VACATION OF AWARD – SUBSTANTIAL CHANGE IN CONDITION. Where the employee failed to provide any evidence to demonstrate the existence of a causal relationship between the work injury and her present condition, we conclude that the employee has failed to show cause sufficient to vacate the award on stipulation on the grounds of a substantial change in condition.
Compensation Judge: Nancy Olson
Attorneys: Raymond R. Peterson, McCoy Peterson Limited, Minneapolis, Minnesota, for the Petitioner. Joshua M. Steinbrecher, Heacox, Hartman, Koshmrl, Cosgriff, Johnson, Lane & Feenstra, P.A., St. Paul, Minnesota, for the Respondent.
Denied.
DAVID A. STOFFERAHN, Judge
The employee has petitioned to vacate an award on stipulation served and filed April 19, 2012, on the grounds that there has been a substantial and unanticipated change in medical condition. Finding that the employee has not established cause under the statute, the petition is denied.
The employee, Maija Karkanen, filed a claim petition in September 2010, alleging that she sustained an injury to her low back and leg arising out of and in the course of her employment as a veterinary technician for the University of Minnesota. The employer denied liability for the alleged injury. In April 2012, the parties reached an agreement to settle the employee’s claims. The stipulation provided for payment to the employee in return for a full, final and complete settlement of all claims with the exception of future medical expenses and permanent total disability benefits after 15 years.
The employee has now filed a petition to vacate the settlement, claiming that there has been a substantial and unanticipated change in her medical condition, such that cause exists under Minn. Stat. § 176.461. The employer has objected to the petition.
The employee first treated for low back problems in March 2000 when she injured herself at home. She was prescribed medication and was advised to modify her activities. In October 2000, the employee was involved in a motor vehicle accident and suffered injuries to her cervical, thoracic, and lumbar spine. The employee treated initially with a chiropractor and then was seen at the Noran Neurological Clinic. On July 5, 2001, the employee had complaints of neck pain, low back pain, numbness down her left leg, and anxiety issues. Her physician at Noran, Dr. Michael Sethna, recommended exercise therapy and prescribed Vioxx. An independent medical exam was done on behalf of the no-fault insurer by Dr. Souhel Najjar. The employee reported to Dr. Najjar that she had constant low back and neck pain. Dr. Najjar found no objective evidence of injury.
The employee also sustained work-related low back injuries in 2006 and 2008 for which she received medical treatment. Medical records from Park Nicollet Clinic in 2008 indicate the employee was seen for what she described as back pain over the course of several years that radiated down her left leg.
On April 17, 2010, the employee was working as a veterinary technician for the University of Minnesota at the Veterinary Medicine School. Among her duties was assisting in surgery of large animals. On that date, she was assisting in surgery being performed on a horse with colic. She was pulling and lifting large bags of fluid when she began experiencing pain in her low back.
The employee began treating at Park Nicollet Clinic on April 22, 2010, for low back pain with radiation into her left buttock and leg. Treatment consisted of physical therapy and medication. When the employee returned to the clinic on May 3, 2010, she reported she had developed cervical pain, as well as pain in her left shoulder area. When treatment did not relieve her symptoms, she was referred for a neurosurgical consultation.
An MRI scan of the lumbar spine was done at Park Nicollet on June 8, 2010, and was read as showing spondylolisthesis at L5-S1 and foraminal narrowing. There was no MRI of the cervical spine. An EMG was read as normal. On July 29, 2010, Dr. Praveen Baimmdi performed a posterior lumbar interbody fusion at L5-S1 with pedicle screws. The employee reported relief of her symptoms but also reported what she described as a painful recovery.
The employee’s claim petition was filed in September 2010. The employee’s deposition was taken by the employer’s attorney on November 10, 2010. The employee stated in her deposition that there had been improvement from the surgery and she was no longer wearing a back brace and was not using a walker. She had been released to return to work with a 25-pound lifting restriction. The employee was seen for an independent medical examination by Dr. Edward Szalapski on January 4, 2011. It was his opinion that the work injury was at most a temporary aggravation of a long-standing pre-existing condition that he diagnosed as spondylolytic spondylolisthesis.
In March 2011, a CT scan of the employee’s lumbar spine showed osseous changes in the neural foramen region. The employee reported to her doctors at Park Nicollet that she had pain in her low back, buttocks, thigh, and calf. Opioid medications were provided for pain relief. The employee was referred to Medical Advanced Pain Specialists (MAPS) for chronic pain management.
Medical records just prior to the settlement show that the employee identified her pain at that time as being at 7/10 with numbness in her buttocks and down her right leg. She had a sacroiliac injection on March 20, 2012, that the employee felt had helped her pain. At that time she was on Lyrica, Nortriptyline, Oxycodone, and Oxycontin. On April 12, 2012, she reported pain in her low back and hips that radiated into her legs bilaterally. The employee was working full time for Twin Cities Public Television as a membership coordinator.
The parties settled the employee’s claims in April 2012 with an Award dated April 19, 2012.
The employee was referred to Dr. Davis at Regions Hospital shortly after the settlement by her physicians at MAPS. Dr. Davis performed additional lumbar surgery on December 27, 2012, extending the employee’s spinal fusion to the L4-5 level with additional instrumentation. On follow-up at MAPS on January 23, 2013, she reported pain at 8/10 and was frustrated with her medication management.
The employee saw Dr. Davis a number of times after her surgery. In March 2013, she stated she continued to have radiating pain and numbness down her left leg. She also had pain in her elbow and shoulder. Dr. Davis provided an epidural steroid injection on June 26, 2013, for what he diagnosed as L3-4 radiculopathy. Because of continued pain, the employee was in physical therapy for most of 2013.
At a physical therapy appointment on November 4, 2013, the physical therapist raised the possibility that the employee had thoracic or lumbosacral neuritis or radiculitis. Cervical and thoracic MRI scans were recommended. The thoracic MRI was read as essentially normal. A head MRI was also done and showed no positive findings. Dr. Davis read the cervical MRI as showing stenosis with cord compression. He recommended surgery which was done on December 27, 2013. The surgery done by Dr. Davis consisted of total disc replacement from C5 through C7. Following the surgery, the employee developed infection in her neck with sepsis and inflammation. She was seen in consultation with Dr. Sheiphali Gandhi and was hospitalized for five days in January 2014.
In April 2014, the employee returned to Regions for “right 5th digit pain/injury.” She reported that she had pinched her finger between a countertop and the arm of a rolling office chair while at work. She complained of numbness of her finger since the injury with swelling at the joint, and some loss of range of motion. The employee was referred to hand therapy and was fitted with an orthotic device.
The employee applied for and was awarded social security disability benefits effective April 1, 2014.
The employee moved to La Crosse, Wisconsin in June 2014 and began treating there at the Gunderson Clinic. At her initial visit she identified numerous diagnoses and prescription medications. An MRI was ordered of the cervical and lumbar spine to determine the condition of her spine at that point.
The most recent medical information in the record before this court is from a visit by the employee to the Gunderson Clinic dated May 12, 2017. The employee was seen for muscle cramps, and pain in multiple joints, neck and back. The spasms were described as being in her hands and feet, and sometimes in her trunk. The chart notes refer to the employee’s claimed work injuries and surgeries. She also reported multiple concussions from objects falling on her head, migraine headaches and three separate surgeries for strabismus. A number of tests were ordered and a referral to a neurologist to review the various problems reported by the employee was recommended.
Minn. Stat. § 176.461 authorizes this court to set aside an award for “cause,” the definition of which includes “a substantial change in medical condition since the time of the award that was clearly not anticipated and could not have reasonably been anticipated at the time of the award,” which is asserted by the employee. As the petitioner, the employee has the burden of establishing that cause exists to vacate the award. Bartz v. Meadow Lane HealthCare, No. WC06-184 (W.C.C.A. Feb. 26, 2007); Hillesheim v. Wooddale Nursing Home Inc., 70 W.C.D. 383 (W.C.C.A. 2009); Coleman v. Prof’l Res. Network, 77 W.C.D. 85 (W.C.C.A. 2017). We conclude that the employee has failed to meet that burden in the present case.
In considering whether there has been a substantial and unanticipated change in medical condition, this court has generally used the criteria considered in Fodness v. Standard Café, 41 W.C.D. 1054 (W.C.C.A. 1989), as a guide in making its analysis. Holtslander v. Granite City Roofing Co., ____ W.C.D. ____ (W.C.C.A. 2017), summarily aff'd (Minn. Feb. 13, 2018). The Fodness factors are a change in diagnosis, a change in the employee’s ability to work, additional permanent partial disability, necessity for more costly and extensive medical care than originally anticipated, a causal relationship between the covered work injury and the worsened conditions, and the contemplation of the parties at the time of the settlement.
In the present matter, we need not consider all of the Fodness factors because the employee has failed to establish a causal relationship between the work injury and her present condition. The employee argues whether a causal relationship exists is a factual determination that should be made by a compensation judge at a hearing after this court vacates the award. However, given the employee’s extensive history of treatment, including surgery, for numerous conditions which may or not be related to the work injury, it is incumbent on the employee to provide some evidence of a causal relationship. There is simply no medical opinion that the employee’s current condition has any connection to the claimed work injury.
We conclude that the employee has failed to establish cause required by the statute. The employee’s petition is denied.