YUSUF M. AHMED, Employee/Appellant, v. LOOP PARKING CO. and SFM, Employer-Insurer/Respondents, and MINNEAPOLIS ORTHOPAEDICS, Intervenor.

The pro se employee appeals from the compensation judge’s denial of his claim for a right knee MRI and for payment of medical expenses. We affirm.

The employee, Yusuf Ahmed, suffered an injury to his right knee on January 21, 2012, while employed as a parking lot attendant.^[1] An August 1, 2012, MRI showed a lateral meniscal tear and an associated lateral and anterior parameniscal cyst.^[2] On October 23, 2012, the employee underwent an arthroscopic partial lateral meniscectomy, decompression of the parameniscal cyst, and reconstruction of the meniscus.^[3] The employee testified that he noticed a mass on the outside of his right knee after the bandages from the surgery were removed.^[4] No mass was noted on physical examination by his orthopedic surgeon, Dr. Nancy Luger, during follow-up visits.^[5]

Following the October 2012 surgery, the employee participated in physical therapy but continued to report ongoing pain.^[6] He underwent an injection in the summer of 2013 and was seen by Dr. Devanshu Kansara for a second opinion.^[7] Dr. Kansara ordered an MRI, which showed either a fluid collection or fibrous mass along the lateral meniscus, but no evidence of tearing.^[8] At an October 23, 2013, follow-up visit one-year post-op, Dr. Luger noted that upon physical examination, there was no sign of a mass. It was her opinion at that time, and again in January 2014, that the employee had exhausted all treatment options and had reached maximum medical improvement.^[9] The employee then presented to the Hennepin County Medical Center in April 2014 with complaints of ongoing pain and recent grinding in the knee.^[10] At that time, the employee was also treating for issues with his right shoulder.^[11] He did not seek further treatment for his knee until 2016.^[12] The employee was released to return to work with restrictions; however, he has not returned to work since his injury.^[13]

In 2015, the employee’s claims were settled on a full, final, and complete basis with the exception of reasonable, necessary, and causally related medical treatment to the right knee. An Award on Stipulation was issued on September 11, 2015.^[14]

On January 27, 2016, the employee sought treatment for pain in his right knee for the first time in over 18 months. The treatment note indicates improvement until a couple of months prior when his pain returned. He denied any new injury. Upon examination, a “prominence” was noted over the lateral tibial plateau and an MRI was ordered.^[15] The February 11, 2016, MRI showed an oblique tear of the lateral meniscus and what was likely a parameniscal cyst.^[16] In February 2016, the employee again participated in physical therapy.^[17]

At the request of the employer and insurer, the employee was evaluated by Dr. Thomas Nelson in 2014.^[18] In his April 28, 2014, report, Dr. Nelson opined that the employee’s injury to his right knee was minor and had resolved with the surgical repair of the meniscus tear and excision of the cyst in 2012. Upon examination, Dr. Nelson noted no effusion, no meniscal pathology, and full range of motion. Dr. Nelson issued an addendum report on December 21, 2016, with the review of updated medical records and scans.^[19] It was Dr. Nelson’s opinion that the employee’s current symptoms were caused by the mass and meniscus tear present on the 2016 MRI that are unrelated to the employee’s 2012 work injury. He noted that the employee’s 2012 surgery had repaired the tear, and no tear was present on the 2013 MRI. Accordingly, he concluded that the tear seen on the 2016 MRI scan was likely the result of a new injury and was not related to the 2012 work injury.

On January 9, 2017, the employee was seen by Dr. Douglas Becker for an evaluation of ongoing right knee pain. On physical examination, Dr. Becker noted swelling and a firm and tender mass anterolaterally in the right knee. He recommended another MRI scan so as to evaluate possible excision.^[20] Dr. Becker issued a brief narrative report indicating that his recommended MRI scan was reasonable, necessary, and related to the employee’s January 21, 2012, injury.^[21]

The employee asserted claims for payment of outstanding medical expenses, including bills from Hennepin County Medical Center and an intervention interest of Minneapolis Orthopaedics, where he treated with Dr. Becker. The employee also sought approval for the MRI recommended by Dr. Becker. His claims were heard by a compensation judge at the Office of Administrative Hearings on April 10, 2017. By Findings and Order dated May 9, 2017, the compensation judge denied the employee’s claims, concluding that the medical treatment received in 2016 and 2017, and the recommended MRI, are not causally related to his January 12, 2012, work injury.

The pro se employee appeals.

The Workers’ Compensation Court of Appeals will uphold the factual findings of the compensation judge if they are supported by substantial evidence and were reached through application of the correct legal standard.^[22] Substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.^[23] In reviewing for substantial evidence to support the compensation judge’s findings, we do not make credibility determinations.^[24] The judge’s factual findings, including the weighing of the evidence as it relates to credibility, are reviewed based on a substantial evidence standard. Where evidence allows reasonable minds to differ as to whether the claimed medical treatment is causally related to the employee’s work injury, the responsibility for that decision rests with the compensation judge.^[25] With this standard of review in mind, we consider the employee’s argument that the compensation judge erred in denying his claims.

The pro se employee appeals from the compensation judge’s denial of claims for payment of medical expenses related to treatment rendered in 2016 and 2017, and for the MRI recommended by Dr. Becker. The compensation judge found that the employee failed to meet his burden of proof to show that the treatment at issue is causally related to the work injury. We affirm.

The compensation judge accepted and adopted the opinions of Dr. Nelson and determined that the treatment at issue was not causally related to the work injury. In his December 21, 2016, report, Dr. Nelson opined that the mass and tear seen on the 2016 MRI scan were likely results of a new injury. He explained the basis for his opinion, which was that the 2012 surgery corrected the previous mass and tear, and that no tear was present on the post-surgical MRI scan in 2013. The compensation judge also noted that the medical records following the surgery indicated that the employee’s 2012 injury had resolved, and that while the employee continued to complain of pain, his right knee was stable with no effusion and had full range of motion. In addition, the employee’s testimony that a mass existed on his right knee nearly immediately following the 2012 surgery is contradicted by the office notes of his orthopedic surgeon upon numerous follow-up visits and examinations. Furthermore, over a year and a half passed between the employee’s treatment in the spring of 2014, and early 2016, when he presented with complaints of a recent flare-up of pain and diagnostic imaging first revealed findings not present in prior post-op scans.

The question for this court on review of this case is whether the findings and conclusions of the compensation judge are supported by substantial evidence in the record.^[26] It is not the function of this court to re-evaluate the probative weight of the evidence.^[27] “[W]here the evidence is conflicting or more than one inference may reasonably be drawn from the evidence, the findings of the Compensation Judge are to be upheld.”^[28] In this case, the compensation judge relied upon the well-founded opinions of Dr. Nelson. Where the facts assumed by an expert in rendering an opinion are supported by the evidence, the findings of the compensation judge must be upheld.^[29] Because substantial evidence in the record supports the findings of the compensation judge, we affirm.