ISMAIL OUASSADDINE, Employee/Appellant, v. ROSEMOUNT AEROSPACE, INC. and BERKLEY RISK ADM’RS CO., LLC, Employer-Insurer/Respondents and TRIA ORTHOPAEDIC CTR., MINN. DEP’T OF LABOR & INDUS./VRU, and AM. ACCOUNTS C/O METRO. ANESTHESIA NETWORK, LLP, Intervenors.

The compensation judge found that the preponderance of the evidence failed to establish that the employee sustained work injuries to his wrists. The employee has appealed. We affirm the compensation judge.

Ismail Ouassaddine, the employee, began working for the employer in October 2012. The employee worked on a production line assembling and testing electronic devices. Assembly required the use of a variety of hand tools and testing of the devices was done throughout the assembly process. Generally, the employee held the parts in his left hand, using his right hand to assemble and handle tools. The units were not heavy but required constant repetitive use of both hands.

The employee began having left wrist pain on July 31, 2014. He sought medical attention that same day from Dr. Comfort Oniyah. Dr. Oniyah diagnosed a left wrist sprain, recommended minimal use of the left hand, and prescribed physical therapy. The therapy relieved the employee’s symptoms and in September 2014 he was allowed to work without restrictions.

The employee’s left wrist pain returned in October 2014. Dr.Oniyah referred him to an orthopedist, Dr. Daniel Marek, at Twin Cities Orthopedics. Dr. Marek saw the employee on November 20, 2014. The examination was generally unremarkable, and Dr.Marek diagnosed ulnar impaction syndrome. Dr. Marek provided a cortisone injection to the left wrist and the employee’s symptoms improved. The employee saw Dr. Marek again eight weeks later and reported that his wrist was still painful with gripping and grasping.

Dr. Marek saw the employee several times throughout 2015 and into 2016. Dr. Marek tried various treatments, but no significant long-lasting improvement was noted in the employee’s symptoms. Diagnostic studies, including an MRI scan, x-rays, and EMG studies, were all read as normal. A repeat EMG and a cervical spine MRI done in April 2016 were also reported as normal. Dr. Marek did not make a specific diagnosis but concluded that the employee’s condition was related to his work. The employee worked without restrictions until September 2015. From that time until August 2018, the employee worked light-duty off the assembly line. After the employee’s last visit with him on June 1, 2016, Dr. Marek referred the employee to Dr. Jeffrey Husband.

The employee was seen at the request of the employer and insurer by Dr. Steven Meletiou on January 27, 2016. Dr. Meletiou took a history from the employee, conducted a physical examination, and reviewed the employee’s medical records and radiology studies. Dr. Meletiou also discussed the physical requirements of the employee’s work duties with him. Dr. Meletiou diagnosed the employee’s symptoms as being due to ulnar neuritis at the level of the elbow and/or the wrist. It was his opinion that this condition was not related to employment.

The employee saw Dr. Husband on December 22, 2016. Dr. Husband found tenderness in the ulnar aspect of the left wrist and diagnosed left pisotriquetral joint dysfunction. A local anesthetic was injected into the joint and the employee reported temporary improvement in his pain. Based on the results of the injection, Dr. Husband performed surgery on October 30, 2017, in a procedure identified as a left pisoform excision. The employee reported moderate improvement in his symptoms with continued pain in the ulnar and dorsal aspect of his left wrist, in addition to numbness in his ring and little fingers.

Dr. Husband issued a narrative report in January 2018. He stated that he saw the employee again on December 7, 2017, who reported pain in his right hand due to increased use at work. The employee also reported moderate improvement of his pre-operative symptoms. Dr. Husband stated there were no definitive objective findings and concluded that he was unable to make a specific diagnosis. Based on the employee’s work activity requiring repetitive, forceful gripping, and torqueing, Dr. Husband stated, “In the absence, however, of any other injury or pre-existing condition, it is my opinion that Mr. Ouassaddine’s work at [the employer] was a substantial contributing factor to his left wrist pain.” Dr. Husband placed restrictions of no lifting over ten pounds, rare gripping, and no torqueing or crimping.

The employee was seen for another IME with Dr. Meletiou on February 21, 2018. Dr. Meletiou again reviewed the employee’s medical history, his work activity, and additional medical records. Dr. Meletiou disagreed with Dr. Husband’s diagnosis and treatment regime, including surgery. It was Dr. Meletiou’s opinion that the employee had subjective pain in the left and right ulnar wrist. It continued to be Dr. Meletiou’s opinion that the employee had not sustained a Gillette^[1] injury from his employment.

The employee filed a claim petition, alleging a Gillette injury to his left wrist in the nature of pisotriquetral joint dysfunction as well as a consequential injury to his right wrist. The employee claimed entitlement to temporary total disability benefits and medical providers filed intervention claims.

The employee’s claim was heard by a compensation judge on November 9, 2018. In her Findings and Order of December 14, 2018, the compensation judge determined that the preponderance of the evidence failed to establish the employee sustained a Gillette injury to his left wrist and a consequential injury to his right wrist. (Finding 16.) The employee’s claims were denied. 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).

The compensation judge considered the opinion of the IME, Dr. Meletiou, to be persuasive. She stated Dr. Meletiou had reviewed the employee’s treatment history, his history of symptoms, and diagnostic findings. Dr. Meletiou had explained the basis for his opinions, including his opinion that Dr. Husband’s diagnosis of pisotriquetral joint dysfunction was not supported by objective evidence.

It is the function of a compensation judge to consider and choose between competing medical opinions and the compensation judge’s determination in that regard will generally be affirmed by this court as long as the accepted opinion has adequate foundation. Smith v. Quebecor Printing, 63 W.C.D. 566 (W.C.C.A. 2003), summarily aff’d (Minn. Aug. 15, 2013); Klein v. Minn. Ass’n of Townships, No. WC19-6243 (W.C.C.A. Apr. 15, 2019).

In his appeal, the employee argues that Dr. Meletiou did not have adequate foundation for his opinion. Specifically, the employee alleges that Dr. Meletiou failed to examine the pisoform or pisotriquetral joint space before reaching his opinion. Secondly, the employee states that Dr. Meletiou’s statement as to the extent of improvement in the employee’s wrist after treatment was a “total fabrication.” (App. Brief, p. 5.) We disagree.

Dr. Meletiou prepared a report after each of his examinations of the employee. In each, he recounted in detail his review of the employee’s medical records, the history he took from the employee, and his examination of the employee. We find no basis for a claim that Dr. Meletiou did not examine the employee’s wrists. This background provides more than adequate foundation for his opinion. Dr. Meletiou examined the employee’s left ulnar wrist on both occasions. His findings are consistent with those of Dr. Husband, who noted in his last report that there were symptoms without much in the way of objective findings.

The employee states in his brief that Dr. Meletiou quoted the employee incorrectly in recording only a 15 percent improvement after the cortisone injection on November 20, 2014, when in fact there had been a 50 percent improvement. This is a misstatement of Dr. Meletiou’s report. In his March 2, 2018, report, Dr. Meletiou stated the employee had only a 15 percent improvement following surgery. He obtained this information from the employee in his examination and the employee has not challenged that statement.

We are satisfied, as was the compensation judge, that Dr. Meletiou had adequate foundation to express an expert opinion on the issues in this case. That being so, the compensation judge’s decision, which is based on her acceptance of that opinion, is affirmed.