The employee appeals from the compensation judge’s finding that the October 28, 2010, work injury resolved and from the judge’s resulting denial of the employee’s claims for temporary total disability benefits and right hip replacement surgery.  We reverse and remand the matter to the compensation judge for reconsideration and further findings.

The employee sustained a work-related injury to his right hip on October 28, 2010, while working as a shipping supervisor for Ratner Steel Supply Company [the employer].  The employee first treated for that injury with Dr. Walid Mikhail on November 2, 2010.  He complained of hip pain, and x-rays taken on that date showed some joint space narrowing of the hip.  Dr. Mikhail recommended restrictions that included no lifting more than 10 pounds.

An MRI of the employee’s right hip performed on December 2, 2010, showed mild edema in the subgluteal trochanteric bursa and in the marrow of the greater trochanteric.  The MRI also revealed mild degenerative arthritis of the hip and a probable labral tear.

The employee was referred to orthopedist Dr. Jack Bert, who on December 8, 2010, recorded that the employee had been experiencing pain in the lateral aspect of the right hip, and he diagnosed a right hip labral tear with greater trochanteric bursitis.  Dr. Bert administered a steroid injection into the right greater trochanteric bursa.  When the employee returned to Dr. Bert’s office in February of 2011, Physician Assistant Karl Dennis noted that the employee had done well with the injection and was non-tender at the greater trochanteric area but that the employee’s groin pain persisted on interior and exterior rotation.  P.A. Dennis referred the employee to orthopedist Dr. Chris Larson for consideration of arthroscopy to repair the labral tear.

Dr. Larson saw the employee on March 10, 2011, at which time the employee was complaining of deep lateral pain in the right hip.  Dr. Larson explained to the employee that his labrum tear was not likely causing his significant hip symptoms and that “there is likely a very significant part of extraarticular pain including over the greater trochanteric area.”  He referred the employee for physical therapy and opined that, if the employee’s symptoms did not improve in the next few weeks, he would consider administering a right-sided hip intraarticular cortisone injection.  He also explained that arthroscopic surgery might not help the employee and could “actually make him worse.”

The employee continued to experience hip pain, was diagnosed with mild hip dysplasia, and underwent physical therapy and corticosteroid injections.  He returned for treatment with Dr. Mikhail and Dr. Larson and also treated with Dr. Daniel Hoeffel at Summit Orthopedics.  An MRI performed on October 15, 2011, showed ongoing reactive changes of marked arthropathy/osteoarthritis of the right hip joint, including a large hip joint effusion.  It was noted that the MRI appearance would not exclude the possibility of infection and septic arthritis.  New x-rays taken on November 7, 2011, showed bone-on-bone end-stage cartilage loss in the right hip.  Upon review of those x-rays, Dr. Hoeffel diagnosed rapid cartilage loss, discussed a right hip replacement with the employee, and ordered lab tests to determine whether there was a progressive inflammatory process or infection in the employee’s right hip.  Dr. Hoeffel subsequently diagnosed right hip arthritic changes, with a permanent aggravation due to the work-related injury.

The employer and insurer initially accepted liability for a work-related right hip injury and began paying temporary total disability benefits and medical expenses in January of 2011.  The employee was examined by Dr.  Gary Wyard on September 1, 2011, and February 16, 2012.  It was ultimately Dr. Wyard’s opinion that the employee suffered from an inflammatory process of the right hip, etiology undetermined but nontraumatic in nature.

The employee filed a claim petition alleging underpayment of temporary total disability benefits, unpaid temporary partial disability benefits, and undetermined permanent partial disability.  That claim petition was subsequently amended to include a claim for a total hip replacement.  Based on Dr. Wyard’s report, the employer and insurer filed a petition to discontinue benefits, withdrawing their admission of liability for a work injury.  Those pleadings were joined for the purpose of hearing.

At hearing, the employee itemized more than 19 issues for the compensation judge to address.  The compensation judge found, in part, that the employee had sustained a specific injury to his right hip on October 28, 2010, that the employee’s right hip injury had resolved by March 10, 2011, that the employee now requires a right total hip replacement due to cartilage loss, and that the cartilage loss did not arise out of or in the course of the employee’s employment and is not related to “the right hip labral tear or trochanteric bursitis.”  The judge granted the employer’s request to discontinue benefits and awarded a credit for benefits paid after March 11, 2011.  The employee appeals.

The employee raises numerous issues on appeal, the first being whether substantial evidence supports the judge’s finding that the work injury of October 2010 had resolved, the second being the judge’s failure to address maximum medical improvement [MMI] with regard to that injury.  We conclude that adequate review of the issues raised by the employee’s appeal is not possible without an express finding by the compensation judge as to the specific nature of the employee’s work injury.

The judge’s findings relevant to the nature of the employee’s injury are:

For these reasons, we reverse the judge’s decision and remand this matter to the compensation judge for additional findings as to the specific nature of the October 28, 2010, work injury, whether the employee reached MMI from the effects of that injury, and whether the work injury, as determined by the judge, has resolved, and, if so, when.  The judge should explain, specifically, what evidence she is relying on to support her conclusions on these issues.  Given the complexity of the medical evidence, the compensation judge may in her discretion request additional argument by the parties.  Any party may of course appeal from the judge’s decision on remand.