ALFRED MARTAGON, Employee, v. MINNESOTA BREWING CO. and FIREMAN=S FUND INS. CO., Employer-Insurer/Appellants.

 

WORKERS= COMPENSATION COURT OF APPEALS

MARCH 21, 2002

 

HEADNOTES

 

JURISDICTION - SUBJECT MATTER.  The compensation judge properly determined that she lacked subject matter jurisdiction to determine MIGA=s liability for benefits, where the employee had made no claim against MIGA for the benefits at issue, and the matter was before the judge in the context of another employer and insurer=s petition for joinder.

 

CAUSATION - SUBSTANTIAL EVIDENCE.  Substantial evidence, including expert opinion, supported the compensation judge=s decision that the employee=s May 2000 work-related left knee injury was a substantial contributing cause of the employee=s ongoing disability and need for treatment.

 

Affirmed.

 

Determined by Wilson, J., Johnson, C.J., and Rykken, J.

Compensation Judge:  Cheryl LeClair-Sommer.

 

OPINION

 

DEBRA A. WILSON, Judge

 

Minnesota Brewing Company and Fireman=s Fund Insurance Company appeal from the compensation judge=s finding as to liability for the employee=s left knee condition and from the judge=s dismissal of Jacob Schmidt Brewing Company and the Minnesota Insurance Guaranty Association as parties to the proceeding.  We affirm.

 

BACKGROUND

 

The employee worked for Jacob Schmidt Brewing Company [Jacob Schmidt] from about 1973 until the brewery closed in 1990.  During this period, on March 26, 1979, the employee sustained a work-related injury to his left knee.  Jacob Schmidt and its insurer, American Mutual, accepted liability for the injury and commenced payment of benefits.  At some point, American Mutual became insolvent, and the Minnesota Insurance Guaranty Association [MIGA] took over administration of claims.

 

The employee underwent five surgical procedures on his left knee following his 1979 injury: the first procedure, in 1979, apparently an open anterior cruciate ligament repair; the second, in 1980, an arthroscopic debridement; the third, in 1982, a repeat arthroscopy with a partial medial meniscectomy; the fourth, in 1984, another arthroscopic debridement; and the fifth, in 1990, another medial meniscectomy.  MIGA evidently paid medical expenses related to some or all of these procedures, as well as benefits for wage loss and for a 15% permanent partial disability of the lower extremity.  In 1991, the employee and MIGA entered into a stipulation for settlement, settling the employee=s claims for an additional 3% permanent partial disability of the whole body, or 7.5% of the left lower extremity.^[1]

 

In 1992, Minnesota Brewing Company [Minnesota Brewing] began operating the former Jacob Schmidt plant, and the employee obtained work there.  He testified that his left knee was occasionally symptomatic but that he had little trouble with it after he recovered from the 1990 surgery, and he apparently received virtually no treatment for left knee symptoms from 1990 until July of 1999, when he sought care for what were described as Amultiple complaints,@ including left knee discomfort after golfing on vacation.  The treating physician diagnosed an exacerbation of the employee=s underlying osteoarthritis and prescribed an anti-inflammatory.  The employee then apparently received no further care for knee symptoms for the next ten months.

 

On about May 13, 2000, the employee experienced a popping sensation and pain in his left knee upon stepping over a three-foot high piece of equipment at work.^[2]  A few days later, he sought treatment for what physicians initially diagnosed as a left knee sprain.  However, shortly thereafter, the employee=s then treating doctor, Dr. Richard Edwards, indicated that the employee would likely need a total knee replacement in the near future.  Subsequent medical reports note the probable presence of loose bodies in the employee=s knee joint, and Dr. Peter Daly, who took over the employee=s care when Dr. Edwards retired, suggested that the employee undergo another arthroscopic debridement before considering total knee replacement.

 

Minnesota Brewing and Fireman=s Fund Insurance Company [Fireman=s Fund] eventually admitted liability for a temporary aggravation and paid certain medical expenses.  However, based on the opinion of Dr. Richard Strand, their independent examiner, they denied that the employee=s ongoing condition was causally related to the May 2000 incident.

 

The employee filed two medical requests, which were consolidated for hearing, seeking an order requiring Minnesota Brewing and Fireman=s Fund to pay for left knee treatment, including surgery, allegedly necessitated by the employee=s May 2000 work injury.  Minnesota Brewing and Fireman=s Fund denied that the May 2000 work injury was a substantial contributing factor in the employee=s need for treatment and ultimately filed a motion requesting joinder of Jacob Schmidt and MIGA as necessary parties.  The compensation judge initially granted the motion but, after further proceedings, the judge issued an order stating that Jacob Schmidt and MIGA Aare not proper parties to the proceedings and are hereby dismissed without prejudice.@

 

A hearing on the employee=s medical requests was held a few days later.  Evidence submitted in connection with the employee=s claim against Minnesota Brewing and Fireman=s Fund included the employee=s testimony as to his symptoms before and after the May 2000 work injury, the reports of Drs. Strand and Daly, and certain other medical records.  As would be expected given the dismissal order, Jacob Schmidt and MIGA did not take part in the hearing.  In a decision issued on October 10, 2001, the compensation judge concluded that the employee=s May 13, 2000, work injury was Aan ongoing aggravation of [the employee=s] underlying condition@ and Aa substantial contributing factor to the arthroscopic surgery prescribed by Dr. Daly.@  Minnesota Brewing and Fireman=s Fund were therefore ordered to pay for the procedure.  Minnesota Brewing and Fireman=s Fund appeal.

 

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.

 

A[A] decision which rests upon the application of a statute or rule to essentially undisputed facts generally involves a question of law which [the Workers= Compensation Court of Appeals] may consider de novo.@  Krovchuk v. Koch Oil Refinery, 48 W.C.D. 607, 608 (W.C.C.A. 1993).

 

DECISION

 

1.  Dismissal of MIGA

 

Citing a line of cases concerning claims against MIGA, the compensation judge concluded that she lacked subject matter jurisdiction to determine MIGA=s liability for benefits in these proceedings.  Minnesota Brewing and Fireman=s Fund appeal, contending that the cited cases are distinguishable and do not require dismissal under the circumstances presented here.  We disagree.

 

In Taft v. Advance United Expressway, 464 N.W.2d 725, 44 W.C.D. 35 (Minn. 1991), the Minnesota Supreme Court held that the Workers= Compensation Court of Appeals [W.C.C.A.] had correctly determined that it did not have subject matter jurisdiction over a claim by a workers= compensation insurer against MIGA for reimbursement of benefits, because the legislature had provided a specific mechanism for dealing with claims against insolvent insurers -- in Minn. Stat. ch. 60C -- and the W.C.C.A.=s authority did not extend to interpreting or applying that legislation.  The issue, as the supreme court saw it, was not whether the workers= compensation insurer had a claim against the insolvent insurer, but whether the workers= compensation insurer had a Acovered claim,@ within the meaning of Chapter 60C, against MIGA, an issue beyond the W.C.C.A.=s purview.  Later that same year, in Wiss v. Advance United Expressway, 488 N.W.2d 802, 47 W.C.D. 260 (Minn. 1992), the supreme court reached the same conclusion in a case in which the employee had filed claims against both a workers= compensation insurer and MIGA, reasoning that the matter was still primarily a collateral dispute between MIGA and an insurance carrier that was seeking to reduce its liability to the employee through the workers= compensation system rather than the procedures contained in Chapter 60C.  Id. at 804, 47 W.C.D. at 261-62; see also Ast v. Har Ned Lumber, 483 N.W.2d 66, 46 W.C.D. 495 (Minn. 1992).

 

In their appeal of the judge=s ruling on this issue, Minnesota Brewing and Fireman=s Fund allege as follows:

 

There is a fundamental difference between the various cases relied upon by the Compensation Judge, and the instant case: There is no claim for contribution/reimbursement at issue here.  Fireman=s Fund has paid a nominal amount in medical expense in connection with treatment rendered to the Employee as a result of the strain/sprain.  No attempt has been made to recoup any portion of those bills from MIGA nor apportion any liability for the strain/sprain.

 

Rather, it is the contention of Fireman=s Fund that, while it is liable for the Employee=s strain/sprain, this episode had nothing whatsoever to do with the problems which the Employee has experienced with his left knee for the previous 20 plus years.  Accordingly, Fireman=s Fund should have no liability for the proposed sixth knee surgery.

 

This attempt to distinguish Taft and Wiss is unpersuasive.  Had they prevailed on their defense against the employee=s claim, Minnesota Brewing and Fireman=s Fund would have absolutely no interest in whether or not MIGA had been made a party to the proceedings, because Minnesota Brewing and Fireman=s Fund would have no liability for the employee=s ongoing condition or the medical expenses at issue.  As such, it is clear that the only reason Minnesota Brewing and Fireman=s Fund sought to join MIGA was to lessen their liability in the event that both the 1979 injury and the 2000 injury were found to be substantial contributing causes of the employee=s disability.  The fact that Minnesota Brewing and Fireman=s Fund formally asked only for joinder, not contribution, does not change the essential nature of the relief sought; certainly Minnesota Brewing and Fireman=s Fund have not explained what they hoped to gain by joining MIGA with no possibility of contribution or apportionment.  See Hill v. Mackay Envelope, slip op. (W.C.C.A. July 10, 1998).

 

Minnesota Brewing and Fireman=s Fund also argue that, because injured workers may make direct claims against MIGA, and this employee had a claim against MIGA, as evidenced by MIGA=s previous payments and various causation opinions by medical experts, the claim may be resolved in the workers= compensation forum.  However, while the evidence may well suggest that the employee=s 1979 injury is a substantial cause of the employee=s need for treatment, the fact remains that the employee did not make any claim against MIGA for the disputed medical treatment -- only against Minnesota Brewing and Fireman=s Fund.  Whatever the employee=s rights against MIGA, Minnesota Brewing and Fireman=s Fund may not assert those rights on the employee=s behalf.  See also Andor v. Buhler Mfg., 56 W.C.D. 1 (W.C.C.A. 1996).

 

Finding no compelling basis to distinguish the present case from Taft, Wiss, and related cases, we affirm the compensation judge=s decision to dismiss Jacob Schmidt and MIGA as parties to this proceeding.

 

2.  Medical Causation

 

In finding the May 2000 injury to be a substantial contributing cause of the employee=s need for left knee surgery, the compensation judge accepted the opinion of Dr. Daly, the employee=s latest treating physician, over the opinion of Dr. Strand, Minnesota Brewing and Fireman=s Fund=s independent examiner.  On appeal, Minnesota Brewing and Fireman=s Fund argue in part that the judge erred in rejecting Dr. Strand=s opinion on foundation grounds.

 

The compensation judge explained her decision to reject Dr. Strand=s opinion as follows:

 

Dr. Strand describes the injury as an Aaggravation of a preexisting condition@ indicating the aggravation would have recovered in four to six weeks.  His opinions, however, fail to explain the reasoning.  Dr. Strand, in addition, fails to explain the description of both Dr. Daly and Dr. Edwards of a loose body protruding from the left knee subsequent to the May 13, 2000 work injury.  Upon review of the medical records, the conclusion is reached that the condition has not abated subsequent to the May 13, 2000 work injury.

* * *

Dr. Strand took a history of preexisting problems and since 1990, the Apain has progressively gotten worse and he reports no definite new injury.@  Dr. Strand fails to mention the history of a specific incident on May 12, 2000 which increased the knee pain and states that A[h]e does not describe any specific new injury.@  Dr. Strand goes on to state that A[t]here is no definite history of any injuries while on the job for Minnesota Brewing, and I certainly, in view of Mr. Martagon=s history, cannot make a Gillette injury out of this case.@  The opinion of Dr. Strand lack[s] adequate foundation failing to describe the specific incident which occurred on May 13, 2000 when stepping over a manifold at the employer.  In addition, Dr. Strand fails to recognize that the condition since May 13, 2000 has worsened with instability, increased pain, and loose body.

 

With the inadequate foundation of Dr. Strand=s opinion, the testimony of the employee to increased symptoms subsequent to May 13, 2000, and the opinion of Dr. Daly, the work injury of May 13, 2000 has been proven to be a substantial contributing factor to the necessity for arthroscopic debridgement [sic] to the left knee.

 

Whether Dr. Strand=s failure to acknowledge a work injury in May of 2000 goes to weight or foundation, we cannot conclude that the compensation judge erred in rejecting the doctor=s opinion on that basis.

 

The record as a whole reasonably supports the judge=s liability determination.  The employee testified that he had little trouble with his left knee between his last surgery in 1990 and the work injury in 2000, testimony that is supported by the fact that the employee treated only once for left knee symptoms during that ten-year period.  The evidence also reasonably establishes that the employee=s left knee never returned to baseline after the May 2000 work injury, and Dr. Daly specifically reported that that work injury was Aresponsible for the need for arthroscopic intervention.@  While Dr. Strand disagreed, the compensation judge was entitled to accept Dr. Daly=s opinion on this issue.  See Nord v. City of Cook, 360 N.W.2d 337, 37 W.C.D. 364 (Minn. 1985).  Certainly there may also be evidence that the 1979 work injury is at least partially responsible for the employee=s need for treatment, but that fact is irrelevant to Minnesota Brewing=s liability to pay for the benefits at issue here.  Because substantial evidence supports the judge=s decision that the May 2000 work injury substantially contributed to the employee=s ongoing disability and need for treatment, we affirm the judge=s decision in its entirety.