The employer and insurer appeal from the compensation judge’s determination that the employee sustained an injury to his right shoulder in a work-related fall on January 5, 2009.  We affirm.

Randall Swanson was in the course of his employment as a purchasing manager for Permac Industries when he was injured on January 5, 2009.  The employee was leaving work when he fell, landing on his right buttock, shoulder, and low back.  The present appeal follows a hearing on April 29, 2010, before Compensation Judge Jennifer Patterson.  At issue was whether the employee sustained an injury to his right shoulder as a result of the January 2009 fall.

There was an earlier hearing on January 6, 2010, also before Compensation Judge Patterson, where the parties disputed whether the employee’s low back, which had been injured in the January 2009 fall, had resolved or continued to be a factor in the employee’s claimed disability.  Evidence included the employee’s testimony and his medical records.  In unappealed findings, the compensation judge determined that when the employee fell, he had landed “on his right buttock, low back and right shoulder.”  The compensation judge also concluded that the employee continued to be temporarily totally disabled from the injury to his low back, but that the two-level fusion surgery recommended by his treating orthopedic surgeon was not appropriate at that time.

Medical records introduced at the most recent hearing indicate that the employee made no specific complaint of right shoulder pain before April 20, 2009.  The employee testified that his low back bothered him the most after his fall and was the focus of his initial medical visits.  The records also show that, in addition to his low back injury, the employee was initially diagnosed as having sustained a cervical strain and testicular pain from indirect trauma in the fall.

On April 20, 2009, the employee met with a qualified rehabilitation consultant [QRC] for an initial rehabilitation consultation.  He told her that he had landed on his head and his right shoulder when he fell, and he had experienced “continued difficulties with low back pain, testicle pain and swelling, right shoulder and neck pain.”  The employee told the QRC that the right shoulder pain was worse with use of his arm.

On May 11, 2009, when the employee returned to Dr. Ronald Tarrell, the neurologist he had seen for his low back, the employee told the doctor that, in addition to his low back and cervical pain, he was also experiencing right shoulder discomfort.  Dr. Tarrell’s examination on that date found pain with abduction and external rotation of the right upper extremity, as well as “tissue texture changes consistent with rotator cuff injury palpated over the right suprascapular region when compared with left.”  Dr. Tarrell concluded that MRI of the right shoulder was appropriate.

The MRI was done on May 15, 2009, and was read as showing:

Dr. Tarrell referred the employee to an orthopedist, Dr. Douglas Becker.  Dr. Becker saw the employee on June 3, 2009, and diagnosed “right shoulder impingement syndrome, partial rotator cuff tear, AC joint strain, and probable SLAP tear.”  Dr. Becker provided a therapeutic injection and when the employee reported continuing symptoms on his return, Dr. Becker recommended surgery.  The surgery he proposed was “right shoulder arthroscopic evaluation with debridement, decompression and AC resection, and probable arthroscopic SLAP and possible arthroscopic rotator cuff repair.”

In response to a letter from the employee’s attorney, Dr. Becker issued a report dated October 28, 2009, in which he stated that the employee’s right shoulder condition was related to the work injury of January 5, 2009.  He subsequently authored two additional reports in which he reaffirmed his opinion.

The employer and insurer had the employee evaluated by an orthopedist, Dr. Michael D’Amato, on October 2, 2009.  Dr. D’Amato reviewed the medical records, examined the employee, and in his report of October 22, concluded, “There is absolutely no evidence to support a claim that Mr. Swanson sustained a right shoulder injury as the result of his fall on January 5, 2009.”  Dr. D’Amato based his opinion on the absence of right shoulder symptoms in the medical records after the fall until May 11.  Dr. D’Amato was also of the opinion that the employee was exaggerating his symptoms, and based on this opinion, concluded surgery would not be appropriate.  Dr. D’Amato’s deposition was taken for the hearing and he testified that, in his opinion, the right shoulder condition diagnosed by Dr. Becker could happen only if the employee fell on his outstretched arm.  Since the evidence seemed to indicate that the employee’s arm was at his side when he hit the ground, Dr. D’Amato pointed to this fact as further indication that the employee had not injured his right shoulder when he fell.

In her findings and order issued June 25, 2010, the compensation judge determined the employee’s right shoulder condition was the result of the January 2009 work injury and also found that the surgery recommended by Dr. Becker was reasonable and necessary.  The employer and insurer appeal.

On appeal, the employer and insurer raise two arguments.  First, they argue that the compensation judge drew improper inferences from the evidence to support her decision.  Second, they contend that the opinion of Dr. Becker, which the compensation judge relied on, in part, lacked adequate foundation.  We disagree.

In her findings, the compensation judge listed the evidence which she found persuasive in reaching her decision.  We see no reason to repeat that list here since the employer and insurer do not suggest that any specific piece of evidence does not exist.  Instead, they claim that the compensation judge drew improper conclusions from the evidence.  As one example, the employer and insurer state that the compensation judge noted the employee’s chiropractor found bilateral shoulder tenderness one week after the fall.  The employer and insurer argue that there is no medical evidence which connects that finding with the employee’s shoulder condition before May 11, 2009, and that the compensation judge improperly concluded from this finding that medical treatment for the right shoulder occurred earlier than that date.

We are not convinced.  The employer and insurer’s position was that there was no evidence of any shoulder condition before May 11, 2009.  The compensation judge drew contrary conclusions from the evidence.  The compensation judge also referred to the employee’s severe low back pain which masked his shoulder pain, the employee’s statements to his QRC, the objective findings by Dr. Tarrell, and the MRI findings.  Drawing conclusions from the conflicting evidence presented by the parties is the proper role of a compensation judge.  Where evidence exists to support those conclusions, as it does here, the compensation judge’s decision is to be affirmed.  Hengemuhle v. Long Prairie Jaycees, 358 N.W.2d 54, 59, 37 W.C.D. 235, 239 (Minn. 1984).  We recognize that the employer and insurer wish that the compensation judge had drawn contrary conclusions, but our question is not whether a contrary conclusion might have been reached, but whether substantial evidence supports the compensation judge’s decision.  We find substantial evidence exists here.

The second argument of the employer and insurer is that Dr. Becker’s opinion lacked adequate foundation and should not have been relied upon by the compensation judge.  We note that Dr. Becker treated the employee, reviewed his medical records, including the report of the independent medical examiner [IME], and considered correspondence from the employee’s attorney.  This level of information provides sufficient foundation for a medical opinion.  Grunst v. Immanuel - St. Joseph’s Hosp., 424 N.W. 2d 66, 40 W.C.D. 1130 (Minn. 1988).

The argument of the employer and insurer is not actually a challenge to Dr. Becker’s foundation, however, but rather a challenge to his medical opinion.  The employer and insurer assert as a fact Dr. D’Amato’s opinion that the right shoulder condition diagnosed by Dr. Becker could have occurred only after a fall on an outstretched arm, that Dr. Becker assumed such a history, and that the evidence is that the employee’s arm was at his side when he fell.

Dr. Becker clearly did not agree with Dr. D’Amato’s opinion as to the type of fall required to produce the diagnosed condition.  Dr. Becker, his report of November 4, 2009, stated, “The accident such that occurred on this date usually results in a direct contusion and/or axial strain to the upper extremity.  This would be an appropriate mechanism for developing rotator cuff and/or SLAP tearing of the shoulder.”  The employee consistently reported to his healthcare providers and consistently testified that when he fell on January 5, 2009, he landed on his right shoulder.  Dr. Becker concluded that this type of traumatic event could result in the condition he had diagnosed.  Dr. Becker disagreed with Dr. D’Amato’s opinion on this point and the compensation judge accepted the well-founded opinion of Dr. Becker.  We have consistently held that a well-founded medical opinion may serve as the basis for a determination such as in this case.  Nord v. City of Cook, 360 N.W.2d 337, 37 W.C.D. 364 (Minn. 1985); Smith v. Quebecor, 63 W.C.D. 566 (W.C.C.A. 2003).

The compensation judge’s decision is affirmed.