The employee appeals the compensation judge’s denial of his claim for permanent partial disability related to his December 29, 2009, low back injury.  We affirm.

In 2008, Greg Monson, the employee, began working as a maintenance supervisor for Skaff Apartments, the employer, which was insured for workers’ compensation liability by Auto-Owners Insurance Group.  In November 2008, the employee saw Dr. Ross A. Kringlie, for his annual physical at MeritCare Clinic in Moorhead, Minnesota.  The employee reported left low back pain that had been present for ten years and bilateral leg parethesias.  Dr. Kringlie noted muscle spasm in the left paraspinous lumbar region, assessed chronic but worsening left low back pain, and recommended an MRI scan.  A November 19, 2008, MRI scan indicated multi-level degenerative changes and foraminal narrowing without definite nerve root compression at L4-5; moderate to severe foraminal narrowing with possible nerve root compression at L5-S1; and a central right paracentral disc extrusion at S1.  Dr. Kringlie prescribed medication and referred the employee to a neurosurgeon, for physical therapy, and for a pain management program.  The employee declined physical therapy, and his medications were refilled through December 2008.  The employee did not return to Dr. Kringlie for treatment.  The employee continued working at his heavy job in maintenance for the employer with no restrictions and did not miss any time from work.

On December 29, 2009, the employee injured his low back while loading a snow blower into a truck.  The next day, the employee reported the injury and sought medical treatment with Dr. John Beauclair at the MeritCare Occupational Health Clinic in Fargo, North Dakota.  The employee indicated that he had pain in his low back radiating into his legs and significant numbness in both legs.  The employee also reported his previous low back pain, which he related to the bending, twisting, and lifting associated with snow removal.  He stated that he had experienced low back pain about the year before, was treated conservatively, and recovered.  Dr. Beauclair recommended physical therapy, prescribed medication, and assigned work restrictions including no lifting, pulling or pushing over 10 pounds, no overhead reaching, and frequent position changing.  The employer was able to accommodate these restrictions for a month, after which, the employee’s position was terminated since the employer did not have work available within the restrictions.  The employer and insurer accepted liability for this injury and paid temporary total disability benefits and medical expenses.

The employee continued to have symptoms and to treat with Dr. Beauclair, who assessed lumbar strain.  In January 2010, the employee reported sharp back pain as well as achiness and numbness in his low back.  The employee underwent physical therapy from January 2010 through at least May 2010 at MeritCare Clinic.  Dr. Beauclair also referred the employee to Dr. Charles G. Koski at the same clinic.  The employee reported severe pain, difficulty sleeping, leg weakness, and pain aggravated by bending, lifting, and squatting.  Dr. Koski’s examination indicated lumbar lordosis flattening, several trigger point areas, low back tenderness, and reduced range of motion.  Dr. Koski recommended another MRI, which was completed on January 21, 2010, and indicated moderate disc space narrowing at L4-5 and L5-S1 with mild central canal narrowing on both sides without definite nerve root compression and equivocal compression of the exiting L5 nerve roots, as well as multi-level degenerative facet changes and a central disc protrusion at L5-S1.  The MRI scan’s findings were very similar to those of the 2008 MRI scan.  The employee continued to treat with Dr. Beauclair and Dr. Koski for symptoms including low back pain with radiculopathy, lumbar lordosis flattening, muscle spasm, trigger point tenderness, reduced range of motion, numbness and weakness in his legs, diminished reflexes, difficulty walking, and difficulty sleeping.  He was treated with prescription medication and physical therapy, including ultrasound and traction.  At this point, Dr. Beauclair had assigned the employee restrictions including no lifting, pushing, or pulling over 15 pounds, frequent changes in positions, and to lie down as needed.  Later, Dr. Beauclair recommended steroid and trigger point injections.

Dr. Beauclair also referred the employee to Dr. Brad Selland, a neurosurgeon, who examined the employee on August 10, 2010.  The employee reported severe low back pain radiating down his legs, as well as intermittent numbness and tingling.  Dr. Selland noted tenderness in the sciatic notch, positive straight leg test, reduced reflexes, mild weakness, and that the employee walked with a limp.  He assessed lower back and bilateral radicular pain, most likely due to L4-5 and/or L5-S1 disc injury.  The doctor recommended a dynamic lumbar myelogram/contrast CT and a lumbar discography of L3, L4, and L5.  These tests were not completed due to the employee moving across the state in order to assist an ailing family member.

On August 23, 2010, the employee fell off a deck at a friend’s house and sustained a severe anterior compression fracture injury of the L2 vertebral body.  He underwent extensive treatment with Dr. Frederick Harris at St. Mary’s/Duluth Clinic Health System in Duluth, Minnesota, for this injury, including a six-level fusion surgery with instrumentation from T10 through L4.^[1]  The employer and insurer continued temporary total disability benefits through October 1, 2010, when they filed a notice of intention to discontinue benefits based on the employee having sustained another injury not related to the work injury.  The employee continued to treat for low back and leg pain.  At a check up on August 16, 2011, the employee reported chronic low back pain and worsening right leg pain with numbness and tingling.  An August 22, 2011, MRI scan indicated extensive facet hypertrophy with mild narrowing of the neural foramina at L4-5 and an L5-S1 disc bulge with a central disc protrusion and bone marrow edema, as well as extensive facet hypertrophy with moderate narrowing of the neural foramina at L5-S1.  Dr. Harris reviewed the MRI scan results, did not recommend surgery, and referred the employee to Dr. Eric Rudd for a consultation.  In October 2011, Dr. Rudd assessed a pre-existing degenerative condition in the lower lumbar spine with low back pain, exacerbated by the December 2009 injury.  Dr. Rudd ordered further testing and recommended facet injections at L4-5 and L5-S1.

On October 6, 2011, the employee was evaluated by Dr. William P. Fleeson.  Dr. Fleeson’s diagnosis included “continued symptomatology of low back pain as well as lumbar radiculopathy on the right with leg weakness as part of the symptomatology.”^[2]  Dr. Fleeson opined that the employee’s December 2009 work injury was a substantial contributing factor to his L4-5 and L5-S1 disc pathology.  He assigned permanent partial disability ratings for all of the employee’s injuries.  Specifically, he assigned ratings of 9 percent under Minn. R. 5223.0390, subp. 4.D., for radicular pain or parathesia with MRI scan evidence of intervertebral disc bulging, protrusion, or herniation impinging on a nerve root; 3 percent under Minn. R. 5223.0390, subp. 4.D.(1), for ongoing radicular pain despite treatment; and an additional 9 percent under Minn. R. 5223.0390, subp. 4.D.(4) for a concurrent lesion which meets the other criteria of the rule. ^[3]  He determined that these ratings were due to the December 2009 injury and not to the pre-existing degenerative condition, even though the MRI scans from November 2008 and January 2010 were similar, since the employee did not have ongoing symptoms or medical treatment until after the December 2009 injury.

On April 3, 2012, the employee was evaluated by Dr. Paul Cederberg at the employer and insurer’s request.  Dr. Cederberg opined that the employee had a history of pre-existing two-level degenerative disc disease with chronic low back pain and that he sustained a lumbar strain as a result of the December 29, 2009, work injury.  He also found that the employee had reached maximum medical improvement for this injury on June 25, 2010, had no permanent partial disability from the 2009 injury, and did not need work restrictions or any additional medical treatment for this injury.  At his deposition, Dr. Cederberg also indicated that the January 2010 MRI scan showed the same results as the November 2008 MRI scan.

The employee filed a claim petition for permanent total disability and permanent partial disability benefits.  The employer and insurer objected, arguing that the December 2009 work injury was temporary and had resolved before the August 2010 injury.  They also argued that the August 2010 injury was an intervening injury and that any wage loss benefits or permanent partial disability benefits were related to that injury.  The employee asserted that the August 2010 injury was related to his work injury, arguing that the fall occurred because of his leg condition after the December 2009 work injury.  A hearing was held on October 3, 2012.  The compensation judge found that the August 2010 injury was not related to the employee’s December 2009 work injury and denied the employee’s claim for permanent total disability benefits and all benefits related to the 2010 injury.^[4]  The employee did not appeal this decision.  The judge also denied the employee’s claim for permanent partial disability benefits solely related to the December 2009 injury, which the employee appeals.

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.^[5]  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.^[6]  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.^[7]  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.”^[8]

The employee contends that the compensation judge erred by failing to find permanent partial disability attributable to the employee’s 2009 work injury.  Specifically, the employee claims that the evidence supporting permanent partial disability for that injury was uncontroverted and further maintains the employee’s work-related disability is separate and distinct from the 2010 injury.  The employee cites Dr. Fleeson’s report that lays out the assignment of permanent partial disability ratings for the employee: 9 percent under Minn. R. 5223.0390, subp. 4.D. for radicular pain or parathesia with MRI scan evidence of intervertebral disc bulging, protrusion, or herniation impinging on a nerve root; 3 percent under Minn. R. 5223.0390, subp. 4.D.(1), for ongoing radicular pain despite treatment; and an additional 9 percent under Minn. R. 5223.0390, subp. 4.D.(4) for a concurrent lesion which meets the other criteria of the rule.  Since Dr. Fleeson’s medical opinion had adequate foundation and the judge did not accept Dr. Cederberg’s medical opinion that the employee was at maximum medical improvement for the 2009 work injury, the employee contends the compensation judge erred by not accepting an uncontroverted medical opinion.^[9]  We disagree with the employee’s argument.  The compensation judge did not disregard an unopposed medical opinion; he rejected certain medical opinions on the basis of other credible evidence^[10] and ultimately viewed the evidence as insufficient to sustain the employee’s claim.^[11]  First, the judge did not accept Dr. Fleeson’s opinion that permanent partial disability ratings for the employee’s low back condition resulted from the December 2009 injury in absence of some further discussion, comparison, or contrast to the employee’s pre-existing condition.  In calling Dr. Fleeson’s opinion “insufficient,” the judge was addressing the weight and persuasiveness of the evidence.  He emphasized that Dr. Fleeson had testified that the status of the employee’s lumbar spine remained unstable and unknown.  The judge gave Dr. Fleeson’s opinion less weight than other evidence in the record.  We find the weighing of the evidence the appropriate role for the compensation judge as the finder of fact.^[12]  We find no basis to conclude that the compensation judge erred by disregarding Dr. Fleeson’s medical testimony in view of the entire record.

Other evidence in the record supports the compensation judge’s Findings and Order denying permanency on the basis of insufficient evidence.  The judge noted that the August 2010 injury “interrupted the diagnostic procedures needed to address the nature, extent and etiology of the employee’s L4-5 and L5-S1 symptoms.”^[13]  No permanent partial disability ratings had been assigned to the employee’s low back condition before the 2010 injury occurred.  No treating doctor for the 2009 injury had provided an opinion that the employee had reached maximum medical improvement, and the judge concluded that the employee had not reached maximum medical improvement for the December 2009 injury as of the date of the hearing.  While a finding of maximum medical improvement is not dispositive to a determination of permanent partial disability, in this case, the judge considered the absence of maximum medical improvement a significant factor in weighing the evidence to determine that the cumulative evidence did not support an award of a work-related permanent partial disability at this time.

Further, the judge noted that while Dr. Rudd had referred to the 2009 injury after examining the employee in 2011, he had not assigned responsibility for the employee’s symptoms to the work injury.  After noting that the employee had moderate to moderately advanced pre-existing degenerative change in the lower lumbar spine and pre-existing low back pain exacerbated by the December 2009 work injury, Dr. Rudd discussed the employee’s leg symptoms:

A compensation judge’s finding regarding causation is one of ultimate fact and will be affirmed if it is supported by substantial evidence.^[16]  Based on the compensation judge’s interpretation of the evidence as indicated in the findings and memorandum, the judge could not resolve the nature and extent of the employee’s permanent partial disability among the pre-existing degenerative condition, the 2009 work injury, and the 2010 fall.  As a result, the judge essentially concluded that the employee’s claim for permanent partial disability was premature.  Substantial evidence supports the compensation judge’s denial of the employee’s claim for permanent partial disability benefits related to the employee’s December 2009 work injury at this time, and we affirm.^[17]