TIFFANY TORGUSSON, Employee/Appellant, v. LUTHERAN SOC. SERVS. and SFM RISK SOLUTIONS, INC., Employer-Insurer/ Respondents.

The employee appeals from the compensation judge’s determination that her work injury was temporary and resolved by September 15, 2015. We affirm.

The employee, Tiffany Torgusson, was hired by the employer in May 2015 as a house coordinator at the Deer Valley House, a facility for physically and mentally handicapped adults. Most of her work was administrative but she was also involved with direct patient care.

On July 21, 2015, the employee was providing care to a patient who was paralyzed from the chest down. Getting the patient dressed required rolling him from side to side on his bed. As the employee was bending over and doing so, she felt a strain or pull in her lower back. The employee reported the incident to her employer but did not go to a doctor. In August, the employee accompanied the same resident on a trip to Duluth. While providing care to him and bending over, the employee again experienced an onset of low back pain on her right side. She notified her supervisor of the incident.

The employee has a history of treatment for low back problems going back to 2007. The employee had a work related low back injury in May 2008 when she was working in a nursing home. She had helped lift a patient at work and had low back pain. An MRI in July 2008 was interpreted as showing mild posterior disc bulging at L5-S1. Her provider at that time, Dr. Robert Vennerstrom, concluded the employee had a “lumbar strain with some nerve root irritation, L5-S1 secondary to bulging disc.” The employee treated extensively for low back problems between 2008 and 2013. During that time, she received seven low back injections, three medial branch injections, and a radio frequency ablation. The employee did not work at all between 2009 and 2013 because of chronic low back pain.

Following the August 2015 incident, the employee sought care on August 18, 2015, at Lake Regions Healthcare when she saw Sheryl Olson, a certified nurse practioner. The employee presented with complaints of pain at the level of her waist that went down her posterior right leg to the knee. Examination showed decreased range of motion, no tenderness along the spine, and good bilateral straight leg raising. The diagnosis at that time was low back strain and permanent disability was felt not to be likely. Physical therapy and medication was recommended as treatment. In a workability form, the employee was allowed to work with no lifting over 10 pounds.

The employee continued to work on a light duty status with the employer until December 2015. At that time she was taken off work as of December 14, 2015, to “rest her back.” An MRI was done on December 11, 2015, and was read as showing “very mild progression of disc desiccation and diminished height at L4-5 level.” Treatment consisted of “icing, stretching, taking Flexeril and Percocet only as needed.” No improvement was noted in subsequent visits and the employee was never released to return to work during the pendency of her claim. An epidural steroid injection was done on January 18, 2016, and in follow-up on January 25, it was noted “no pain relief, may be slightly less right leg pain but still tingling into toes.”

Dr. John Hutchison at Sanford Neuroscience Clinic saw the employee for a surgery consultation on May 10, 2016. His impression of the employee’s condition was “chronic low back pain, right SI pain, some foraminal stenosis L4-5 and L5-S1 on right but radicular symptoms are only a small part of clinical picture.” Surgery was not advised. Dr. Hutchison recommended physical therapy and SI joint injections on the right.

At the request of the employer and insurer, the employee was evaluated by Dr. David Carlson on April 28, 2016. In addition to reviewing medical records and taking a history from the employee, Dr. Carlson conducted a physical examination. Dr. Carlson set out his opinions in his May 10, 2016, report. He concluded that the employee “may have sustained lumbosacral spine musculoligamentous strain and certainly that would have resolved no later than eight weeks of the inception. . . . There is no objective medical evidence that the incident on July 21, 2015, resulted in any injury that would have aggravated or accelerated her lumbar spine condition beyond any normal progression.” Dr. Carlson did not believe further treatment was necessary or appropriate and also stated that no restrictions would be necessary as the result of the July 21, 2015, work injury.

The employer filed a petition to discontinue benefits which was heard by Compensation Judge Grant Hartman on August 17, 2016. In his findings and order issued September 13, 2016, the compensation judge determined that the July 21, 2015, injury was temporary and resolved by September 15, 2015. The employer’s petition was granted. In his memorandum the compensation judge referred to factors that he identified as significant in reaching his decision. He referred to the employee’s seven year history of chronic back pain, the lack of any persuasive opinions from the employee’s doctors that the employee continued to suffer from the effects of the work injury and the “credible and persuasive” opinion of Dr. Carlson.

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(3). 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).

The employee argues on appeal that the compensation judge erred in relying on Dr. Carlson’s opinion in making his decision. Specifically, the employee contends that in reaching his opinion, Dr. Carlson failed to take into consideration the results of the MRI scan which, according to the employee, demonstrated nerve root impingement in the lumbar spine and established that the employee’s work injury was more than the musculoligamentous strain diagnosed by Dr.Carlson. The implication is that since Dr. Carlson was wrong as to the diagnosis, his opinion cannot support the compensation judge’s decision.

In her brief, the employee reviews in detail comments made by various health providers in medical records and conclusions found in MRI reports or other radiologic studies. The employee argues these comments and notes establish the permanent nature of her injury. What significance may attach to these radiological notes, findings, and comments is a question for medical expertise. We note, as did the compensation judge, that there is no medical opinion that these findings are related to the employee’s work injury or have anything to do with the employee’s symptoms. Dr. John Hutchison, who saw the employee at Sanford Neuroscience Clinic, lists the following conditions under impression: “Chronic low back pain, Right SI pain, Some foraminal stenosis L4-5 and L5-S1 on right but radicular symptoms are only a small part of clinical picture, rotoscoliosis.” Dr. Hutchison does not attribute these conditions to the work injury. He does not address at any point the issue in this case: whether the employee’s work injury was temporary.

Whether the employee’s low back injury had resolved or was an ongoing condition was a question of fact for the compensation judge to resolve. In answering that question, the compensation judge looked to the medical records and to medical opinion. It is the unique function of the compensation judge to choose between competing medical opinions. Nord v. City of Cook, 360 N.W.2d 337, 37 W.C.D. 364 (Minn. 1985); Fiedler v. Home Depot, 75 W.C.D. 431 (W.C.C.A. 2015). Where the opinion chosen by the compensation judge has adequate foundation, that opinion constitutes substantial evidence to support a compensation judge’s decision and the decision will generally be accepted by this court. Smith v. Quebecor Printing, Inc., 63 W.C.D. 566 (W.C.C.A. 2003), summarily aff’d (Minn. Aug. 15, 2003); Puffer v. Precision Tune, No. WC16-5948 (W.C.C.A. Sept. 23, 2016). The compensation judge accepted and relied upon Dr. Carlson’s opinion in making his determination. Dr. Carlson provided the only expert opinion on the question of whether the employee’s injury was temporary and Dr. Carlson had adequate foundation for his opinion. The compensation judge’s decision is affirmed.