PRACTICE & PROCEDURE – ADEQUACY OF FINDINGS. The compensation judge’s implicit conclusion that the employee did not suffer an ongoing soft tissue injury to his right lower extremity due to his work injury is supported by substantial evidence and does not require remand.
EVIDENCE – EXPERT MEDICAL OPINION. The compensation judge’s rejection of an expert medical opinion that was inconsistent, lacked foundation, and was based upon facts unsupported by the record with respect to the employee’s onset of symptoms, prior symptoms and treatment, and unclear statements regarding the source of complaints, did not rise to the level of an abuse of her discretion.
Compensation Judge: Kathleen Behounek
Attorneys: Dana Gerber, Atkinson Gerber Law Office, P.A., Arden Hills, Minnesota, for the Appellant. Jason L. Schmickle, Aafedt, Forde, Gray, Monson & Hager. P.A., Minneapolis, Minnesota, for the Respondents.
Affirmed.
DAVID A. STOFFERAHN, Judge
The employee appeals from the compensation judge’s determination as to the nature and extent of his March 11, 2019, work injury, and from the denial of his claim for benefits. We affirm.
Michael Domarus had been employed by Yule Transport as an over-the-road trucker for 20 years when he was injured on the job on March 11, 2019. He drove five to seven days a week, making trips to Texas and to the East Coast. He was paid on the basis of mileage and was not required to load or unload his trucks.
On March 11, 2019, the employee drove to Alabama to deliver a shipment. He was in the trailer of his truck, standing on a movable platform about four inches high to reach and release the overhead straps holding the cargo in place. As he reached above his head, his right leg gave out and he fell, injuring his right leg. Mr. Domarus reported the injury to his employer and then drove his truck back to Minnesota.
On March 13, 2019, the employee sought medical care for his injury at Mayo Clinic. Examination and x-rays showed a fractured fibula in his right leg and he was referred to orthopedic services. Further testing showed medial and lateral meniscus tears. Dr. David Ivance performed a right knee arthroscopy and meniscectomies on June 6, 2019. The employer and insurer admitted liability for the work injury and paid wage loss benefits and medical expenses.
The employee continued to treat with Dr. Ivance following his surgery. In July 2019, he reported to Dr. Ivance that he continued to have pain in his right hip and some pain in his right knee. Dr. Ivance recommended pool therapy for the right knee complaints and attributed the hip complaints to trochanteric bursitis and arthritis. Dr. Ivance also released the employee to return to work without restrictions as of August 1, 2019.
The employee did not believe he could physically perform his regular job duties and on August 2, 2019, he saw a physician’s assistant at Mayo Clinic. She recommended pool therapy and physical therapy. She also provided work restrictions, limiting the employee to light-duty work with no driving more than 60 to 90 miles.
The employee saw Dr. Ivance again in September and October 2019 with his primary complaint being right hip pain. He was given a cortisone injection in his right hip and the employee reported some improvement in his symptoms. Dr. Ivance restricted the employee to working no more than two to three days a week and six hours a day. The employee returned to work with the employer within these restrictions.
The employer and insurer discontinued the employee’s benefits as of August 1, 2019, relying on Dr. Ivance’s initial release of the employee to work without restrictions as of that date. The employer and insurer also denied that the employee had sustained injuries to his right hip or low back as a result of his fall on March 11, 2019.
In addition to Dr. Ivance’s initial opinion, the employer and insurer relied upon the opinion for their independent medical examiner, Dr. Nolan Segal, to discontinue benefits. Dr. Segal examined the employee on September 16, 2019, and reviewed the employee’s medical records, including records for treatment rendered prior to the work injury. In his report, Dr. Segal stated that on examination, he found no evidence of radiculopathy or nerve root injury suggestive of a back injury. Dr. Segal opined the right hip symptoms were not due to the work injury, but due to the employee’s idiopathic arthritis, obesity, and diabetic peripheral neuropathy. He agreed with Dr. Ivance’s initial conclusion that the employee was capable of working without restrictions due to his work injury as of August 1, 2019.
Dr. Ivance issued a narrative report on January 26, 2020. Dr. Ivance described the employee having injured his right knee and proximal thigh near his hip when he fell carrying a heavy box. He opined that the leg fracture, meniscus tears, and soft tissue injuries at the hip were related to the March 11, 2019, work injury.
The employee filed a claim petition on April 5, 2020, seeking various benefits arising out of the March 11, 2019, work injury. The employee’s claim for benefits was heard by a compensation judge on August 17, 2020. At issue was the nature and extent of the employee’s work injury, and his entitlement to benefits as a result of that injury. In her Findings and Order, served and filed October 6, 2020, the compensation judge found that the employee failed to show that he sustained a low back or right hip injury as a result of the March 11, 2019 work injury, and that he failed to show entitlement to benefits after August 1, 2019. 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).
On appeal, the employee asserts two bases for reversal of the compensation judge’s denial of his claim.[1] First, he argues that the compensation judge failed to address his claim that he suffers an ongoing soft tissue injury to his right lower extremity. Second, he argues that substantial evidence in the record does not support the compensation judge’s conclusion that the employee’s work injury had resolved as of August 1, 2019. We disagree.
The issue at hearing was the nature and extent of the employee’s March 11, 2019, work injury. There is no dispute that the employee suffered injuries to his right lower extremity in the nature of a leg fracture and meniscus tears. The employee also alleged that he suffered injury to his low back and right hip, including a soft tissue injury to the right leg, as a result of the work injury. These conditions were in dispute at the hearing. On appeal, the employee asserts that the compensation judge limited her decision to the low back and right hip only and failed to address the employee’s claim that he also suffered a soft tissue injury. Because the compensation judge failed to address all of the employee’s claims, he argues, remand is required.
A review of the hearing transcript, the medical exhibits, and the Findings and Order and supporting memorandum of the compensation judge does not support the employee’s assertion. The employee’s claim of a soft tissue injury was clearly articulated during opening statements at the hearing. (T. 16.) The therapy records and the narrative report of Dr. Ivance discuss complaints the employee had regarding the musculature surrounding his right hip and proximal thigh. In her Findings and Order, the compensation judge made findings with respect to the low back and the right hip, but, as pointed out by the employee, she did not make a specific finding regarding the soft tissues surrounding the right hip. Nevertheless, it is apparent that the judge was aware of the employee’s claim of a soft tissue injury, and that she rejected that injury in rejecting the opinions of Dr. Ivance. In her memorandum, she specifically rejects the employee’s claim that his hip and thigh symptoms are a result of inactivity and reduced range of motion of the right knee arising from the work injury. (Mem. 8.) We are not persuaded by the employee’s argument that remand is necessary because the compensation judge described the employee’s soft tissue injury to his right hip and thigh in her Findings and Order as a right hip injury.
Asserting a lack of substantial evidence, the employee appeals from the compensation judge’s determination that the employee’s work injury had resolved as of August 1, 2019, and that any need for ongoing work restrictions or medical care were not causally to the work injury. In support of his claim that his injury had not resolved, the employee submitted the opinion of his treating orthopedist, Dr. Ivance. The compensation judge concluded that the opinions of Dr. Ivance were inconsistent, lacked foundation, and were based upon facts unsupported by the record with respect to the onset of symptoms, prior hip symptoms and treatment, and unclear statements regarding the source of the hip complaints. The compensation judge concluded that, with respect to the low back and right hip conditions, the opinions submitted by Dr. Segal were more persuasive than those of Dr. Ivance. The opinion of Dr. Segal is adequately founded and this court defers to a compensation judge’s choice between expert medical opinions. See Nord v. City of Cook, 360 N.W.2d 337, 37 W.C.D. 364 (Minn. 1985). Further, this court will uphold a compensation judge’s assessment of the weight to be given to conflicting opinions, absent an abuse of discretion. Mattick v. Hy-Vee Food Stores, 898 N.W.2d 616, 77 W.C.D. 617 (Minn. 2017).
The determination of the nature and extent of an injury is within the province of the compensation judge. Felton v. Anton Chevrolet, 513 N.W.2d 457, 50 W.C.D. 181 (Minn. 1994). Also within the province of the compensation judge is the determination of the adequacy of the foundation for an expert’s opinion, which this court reviews for abuse of discretion. See Giannoti v. Indep. Sch. Dist. 152, 889 N.W.2d 796, 802, 77 W.C.D. 117, 124 (Minn. 2017) (citing Gross v. Victoria Station Farms, Inc., 578 N.W.2d 757, 760-61 (Minn. 1998)). The compensation judge found that the opinions of Dr. Ivance lacked adequate foundation and did not support the employee’s claim for benefits beyond August 1, 2019. We conclude the compensation judge did not abuse her discretion in reaching this conclusion. Because the compensation judge’s decision is supported by well-founded medical opinion and substantial evidence in the record, her decision is affirmed.