MELVIN RIVERA-MATA, Employee/Appellant, v. G & L EMP. SERVS., d/b/a SPECIALTY PERS. SERVS., with EEP WORKERS’ COMP. FUND, admin. by BERKLEY RISK ADM’RS CO., LLC, Self-Insured Employer/Respondent, and VOCATIONAL RESTORATION SERVS., INC., MAYO CLINIC, SUMMIT ORTHOPEDICS, LTD., NORTHFIELD HOSP. & CLINICS, MANKATO CLINIC, LTD., OLMSTED MED. CTR., MINN. DEP’T OF HUM. SERVS., and MINN. DEP’T OF LABOR & INDUS./VOCATIONAL REHABILITATION UNIT, Intervenors.

The employee appeals the compensation judge’s finding that he did not sustain a work-related injury on September 25, 2019.  We affirm.

In August 2019, Melvin Rivera-Mata, the employee, started working for G & L Employment Services, d/b/a Specialty Personnel Services, a self-insured employer which provides temporary workers for businesses.  The employee was placed at Welsh Equipment, where his primary duties involved cleaning concrete haulers using a power washer.  The employee claims that on the date of injury, listed as September 25, 2019, he was using the washer when its hose became stuck.  As he pulled on the hose, it suddenly came loose and “jarred” his left shoulder and neck as he fell over.  He testified that he felt pain immediately at the top of his left shoulder and the back of his neck.  The employee did not report the injury to the employer until October 23, 2019.  The employer initially admitted liability for neck and left shoulder injuries and paid temporary total disability (TTD) benefits and medical expenses.

The employee first sought medical care for the injury on October 23, 2019, at the Department of Family Medicine at Mayo Clinic in Waseca, Minnesota.  He reported a shoulder and neck injury approximately three to four weeks prior and stated that he could not reach overhead or use his left arm normally because of the pain.  X-rays were negative for fractures or dislocations but indicated mild degenerative disc disease at C6-7.  The employee was given work restrictions to avoid repetitive movement, heavy lifting, pushing, pulling, or any activity affecting the use of his left arm for two weeks, at which point he was to return.

The employee returned to the clinic on November 4, 2019, and reported that his symptoms were worsening.  He was referred to an orthopedist and saw Dr. Michael Hendele on November 14, 2019, for left shoulder pain.  Dr. Hendele scheduled an MRI scan, which was read as showing left shoulder tendinitis and a possible labral tear, and diagnosed left shoulder impingement syndrome.  The employee reported pain spreading to the upper right side of his body and weakness in his left leg causing him to limp.  He began physical therapy in December 2019.

In January 2020, the employee began complaining of low back pain radiating to his left leg and memory loss which he connected to the work injury.  The employee saw Dr. John Jakovich at Mayo Clinic.  An MRI scan of the cervical spine showed mild degenerative disc disease at C6-7 with no spinal canal stenosis, and with mild and moderate left neural foraminal stenosis.  The employee received physical therapy through February 2020 but reported no improvement in his symptoms.

The employer began video surveillance of the employee in February 2020 and continued the surveillance until late 2021.  Ultimately, over 160 hours of the employee’s activities were recorded on video and provided to the compensation judge at the hearing.  The video shows the employee arriving at or leaving medical appointments and engaging in physical activities that he had denied being able to do because of his extreme pain.

The employee was evaluated by Dr. Edward Szalapski at the employer’s request on May 5, 2020.  Dr. Szalapski opined that the employee did not sustain any significant injury on September 25, 2019, neither temporary or permanent, and that he was malingering.  He noted that the employee “put on a show” but, given his observations of the surveillance video, felt that the show was “factitious.”  (Ex. 9.)

The employee was treated by Dr. Jerome Perra at Summit Orthopedics on November 12, 2020.  Dr. Perra recommended ganglion blocks and later assessed the employee as having complex regional pain syndrome (CRPS) involving the left upper extremity and neck.  On January 8, 2021, the employee treated with Dr. Ifechi Anyadioha, a pain management specialist at Mankato Clinic’s Pain Management Center.  Dr. Anyadioha did not observe all the symptoms required for a diagnosis but assessed the employee with CRPS of the left lower and left upper extremities based on his reported symptoms.  He recommended left stellate ganglion blocks, superior and cervical ganglion blocks, and lumbar sympathetic blocks at two levels.

Dr. Szalapski evaluated the employee again on January 27, 2022.  He noted that his opinion had not changed and that he had observed the employee using his upper extremities to a greater extent than during the initial examination.  He further opined that the employee did not meet the diagnostic criteria for CRPS.  In a report dated May 25, 2022, Dr. Anyadioha opined that the employee sustained specific injuries to his neck, lower back, and left upper extremity which arose out of and in the course and scope of his employment with the employer on September 25, 2019, and that his CRPS condition was a consequence of the work injury.

Based on Dr. Szalapski’s opinion and the surveillance video, the employer filed a notice of intention to discontinue benefits denying primary liability on June 4, 2020, after which discontinuance was allowed.  The employee filed a claim petition and amended claim petitions for injuries to his neck, left shoulder and arm, low back, and consequential CRPS, claiming wage loss benefits, medical mileage reimbursement, and payment or reimbursement for intervenors.

A hearing was held before a compensation judge on June 1, 2022.  In her findings and order, issued June 21, 2022, the compensation judge made 80 findings of fact detailing the evidence presented by the parties, which described the surveillance video introduced by the employer, discussed the medical evidence, and addressed the issues specifically, finding that the employee’s testimony was not credible, and that the employee failed to prove he sustained a work-related injury on September 25, 2019.  The compensation judge accordingly denied all of the employee’s claims. In her memorandum, the compensation judge stated that her decision was based on the employee’s delay in seeking treatment, the inability of providers to find an organic cause for his complaints, the employee’s exaggerated pain response on evaluation, and the persuasive opinion of Dr. Szalapski.  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 found that the employee failed to prove he sustained a work-related injury on September 25, 2019.  The determination of the nature and extent of an injury is a question of fact within the province of the compensation judge based on consideration of the evidence submitted by the parties.  Felton v. Anton Chevrolet, 513 N.W.2d 457, 50 W.C.D. 181 (Minn. 1994); Domarus v. Yule Transp., No. WC20-6387 (W.C.C.A. June 29, 2021).  The issue on appeal is whether substantial evidence supports the compensation judge’s decision, not whether substantial evidence might support a conclusion contrary to that reached by the compensation judge.  Emam v. Cmty. Action P’ship of Ramsey, No. WC21-6406 (W.C.C.A. Sept. 1, 2021); see also Redgate v. Sroga’s Standard Serv., 421 N.W.2d 729, 40 W.C.D. 948 (Minn. 1988) (substantial evidence is evidence that a reasonable mind might accept as adequate).

The employee first argues that the compensation judge mischaracterized the evidence in stating that the employee first sought treatment “approximately one month” after the incident, claiming that he had instead first treated two to three weeks after the incident.  He asserts that it was the employer who chose September 25, 2019, as the date of injury and that the actual injury date was closer to the first date of treatment.  We note, however, that the employee did not appeal Finding 3 of the compensation judge’s decision, which determined the date of injury.  Further, the employee’s medical records from October 23, 2019, state that he reported being injured about three weeks prior and, in the history section, that he was injured approximately four weeks before the appointment.  We also note that the employee’s own medical expert’s reports and all his claim petitions used September 25, 2019, as the date of injury.  The compensation judge did not mischaracterize the evidence in stating that the employee was first treated approximately one month after the incident with the power washer.

The employee next asserts that the compensation judge erred by relying on Dr. Szalapski’s opinion over that of Dr. Anyadioha and that she mischaracterized Dr. Szalapski’s opinion.  The determination of the adequacy of foundation for an expert opinion is within the discretion of the compensation judge which this court reviews for abuse of discretion.  See Gianotti 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)).   In this case, where Dr. Szalapski obtained a history from the employee, reviewed the employee’s medical records, performed a physical and neurological examination, and had an opportunity to observe the employee and to review surveillance videos of the employee, his opinion is adequately founded.  A medical opinion based on adequate information may constitute substantial evidence that a compensation judge may rely on in deciding a case.  Carda v. State of Minn./Dep’t of Human Servs., 79 W.C.D. 649 (W.C.C.A. 2019).  In weighing medical evidence, the trier of fact has the discretion to choose between competing and conflicting medical experts’ reports and opinions.  This assessment of the weight to be given to the conflicting opinions is upheld on appeal absent an abuse of discretion.  Mattick v. Hy-Vee Food Stores, 898 N.W.2d 616, 77 W.C.D. 617 (Minn. 2017); see also Nord v. City of Cook, 360 N.W.2d 337, 37 W.C.D. 364 (Minn. 1985).

Dr. Szalapski opined that the employee did not sustain any significant temporary or permanent injury on September 25, 2019, that he was malingering, and that he did not meet the diagnostic criteria for CRPS.  The employee argues that Dr. Szalapski did not opine that the employee had a “complete absence of an injury,” but rather disputed whether the employee continued to suffer from an ongoing disability related to a September 25, 2019, injury.  We note that Dr. Szalapski stated that the employee “did not sustain any substantial injury to any body parts on September 25, 2019.  If in the alternative he did, they were extremely minor, and have long since resolved.”  (Ex. 9.)  The compensation judge did not mischaracterize Dr. Szalapski’s opinion and did not err by relying on his opinion over that of Dr. Anyadioha.

The employee further contends that the judge’s findings failed to address all of the evidence submitted by the parties and were not based upon substantial evidence in light of the employee’s testimony regarding the severity of the inciting incident and that he attempted to work through the injury as instructed by his supervisor.  We are not persuaded.  The compensation judge specifically found the employee not to be credible.  A determination as to witness credibility is a unique function of the compensation judge as the trier of fact because the judge has the ability to evaluate the demeanor and testimony of witnesses at the hearing.  Where the judge’s assessment of credibility is supported by evidence that a reasonable mind might accept as adequate, we must defer to it.  Even v. Kraft, Inc., 445 N.W.2d 831, 42 W.C.D. 220 (Minn. 1989); Brennan v. Joseph G. Brennan, M.D., 425 N.W.2d 837, 41 W.C.D. 79 (Minn. 1988).  It is not the role of this court to reevaluate the credibility and probative value of a witness’s testimony or to choose different inferences than those of the compensation judge.  Krotzer v. Browning-Ferris/Woodlake Sanitation Serv., 459 N.W.2d 509, 513-14, 43 W.C.D. 254, 260-61 (Minn. 1990).

Finally, the employee asserts that the compensation judge erred by failing to explain her basis for rejecting the medical evidence supporting a CRPS condition, and accordingly contends that the compensation judge failed to consider the evidence as a whole.  A compensation judge, however, is not required to refer to or discuss every piece of evidence introduced at the hearing in the findings and order.  See Regan v. VOA Nat’l Hous., 61 W.C.D. 142, 149 (W.C.C.A. 2000), summarily aff’d (Minn. Apr. 6, 2001); see also Ruby v. Casey’s Gen. Store, 71 W.C.D. 535 (W.C.C.A. 2011), summarily aff’d (Minn. Sept. 28, 2011); Land v. Washington Cnty. Sheriff’s Dep’t, slip op. (W.C.C.A. Dec. 23, 2003).  The fact that the compensation judge did not mention all medical evidence in her findings and order does not establish that the evidence was not considered.  Rothwell v. Minn. Dep’t of Nat. Res., slip op. (W.C.C.A. Dec. 6, 1993); Braun v. St. John’s Univ., slip op. (W.C.C.A. July 20, 1992).  It is sufficient that the issues presented are decided, substantial evidence in the record supports the compensation judge’s decision, and the judge’s reasoning provides an adequate basis for this court to review the disputed issue.  See Cochran v. Target Stores, 77 W.C.D. 415 (W.C.C.A. 2017); Lang v. H & W Motor Express, slip op. (W.C.C.A. June 11, 1991).

The compensation judge’s findings in this case adequately discuss the conflicting medical evidence regarding the employee’s CRPS condition.  While Dr. Anyadioha and Dr. Perra assessed the employee as having CRPS as a consequence of his work injury, they did not observe symptoms meeting all of the criteria for a CRPS diagnosis.  The compensation judge chose to rely on Dr. Szalapski’s opinion that the employee did not meet the diagnostic criteria for CRPS and that the employee had not sustained a work injury which could have caused a consequential CRPS condition.  Weighing of evidence is within the sound discretion of the trier of fact.  See, e.g., Trevino v. Granite Falls Municipal Hosp., 72 W.C.D. 481, 489 (W.C.C.A. 2012).  Findings of fact should not be disturbed “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).  In this case, substantial evidence in the record supports the compensation judge’s findings.

On appeal, the employee has not presented any argument which would compel us to reject the compensation judge’s findings, which were based on her evaluation of the employee’s testimony and the evidence presented at the hearing.  The decision of the compensation judge is affirmed.