The compensation judge denied the employee’s claim for workers’ compensation benefits arising out of the employee’s July 7, 2012, work injury. The employee has appealed the compensation judge’s decision.  We affirm.

Mr. Tamayo Lopez was employed by JBS/USA, LCC, at its pork processing plant in Worthington, Minnesota, on July 7, 2012.  Mr. Tamayo Lopez was working on the kill floor and was injured when a co-worker accidentally cut his left hand as he was moving a hog carcass.

The employee was treated after the incident by Dr. R. Peter Thompson at Sanford Worthington Medical Center.  Dr. Thompson diagnosed a complex laceration to the thenar area of the employee’s left hand. Dr. Thompson concluded there was no nerve damage and only a mild laceration of the underlying muscle.  The wound was sutured and Dr. Thompson prescribed an antibiotic and pain medication.  The employee was instructed to return in 10 days for suture removal and he was released to light duty work.  The employer and its insurer, Zurich American Insurance Company, accepted liability for the work injury.

On July 9, 2012, Mr. Tamayo Lopez went to Avera McGreevy Clinic in Salem, South Dakota.  He stated that when he had returned to work, he had been placed on the kill floor again and that he was concerned about infection and pain control.  He was given work restrictions not to use his left hand until the sutures were removed and the wound was healed.

On July 13, 2012, Mr. Tamayo Lopez went to the walk-in clinic at Sanford Orthopedic and Sports Medicine in Sioux Falls, South Dakota, where he saw Physician’s Assistant Ryan Slaba.  The employee told PA Slaba that he had some numbness and tingling in his thumb and wanted him to check the incision site.  PA Slaba stated that the wound site looked good and recommended occupational therapy for range of motion exercises.  The employee was also told to follow up with Dr. Robert Van Demark.  The employee continued to work at the employer’s plant on a light duty basis.

Dr. Van Demark saw Mr. Tamayo Lopez on July 19, 2012.  In his examination, Dr. Van Demark noted a laceration 8 cm long that was clean and dry.  Dr. Van Demark removed the sutures and prescribed occupational therapy for motion improvement and strengthening.  Dr. Van Demark also commented that “I did discuss the possibility of CRPS in this setting.”  The employee was taken off work.

Mr. Tamayo Lopez returned for a follow-up examination on July 26, 2012.  Dr. Van Demark found dramatic improvement in the thumb but noted that the employee continued to complain of pain and numbness in his thumb.  A release to light duty work was given and Elavil for night time use was prescribed.

The employee was evaluated at the request of the employer and insurer by Dr. Gary Wyard on August 24, 2012, and he issued his report of his evaluation on August 30, 2012.  The employee’s chief complaints at the time of the evaluation were of pain in his hand as well as symptoms going up into his arm and chest wall with what the employee described as heart palpitations.  The examination was normal except for “decreased sensation over the dorsum of the thumb.”  Dr. Wyard also reviewed the employee’s medical records before providing his conclusion.  Dr. Wyard stated in his report that the employee’s medical treatment up to the date of the evaluation had been appropriate but that no further treatment for the work injury was necessary.  Dr. Wyard also concluded that Mr. Tamayo Lopez did not have complex regional pain syndrome, did not have any permanent partial disability, and was able to work without restrictions.

The employee continued to see Dr. Van Demark.  After a visit on September 4, 2012, Dr. Van Demark continued the work restrictions he had provided previously.  In October, Dr. Van Demark referred Mr. Tamayo Lopez for physical therapy and occupational therapy because of the employee’s complaints of left shoulder pain. The employee last saw Dr. Van Demark on November 12, 2012.  As that time, he gave a history of pain in his hand, left shoulder, neck, and left leg.  He also reported difficulty sleeping because of pain.  Dr. Van Demark recommended a functional capacities evaluation (FCE) to set restrictions and an appointment at the Spine Center for neck and shoulder pain.

The employee consulted with Dr. Jorge Inga, a neurologist surgeon in Tampa, Florida, on May 2, 2013.  The employee reported pain, tingling, and numbness affecting his left hand and arm since the July 7, 2012, work injury.  He also said that he had pain going down into the base of his neck extending into his dorsal and lumbar spine as well as pain in his gluteal area and both legs.  Mr. Tamayo Lopez told Dr. Inga that he had immediate sharp pain in his left shoulder at the time of the incident and was unable to move his fingers for several weeks.  Dr. Inga diagnosed “traumatic neurotmesis” involving the radial nerve of the left hand and “early reflex sympathetic dystrophy of the left upper extremity.”  The employee was referred for an EMG and was prescribed Pregabalin.

Dr. Bradley Helms performed an independent medical examination on June 20, 2013.  The employee’s recitation of his symptoms was essentially the same as he provided to Dr. Inga.  Dr. Helms reviewed the employee’s medical records and a surveillance video taken of the employee on January 10 and 11, 2013.  In his report dated July 31, 2013, Dr. Helms diagnosed the July 7, 2012, work injury as a “left hand laceration over the dorsal aspect of the left thumb” with some residual numbness and decreased sensation.   Dr. Helms stated that none of the employee’s other symptoms were related to the work injury and that a diagnosis of complex regional pain syndrome or reflex sympathetic dystrophy was not supported by the diagnostic criteria for those conditions.  Dr. Helms’ opinion was that no further treatment for the work injury was necessary and that the employee could work without restrictions.

Litigation in this matter started with a claim petition filed by the employee, then represented by an attorney, in October 2012. The claim petition sought wage loss and other benefits.  The employee’s attorney withdrew from representation in January 2013.   Amended Claim Petitions were filed by the employee’s new attorney in April 2013 but were stricken from the calendar in September 2013 by the employee’s attorney who withdrew from representation in July 2014.  The employee, now representing himself, filed an Amended Claim Petition in January 2015, as well as a request for a formal hearing on the issue of his entitlement to rehabilitation services.  The employer and insurer had previously filed a request for a hearing on the issue of the employee’s request for a functional capacities evaluation.  These various pleadings were consolidated and were heard by Compensation Judge Bradley Behr on March 18, 2015.

At the hearing, the issues that were identified to be decided were:

The compensation judge issued his Findings and Order on April 2, 2015.  With respect to the issues identified for decision, the compensation judge determined:

The employee has appealed the compensation judge’s decision.

In reviewing cases 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.  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, “[f]actfindings are clearly erroneous only if the reviewing court on the entire evidence is left with a definite and firm conviction that a mistake has been committed.”  Northern States Power Co. v. Lyon Foods Prods., Inc., 304 Minn. 196, 201, 229 N.W.2d 521, 524 (1975).

In his appeal, Mr. Tamayo Lopez raises a number of issues, not all of which are related to his workers’ compensation claim.^[1]  This review will deal with the employee’s workers’ compensation claims only.

An employee is entitled to workers’ compensation benefits when the injury arises out of and in the course of employment.  In the event of a dispute concerning a work injury or benefits arising from that injury, an employee has the obligation or burden of proof in establishing entitlement to those benefits by a preponderance of the evidence.  Minn. Stat. § 176.021, subd. 1.

The major dispute at the hearing was the nature of the injury and the extent or consequences of that injury.  The employee claimed that the knife cut his thumb to the bone, damaging or severing his radial nerve.  The employee alleges that as a result of the injury he has pain in his left arm, shoulder, chest, neck, back and legs as well as reflex sympathetic dystrophy or complex regional pain syndrome.  To establish a causal relationship or connection between a work injury and a medical condition in medically complex cases, a medical opinion with proper foundation is necessary.  Westling v. Untiedt Vegetable Farm, slip op. (W.C.C.A. April, 29, 2004).  Foundation means that the doctor has sufficient information of the case to express a knowledgeable opinion.  Wiggin v. Marigold Foods, No.WC04-136 (W.C.C.A. July 29, 2004).  The only medical opinion that may be read as supporting the employee’s claim is that of Dr. Inga who saw Mr. Tamayo Lopez in May 2013.  However, it is clear that Dr. Inga did not review any of the extensive medical records in this case.  Further, the history he took that the employee was unable to move his fingers for several weeks is contrary to all of the employee’s medical records.  Dr. Inga’s opinion, that there was a traumatic neurotmesis or severing of branches of the superficial radial nerve as well as early onset of reflex sympathetic dystrophy, is disputed by all of the other doctors who have treated or evaluated the employee.

When there is a dispute in the medical opinions on a case, the compensation judge is expected to consider those opinions and accept the opinion that the judge finds most persuasive.  In reviewing the compensation judge’s decision, this court must defer to the compensation judge’s choice of medical opinions if the doctor expressing the opinion has sufficient information to provide foundation.  Smith v. Quebecor, 63 W.C.D. 566 (W.C.C.A. 2003).

The compensation judge in this case relied on the records of Dr. Thompson, the records of Sanford Orthopedic, the records from McGreevy Clinic, the opinion of Dr. Wyard, and the opinion of Dr. Helms.  All of the records and all of those doctors agree that the left hand cut was superficial and that there was no injury to the radial nerve that would cause the symptoms the employee claims.  In addition, Dr. Wyard and Dr. Helms stated that the injury had healed with no disability, no need for work restrictions, and no need for further treatment.  As would be expected, the employee does not agree with these opinions, but the compensation judge accepted them and they are consistent with the medical records from the providers the employee saw in the months after the injury.

The compensation judge concluded that “the preponderance of the evidence demonstrates that he sustained a laceration of the left hand that did not involve the tendons or nerve and which had fully resolved by the time he saw Dr. Helms on June 20, 2013.”  We find that the compensation judge’s conclusion is amply supported by substantial evidence and we affirm the compensation judge on this point.

The employee claims he is entitled to payment of permanent partial disability for his injury.  Permanent partial disability is payable for loss of use or function resulting from the work injury.  Minn. Stat. § 176.021, subd. 3.  The compensation judge concluded, and we affirm, that the employee’s hand injury fully resolved by June 20, 2013.  Since there is no loss of function from the work injury, no permanent partial disability is payable.

Dr. Thompson, who saw the employee on the date of injury, released the employee to light duty work and restricted only the employee’s use of his left hand.  The employee worked light duty at the employer’s plant through August 30, 2012.  Dr. Van Demark placed work restrictions on the employee that were consistent with his light duty assignment.  Based on the independent medical evaluation of Dr. Wyard on August 24, 2012, the employer offered the employee full-time regular work.  The employee rejected the job offer and stopped working for the employer.  The employee claimed at the hearing that he was entitled to temporary total disability or permanent total disability benefits from August 30, 2012, and continuing.

To be entitled to benefits for temporary total disability, an injured employee must demonstrate that he is able to work only with restrictions that preclude the employee’s usual employment and must show that he has tried to find replacement employment through a diligent search for suitable work.  Redgate v. Sroga’s Standard Service, 421 N.W. 2d 729, 40 W.C.D. 948 (Minn. 1988).

Mr. Tamayo Lopez presented no evidence that he tried to find work within his restrictions after August 30, 2012.  There was some testimony by the employee that between October and December 2012 he worked for a cleaning service but no further information concerning this employment was provided.

Given the evidence presented at the hearing, we conclude the compensation judge was correct in denying the employee’s claim for temporary total disability benefits based on the employee’s failure to demonstrate an adequate job search.

Permanent total disability compensation is to be paid when an injured employee is no longer able to engage in any type of sustained gainful employment that might be available in the labor market.  Minn. Stat. § 176.101, subd. 5.  For an employee younger than 50 years old on the date of injury, a minimum of 17% permanent partial disability is required to be eligible for permanent total disability benefits.  Mr. Tamayo Lopez was 35 years old on the date of injury.  There is no rating of permanent partial disability in evidence.

Further, since the compensation judge found that the work injury healed without any ongoing disability as of June 20, 2013, no award of wage loss benefits after that date would be appropriate.

Dr. Van Demark recommended a functional capacities evaluation when he saw the employee in November 2012.  At that time, the employee was complaining of pain in his left hand, shoulder, neck, and left leg.  The requested functional capacities evaluation was the subject of an administrative conference in which the evaluation was awarded.  The employer and insurer requested a formal hearing on the issue and the compensation judge considered the employee’s claim at the hearing.  The compensation judge denied the functional capacities evaluation.

A functional capacities evaluation may be appropriate to determine employment restrictions following a work injury.  However in the present case, the compensation judge determined that the employee’s injury resolved without any continuing disability by June 20, 2013.  Since the injury has healed without restrictions, there is no reason for a functional capacities evaluation.  The compensation judge’s denial is affirmed.

Vocational rehabilitation is intended to return an injured worker to the economic status the employee would have had but for the work injury.  Minn. Stat. § 176.102.  To be eligible for rehabilitation services, an employee must demonstrate that he or she is precluded from returning to their usual employment because of a work injury.  Minn. R. 5220.0100, subp. 22.  Mr. Tamayo Lopez had to prove at the hearing that his left hand injury prevented him from doing his regular job at JBS, but the compensation judge found the employee’s injury healed without restrictions.  Since there are no restrictions on the employee’s use of his left hand, the employee would be able to do his usual job.  The compensation judge properly found that the employee was not entitled to rehabilitation services.

The compensation judge concluded that the employee failed to establish by preponderance of the evidence that he was entitled to workers’ compensation benefits.  We find the compensation judge’s decision is supported by substantial evidence and we affirm the decision of the compensation judge.