LORI KRULL, Employee/Appellant, v. DIVINE HOUSE, INC., and BERKLEY RISK ADM’RS CO., LLC, Employer-Insurer/Respondents and SANFORD HEALTH and BLUE CROSS BLUE SHIELD OF MINN. & BLUE PLUS, Intervenors.

The employee appeals from the compensation judge’s denial of her claim for workers’ compensation benefits related to a knee injury sustained on February 23, 2017. As substantial evidence supports the compensation judge’s finding that the employee’s injury did not arise out of her employment, we affirm.

The employee works as a program coordinator for a group home operated by the employer, Divine House, Inc. The employee suffered from left knee osteoarthritis on an ongoing basis. On February 6, 2017, the employee was examined by Autumn Nelson, CPRN, who noted that the employee’s left knee exhibited swelling and tenderness. No imaging of the knee was performed at this examination. The employee was diagnosed with osteoarthritis and prescribed naproxen. A follow-up appointment in 30 days was directed.

On February 23, 2017, the employee was helping a client carry groceries into the group home. The employee picked up three gallons of milk from her car and turned toward the building. As she began walking toward the building, the employee experienced a loud popping noise in her left knee along with severe pain. The employee was unable to bear weight on her left leg due to the condition of her knee. That day, the employee was examined by Jamey Jessen, M.D. Dr. Jessen noted that the employee “was just walking today and heard a loud pop and snap in the knee and has been unable to bear weight on it since. She does not necessarily feel like it bent in any wrong direction or that she torqued it wrong. She has never had this happen before.”^[1] Imaging showed mild degenerative changes and some joint space narrowing. The employee was placed in a knee brace and issued crutches. The employee was prescribed hydrocodone and referred to an orthopedist.

On February 28, 2017, the employee was examined by orthopedist Kevin Dahl, M.D. Dr.Dahl’s notes indicate that the employee was helping a client carry groceries into the group home when she heard a loud pop and snap from her knee and experienced pain. The pain was alleviated by elevation of her leg, and the employee tried to keep weight off of her left leg.^[2] Based on MRI results, Dr. Dahl diagnosed a medial meniscus tear. On April 6, 2017, the employee underwent a partial medial meniscectomy and minimal chondroplasty. The employee was taken off of work until May 20, 2017. On April 21, 2017, she was released to light duty, assigned a 10-pound lifting restriction, and restricted against using stairs, squatting, and kneeling. The employee returned to work after her recovery from surgery.

On January 16, 2018, the employee underwent an independent medical examination (IME) performed by Paul Cederberg, M.D., on behalf of the employer and insurer. Dr. Cederberg noted no tenderness or swelling of the employee’s left knee. The left knee displayed a range of motion similar to the employee’s right knee. Dr. Cederberg opined that the employee’s knee surgery resulted from a pre-existing condition unrelated to any specific work activity.^[3]

On January 17, 2018, Dr. Dahl issued a narrative report stating that it was “possible” that the employee had sustained the left knee meniscus tear in the work incident on February 23, 2017. Dr. Dahl also clarified that the employee’s knee was not demonstrated to have a normal meniscus at the February 6, 2017, examination, as an MRI would have been required to make such a determination and the employee had been complaining of left knee pain for several months.^[4]

The employee filed a claim petition seeking benefits. On January 23, 2018, the matter came on for hearing before a compensation judge. The employee was the only witness. The judge found that the employee did not suffer a compensable work injury to her knee as the employee was not exposed to a condition that put her at an increased risk of injury. The employee appeals.

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).

A decision which rests upon the application of a statute or rule to essentially undisputed facts generally involves a question of law which the Workers’ Compensation Court of Appeals may consider de novo. Krovchuk v. Koch Oil Refinery, 48 W.C.D. 607, 608 (W.C.C.A. 1993), summarily aff’d (Minn. June 3, 1993).

Employers are responsible for “compensation in every case of personal injury arising out of and in the course of employment without regard to negligence.” Minn. Stat. § 176.021, subd. 1. In this matter, the employee was carrying milk into the group home in which she works for consumption by persons in the employer’s care. This situation meets the “in the course of” component of the statute. For the injury to be compensable, however, the employee must also show that the injury arose out of her employment. This element has been held to require that the employee show a causal connection between the work activity and the injury. Gibberd v. Control Data Corp., 424 N.W.2d 776, 780, 40 W.C.D. 1040, 1047 (Minn. 1988).

In this matter, the employee testified that she had “turned around and taken a step” when she heard the pop from her left knee and experienced pain.^[5] The pain began when she took the step forward and no twisting was involved.^[6] The employee did not claim that there was anything amiss with the surface that she was walking on at the time of the knee injury.^[7] She reported that the three gallons of milk that she was carrying did not affect her stability and she was engaged in “normal walking.”^[8]

The employee argues that the compensation judge erred in not finding that the employee’s carrying of three gallons of milk substantially contributed to the employee’s February 23, 2017, work injury. But the employee must first meet her burden to show that the injury arose out of employment to meet the compensability standard of Minn. Stat. § 176.021, subd. 1. Where an employee cannot show a causal connection between the work and the injury, the injury is not compensable. Dykhoff v. Xcel Energy, 840 N.W.2d 821, 73 W.C.D. 865 (Minn. 2013). The causal connection is some form of increased risk that the employee is exposed to through employment. Hohlt v. Univ. of Minn., 897 N.W.2d 777, 781, 77 W.C.D. 509, 514 (Minn. 2017); see also Roller-Dick v. Centracare Health Sys., 916 N.W.2d 373, ___ W.C.D. ___ (Minn. 2018).

The employee maintains that this case is controlled by Papesh v. Kandersteg, Inc., No. WC10-5109 (W.C.C.A. Nov. 1, 2010). In that case, the employee was turning after she picked up a box. In the process of turning, the employee experienced pain in her right knee. The compensation judge in that matter found that the injury was caused by the twisting motion that was required to carry out her job duties. Similarly, this court has recently held that a change in position necessitated by work meets the employee’s burden of proof of the necessary causal connection component for compensability. James v. Duluth Clinic, No. WC18-6128 (W.C.C.A. Aug. 21, 2018).

In both Papesh and James, the injury arose from a twisting motion necessitated by the employee’s working conditions. In this matter, the employee had completed her turn and was striding normally. The employee’s testimony was unequivocal that she was walking normally, and unaffected by the three gallons of milk that she was carrying. A reasonable inference from this testimony is that there was no increased risk attributable to the employee’s work duties that caused her knee problem. As the Minnesota Supreme Court has held, simply walking without some increased risk does not meet the employee’s burden to demonstrate a causal connection between the employment and the injury. Dykhoff, 840 N.W.2d at 827. With no showing of increased risk, the employee has not met her burden to prove an injury that arose out of employment. The compensation judge’s Findings and Order, served and filed March 9, 2018, are affirmed.