THERESA S. WANTA, Employee/Appellant, v. NORTHWESTERN NAT’L LIFE and ZURICH N. AM. INS., Employer-Insurer, and JEAN THORNE, INC., and AMERICAN COMP. INS. CO./RTW, Employer-Insurer, and MINNESOTA DEP’T OF HUMAN SERVS. and PRIMARY BEHAVIORAL HEALTH, Intervenors.

WORKERS’ COMPENSATION COURT OF APPEALS
AUGUST 11, 2009

No. WC09-129

HEADNOTES

CAUSATION - SUBSTANTIAL EVIDENCE.  Substantial evidence supports the compensation judge’s determination that the employee did not sustain a work injury to her hand as she claimed.

Affirmed.

Determined by: Stofferahn, J., Wilson, J., and Pederson, J.
Compensation Judge: Paul D. Vallant

Attorneys: Mark E. Tracy, Tracy Law Firm, St. Paul, MN, for the Appellant.  Patrick T. Grove, Drawe & Maland, Edina, MN, for the Respondents Northwestern Nat’l/Zurich.  Deborah L. Crowley and Jeffrey R. Homuth, McCollum, Crowley, Moschet & Miller, Minneapolis, MN, for the Respondents Jean Thorne/RTW.

 

OPINION

DAVID A. STOFFERAHN, Judge

The employee appeals from the compensation judge’s determination that she did not sustain a work injury on October 3, 2006.  We affirm.

BACKGROUND

Theresa Wanta was employed by Jeane Thorne, Inc., on October 3, 2006, on a temporary assignment at HealthEast.  She was assigned to enter information from time cards into a computer, using a mouse and a 10-key pad.  The employee received one hour of training and was scheduled to work an additional three hours that day.  The employee testified at the hearing that, after keying for about an hour, she noted pain in her right thumb, index, and middle fingers.  At the end of her four-hour shift, the pain was at a level of 3 or 4 on a 10 point scale.  Records from HealthEast show that the employee had entered information from 50 timecards, and made 148 keystrokes during her shift, compared with 500 keystrokes for the average Jean Thorne employee.

On October 10, 2006, the employee sought medical care with her family doctor, Dr. Geeta Dash, for pain in the right “thumb, dorsum of hand, and dorsal surface of radial aspect of forearm.”  She told Dr. Dash that she began having right hand pain on October 3 after using a computer for four hours.  Her physical exam was normal except for some reported tenderness in the hand.  Dr. Dash assessed “right wrist pain, likely secondary to overuse on computer as exact same symptoms have been present in past.  Likely tendinous/muscular etiology, as opposed to neurogenic.”  The employee was given a wrist splint and a prescription for a pain reliever and was taken off work for two weeks.  Dr. Dash stated that after two weeks, the employee would be released to work, using a keyboard on an intermittent basis for one hour out of a four-hour shift.

The employee had right knee surgery for a chronic condition on November 3, 2006.  She advised Dr. Dash on December 12 that she had experienced intermittent wrist pain since a work injury 15 years before.  The employee told Dr. Dash she did not want to see a specialist because “her wrist pain eventually disappears with time.”

The employee was referring to an overuse injury to both hands she had incurred on June 25, 1987, while employed at Northwestern National Life.  She was treated for her injury with physical therapy and pain medication.  In 1989, she settled her claim for this injury, leaving open permanent partial disability and medical expenses.  The employee stopped treating for her hands in 1990 and testified at the hearing that she had no pain in her hands between 1990 and October 2006.

On December 15, 2006, the employee saw Dr. Dash again and reported that her hand pain had lessened in frequency and intensity, but would worsen with activities such as slicing bread, writing, and wringing out a cloth.  The physical exam was normal except for decreased grip strength due to reported tenderness.  Dr. Dash continued the employee’s pain medication and use of a wrist splint.

When the employee returned to Dr. Dash on February 6, 2007, she reported no pain and also stated she had avoided doing any keyboard activity.  Dr. Dash stated, “She is at risk for recurrent symptoms if she resumes keyboarding activity.  Letter written to avoid this activity in her employment.”  There is no record of subsequent treatment for her hand.

The employee filed a claim petition in August 2007 and an amended claim petition in March of 2008.  As presented at the hearing, the employee asserted claims arising out of the 1987 injury at Northwestern National Life and the alleged October 2006 injury at Jean Thorne.  The employee claimed entitlement to temporary total disability benefits or permanent total disability benefits from October 4, 2006, and continuing.  She also sought payment of medical expenses, approval of rehabilitation services, and penalties for frivolous denial of her claims.

The employee’s claims were supported in part by the opinions of Dr. Michael Wengler, who had examined the employee at the request of her attorney on July 15, 2008.  The employee gave Dr. Wengler a history of the onset of right hand pain on October 3, 2006, after using a computer.  She told him she had no hand pain at the time of her evaluation but attributed this to the fact she did no keyboard work.  There were no findings on examination.  Dr. Wengler, in his assessment, noted the employee’s other medical conditions, and, with regard to the right hand, diagnosed “history of a probable tenosynovitis to the right extensor tendons through the wrist and hand region.”  He concluded the October 2006 injury was the cause of this condition with no responsibility attributable to the 1987 injury.  He recommended that the employee should avoid “repetitive extension of the fingers and wrist.”

The employee also claimed a psychological impairment as a result of the alleged October 2006 hand injury.  Her claim on this issue was supported by Dr. John Cronin, a psychologist who evaluated her at the request of her attorney on October 6, 2008.  In the history portion of his report, Dr. Cronin stated, “following her 2006 injury, she now experiences numbness and tingling, swelling, and constant pain.”  Dr. Cronin concluded the employee had chronic pain syndrome as the result of the October 2006 injury and opined that the employee was not “capable of sustained gainful employment.”

Dr. William Call evaluated the employee on behalf of Jean Thorne and its insurer on November 12, 2007.  He took a history from the employee, reviewed her medical records, and conducted a physical examination.  It was Dr. Call’s opinion that the employee did not sustain a work injury on October 3, 2006.  He found some developmental thinning of the scaphotrapeziotrapezid joint which could become symptomatic with certain activities such as stirring batter or opening jars. Such complaints would have nothing to do “with any work exposure.”  Dr. Call pointed to the minimal amount of work activity on October 3, 2006, and to the lack of objective findings in any physical exam done since that time as support for his opinion that there was no work injury. After reviewing Dr. Wengler’s reports, Dr. Call wrote an additional report in which he noted the lack of any findings by Dr. Wengler on examination.  Dr. Call disagreed with Dr. Wengler’s diagnosis of tenosynovitis, stating that to make this diagnosis “swelling, warmth or redness, or clicking and snapping need to present.  None was present.”  He reaffirmed his original opinion that there was no work injury.

The employee’s claims were heard by Compensation Judge Paul Vallant.  In his findings and order, the compensation judge specifically adopted Dr. Call’s opinion and determined that the employee did not have a work injury on October 3, 2006.  The employee appeals.[1]

DECISION

The employee argues on appeal that there is no support for the compensation judge’s finding that there was no work injury.  The compensation judge relied on Dr. Call’s opinion but, according to the employee, that opinion lacked foundation and, in any event, Dr. Call failed to say that the employee’s symptoms, as reported to Dr. Dash on October 10, 2006, were not caused by her work on October 3.  As a result, the employee claims she should be entitled to temporary total disability benefits since she was taken off work by Dr. Dash for her work-related symptoms.  We are not persuaded.

The statute imposes liability on an employer for a personal injury arising out of and in the course of employment.  Minn. Stat. § 176.021, subd. 1.  Whether or not an employee has sustained a work-related personal injury is a question of fact to be determined by the compensation judge. The question for this court is whether the compensation judge’s determination is supported by substantial evidence.  Hengemuhle v. Long Prairie Jaycees, 358 N.W.2d 54, 59, 37 W.C.D. 235, 239 (Minn. 1984).

In the present case, the compensation judge adopted the opinion of Dr. Call that there had not been a work injury on October 3, 2006.  We have held previously that substantial evidence supporting a compensation judge’s decision may take the form of a well-founded medical opinion.  Heitland v. R. O. Drywall, 65 W.C.D. 359 (W.C.C.A. 2005); Hovland v. Streater, Inc., No. WC06-222 (W.C.C.A. Feb. 6, 2007).  Dr. Call took a history, conducted an examination, and reviewed medical records.  This information generally establishes adequate foundation for a medical opinion.  Scott v. Southview Chevrolet Co., 267 N.W.2d 185, 30 W.C.D. 426 (Minn. 1978); Kuisle v. Sunrise Assisted Living, 63 W.C.D. 72 (W.C.C.A. 2002).

The employee contends, however, that Dr. Call’s opinion lacked foundation because, in his report, he stated that neither the diagnosis of tendonitis or of repetitive strain injury was “scientifically accepted.”  The employee cites to a decision by this court, Homan v. Hoffman Eng’g, Inc./Pentair Co., No. WC04-179 (W.C.C.A. Nov. 23, 2004), in which we affirmed a compensation judge’s finding of an overuse injury which was identified by one doctor as tendonitis.  According to the employee, this means that the diagnosis of tendonitis is scientifically accepted in Minnesota and Dr. Call’s statement to the contrary should result in a determination that his opinion lacked foundation.

A decision by this court affirming a compensation judge’s reference to tendonitis does not bestow any scientific standing on the diagnosis and Dr. Call’s disagreement with the use of that diagnosis does not call into question the foundation for his opinion.  If anything, his statement is a question of the persuasiveness of that opinion.  Courtney v. City of Orono, 424 N.W.2d 295, 40 W.C.D. 1117 (Minn. 1988); Christ v. Berwald Roofing Co., slip op (W.C.C.A. Mar. 6, 2002). Further, this statement by Dr. Call has nothing to do with his opinion on causation. He based his opinion on the minimal physical activity done by the employee for only three hours and the complete lack of physical findings at any time since the claimed injury. The compensation judge also referred to these same factors in finding Dr. Call’s opinion to be persuasive.

The employee claims, not withstanding the above, that she is entitled to an award of temporary total disability or permanent total disability benefits because Dr. Dash took her off work due to the symptoms that she had experienced following her work on October 3, 2006, and because Dr. Call did not say the hand symptoms at that time were not caused by her employment.

We read Dr. Call’s report, as did the compensation judge, as concluding that the employee’s hand symptoms were the result of a developmental condition and that the symptoms the employee reported to Dr. Dash on October 10, 2006, were not related to her work activity on October 3.  More importantly, there is no entitlement to workers’ compensation benefits in the absence of a work injury.  As we have indicated previously, substantial evidence supports the compensation judge’s determination on this question.

The decision of the compensation judge is affirmed.



[1] The compensation judge also found that the 1987 injury had resolved completely by 1990.  The finding was appealed but was not addressed in the employee’s brief and is waived.  Minn. R. 9800.0900, subp. 1.