The employee has appealed the compensation judge’s finding that his admitted work injury of August 27, 2012, was temporary and has since resolved, and is not a substantial contributing factor to his current condition.  We affirm.

On August 27, 2012, Kevin Weldon was working for Fahey Sales Agency, Inc., assisting with the setup of auctions.  While preparing for an auction on August 27, 2012, the employee injured his low back as a result of slipping while standing on a scissor-lift as he was washing the ceiling and walls of a building to be used for an upcoming auction.  He felt an immediate sharp pain in his low back on the right side.  This work injury was admitted and benefits were paid.

Following the injury, the employee was seen by his primary care physician, Dr. John Beithon at Lakeview Clinic.  During a visit with Dr. Beithon on September 5, 2012, the employee reported pain in the low back, but no radiating pain down the legs.  He was treated with physical therapy, pain medication, and a TENS unit.  Dr. Beithon released the employee to return to light duty work on October 10, 2012.  Ultimately, the employer could not accommodate the employee’s physical restrictions and he was let go.

The employee was seen by Dr. Edward Szalapski at Mayo Clinic-New Prague on November 2, 2012.  He reported a long-term history of back problems with intermittent episodes of back, buttock, and lower extremity pain.  Dr. Szalapski diagnosed degenerative disc disease.  The employee continued to treat with Dr. Szalapski, who in February 2013 ordered a lumbar spine MRI scan.  After review of the MRI findings, Dr. Szalapski determined that the employee was not a surgical candidate, recommended an epidural steroid injection, and issued lifting restrictions of no more than ten pounds.  The epidural injection did not provide relief.

The employee was seen on May 9, 2013, by Dr. Manuel Pinto at Twin Cities Spine Center.  Dr. Pinto opined that the employee suffered from mechanical low back pain and disc degeneration and was not a surgical candidate.  Both Dr. Pinto and Dr. Szalapski recommended that the employee participate in a MedX program.  The employee did so, and testified that he had good results.

On January 7, 2014, the employee returned to Dr. Pinto with complaints of low back pain and bilateral buttock pain with occasional radiation into the thighs.  Thereafter, the employee underwent a series of lumbar facet joint and nerve blocks, beginning January 22, 2014.  He reported limited, if any, relief, and complained that the blocks had worsened his symptoms.

The employee was seen on May 5, 2014, by Dr. Barbara Seizert of Courage Kenny Rehabilitation Associates, who believed that the employee’s muscles were the source of his pain and recommended pool therapy.  She ultimately diagnosed the employee with degeneration of the lumbar or lumbosacral intervertebral disc, low back pain radiating to both legs, lumbar facet syndrome, and chronic pain syndrome.  On October 27, 2014, she offered an opinion that the employee was permanently unable to work.

On November 17, 2014, the employee again complained of ongoing low back symptoms to Dr. Beithon.  Dr. Beithon’s office note stated there were incongruities with respect to the employee’s back situation, and that it was hard to define which of his symptoms related to the work injury.

The employee had suffered low back injuries and symptoms before the August 27, 2012, work injury.  In the late 1970’s, the employee was involved in a motor vehicle accident resulting in significant injury to his neck, as well as lumbar strain residuals.  On October 4, 1995, the employee was seen by Dr. Beithon for a general exam and reported back pain.  As of January 10, 1996, he reported low back discomfort for the last two months.  At that time, Dr. Beithon noted that the pain was in the central lumbosacral region with some radiating pain to the sides, and physical therapy was recommended.  Physical therapy for the low back was again recommended by Dr. Beithon in June 1998.

The employee suffered a work-related injury to his low back on March 5, 2001, when he slipped and fell while shoveling ice off a roof for a car dealership.  He reported immediate pain in his lower left back and tingling throughout his entire right leg.  He was released with work restrictions of no heavy lifting, bending, or twisting for two days, and was prescribed pain medication.  Dr. Beithon recommended physical therapy and ongoing restrictions related to lifting, bending, twisting, and climbing.

On April 9, 2003, the employee presented at Lakeview Clinic with complaints of low back pain.  X-rays were taken and showed narrowing of the vertebral interspace and mild to moderate degenerative changes at the L5-S1 level.  Mild degenerative changes were also shown at T12-L1.

The employee again injured his low back at work on January 22, 2004.  While getting out of a vehicle, the employee felt sudden and severe pain in his low back, as well as a little bit of pain going down into the right buttock.  Dr. Beithon was of the opinion that this was a ligamentous tendon strain type of injury and prescribed pain medication.  The employee was released to work without restrictions on March 1, 2004, and on June 23, 2004, Dr. Beithon considered the employee to be at MMI.  Dr. Beithon noted an expectation that the employee would have some chronic low back strain symptoms, rated the lumbar strain at 3.5% pursuant to Minn. R. 5223.0070, subp. 1.A.(2), recommended continued use of the TENS unit, and provided four-month work limitations of no lifting of more than 80 pounds, and avoid lifting more than 15 pounds while bending.

In November 2006, the employee was involved in another motor vehicle accident, resulting in complaints of neck, mid, and low back pain.  No radicular symptoms were reported, but tenderness in the lumbosacral spine and musculature and bilateral SI joints was noted upon examination.  He was diagnosed with thoracic and lumbar sprain/strain and referred to physical therapy.  He was examined by Dr. Beithon on January 25, 2007, and demonstrated stiffness but full range of motion.  By February 22, 2007, he was reporting no progress and pain from any activity sustained for longer than five minutes.  An MRI showed a  far lateral disc protrusion at left L3-4 which might impinge the left L3 root, as well as mild degenerative disc disease with posterior disc bulge and dorsal annular fissuring at L5-S1.  Dr. Beithon referred the employee for injection therapy and on March 26, 2007, and April 25, 2007, the employee underwent lumbar epidural steroid injections at CDI.  The employee reported being 50% better as of June 2007.

The employee’s complaints of ongoing low back pain persisted through 2007 and into 2008.  He reported to Dr. Beithon that he was treating with a chiropractor which he found helpful.  He continued to have difficulty performing chores and activities.  Dr. Beithon assessed ligamentous stiffening and inflammatory process as a result of the 2006 motor vehicle accident and recommended a back strengthening program.  Worsened low back symptoms were reported on January 7, 2009.  In an August 17, 2009, note, it was recorded that the employee’s back pain bothered him extensively, and on October 13, 2009, he reported that he had been in a lot of pain.

On May 27, 2010, the employee was seen by Dr. Beithon with complaints of persistent back pain.  He reported that driving required the use of a pillow and that he also used one under his legs at night.  Upon examination, pain and tenderness were noted at L3-4, as was limited flexion and extension, and minimal lateral movement.

The employee was seen for diagnostic testing at Scott County Mental Health Center on August 7, 2012.  According to the assessment, the employee reported back pain as a physical disability and noted his history of a broken neck and hurt back 30 years ago.  Within a few weeks of this assessment, the employee slipped and hurt his low back while working for the employer on August 27, 2012.

The employee was evaluated by Dr. John Dowdle on three occasions. Before his first evaluation on April 1, 2013, Dr. Dowdle only reviewed medical records for treatment after the August 27, 2012, work injury.   The employee complained of low back and bilateral leg pain, and upon examination, Dr. Dowdle noted tenderness in the low lumbar area and limited extension with complaints of pain.  Dr. Dowdle assessed mechanical low back pain with facet inflammation and degenerative disc disease at multiple levels.  He opined that the employee had pre-existing degenerative disc disease and degenerative facet disease, and that the August 27, 2012, work injury caused an irritation/inflammation of the facet joints.  It was his opinion that the employee had not yet reached maximum medical improvement (MMI), that he required lifting and activity restrictions, and recommended medial branch blocks and potential radiofrequency facet denervation.  Dr. Dowdle further opined that the employee’s aggravation would resolve with proper care and he would be able to return to work without permanency.

Dr. Dowdle again examined the employee on October 28, 2013.  Additional recent treatment records were reviewed.  It remained Dr. Dowdle’s opinion that on August 27, 2012, the employee suffered an aggravation of his pre-existing degenerative condition and that this condition would resolve with proper care.  Dr. Szalapski had disagreed with Dr. Dowdle’s recommendation for radiofrequency ablation, and in his report, Dr. Dowdle outlined how he believed his treatment recommendations could result in a decrease in the employee’s symptoms and aid in his eventual return to work.  Exercises and strengthening were not recommended until the employee’s pain was decreased.  Dr. Dowdle considered the employee’s facet joint inflammation to be causing limitations, but were treatable and not severe.  Dr. Dowdle also noted that upon completion of his recommended treatment options, the employee should undergo a functional capacity evaluation to determine the appropriate restrictions for his return to work.

Dr. Dowdle’s third and final evaluation of the employee took place on August 4, 2014.  His August 18, 2014, report outlines medical records reviewed dating back to January 1996, as well as recent treatment records.  At the time of the evaluation, the employee was still symptomatic with back and bilateral leg pain and was undergoing a home exercise program with physical therapy twice per week, as well as pool exercises.  With his review of records that pre-dated the employee’s work injury, Dr. Dowdle noted that the employee’s low back condition was chronic and that various treatment methods had been tried over the years.  He concluded that there was no evidence of structural change following the work injury and that the August 27, 2012, work injury was a temporary aggravation of his pre-existing condition.  It was Dr. Dowdle’s opinion that while the employee was capable of gainful employment, he was not currently able to lift 30 pounds as he had been doing at his job for the employer.  His need for lifting and activity restrictions were based upon his underlying condition and not a result of the work injury.  Dr. Dowdle opined that the employee had reached MMI for the work injury as of January 22, 2014, but had not reached MMI for his current low back condition.  With regard to the employee’s low back condition, which Dr. Dowdle considered pre-existing and not causally related to the work injury, he rated a 10% permanent partial disability pursuant to Minn. R. 5223.0390, subp. 3.C.(2).  No permanent injury was sustained as a result of the August 27, 2012, work injury.  He recommended that the employee be evaluated for a chronic pain program, but reiterated that any need for this treatment was not related to the temporary aggravation of August 27, 2012.

The employee claimed to be permanently and totally disabled as a result of the August 27, 2012. work injury.  Because he was 53 years old at the time of the injury, the relevant permanent partial disability threshold was 15% which the employee claimed to meet with a combination of 4% from his cervical fracture, 2% from an ankle fracture and surgery, and the 10% rating provided by Dr. Dowdle.  The matter was heard by Compensation Judge Bouman on December 15, 2014.  In her Findings and Order dated March 23, 2015, the compensation judge denied the employee’s claims and found that the employee’s August 27, 2012, injury to his low back was temporary, had resolved, and was not a substantial contributing factor to his current condition.  The employee appeals this determination.

In denying the employee’s claim, the compensation judge adopted and relied upon the opinion of Dr. Dowdle.  In particular, the compensation judge found that the employee’s work injury of August 27, 2012, was temporary, had resolved, and was not a substantial contributing cause of his current condition.

The employee argues that because the compensation judge’s findings rely solely on the opinion of Dr. Dowdle, she therefore erred in disregarding the other factors set forth in Wold v. Olinger Trucking, Inc., slip op. (W.C.C.A. Aug. 29, 1994).^[1]  This argument is not persuasive.  This court is to give deference to a compensation judge’s determination of which factors are significant and the weight to be given to the factors.  Id.  In deciding whether an injury is a permanent or a temporary aggravation, the compensation judge is not required to address each of the factors.  Johnson v. Micro Control Co., No. WC10-520 (W.C.C.A. June 2, 2011).

The employee also argues the compensation judge’s finding that the employee’s injury has resolved goes beyond the opinion of Dr. Dowdle, and has no support in the record.  At oral argument, counsel for the employee cited to Harvey v. Central Lutheran Church, 73 W.C.D. 369 (W.C.C.A. 2013) in support of his request for reversal on this issue.  In Harvey, this court reversed the compensation judge’s finding that the employee’s injury was temporary and had resolved.  The compensation judge’s findings were premised upon the independent medical examiner’s opinion that the employee would have reached maximum medical improvement within six weeks of the injury.  Upon review, this court could find no support for a six-week resolution timeline, and distinguished the issue of maximum medical improvement from a determination of whether an injury was temporary and resolved.

The opinions of Dr. Dowdle do not explicitly state that the employee’s work injury of August 27, 2012, had resolved.  In his August 18, 2014, report, Dr. Dowdle concluded that the employee has an underlying degenerative condition and that the August 27, 2012, injury was a temporary aggravation of that condition.  He further concluded that the August 27, 2012, temporary aggravation was not a substantial contributing factor to the employee’s current and ongoing degenerative back condition.  According to Dr. Dowdle, the employee had reached maximum medical improvement with regard to the August 27, 2012, injury as of January 22, 2014, and as of January 22, 2014, any need for ongoing work restrictions and medical treatment were no longer causally related to the August 27, 2012, injury.  While his opinion does not specifically state that the August 27, 2012, temporary aggravation had resolved, read in its entirety, it is clear that Dr. Dowdle considered January 22, 2014, to be the date of resolution of the work injury.  Certainly, had he considered the employee’s temporary aggravation to have been unresolved after January 22, 2014, he would not have opined that causation had ended as of that date.  Unlike Harvey, the compensation judge’s finding that the employee’s temporary aggravation had resolved is supported by opinions rendered by Dr. Dowdle beyond merely maximum medical improvement.

Finally, the employee argues that the compensation judge’s reliance upon the opinion of Dr. Dowdle was improper because of alleged inconsistencies in his reports.  Specifically, the employee states that Dr. Dowdle’s third and final report focuses on an absence of structural change in the lumbar spine following the August 27, 2012, injury, rather than facet inflammation and irritation as were discussed in his prior reports.  Dr. Dowdle identified January 22, 2014, as the date upon which the employee had reached MMI for the work injury, and upon which any need for ongoing restrictions and medical treatment could not be causally linked to the work injury.  On January 22, 2014, the employee underwent medial branch blocks with no relief.  Instead, the employee reported an exacerbation of symptoms following that treatment.  Prior to his third and final examination, Dr. Dowdle had not reviewed treatment records with regard to the employee’s pre-existing low back problems.  At that time, Dr. Dowdle recommended medial branch blocks to identify the source of the employee’s pain and to reduce his symptoms.  It is reasonable for Dr. Dowdle to have considered the lack of efficacy of the January 22, 2014, medial branch block, coupled with a more complete understanding of the nature of the employee’s pre-existing condition and prior treatment efforts, and to have concluded that the August 27, 2012, work injury was a temporary aggravation and was no longer a substantial contributing cause to his current condition.  Substantial evidence in the record supports the compensation judge’s choice of expert opinion, and her reliance on those opinions in denying the employee’s claim.  See, Nord v. City of Cook, 360 N.W.2d 337, 37 W.C.D. 364 (Minn. 1985).