee’s treating physician, over the opinion of Dr. Cederberg, the employer and insurer’s examiner. On appeal, the employer and insurer contend that the compensation judge should have accepted the opinion of Dr. Cederberg, because Dr. Groeschel did not explain the basis for her opinion as to the employee’s alleged neck injury. The employer and insurer also appear to suggest that the employee’s cervical condition is the result of the employee’s 2007 motor vehicle accidents, or, in the alternative, that the employee has no real cervical disability at all. The employer and insurer also maintain that even the employee’s “own testimony is conflicted on whether or not he suffered more than a back injury on May 17, 2009.” None of these arguments is persuasive.
The employee was complaining of neck and left shoulder symptoms within two or three days of the May 17, 2009, date of injury. There is no evidence that the employee had any continuing effects from his 2007 motor vehicle accidents or that he had received any treatment related to those accidents for more than a year prior to the work incident, and even Dr. Cederberg, the employer and insurer’s own expert, failed to attribute any continuing symptoms or injury to the 2007 accidents. Finally, Dr. Groeschel was the employee’s treating physician and, contrary to the argument of the employer and insurer, Dr. Groeschel clearly had adequate knowledge of the employee’s condition to render an opinion on causation. Her failure to explain the basis of that opinion was for the compensation judge to weigh.
In the end, this is a case based primarily on the compensation judge’s choice between conflicting expert opinions. See Nord v. City of Cook, 360 N.W.2d 337, 37 W.C.D. 364 (Minn. 1985). The employer and insurer’s arguments provide no basis to overturn the judge’s reliance on the opinion of Dr. Groeschel. We therefore affirm the judge’s decision in its entirety.
 The employee had also been evaluated by Noran physicians following his 2007 motor vehicle accidents.
 For cervical pain and stiffness substantiated by persistent objective clinical findings, that is, involuntary muscle tightness or decreased passive range of motion, with radiographic changes at one level. See Minn. R. 5223.0370, subp. 4.C.(1).