The employee appeals from the compensation judge’s denial of medications the employee asserts are related to her work injury and are reasonable and necessary treatment for that injury.  We affirm.

Robin Lehto sustained a work-related injury to her low back on October 1, 2001.  Since then, she has had a number of surgeries and other procedures, including placement of a spinal cord stimulator.  None of this treatment has been successful in materially improving Ms. Lehto’s condition and symptoms.  More recent treatment has consisted of medication prescribed by the employee’s doctors.

In December 2012, the employer and insurer had the employee’s medical records reviewed by Dr. Donald Starzinski.  In his report, Dr. Starzinski, identified as a neurology consultant, reviewed the employee’s medication and concluded that many of them were inappropriate for what he described as Ms. Lehto’s chronic pain syndrome.

Based on Dr. Starzinski’s report, the employer and insurer filed a medical request to “implement the recommendations of Dr. Starzinski.”  An administrative conference was held, and, subsequently, the employer and insurer filed a request for a formal hearing.  The hearing was held on July 23, 2013, before Compensation Judge Cheryl LeClair-Sommer.

At the hearing, the parties stipulated that some of the employee’s medications were reasonable and related to the work injury: Methocarbomal, Lyrica, Lidoderm, and Ambien used on an intermittent basis.

In dispute was the employee’s use of Fentanyl, Lortab, Voltaren, and Robaxin for relief of back pain; Protonix for gastric problems the employee claims were the result of her use of pain medications; Prozac and Xanax that the employee asserted were needed for treatment of anxiety and depression resulting from her chronic pain; and Tylenol PM Extra Strength as a sleep aid.

In her findings and order issued on August 30, 2013, the compensation judge denied the disputed medications, and the employee has appealed.

An employer is responsible for furnishing medical care that is related to a work injury and that is reasonably required to cure and relieve the effects of the injury.  Minn. Stat. § 176.135, subd. 1.  The employee has the burden of establishing the medical care, including medication, to be reasonable and related to the work injury.  Adkins v. Univ. Health Care Ctr., 405 N.W.2d 233, 39 W.C.D. 898 (Minn. 1987); House v. Heartland Homecare, 73 W.C.D. 77 (W.C.C.A. 2013).

In her findings, the compensation judge considered the testimony of the employee as well as the records and opinions of the employee’s treating doctors.  She also considered the opinions of Dr. Starzinski and, in substantial part, accepted Dr. Starzinski’s opinions and based her decision on those opinions.

On appeal, the employee contends that Dr. Starzinski lacked foundation for his opinion and that it was error for the compensation judge to rely on Dr. Starzinski’s opinion.  The employee argues that Dr. Starzinski had no foundation for his opinion because he never examined or even talked to the employee about her medication and its benefits to her.

The question of foundation goes to the adequacy of the information possessed by a medical doctor or other professional in rendering an opinion.  It is often true that foundation for a medical opinion may be established by taking a history from the employee, performing an examination, and reviewing medical records.  Scott v. Southview Chevrolet, 267 N.W.2d 185, 30 W.C.D. 426 (Minn. 1978); Wiggin v. Marigold Foods, No. WC04-136 (W.C.C.A. July 29, 2004); Wanta v. Nw. Nat’l Life, No. WC09-129 (W.C.C.A. Aug. 11, 2009).  We have also held, however, that a review of medical records and a response to a hypothetical question may provide enough information to provide foundation for an opinion.  Smith v. Quebecor, 63 W.C.D. 566 (W.C.C.A. 2003).

In the present case, the employee had been using the medications in dispute for some time, generally for more than three or four years.  We do not think it unreasonable to conclude that any benefit from the use of the medications should be reflected in the medical records of the medical provider supplying the prescriptions.  By reviewing the records from the employee’s treating doctors, Dr. Starzinski had adequate foundation for his opinion as expressed in his December 2012 report.

In considering the disputed medicines for back pain, Dr. Starzinski stated that the employee’s long-term use of Fentanyl and Lortab was inappropriate because they were narcotic analgesics and “may actually be perpetuating and exacerbating the chronic pain process.”  Dr. Starzinski concluded that only Lyrica, Lidoderm, and methocarbamol on an as-needed basis were appropriate for the treatment of the employee’s back pain.  Dr. Starzinski also agreed that intermittent use of Ambien as a sleep aid was reasonable.  As to the Prozac and Xanax, prescribed for anxiety and depression, Dr. Starzinski was of the opinion that these were medications for psychological conditions unrelated to the work injury, although treatment of the psychological conditions might be beneficial in “helping” the employee’s pain.

In her claims, the employee relied on her testimony that the medications in dispute had been beneficial for managing her pain, and that, after the employer and insurer stopped paying for the medications, her pain had been substantially worse.  She also relied upon statements from treating doctors.  Dr. Timothy Garvey did some of the back surgeries for the employee and continued to provide follow up care.  Dr. Less Riess at Raiter Clinic in Cloquet had been the employee’s treating doctor for many years.  Dr. Hal Heyer at Pain Clinic of Lake Superior has been treating the employee since 2005.  All of these physicians provided reports that the employee’s prescriptions were related to her work injury and were reasonable treatment for the injury.

In this case, the compensation judge was presented with competing, well-founded medical opinions as to the reasonableness of the claimed medications for treatment of the work injury.  The role of the compensation judge is to choose between those opinions, and a decision based on that choice will generally be affirmed by this court.  Nord v. City of Cook, 360 N.W.2d 337, 37 W.C.D. 364 (Minn. 1985); Koppen v. Knowlan’s Supermarket, 71 W.C.D. 99 (W.C.C.A. 2011).

The compensation judge provided the rationale for her decision in her memorandum:

The decision of the compensation judge is affirmed.