The employer and insurer appeal from the compensation judge’s determination that the employee sustained a Gillette^[1] injury in the nature of bilateral carpal tunnel syndrome culminating on January 8, 2013. We affirm.

Charles Hagen began working for Great Northern Baking Company on September 13, 2012.  Great Northern produces frozen dough and baked products for a number of private label businesses as well as different school districts, including the Minneapolis School District.  Mr. Hagen’s first assignment was in packaging, taking products from trays and placing them on a conveyor belt for packaging.  He then boxed up the packages for shipping.  After about a month and a half, Mr. Hagen transferred to the sanitation department.  His duties there consisted of cleaning the break room and restrooms for about two hours each day, and then spending the rest of his time cleaning baking pans, utensils, and mixing bowls after they had been used in the production process.

Mr. Hagen handled about 600 flat pans on a daily basis.  He took the pans from a pallet and loaded them on a rack which he then pushed into a walk-in dishwasher.  Mr. Hagen testified that it was common for residue to be left on pans even after they had gone through the dishwasher.  He would then need to use a scouring pad on each pan and rinse the pan with a garden hose with a trigger nozzle.  Mr. Hagen stated that he is left-handed and would always use his left hand to squeeze the handle on the nozzle.  About three times a week, Mr. Hagen also cleaned muffin pans.  The muffin pans needed to be pre-washed before they could be sent into the dishwasher, again using a hose with a trigger nozzle.  After pans came out of the dishwasher, Mr. Hagen would take them from the racks and load them on pallets.

At the end of October, Mr. Hagen began noticing numbness in both hands.  He first sought medical attention for these symptoms when he saw Dr. Michelle Van Vranken at the East Side Family Clinic on November 30, 2012.  At that time, Mr. Hagen was complaining of numbness in his feet as well as in his hands, and Dr. Van Vranken assessed myalgia with an “unclear etiology.”  Mr. Hagen was given a prescription to relieve his symptoms but he stated that his symptoms continued to worsen.

Mr. Hagen worked his regular duties at Great Northern until January 8, 2013, his last day there.  On that date, while he was cleaning a dough dispensing machine, he dropped a roller weighing 20 to 25 pounds.  Mr. Hagen said that he dropped the roller because he could not hold on to the part due to weakness in his hands.  He told his supervisor about the incident, and completed a first report of injury.

Mr. Hagen saw Dr. Muaj Lo at East Side Family Clinic on January 11, 2013.  He told Dr. Lo that he thought he had carpal tunnel syndrome that began about a month ago, that both hands were numb and painful, that his symptoms were worse after work, and that he was unable to do his job.  Dr. Lo found positive Phalen’s signs bilaterally as well as “tenderness with palpation over extensors on both forearms, lateral and medial epicondyles bilaterally.”

Mr. Hagen consulted with Dr. Susan Evans, a neurologist at the Noran Neurological Clinic January 18, 2013.  An EMG was done at her direction on February 1, 2013, and was interpreted as showing bilateral carpal tunnel syndrome, worse on the left.  Dr. Evans recommended physical therapy, and the employee went through physical therapy at Novacare Rehabilitation between February 7 and March 11, 2013.  He noted significant improvement in his symptoms, especially in his right wrist.

Mr. Hagen was seen by Dr. Thomas Walsh from the department of hand surgery at Park Nicollet Clinic on March 7, 2013.  In his history, he told Dr. Walsh that his

After he left his job at Great Northern, Mr. Hagen contacted the vocational rehabilitation unit at the Department of Labor & Industry and, with their assistance, began looking for other employment.  He was hired by American Crystal Sugar Company and worked in a temporary position there from March 18, 2013 to June 10, 2013.  Before he was laid off, he began looking for other employment with the help of a number of agencies - - AMICUS, Salvation Army, Lutheran Social Services, and Eastside Financial Services.  The employee submitted copies of job logs he had kept.  In an unappealed finding, the compensation judge determined that his job search was reasonable and diligent.

The employee was evaluated at the request of the employer and insurer by Dr. William Call on June 25, 2013.  Dr. Call examined the employee, reviewed the medical records, and prepared a report setting out his conclusions.  He agreed with the diagnosis of bilateral carpal tunnel syndrome, stated that the past medical treatment had been reasonable, but also concluded that the condition had completely resolved and no further treatment or work restrictions were necessary.  It was also Dr. Call’s opinion that Mr. Hagen’s bilateral carpal tunnel syndrome was not related to his work at Great Northern, since, according to Dr. Call, there is no causal relationship between carpal tunnel syndrome and repetitive work activities.  Dr. Call stated, “the mere production of symptoms at work is not indicative of causation, exacerbation, or contribution, but merely the way carpal tunnel syndrome presents itself.”

Dr. Walsh, at the request of the employee’s attorney, prepared a written report concerning Mr. Hagen dated July 12, 2013.  He stated, “it is my opinion that the employee’s work activities as a maintenance worker were substantially contributory to the development and persistence of bilateral carpal tunnel syndrome.”  Dr. Walsh then went on at some length to describe the nature of the employee’s work activities and his rationale for determining that those activities were related to the employee’s condition.

The employee’s claim petition was heard by Compensation Judge James Kohl on July 15, 2013.  Mr. Hagen and a supervisor at Great Northern testified, and the compensation judge also considered medical records as well as the reports of Drs. Call and Walsh.  In his findings and order, the compensation judge determined that the employee’s carpal tunnel syndrome was the result of a Gillette injury from his employment at Great Northern, culminating on January 8, 2013, the last day he worked there.  The compensation judge also found that the employee had provided statutory notice to the employer on a timely basis and that the employee was temporarily totally disabled and was a qualified employee for rehabilitation.  The compensation judge also determined the employee’s past medical care and the proposed surgery to be reasonable and related to the work injury.  The employer and insurer have appealed.

The compensation judge adopted the opinion of Dr. Walsh and determined that the “medical evidence, coupled with the employee’s credible testimony, wholly supports that the work activities at Great Northern Bakery were substantially contributing factors in his ongoing disability, need for physical restrictions, and ongoing medical care.” The employer and insurer argue that Dr. Walsh lacked foundation for his opinion and the compensation judge erred in relying on Dr. Walsh’s opinion.  It is claimed that Dr. Walsh was not sufficiently aware of the details of the employee’s duties and that, further, although the employee testified that he had discussed the details of his work with Dr. Walsh, those details were not documented in Dr. Walsh’s records.

Foundation for a medical opinion requires medical knowledge and experience with the subject at issue.  Drews v. Kohl’s, 55 W.C.D. 33 (W.C.C.A. 1996); Gardner v. Elbow Lake Co-op, No. WC07-180 (W.C.C.A. Jan. 10, 2008).  The employer and insurer do not allege that Dr. Walsh lacks these basic prerequisites for providing a medical opinion.  Dr. Walsh examined the employee and, as his chart notes indicate, discussed with Mr. Hagen the nature of his job.  We conclude, as did the compensation judge, that Dr. Walsh had adequate foundation for his opinion.  Scott v. Southview Chevrolet, 267 N.W.2d 185, 188, 30 W.C.D. 426, 430 (Minn. 1978); Kelsey v. Lovegreen Indus. Servs., No. WC07-159 (W.C.C.A. Dec. 12, 2007).

As support for their position, the employer and insurer cite to an earlier decision by this court, Chan v. C. F. Haglin & Sons, 55 W.C.D. 598 (W.C.C.A. 1996).  In that case, this court affirmed the compensation judge’s denial of an employee’s Gillette claim.  There was no finding, however, that the supporting medical opinion lacked foundation.  Instead, the compensation judge had decided not to accept the medical opinion supporting the claim because the doctor appeared to have no more than a “general understanding” of the employee’s work activities.  We affirmed the compensation judge’s decision based on the choice between competing medical opinions.  See, Nord v. City of Cook, 360 N.W.2d 337, 37 W.C.D. 372 (W.C.C.A. 1985).

The extent of knowledge possessed by a physician of the employee’s work activity in a Gillette injury claim goes to the weight to be provided to that opinion by the compensation judge and is a factual determination to be made by the compensation judge.  Kuehn v. Vickerman Constr., Inc., No. WC05-103 (W.C.C.A. Aug. 16, 2005); Parker v. Teamvantage Molding, 72 W.C.D. 559 (W.C.C.A. 2012).  Here, the employee testified that he discussed his job duties in detail with Dr. Walsh and in both his chart note of March 7, 2003, and his report of July 12, 2013, Dr. Walsh explained his knowledge of the employee’s job and his reasons for finding the carpal tunnel syndrome to be work-related.  The compensation judge found the opinion of Dr. Walsh to be consistent with what he described as the employee’s credible testimony about his job duties.  We find no error in the compensation judge’s acceptance and reliance upon the opinion of Dr. Walsh.  The decision of the compensation judge on this issue is supported by substantial evidence.

Mr. Hagen worked his regular duties at Great Northern until January 8, 2013.  He stopped working for Great Northern on that date after he dropped a roller due to the decreased grip strength in his hands.  He reported this incident to his supervisor the same day and completed a first report of injury.  The compensation judge found the employee’s date of injury to be January 8, 2013, and determined that the employee gave timely notice of his injury pursuant to Minn. Stat. § 176.141.

The employer and insurer argue on appeal that because the employee started having symptoms in his wrists in October or November 2012, and because, according to this argument, the employee had reason or should have had reason to know that his symptoms may have been work related, the employee had an obligation to provide notice to the employer at that time.  Because he did not do so, he failed to meet the requirements of the statute.

As a general rule, a compensable personal injury from repetitive trauma occurs when the cumulative effect is sufficiently serious to disable the employee from further work.  Carlson v. Flour City Brush Co., 305 N.W.2d 347, 33 W.C.D. 594 (Minn. 1981).  The compensation judge determined the injury date in the present case to be January 8, 2013.  Minn. Stat. § 176.141 requires the employee to give notice to the employer of an injury 14, 30, or 180 days “after the occurrence of the injury.”  The employee clearly did so in this case.  The employer and insurer cite to Anderson v. Frontier Commc’ns, 819 N.W.2d 143, 72 W.C.D. 417 (Minn. 2012), but the issue in that case was the timeliness of the employee’s notice to the employer after his injury.

Substantial evidence supports the compensation judge’s finding on this issue.

Based on their argument that substantial evidence does not support the compensation judge’s finding of a Gillette injury, the employer and insurer contend that the compensation judge’s determinations on maximum medical improvement, eligibility for rehabilitation services, surgery, and temporary total disability were in error also.  Our affirmance of the compensation judge’s finding on causation resolves these questions as well.

The compensation judge’s decision is affirmed.