The employer and insurer appeal from the compensation judge’s determination that (1) the employee sustained a permanent injury to her low back and SI joints; (2) medical care and treatment provided to the employee was reasonable and necessary; (3) the employee was a qualified employee entitled to rehabilitation benefits; and (4) the employee was temporarily and totally disabled from October 13, 2012, through the date of hearing.  We affirm.

The parties stipulated that while working for the employer, Belgrade Nursing Home, the employee, Kimberly Schramel, sustained a personal injury to her low back on February 17, 2012, the nature and extent of which was in dispute.^[1]  The employer and insurer initially admitted the injury and paid temporary total disability benefits from February 18 through April 11, 2012, together with certain medical expenses.

The employee graduated from high school in 1990.  Thereafter, she worked as a hairstylist at various locations.  The employee experienced low back problems as a teenager and into her early adult years, and eventually was diagnosed with grade IV spondylolisthesis at L5 on S1.  She underwent surgery on February 25, 1997, consisting of a bilateral decompression at L5-S1 with a posterolateral fusion from L4 through the sacrum with TSRH segmental fixation.

The employee testified she experienced significant relief and was able to work without restrictions after the surgery.  (T. at 58, 114.)  She returned to work as a hairstylist and opened her own salon in 2007.  She closed her business in 2009 and began working in sales.  The sales position required a significant amount of driving which, according to the employee, caused some neck and upper back problems.  The employee stated she left that position because of the time it required away from home.

From August 2003 through April 2008, the employee received care at Jacklitch Chiropractic Clinic primarily for her neck and upper to mid-back.^[2]  She continued care at Back to Health Acupuncture and Chiropractic Center starting in November 2008.  The chiropractor diagnosed cervical, thoracic, and lumbar subluxation with myofascitis, and provided treatment to the entire spine through January 2010.  The employee began seeing John Haefner, D. C., at Meridian Disc Institute in August 2010.  At her initial examination, the employee described pain in the neck, upper back and mid-back.  Dr. Haefner diagnosed subluxation at C1, T5 and L1.  The employee was seen approximately once a month and, on a few occasions, up to once a week, for adjustments to the entire spine.  Her last visit with Dr. Haefner prior to the work injury occurred on February 13, 2012.

In 2012, the employee enrolled in a certified nursing assistant (CNA) program at Alexandria Technical College.  On January 30, 2012, the employee began working for the employer as an activities aide and CNA trainee.  On February 17, 2012, the employee was sitting in an office chair at the nurse’s station when the chair broke, tipping her backwards.  The employee’s right wrist struck the desk and she landed on her back on the floor.

Upon leaving work, the employee was seen by Dr. Haefner.  She reported her muscles were beginning to tighten and spasm with pain of 5 out of 10 in the mid and low back as well as significant neck pain.  Dr. Haefner diagnosed a cervical, thoracic, and lumbar strain/ sprain.  The employee thereafter received chiropractic care and massage therapy at Meridian Disc Institute on a regular weekly basis.  On April 6, 2012, Dr. Haefner released the employee to work with restrictions of occasional bending and twisting, lifting up to 20 pounds, and changing static positions every 30 minutes.  The employee returned to light-duty work with the employer on April 12, 2012.

In May 2012, Dr. Haefner noted worsening low back pain, recommended a lumbar spine MRI scan, and referred the employee to Dr. John Damergis at Noran Neurological Clinic.  When seen by Dr. Damergis on June 14, 2012, the employee reported her low back pain had returned and had worsened since the February 2012 incident, with weakness, imbalance, numbness, and tingling on the plantar aspect of the right foot similar to her lumbar issues fourteen years previously.  A lumbar spine MRI scan was inconclusive due to hardware artifact from the previous surgery.  An EMG study was suggestive of right-sided radiculopathy at either the L5 or S1 nerve root.  The employee returned to Dr. Damergis on August 14, 2012.  The doctor diagnosed a work-related injury with resultant low back pain and likely right-sided L5 radiculopathy.  The employee was prescribed Flexeril and Vicodin as needed for pain, and a referral was made to Twin Cities Spine Center for a surgical evaluation.  Dr. Damergis recommended very light work duties, including no lifting over 10 pounds, carrying less than 5 pounds, no pushing/pulling over 10 pounds, and no repetitive flexion or rotation.  As of September 20, 2012, the employer could not provide work within the restrictions provided and the employee was released from work.

On August 22, 2012, the employee was seen by Dr. Rajan Jhanjee at the request of the employer and insurer.  By report dated September 5, 2012, Dr. Jhanjee opined the employee’s February 17, 2012, injury was a musculoligamentous lumbosacral strain that had resolved with no evidence of any spinal stenosis, acute injury, or ongoing soft tissue injury, and was not a substantial contributing factor to her current condition or need for medical care.  He further stated the employee did not need work restrictions and was capable of working full duty in her pre-injury job.  Based on Dr. Jhanjee’s report, the insurer denied referral to the Twin Cities Spine Center, stated the employer would not accommodate work restrictions, and stated that a job search would not be authorized.

On September 29, 2012, the employee was involved in a non-work-related motor vehicle accident in which her vehicle was struck by a truck and forced off the road into a field.  She denied injury to the lumbar spine, but reported increased neck, upper back, and mid-back pain.

On October 8, 2012, the employee began working with Joseph Bohlke, a qualified rehabilitation consultant (QRC).  An R-2 rehabilitation plan completed on October 24, 2012, indicated the QRC would provide medical management and vocational counseling with the goal of returning the employee to work in the same or a similar job with the date-of-injury employer.

The employee continued to receive treatment at Meridian Disc Institute from October 2012 through May 2013 directed to the low back along with the neck, mid-back, and shoulders.  The employee also treated with Dr. Damergis who renewed prescriptions for Vicodin, muscle relaxant medications, and gabapentin.  The doctor reaffirmed his recommendation of a surgical evaluation, and advised the employee to continue chiropractic care and physical therapy, as well as extending her very light-duty work restrictions.  On March 28, 2013, Dr. Damergis stated the employee should remain off work until June 1, 2013.

The employee was seen by Dr. Damergis on May 30, 2013, in a follow-up for low back pain and bilateral lumbar radiculopathy.^[3]  The doctor stated that at that point her low back pain was her most significant issue and it appeared to be worsening.  Dr. Damergis diagnosed work-related lumbar pain syndrome with intermittent numbness and tingling in both lower extremities, and EMG documentation of denervation at the right L5 or S1 myotome.^[4]

On June 14, 2013, the employee underwent an examination with Dr. Robert Wengler at the request of her attorney.  Dr. Wengler opined the February 2012 incident was a substantial contributing cause of the employee’s current low back condition.  The doctor stated the employee’s symptom complex suggested predominant involvement of the right L5 nerve root, but felt she was in need of additional diagnostic imaging to isolate the pain generator and recommended a CT/myelogram.  Dr. Wengler concurred with light-duty work restrictions, stating the employee should be restricted to 5-10 pounds lifting, and no repetitive bending or stooping, heavy pushing or pulling, or positions of postural stress.

The employee returned to see Dr. Damergis on July 30, 2013.  The doctor ordered a CT/myelogram, continued the employee’s medications, and maintained the employee off work for an additional three months.  The August 5, 2013, CT/myelogram showed a solid lumbosacral fusion from L4 through S1, a fusion screw that missed the pedicle bone of the L4 vertebral body, and moderate to severe spinal stenosis at L5-S1 with possible impingement of the L5 ganglia.  After review of the imaging, on August 13, 2013, Dr. Damergis referred the employee to the Institute for Low Back and Neck Care (ILBNC).  By letter report dated September 8, 2013, Dr. Damergis stated the CT/myelogram confirmed an abnormal position of a pedicle screw and moderate to severe bilateral L5-S1 neuroforaminal stenosis consistent with the L5 or S1 denervation seen on the 2012 EMG.  He agreed with Dr. Wengler that the work injury of February 17, 2012, was a substantial contributing cause of the employee’s low back pain that he had treated, and he recommended she remain off work for the indeterminate future.

On August 29, 2013, the employee began treating with Dr. Jeffrey Pinto at ILBNC.  On September 9, 2013, the employee underwent a hardware injection at the level of the L4 and S1 pedicle screws.  The employee reported 80% relief from the injections and surgical removal of the TSRH hardware was recommended and performed on September 16, 2013.  Two weeks postoperatively, the employee reported improvement in her low back pain and her ability to stand upright.

The employee was seen at ILBNC for a two month follow-up on November 13, 2013.  She reported difficulty sitting for any prolonged period with continuing low back and tailbone pain as well as increasing neck and right arm pain.  Mr. Robinson, PA-C, observed the employee’s tailbone pain seemed to be an ongoing issue, and ordered coccyx x-rays and a coccyx injection.  By letter dated November 19, 2013, Dr. Pinto opined the February 17, 2012, injury constituted a substantial contributing factor to the employee’s low back pain, and stated he was keeping the employee on light duty with no bending, twisting, or lifting until he could determine what was going on.

On December 3, 2013, the employee underwent a sacrococcygeal region injection.  The employee returned to Dr. Pinto on December 12, 2013, reporting 60 to 70% relief.  The employee felt her back pain was further up, but Dr. Pinto disagreed.  A lumbar MRI scan on December 17, 2013, showed a solid fusion from L4 to S1, chronic moderate foraminal narrowing bilaterally at L5-S1 with foraminal encroachment on the L5 ganglia bilaterally, and no disc herniation, significant central stenosis, or spondylolysis.  An MRI scan of the sacrum and coccyx showed signal changes within the sacral components of both sacroiliac (SI) joints, right greater than left, indicative of ongoing bilateral degenerative sacroiliitis.^[5]

The employee returned to Dr. Pinto on December 18, 2013.  He noted the employee seemed to be a bit better for a period of time following the hardware removal surgery, but longer-term had had more problems.  Dr. Pinto concluded that given the results of the lumbar MRI scan, he did not believe that a multilevel fusion was going to help her pain.  The doctor concluded the employee’s neck problems were likely the easiest thing to deal with at that point, and the employee was scheduled for a cervical discectomy and fusion surgery performed on February 3, 2014.

Following the neck treatment and recovery from surgery, Dr. Pinto returned his attention to the employee’s low back.  On March 9, 2014, Dr. Pinto stated the most recent MRI scan did appear to show irritation in the SI joints and recommended bilateral SI joint injections to see if that would diminish her pain.

On April 23, 2014, the employee was examined by Dr. Charles Burton at the request of the employer and insurer.  By report dated May 21, 2014, Dr. Burton diagnosed gradually progressing, non-work-related cervical and lumbar degenerative disease with a high degree of functional pain behavior.  The doctor opined the February 17, 2012, injury was a minor musculoligamentous strain/sprain that would have resolved within a period of 8 to 12 weeks.  He agreed with Dr. Jhanjee that the February 2012 injury was not a substantial contributing factor to her continuing low back complaints and opined that none of the medical treatment after May 17, 2012, was related to the reported work injury, and that the employee could work in a very light-duty capacity, but that the restrictions were not due to her work injury.

In May 2014, Dr. Richard Salib at ILBNC saw the employee for SI joint evaluation.  SI joint injections resulted in 85% to 90% relief of pain for several hours.  Stress tests to the SI joints including distraction, compression, hyperflexion, and direct compression of the scrum reproduced pain.  In Dr. Salib’s opinion, “[a]ll signs seem[ed] to point to SI joint disease secondary to the fall occurring February 2012.”  (Ex. J.)  The doctor recommended diagnostic medial nerve branch blocks and took the employee off work indefinitely.  On May 23, 2014, Dr. Salib stated the medial branch blocks did not provide nearly as good pain relief as the SI joint injections.  Dr. Salib opined the employee’s current problem was related to SI joint pain and instability with marked synovitis of the SI joint on the right, and recommended a right-sided SI joint fusion.

The employee filed a claim petition on November 14, 2012, seeking temporary total disability benefits after September 20, 2012, payment of medical expenses, and rehabilitation benefits.  The employer and insurer denied liability for further benefits.  The case was heard by a compensation judge on June 3, 2014.  By Findings and Order served and filed August 8, 2014, the compensation judge found that the employee sustained an injury to her SI joints and a permanent aggravation of her preexisting lumbar spine condition; the medical care provided to the employee, including the hardware removal surgery, was reasonable and necessary; the employee cooperated with the rehabilitation plan created by QRC Bohlke and any job search would have been futile due to the effects of the employee’s work injury; and the employee was entitled to temporary total disability benefits from October 13, 2012, through the date of hearing.^[6]  The employer and insurer appealed.

On appeal, 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.”  Minn. Stat. § 176.421, subd. 1 (2014).  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.”  Hengemuhle v. Long Prairie Jaycees, 358 N.W.2d 54, 59, 37 W.C.D. 235, 239 (Minn. 1984).  Where evidence conflicts or more than one inference may reasonably be drawn from the evidence, the findings are to be affirmed.  Id. at 60, 37 W.C.D. at 240.  Similarly, 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 evidence or not reasonably supported by the evidence as a whole.”  Northern States Power Co. v. Lyon Food Prods., Inc., 304 Minn. 196, 201, 229 N.W.2d 521, 524 (1975).

“[A] decision which rests upon the application of a statute or rule to essentially undisputed facts generally involves a question of law which [the Workers’ Compensation Court of Appeals] may consider de novo.”  Krovchuk v. Koch Oil Refinery, 48 W.C.D. 607, 608 (W.C.C.A. 1993).

The employer and insurer argue that substantial evidence does not support the compensation judge’s finding that the February 17, 2012, injury was a substantial contributing cause of a permanent aggravation to the employee’s preexisting lumbar spine condition and resulted in an injury to her SI joints.  They assert the facts relied upon by the employee’s medical experts and the compensation judge were “inaccurate, incorrect and wrong.”  (Appellant’s Brief at 13.)  The appellants contend specifically that Drs. Wengler, Damergis, and Pinto incorrectly believed the employee had good relief from the 1997 surgery, was symptom free after the lumbar fusion, and was asymptomatic until the February 2012 fall.  The employer and insurer also cite testimony from the employee indicating that her memory is not good and that she would not dispute medical records if there was evidence showing that she had problems with her low back before her injury.

The compensation judge, however, specifically found the employee’s testimony to be credible (finding 3), and found she “experienced significant relief from the surgery” and “was able to work without restrictions” following the 1997 surgery.  (Finding 4.b.)  Assessment of a witness’s credibility is the unique function of the trier of fact.  In reviewing the findings of a compensation judge, the Workers' Compensation Court of Appeals must give due weight to the compensation judge's opportunity to judge the credibility of the witnesses.  Even v. Kraft, Inc., 445 N.W.2d 831 (Minn. 1989); Brennan v. Joseph G. Brennan, M.D., P.A., 425 N.W.2d 837, 839‑40 (Minn. 1988).

No evidence was submitted of any treatment to the back for six years following the 1997 surgery.  Between 2003 and 2008, the employee received chiropractic treatment primarily to the neck and upper back.  The employee changed chiropractic clinics in November 2008, and received chiropractic care between 2008 and 2012 for the entire back including the lumbar region.  Most of the chiropractic records contain little specific detail regarding complaints, findings, or treatment.  There is no documentation of radicular symptoms into her lower extremities.  The compensation judge acknowledged the employee received ongoing chiropractic care, including treatment at Meridian Disc Institute during this time, but concluded the care was primarily in the form of maintenance and did not address acute symptoms.  The record further reflects employment without restrictions through the date of the injury.  Upon review of the record, we cannot conclude the compensation judge’s finding that the employee’s preexisting lumbar spine condition was asymptomatic prior to the 2012 injury is clearly erroneous and contrary to the evidence.

The employer and insurer further argue the employee could not have sustained an SI joint injury in February 2012 as there was no SI joint diagnosis until almost two years later, when the employee began treating with Dr. Salib.  They additionally point to her December 12, 2013, appointment with Dr. Pinto in which the employee reported 60 to 70% relief following sacrococcygeal region injections, but stated she felt the majority of her pain was further up her back.

Following referral to Dr. Pinto at ILBNC for surgical evaluation, and the September 2013 hardware removal surgery, the employee reported to Dr. Damergis and to Mr. Robinson, PA-C at ILBNC, improved, but not eliminated, low back pain.  She additionally reported difficulty sitting and tailbone pain.  On November 13, 2013, Mr. Robinson noted the employee’s tailbone pain seemed to be an ongoing issue, and ordered coccyx x-rays and a coccyx injection to determine whether the tailbone was a factor in the employee’s continuing low back pain.  Sacrococcygeal region injections on December 3, 2013, provided 60 to 70% relief.  Although the employee did not think that was where the pain was coming from, Dr. Pinto disagreed, stating it was possibly a real diagnostic effect, and ordered an MRI scan of the sacrum and coccyx.  The December  17, 2013, scan showed signal changes within the sacral components of both SI joints, right greater than left, indicative of ongoing bilateral degenerative sacroiliitis.  In May 2014, Dr. Richard Salib at ILBNC saw the employee for evaluation of her SI joints.  SI joint injections provided significant temporary relief, and stress tests to the SI joints including distraction, compression, hyperflexion, and direct compression of the scrum reproduced pain.  In Dr. Salib’s opinion, “[a]ll signs seem[ed] to point to SI joint disease secondary to the fall occurring February 2012.”  (Ex. J.)  There is sufficient evidence in the record as a whole to support the compensation judge’s finding that the employee suffered an injury to her SI joints as a result of the February 17, 2012, work injury.

The compensation judge accepted the opinions of Dr. Wengler and the employee’s treating physicians that the February 17, 2012, injury was a substantial contributing cause of her low back and SI joint conditions.  Dr. Wengler, Dr. Damergis, and Dr. Pinto were provided copies of the employee’s medical records, including records from the St. Cloud Hospital, Back to Health Chiropractic, and Meridian Disc Institute, a copy of the employee’s deposition, and a hypothetical set of facts.  Dr. Wengler took a history and performed an examination and Dr. Damergis and Dr. Pinto provided treatment to the employee over an extended period of time.  This level of knowledge affords adequate foundation for a doctor to render an expert medical opinion.  See Grunst v. Immanuel‑St. Joseph Hosp., 424 N.W.2d 66, 68, 40 W.C.D. 1130. 1132‑33 (Minn. 1988); Scott v. Southview Chevrolet Co., 267 N.W.2d 185, 188, 30 W.C.D. 426 (Minn. 1978).  It is the compensation judge’s function as the trier of fact to resolve the issue of causation, and the compensation judge’s choice of expert opinion was not clearly erroneous given the facts of this case.  We, therefore, affirm.

The employer and insurer maintain the compensation judge erred in finding that the employee’s medical treatment, including the hardware removal surgery, was reasonable and necessary.  They argue that Dr. Pinto recommended hardware removal, but admitted the surgery could be “rather fickle” and might not help with the employee’s problems.  The employer and insurer assert there was no suggestion prior to the procedure that it was performed for anything other than pain relief.

In June 2012, Dr. Damergis ordered an MRI scan of the lumbar spine to help diagnose the employee’s low back and right leg symptoms.  The scan was inconclusive due to hardware artifact from the previous fusion surgery.  Upon referral to ILBNC, on September 5, 2013, hardware injections were performed at the bilateral L4 and S1 pedicle screws.  The employee reported about 80% relief following the injections.  It was decided to proceed with hardware removal surgery.  Although Dr. Pinto did advise the employee the surgery could be fickle, and might not help with pain reduction as much as hoped, he further specifically noted it might lead to a better diagnosis of where the employee’s problems were coming from.  Post-surgery, the employee reported some improvement in her low back pain.  An improved image was obtained in a post-surgery lumbar MRI scan on December 17, 2013, which helped clarify the employee’s low back condition.  It was not unreasonable for the compensation judge to conclude on this record that the hardware removal surgery was reasonable and necessary to cure and relieve the effects of the February 2012 work injury.

The employer and insurer also point to incongruencies in the record, contending the employee cited other causes at times, including the motor vehicle accident, as a reason for treatment; that the employee exhibited drug-seeking behavior; and that the treating physicians lacked understanding of the long-standing continuous symptoms and non-organic basis for many of the employee’s complaints which the appellants argue led them to try and find something that was not there.  They cite to references in the records, including those from Dr. Wengler and Dr. Pinto, which tend to indicate that the physicians were having a difficult time diagnosing the employee’s condition.

The parties presented sharply differing medical expert opinions in this case.  Dr. Wengler, by report dated June 14, 2013, opined the employee’s treatment to date was reasonable and necessary to cure and relieve the symptoms resulting from the February 2012 injury, and further opined that she was in need of further diagnostic work-up.  Dr. Damergis, by report dated September 8, 2013, also opined the care provided to the employee was reasonable and necessary for diagnosis and treatment of the injuries sustained by the employee in the February 2012 accident.  Finally, Dr. Pinto on November 19, 2013, opined the surgery and treatment rendered by his office was reasonable and necessary to cure and relieve the employee’s condition resulting from the February 17, 2012, injury.  Dr. Jhanjee, on the other hand, as of September 5, 2012, did not feel the February 2012 injury was a contributing factor to the employee’s need for medical treatment, and did not feel further medical treatment was necessary.  Dr. Burton opined that none of the employee’s medical treatment after May 17, 2012, was related to her work injury.

The ultimate determination of medical causation is within the province of the compensation judge.  Felton v. Anton Chevrolet, 513 N.W.2d 457, 50 W.C.D. 181 (Minn. 1994).  The competency of a witness to provide expert medical testimony depends upon the witness’s scientific knowledge and practical experience with the issue which is the subject of the offered testimony.  Drews v. Kohl’s, 55 W.C.D. 33, 37 (W.C.C.A. 1996) (citing Reinhardt v. Colton, 337 N.W.2d 88, 93 (Minn. 1983)).  While there was considerable disagreement as to the employee’s medical condition and its causal relationship to the February 2012 incident, the employee’s medical experts were, without question, qualified to provide an opinion.  Where there is adequate foundation for the opinions adopted by the judge, this court generally upholds the compensation judge’s choice among medical experts.  See Nord v. City of Cook, 360 N.W.2d 337, 342-43, 37 W.C.D. 364, 372-73 (Minn. 1985).  The compensation judge’s finding that the employee’s medical treatment was reasonable and necessary has substantial evidentiary support, and we affirm.

The compensation judge found the employee was a qualified employee entitled to rehabilitation benefits and ordered the employer and insurer to pay for rehabilitation services in the amount claimed.  The employer and insurer argue, first, that entitlement to rehabilitation services was disputed and that QRC Bohlke, accordingly, filed a motion to intervene on March 11, 2013, seeking payment for rehabilitation services provided to the employee.^[7]  Although the QRC intervened, he did not appear at the hearing.  The employer and insurer argue that intervenors are required to personally attend and participate in scheduled hearings to ensure reimbursement issues are fairly and finally determined, citing Minn. Stat. § 176.361, Minn. R. 1415.1100, Minn. R. 1415.1250, and Sumner v. Jim Lupient Infinity, No. WC13-5639 (W.C.C.A. Apr. 3, 2014).  Accordingly, the appellants argue, as intervenor QRC Bohlke did not appear to substantiate his claim for reimbursement of rehabilitation expenses, the claim should have been denied.

Attendance by an intervenor may, however, be waived at the discretion of the compensation judge,^[8] who can assess from the status of the issues in the case and the parties’ positions whether an intervenor’s presence at the hearing is necessary for the full and fair litigation of the claim.^[9]  Sumner, id.; Aegerter v. Fairway Foods, Inc., No. WC14-5715 (W.C.C.A. Dec. 12, 2014).  In this case, the employee sought rehabilitation benefits in her Claim Petition and in a Rehabilitation Request filed on May 9, 2013, consolidated by order filed on June 17, 2013.  When an employer and insurer dispute rehabilitation services received by an employee, the employee has a right to make a claim directly for rehabilitation benefits either through a claim petition or by way of a rehabilitation request, regardless of the intervention status of any provider.  See Carlino v. Peterson Constr. No. WC04-169 (W.C.C.A. Oct. 4, 2004).  Entitlement to rehabilitation benefits was at issue before the compensation judge and was presented for determination by the employee as part of her case in chief.  (See T. at 22.)  The compensation judge properly determined the employee’s qualification for rehabilitation services and payment for services rendered.

In the alternative, the employer and insurer argue the compensation judge failed to make specific findings necessary to establish the employee was a “qualified employee” for the purposes of rehabilitation assistance.  Pursuant to Minn. R. 5220.0100, subp. 22, a qualified employee is one who is (A) precluded from engaging in the job the employee held at the time of injury; (B) cannot reasonably be expected to return to suitable gainful employment with the date-of-injury employer; and (C) can reasonably be expected to benefit from the provision of rehabilitation services.

Rehabilitation assistance is available so long as the employee is precluded from engaging in the same work that she was engaged in at the time of the injury.  Richardson v. Unisys Corp. 44 W.C.D. 199 (W.C.C.A. 1990).  Following the injury, on April 12, 2012, the employee returned to work with the employer in a light-duty capacity.  On August 14, 2012, Dr. Damergis imposed very light-duty restrictions that the employer could not accommodate, and the employee was released from work.  By March 28, 2013, Dr. Damergis took employee off work, and the employee’s doctors continued the employee off work through the date of hearing.  It would not be unreasonable, on the evidence submitted, to conclude the employee was unable to engage in her work as a CNA trainee and activity aide for the employer during the period in question.

The employer and insurer argue that the QRC did nothing to to help the employee find a job.  The employee began working with QRC Bohlke on October 8, 2012.  An R-2 rehabilitation plan completed on October 24, 2012, stated the QRC would provide medical management and vocational counseling with the goal of returning the employee to work with the date-of-injury employer.  The fact that the goal of a rehabilitation plan is to return the employee to employment with her date-of-injury employer does not automatically render the employee ineligible for rehabilitation services.  Keaveny v. Hennepin County, slip op. (W.C.C.A. June 1, 2000).  It was the employee’s desire to return to work with the employer, and she testified she believed she had not been terminated and was still employed by the employer.  (T. at 97.)  As noted previously, the employee was subject to very light duty restrictions and was then taken off work entirely during the period in question.  The compensation judge found the employee cooperated with the rehabilitation plan submitted by QRC Bohlke, and that a job search would have been futile due to the effects of the February 17, 2012, work injury.  There is adequate evidence in the record to support these findings.

Finally, the employer and insurer argue the compensation judge made no findings as to the reasonableness and necessity of the services rendered and expenses incurred by the QRC.  The appellants assert that the most the QRC did was to accompany the employee to medical appointments, send restrictions to the employer, and write reports.  Such activities, the appellants argue, are not compensable rehabilitation services.  Minn. R. 5220.0100, subp. 20, provides that medical management by a QRC includes rehabilitation services that assist communication of information among parties about the employee’s medical condition and treatment and are necessary to facilitate the employee’s return to work.  The employee submitted the QRC’s extensive rehabilitation records in support of her claims.  The records included detailed progress reports and invoices outlining the services provided and the costs incurred.  The QRC maintained “careful and meticulous records” as part of the medical management services provided to the employee (Mem. at 10), including detailed information about the employee’s appointments with her medical providers, her medical diagnosis and treatment, and the work restrictions imposed by her physicians, and provided the information to the employer and insurer on a regular basis, along with updated R-3 rehabilitation plans.  During the time the employee was released to very light duty work, the vocational goal was to return the employee to work with the employer.  After March 2013, the employee was off work.  In both instances, the QRC reasonably focused on providing medical management with the goal of enabling a return to work.  There is sufficient evidence in the record to support the compensation judge’s finding that the employee is a qualified employee entitled to rehabilitation benefits, and his order directing the employer and insurer to pay rehabilitation expenses incurred.  We, accordingly, affirm.

Finally, the employer and insurer argue the compensation judge erred in finding the employee was temporarily and totally disabled from October 13, 2012, through June 3, 2014, the date of hearing, asserting the employee was capable of, but failed to conduct, any kind of a job search.

As noted previously, the employee returned to work for the employer in a light-duty capacity on April 12, 2012.  On August 14, 2012, Dr. Damergis referred the employee for a surgical evaluation and recommended very light work duties including no lifting over 10 pounds, carrying less than 5 pounds, no pushing/pulling over 10 pounds, and no repetitive flexion or rotation.  As of September 20, 2012, the employer could not provide work within the restrictions provided and the employee was released from work.  Shortly thereafter, on October 8, 2012, QRC Bohlke commenced working with the employee.  The vocational goal was medical management and a return to work with the date of injury employer.

Dr. Damergis continued to treat the employee while awaiting approval of a surgical consultation, and extended her very light-duty work restrictions.  On March 28, 2013, Dr. Damergis stated the employee should remain off work, and the employee was kept off work by her physicians through the date of the hearing.  The compensation judge accepted the opinions of Drs. Damergis, and Pinto, noting the QRC observed the work restrictions placed upon the employee by her treating physicians and tailored the rehabilitation plan to the employee’s circumstances.  (Mem. at 10.)

From October 13, 2012, through March 27, 2013, the vocational goal was a return to work with the employer.  The employer, however, was unable to accommodate the very light-duty restrictions provided by Dr. Damergis.  The compensation judge properly awarded temporary total disability benefits for the period during which the employer had no work available within the employee’s restrictions.  See, e.g., Goss v. Ford Motor Co., 55 W.C.D. 316 (W.C.C.A. 1996).  Thereafter, the employee was taken off work altogether by her physicians, and the compensation judge concluded that, given the employee’s physical condition, a job search would have been futile.  The compensation judge’s findings are supported by substantial evidence, and the award of temporary total disability benefits is, therefore, affirmed.