AMBER L. LENARTZ, Employee/Respondent, v. CHILDREN’S HOSPS. & CLINICS OF MINN. and BERKLEY RISK ADM’RS CO., LLC, Employer-Insurer/Appellants and ALLINA MED. CLINIC, ABBOTT NW. HOSP., and EQUIAN O/B/O BLUE CROSS MASS., Intervenors.

The employer appeals from the compensation judge’s denial of its petition to discontinue and the compensation judge’s award of continuing benefits to the employee. We affirm.

Amber Lenartz was employed by Children’s Hospital and Clinics as a registered nurse in the pediatric intensive care unit when she sustained a head injury on July 10, 2017. The employee was assisting two radiology technicians who were taking an x-ray of one of her patients. As she was adjusting the patient’s posture for the procedure, the arm of the portable x-ray machine swung suddenly and hit her on the side of her head.

The employee did not lose consciousness but stated she saw “stars,” experienced dizziness, and had pain in the left side of her head. She continued to work until the end of her shift and then reported the injury to the charge nurse. The employee went to the hospital’s emergency room where she was seen by Dr. Sara Friedman. Dr. Friedman diagnosed a concussion without loss of consciousness, provided Motrin and an anti-nausea medication, and took the employee off work.

The employer accepted liability for the work injury and began paying wage loss benefits and medical expenses. The employee was also provided statutory rehabilitation services through the assistance of QRC Melissa Jackson. Ms. Jackson initially provided medical management services.

The employee began treating with Dr. Kristin Stoner, a physical medicine and rehabilitation specialist at Courage Kenny Rehabilitation Institute, on July 18, 2017. Dr. Stoner’s testing showed vestibular, visual, and cognitive impairment and she diagnosed the employee as having sustained a concussion. Dr. Stoner referred the employee to physical therapy, occupational therapy, and neuro-optometry. Dr. Stoner opined that the employee’s pre-existing depression had been aggravated by the work injury and referred the employee to a psychologist, Dr. David Lund, at Courage Kenny Psychological Associates. Dr. Stoner also restricted the employee from work and from lifting over ten pounds.

Dr. Lund provided psychotherapy to the employee beginning in September 2017. He diagnosed post-concussion syndrome and adjustment disorder with anxiety, which he attributed to the employee’s work injury.

The employee testified that she experienced vision impairment after the work injury. In October 2017, she consulted Bright Eyes Vision Clinic at the referral of Dr. Stoner, where she was diagnosed with convergence insufficiency and fitted with prism lenses which she found alleviated her vision problem.

At the request of the employer, the employee was evaluated by Stanley Ferneyhough, Ph.D., L.P., on December 27, 2017. Dr. Ferneyhough provided a report dated February 7, 2018, detailing his examination and review of medical records. It was his opinion that the employee’s work injury was a mild concussion which would have resolved “sometime within 2-6 weeks.” He attributed any ongoing difficulties to somatic symptom disorder, and depression and anxiety, which he considered not related to the work injury.

The employee and QRC met with Dr. Stoner on April 19, 2018, at which time the employee was released to return to work with restrictions. However, the employer did not have suitable work available for the employee at that time.

Dr. Stoner wrote a report on July 13, 2018, expressing her disagreement with Dr. Ferneyhough’s opinion and stating that there are “actually no tests that can definitively diagnose a concussion.” Dr. Stoner also stated that the employee’s symptoms had improved, but that she continued to experience headaches, balance problems, dizziness, and other symptoms.

The employer also arranged for an evaluation of the employee by Dr. Irfan Altafullah on June 13, 2018. Dr. Altafullah reviewed Dr. Ferneyhough’s report and the employee’s records from Allina and CDI. The employee described her current symptoms as headache, neck tightness, and blurred vision which required prism glasses. In his report, Dr. Altafullah noted the subjective nature of the employee’s complaints and stated there were no objective cervical spine findings and no objective evidence of permanent partial disability.

Dr. Lund prepared a report, dated September 3, 2018, regarding his psychotherapy care and treatment of the employee. He also reviewed the employee’s medical records from other providers and the evaluation by Dr. Ferneyhough. Dr. Lund disagreed with Dr. Ferneyhough’s conclusions, viewing the employee’s lack of medical treatment before the injury as an indication that her current symptoms were not due to a pre-existing condition. Dr. Lund reiterated his diagnosis of post-concussion syndrome and adjustment disorder with anxiety disorder, and remained of the opinion that the employee’s July 10, 2017, work injury was a substantial contributing cause of her condition.

The employee and QRC met with the employer on September 10, 2018, to discuss a return to work with the employer on a transitional basis. The employer offered the employee part-time transitional work within the restrictions set by Dr. Stoner. The employee returned to work with the employer in September 2018 and began receiving temporary partial disability benefits.

Based on Dr. Ferneyhough’s report, the employer filed a petition to discontinue the employee’s benefits. The employer’s petition and the employee’s claim petition were combined for hearing and heard by a compensation judge on October 10, 2018, and December 21, 2018. The compensation judge identified several issues for determination: the nature and extent of the employee’s injury; whether the employee had reached maximum medical improvement; the employee’s claims for temporary total disability benefits between May 11, 2018, and September 13, 2018; and for temporary partial disability from September 14, 2018, and continuing; the employer’s request for termination of rehabilitation services; whether certain medical treatment expenses were reasonable, necessary and causally related to the work injury; and claims made by intervenors for payment of medical bills.

In her Findings and Order, issued on February 1, 2019, the compensation judge found in the employee’s favor on these issues. The compensation judge accepted the employee’s testimony as credible and adopted the opinions of Drs. Stoner and Lund. The employer has appealed the Findings and Order of the compensation judge.

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).

The employer argues on appeal that substantial evidence does not support the compensation judge’s findings that the employee continued to be partially disabled, that the employee had not reached maximum medical improvement, and that the employee’s medical treatment was reasonable, necessary, and causally related to the work injury.

At the hearing and on appeal, the employer asserts that the nature and extent of the employee’s injury was such that “nothing happened.” (T. 6), or was a mere “bump on the head.” (Appellant’s Brief at p. 10.) In rejecting this theory, the compensation judge relied upon the testimony of the employee and the opinions of her treating doctors.

The employee testified about the facts surrounding the injury, her immediate symptoms, and the symptoms she continued to have as a result of the injury. She also testified as to her medical treatment and the degree to which the treatment had assisted in her recovery. The employee was cross-examined at length on these matters. The employer presented testimony from other employees of Children’s Hospital and Clinics to refute the employee’s testimony. The compensation judge, however, found that the employee’s testimony was credible. (Findings and Order, memorandum, p. 12.) It is well-established that consideration of witness credibility is uniquely within the province of the compensation judge. Folstrom v. Northgate Liquors, 77 W.C.D. 955 (W.C.C.A. 2017); Jungwirth v. YRC, Int’l, Inc., 78 W.C.D. 395 (W.C.C.A. 2018). The appellant offers no compelling argument why this general rule does not apply in the present case.

In determining the nature and extent of the employee’s disability and whether she continued to be partially disabled as the result of her injury, the compensation judge reviewed the testimony and opinions of the medical experts in this case. She discussed those opinions in detail in her memorandum. The compensation judge adopted the opinions of Drs. Stoner and Lund as more persuasive. (Findings and Order, memorandum, p. 11.)

The employer argues that the compensation judge erred on this issue, contending that the employee’s injury was not severe enough to have caused the employee’s complaints, that there was no objective evidence to support those complaints, and that substantial evidence establishes that the employee’s complaints were due to pre-existing conditions. A compensation judge’s choice of medical opinions will generally be affirmed by this court so long as the opinions relied upon have adequate foundation. Miller v. Valley Paving, Inc., 78 W.C.D. 137 (W.C.C.A. 2018); Smith v. Quebecor Printing, Inc., 63 W.C.D. 566 (W.C.C.A. 2003), summarily aff’d (Minn. Aug. 15, 2003). The opinions of Drs. Stoner and Lund in this matter have adequate foundation.

The decision of the compensation judge is affirmed.