The employee petitions this court to vacate an award on stipulation served and filed in this case on July 15, 1993, on grounds that there has been a substantial change in her condition since the issuance of the award.  Finding sufficient basis to vacate the award on stipulation, we grant the petition.

On March 22, 1991, Karen Davis sustained a work-related injury to her low back in the course of her employment as a licensed practical nurse [LPN] with Trevilla of Golden Valley.  Ms. Davis [the employee] was thirty-nine years old on that date and was earning a weekly wage of $256.32.  Trevilla of Golden Valley [the employer] and its insurer at the time, Old Republic Insurance Company, admitted liability for the injury and commenced payment of benefits.  On July 8, 1993, the parties entered into a stipulation for full, final, and complete close-out of all workers’ compensation claims related to the employee’s work injury of March 22, 1991, except claims for reasonable and necessary medical expenses.  An award on this stipulation was issued and filed on July 15, 1993.

On April 27, 2009, the employee petitioned this court to vacate her award on stipulation filed July 15, 1993, on grounds that there has been a substantial change in her medical condition since the date of her award.  Oral argument on the employee’s petition was held before this court on October 26, 2009, and this court issued a decision in the matter on January 21, 2010.  In our decision, we determined that the employee had sufficiently made her case for vacation of the award at issue except with regard to the issue of causation, and we referred the matter to the Office of Administrative Hearings for a full evidentiary hearing solely with regard to that issue.

On March 17, 2010, the employer and insurer obtained the deposition testimony of their independent medical examiner, Dr. Mark Agre.  On April 26, 2010, counsel for the employer and insurer notified Compensation Judge Bradley J. Behr that the employer and insurer had decided to concede the issue of causation rather than litigate the matter further.  On April 27, 2010, Judge Behr referred the matter back to this court for a final order on the employee’s petition to vacate.

This court has jurisdiction to set aside an award on stipulation upon a showing of cause.  Minn. Stats. §§ 176.461 and 176.521, subd. 3.  Cause, as defined in the statute, includes “a substantial change in the medical condition since the time of the award that was clearly not anticipated and could not reasonably have been anticipated at the time of the award.”  Minn. Stat. § 176.461 (4).  In considering whether there has been a substantial change in medical condition, this court has generally considered the following factors: (1) changes in the employee’s diagnosis; (2) changes in the employee’s ability to work; (3) the development of any additional permanent partial disability; (4) the necessity of more costly and extensive medical care or nursing services than was anticipated; and (5) the causal relationship between the work injury and the worsening of the condition.  Fodness v. Standard Cafe, 41 W.C.D. 1054 (W.C.C.A. 1989).

Because the employee has adequately demonstrated a change in diagnosis, a change in her ability to work, increased permanent partial disability, and the necessity of more extensive medical care than was initially anticipated at the time of settlement, and because the employer and insurer have conceded the causal relationship between the work injury and the worsening of the employee’s condition, we find good cause to vacate the 1993 award on stipulation.  The employee’s petition to vacate the award on stipulation served and filed July 15, 1993, is granted.