CYNTHIA M. MURSCHEL, Employee/Appellant, v. B.F. NELSON FOLDING CARTONS, INC., and TRAVELERS GROUP, Employer-Insurer, and NORAN NEUROLOGICAL CLINIC, NORTH MEM’L HEALTH CARE, MINNESOTA ORTHOPEDIC SURGERY CTR., MEDICAL ADVANCED PAIN SPECIALISTS, HEALTHPARTNERS, INC., NATIONAL DIZZY & BALANCE CTR., and MULTICENTER PHYSICAL THERAPY, Intervenors.
WORKERS’ COMPENSATION COURT OF APPEALS
FEBRUARY 2, 2013
CAUSATION - SUBSTANTIAL EVIDENCE; EVIDENCE - EXPERT MEDICAL OPINION. Substantial evidence, including expert medical opinion, supports the compensation judge’s findings that the employee did not sustain a right shoulder injury, left carpal tunnel syndrome, or a brain injury as a result of a work-related accident on January 21, 2010.
Determined by: Milun, C.J., Wilson, J., and Hall, J.
Compensation Judge: Catherine A. Dallner
Attorneys: Cynthia Murschel, Pro Se Appellant. Gary M. Swanson, John G. Ness & Associates, St. Paul, MN, for Respondents.
PATRICIA J. MILUN, Chief Judge
The pro se employee appeals the compensation judge’s findings that she did not sustain a right shoulder injury, left carpal tunnel syndrome, or a brain injury as a result of a work-related accident on January 21, 2010. We affirm.
On January 21, 2010, Cynthia M. Murschel, the employee, was injured while working for B.F. Nelson Corporation, the employer, which was insured for workers’ compensation liability by Travelers Group. The employee was operating a machine when her leg was caught by the machine and she fell to the ground. The employee stated that she hit her head, hurt her left leg, and hit her tailbone. The employee was treated at the St. Francis Regional Medical Center emergency room. The employee’s diagnoses at that time were left ankle/foot sprain, scalp contusion, and closed head injury. A CT scan of the employee’s brain had negative results, and a left foot x-ray showed no convincing fracture or dislocation. The next day, the employee began treating with Dr. Terry Domino at MultiCare Associates. Dr. Domino noted left leg bruising and scratches, diagnosed coccyx and lower left leg contusions, and took the employee off work.
On January 25, 2010, the employee treated with Dr. Diana Liu at the Silver Lake Clinic, reporting tailbone discomfort, left wrist and left ankle soreness, some soreness in her head when moved, but no complaints of headache, dizziness, or vision impairment. Dr. Liu’s assessment of the employee was status post closed head injury, left ankle sprain, left wrist sprain, and left tailbone contusion, and she recommended ice for the bump on her head and heat for her neck for swelling from whiplash injury. The employee returned to Dr. Domino on January 27, 2010. Dr. Domino ordered another x-ray of the left foot, which indicated a small avulsion fracture, and referred the employee for orthopedic consultation. In February 2010, the employee was evaluated by Dr. Lisa Wasserman, an orthopedist, who diagnosed left ankle sprain and compression inversion injury, and recommended conservative treatment. Dr. Domino referred the employee for physical therapy, which the employee reported as improving her symptoms.
In March 2010, the employee returned to Dr. Domino, reporting left ankle, left foot, and coccygeal pain. The employee continued physical therapy and returned to work with restrictions after being off for about five weeks. On April 6, 2010, the employee was evaluated by Dr. Danny Dunsworth at the Silver Lake Clinic, reporting dizziness, lightheadedness, nausea, and vision changes that had started four to five weeks before the office visit as well as pain and muscle spasms, according to the employee’s medical records. An April 14, 2010, brain MRI did not indicate traumatic injury or clinically significant abnormalities, but did show some white matter changes. Dr. Domino stated that these changes were nonspecific findings and referred the employee for a neurological consultation. A cervical spine MRI indicated straightening of normal cervical lordotic curve, degenerative disc disease throughout the cervical spine, and osteoarthritic changes with uncinate spurring on the right at C5-6 and C4-5. On April 19, 2010, the employee treated with Dr. Domino, reporting that she was feeling much better. Dr. Domino released the employee to return to work without restrictions on April 20, 2010.
Dr. Ana Patricia Groeschel, a neurologist at Noran Neurological Clinic, evaluated the employee on April 28, 2010. The employee’s medical records indicate that the employee reported that she experienced dizziness and weakness which began in March 2010. Dr. Groeschel recommended an angiogram, which indicated the employee had intercranial aneurysms. In May 2010, the employee was evaluated by Dr. John Perl at Consulting Radiologists. Dr. Perl opined that the employee’s aneurysms were not related to her work injury and recommended surgery. On July 22, 2010, the employee underwent surgery for the aneurysms. The employee does not claim that the aneurysms were causally related to her January 21, 2010, work accident.
In June 2010, the employee was seen at the Noran Clinic and reported difficulty with balance, dizziness, concentration and memory, headaches, pressure around the left eye, as well as right arm, knee, ankle, and shoulder pain. A June 20, 2010, EMG of the employee’s leg was suggested, but was not diagnostic for, bilateral S1 radiculopathies. In August 2010, the employee again returned to the Noran Clinic, reporting lightheadedness, memory issues, trouble walking, arm weakness, numbness and tingling, shoulder pain, knee pain, joint pain, and rash. At that time, the employee’s shoulder pain was bothering her the most. An August 2, 2010, MRI of the right shoulder indicated mild bursal surface tendinopathy. The employee began pool therapy as ordered by Dr. Groeschel.
In September and October 2010, the employee reported right shoulder discomfort and achiness to Dr. Domino. On October 19, 2010, the employee was evaluated by Dr. Stefano Sinicropi at Midwest Spine Institute. Dr. Sinicropi recommended bilateral L5-S1 epidural steroid injections and a right subacromial injection for her right shoulder. The employee was also evaluated by Dr. Wetter at Orthopaedic Partners, P.A., in December 2010 for her neck and right arm. Dr. Wetter assessed right shoulder impingement and possible cervical radiculopathy. A January 2011 EMG indicated no evidence for a right-sided cervical radiculopathy, and an MRI of the thoracic spine was essentially normal with minimal posterior disc bulging on the right at T7-8 and T8-9. Dr. Wetter recommended a cervical epidural steroid injection for the employee’s right shoulder/arm condition, which was not successful. Dr. Wetter did not have any other treatment recommendations for the employee.
The employee continued to treat for various conditions. On November 23, 2010, the employee was seen at Noran Clinic, reporting two episodes of short, sudden onset dizziness. In March 2011, the employee treated with Dr. Orrin Mann after Dr. Domino’s retirement. Dr. Mann indicated that the employee had sustained a left leg contusion, left ankle fracture, low back pain, and lumbar contusion and that she had reached maximum medical improvement with no permanent partial disability, restrictions, or additional need for treatment. In April 2011, the employee reported ongoing symptoms to Dr. Groeschel. May 2011 x-rays of the employee’s left knee and right foot were normal. The employee continued to report difficulty with her memory and concentration. An assessment of the employee at the National Dizzy & Balance Center in May 2011 indicated possible post concussive syndrome or vestibular vertigo. A June 2011 EMG of the employee’s legs indicated chronic appearing bilateral S1 radiculopathy. A July 2011 brain MRI was similar to the employee’s previous brain MRI.
In August 2011, the employee treated with Dr. Groeschel, reporting tingling in her arms. Dr. Groeschel recommended an EMG, which was positive for moderate carpal tunnel syndrome on the left arm and was normal for the right arm.
The employee filed a medical request on November 4, 2011, for medical expenses related to referrals for diagnostic services. On November 28, 2011, the employer and insurer admitted liability for a work injury involving the left ankle and low back, but denied the request for payment of the claimed expenses as not related to the admitted work injury. They also noted that the employee was being scheduled for independent medical examinations. On January 26, 2012, the employee was evaluated by Dr. Bruce Idelkope, a neurologist, at the employer and insurer’s request, for what is commonly called an independent medical examination. In a report dated February 9, 2012, Dr. Idelkope opined that the employee’s work-related injuries were confined to her left leg, tailbone, and ankle and had resolved, that the employee had not sustained a concussion or a traumatic brain injury as a result of the January 2010 accident, and that she had not sustained any brain-related injuries, conditions, or symptoms attributable to the work injury.
On January 27, 2012, the employee was evaluated by Dr. Robert Barnett, Jr., an orthopedic surgeon, also at the employer and insurer’s request. In a report dated February 13, 2012, Dr. Barnett opined that the employee’s cerebral aneurysms, right and left shoulder pain, knee pain, right ankle pain, and left carpal tunnel syndrome were not related to the employee’s work injury. He opined that the employee’s cervical strain/sprain, lumbar sprain/strain, sacrococcygeal contusion, left ankle sprain, left leg contusion, and left abductor strain were temporary in nature and were related to the January 21, 2010, injury. Based on Dr. Barnett’s report, the employer and insurer admitted liability for medical expenses related to these conditions and agreed to pay those expenses in April 2012. The employer and insurer denied liability and refused to pay for medical treatment expenses related to a right shoulder injury, a brain injury, or left carpal tunnel syndrome.
On May 4, 2012, Dr. Groeschel issued a report on the employee’s condition and treatment. Dr. Groeschel opined that the employee has had persistent headaches due to her head injury at work, which would be considered posttraumatic due to the concussion. She also noted that the employee’s symptoms of dizziness and being off balance became more prominent as she recovered from her other injuries, which is common for patients who suffer head trauma.
A hearing was held on May 15, 2012. The compensation judge found that the employee had not sustained a right shoulder injury, a brain injury, or left carpal tunnel syndrome related to her work injury and denied the medical request for payment of expenses related to those injuries. There were no other injuries at issue before the compensation judge at the hearing. The pro se employee appeals.
STANDARD OF REVIEW
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. 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. Fact findings are clearly erroneous if the reviewing court, looking at the entire evidence, is left with a definite and firm conviction that a mistake has been committed. 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.”
In her brief on appeal, the employee first questions how Dr. Barnett and Dr. Idelkope were chosen to provide “Independent Medical Evaluations” and whether there were potential grounds for establishing a conflict of interest for the doctors. Under Minn. Stat. § 176.155, subd. 1, the employer and insurer are entitled to have the employee examined by a doctor they choose for a medical evaluation of the employee’s condition and to provide foundation for an opinion on any medical issues. An examination requested by the employer and insurer is called an independent medical evaluation or an adverse examination since the employee is not examined for treatment purposes, but solely for the purpose of providing an opinion in a medical dispute. The doctors who perform these evaluations do not have a conflict of interest under the statute.
The employee argues on appeal that the compensation judge’s findings of fact are not supported by substantial evidence and that the evidence shows that her claimed expenses for a brain injury, a right shoulder injury, and left carpal tunnel syndrome resulted from the work accident. When an appeal is taken from a compensation judge’s factual findings, this court’s review on appeal is limited to a determination of whether the compensation judge's findings are clearly erroneous and unsupported by substantial evidence. Where the judge’s factual determinations are adequately supported by substantial evidence, and not clearly erroneous, we must affirm. This court is not a finder of fact, and on appeal the court will not “retry” the factual issues which were decided by the compensation judge at the hearing. Whether different conclusions could have been made on the evidence in the record than those found by the compensation judge is not a basis for this court to reverse a compensation judge. Therefore, the issue on appeal is not whether the compensation judge could have made a different decision, but whether substantial evidence supports the decision the compensation judge made.
The compensation judge found that the employee did not sustain a brain injury as a result of her January 2010 work accident, relying on Dr. Idelkope’s opinion that the employee had not sustained a concussion or a traumatic brain injury as a result of the January 21, 2010, accident, and that she had not sustained any brain-related injuries, conditions, or symptoms attributable to the work injury. The compensation judge noted that Dr. Idelkope correctly pointed out that the employee’s medical records indicate the employee’s brain injury symptoms were not reported until April 2010. The employee claims that the effects of her head injury began in February 2010 while she was treating with Dr. Domino, but that Dr. Domino did not record all of the symptoms she reported, including nausea, being off balance (not dizziness), memory problems, and difficulty walking. She indicated that she sought treatment with Dr. Dunsworth because she was not improving, and that Dr. Domino just kept telling her the symptoms would go away with time. The judge reviewed the employee’s numerous medical records from January 10, and April 6, 2010, and noted, as Dr. Idelkope had, that there were no neurological complaints during that time. The compensation judge could reasonably rely on Dr. Idelkope’s opinion. A judge’s choice between the opinions of expert witnesses is usually upheld unless the facts assumed by the expert in rendering the chosen opinion are not supported by the evidence. We find no error in the judge’s choice between experts in this case. Substantial evidence supports the compensation judge’s finding that the employee had not sustained a brain injury as a result of her January 2010 work injury, and accordingly, we affirm.
The judge also found that the employee had not sustained a right shoulder injury as a result of her work accident, noting that the first right shoulder complaints indicated in the employee’s medical records appear several months after the work accident. An MRI of the right shoulder indicated mild bursal surface tendinopathy. Dr. Groeschel’s May 2012 report refers to this MRI and seems to imply that the employee’s right shoulder complaints are causally related to the employee’s work injury, but also states that the employee hit her shoulder when she fell in 2010. There is no evidence in the medical records that the employee hit her right shoulder during the January 2010 accident. Where evidence conflicts or more than one inference may reasonably be drawn from the evidence, the judge’s findings are to be affirmed. The compensation judge could reasonably rely on Dr. Barnett’s opinion that the employee’s right shoulder pain was not related to the employee’s work injury. Substantial evidence supports the compensation judge’s finding that the employee did not sustain a right shoulder injury as a result of her January 2010 work accident, and we affirm.
The employee also questions why her claim for expenses related to her left carpal tunnel syndrome were denied since medical testing confirmed the diagnosis. The employee contends that the denial of this claim was based on her testimony at the hearing, and that she did not understand the question. Again, the issue before this court is not whether the employee has been diagnosed with the condition, but whether the condition is causally related to her work accident. Dr. Barnett specifically found that the employee’s left carpal tunnel syndrome was not related to the January 2010 work accident, and the compensation judge relied on Dr. Barnett’s opinion. The judge also noted that there is no other medical opinion on causation for the left carpal tunnel syndrome condition in the record. Substantial evidence supports the compensation judge’s finding that the employee’s left carpal tunnel syndrome was not causally related to her work injury, and we affirm.
The employee also mentions other medical conditions in her brief, but the only conditions at issue at the hearing before the compensation judge were a right shoulder injury, left carpal tunnel syndrome, and a brain injury. This court cannot address issues which were not raised in the hearing below. The medical records, including the reports from Dr. Idelkope and Dr. Barnett, provide substantial evidence to support the judge’s findings that the employee did not sustain a right shoulder injury, a brain injury, or left carpal tunnel syndrome as a result of her work-related injury on January 21, 2010. Therefore, we affirm.
 Stipulation 2, Findings and Order served and filed June 14, 2012.
 Minn. Stat. § 176.421, subd. 1.
 Hengemuhle v. Long Prairie Jaycees, 358 N.W.2d 54, 59, 37 W.C.D. 235, 239 (Minn. 1984).
 Northern States Power Co. v. Lyon Food Prods., Inc., 304 Minn. 196, 201, 229 N.W.2d 521, 524 (1975).
 Minn. Stat. § 176.155, subd. 1, provides in part:
Employer’s physician. The injured employee must submit to examination by the employer’s physician, if requested by the employer, and at reasonable times thereafter upon the employer’s request. . . . The examination shall be completed and the report of the examination shall be served on the employee and filed with the commissioner within 120 days of service of the claim petition.
No evidence relating to the examination or report shall be received or considered by the commissioner, a compensation judge, or the court of appeals in determining any issues unless the report has been served and filed as required by this section . . . . The commissioner or a compensation judge shall extend the time for completing the adverse examination and filing the report upon good cause shown.
 The employee also asserts that her attorney did not adequately present her case at the hearing, claiming that the attorney did not fully inform her of what was to be presented to the judge at the hearing or of his discussions with the employer and insurer’s attorney, and that her concerns and requested relief were not considered nor adequately presented to the judge. We note that this court lacks jurisdiction to determine allegations of inadequate representation by an attorney, and that the employee’s remedy for such allegations lies in a different forum. See Skic v. Beverage Transp. Corp., 53 W.C.D. 424, 430 (W.C.C.A. 1995), summarily aff’d (Minn. Dec. 11, 1995).
 See Ogren v. Mid America Pipe Cleaning, Inc., slip op. (W.C.C.A. Aug. 29, 2000).
 Nord v. City of Cook, 360 N.W.2d 337, 37 W.C.D. 364 (Minn. 1985).
 Hengemuhle, 358 N.W.2d at 60, 37 W.C.D. at 240.
 See, e.g., Troester v. Drapery Servs. of Austin, 49 W.C.D. 74, 78 (W.C.C.A. 1993); Hartman v. 3M Co., slip op. (W.C.C.A. Sept. 8, 1992).