The pro se employee appeals the compensation judge’s determination that the employee did not sustain a work injury on February 28, 2022.  We affirm.

The employee, Maati Grouni, began working as a bus driver for the employer, Transdev, Inc., in May 2021.  The employee’s bus driving duties required him to sit for long hours which allegedly caused an injury to his low back with bilateral leg pain on February 28, 2022.

The employee treated with Dr. Thanh Huynh for low back pain.  On examination on February 2, 2009, Dr. Huynh noted the employee had tenderness to palpation of the low back. The employee was advised to take ibuprofen and apply ice and heat to the back.

On March 14, 2009, the employee was seen by Dr. Lawrence Mulhern at M Health Fairview Urgent Care Highland Park Family Practice for bilateral low back pain radiating to the right buttock, leg, and foot.  The pain had started one month before while lifting weights at a gym and was aggravated by sitting.  Dr. Mulhern diagnosed the employee with a lumbar strain and possible herniated disc at L5-S1.  The employee was prescribed Flexeril, and use of ice packs and heat was recommended.

Dr. Dennis Walston saw the employee for right-sided low back pain with numbness in the right thigh and calf on March 18, 2009.  An x-ray of the low back was normal without evidence of disc fracture.  On examination the employee had postural changes, a decrease in the right Achilles reflex, positive straight leg raising on the right with palpable paralumbar muscle spasm, and right sacroiliac (SI) distribution numbness.  An MRI scan was recommended to rule out a disc condition at L3-L4 or L5-S1.

On March 20, 2009, the employee had an MRI scan performed at St. Paul Radiology for low back pain and right leg radiculopathy.  The scan revealed minimal annular disc bulging at L2-L3, L3-L4, and L4-L5.  At L5-S1 a moderate right paracentral disc extrusion with inferior migration of disc material into the right lateral recess of S1 was revealed resulting in posterior displacement and compression of the right S1 nerve root.

The employee saw Dr. P. Thienprasit at Millennium Neurosurgery for his low back and right leg symptoms on March 30, 2009.  The employee’s condition was believed to be related to his lifting weights weighing 100 pounds with both hands.  The pain in the employee’s low back radiated down his right leg with numbness and tingling on the outside of the right foot.  On examination, straight leg raising on the right was positive with leg pain and numbness.  The ankle reflex on the right was diminished and there was numbness over the right lateral leg and outside of the right foot.  Dr. Thienprasit’s review of the employee’s MRI scan demonstrated a sizeable, herniated disc at L5-S1 with nerve root displacement.  Based on the scan findings, Dr. Thienprasit recommended that the employee undergo a right-sided microdiscectomy at L5-S1.

On April 8, 2009, the employee underwent a right L5-S1 microdiscectomy performed by Dr. Thienprasit at St. Joseph’s Hospital.  During the procedure, a large free fragment was dissected and removed at the L5-S1 level.  The employee, during a follow-up appointment with Dr. Thienprasit on April 30, 2009, reported his pain was almost gone with occasional tingling.  Dr. Thienprasit opined that the employee could return to his work as a cook with a 25-pound lifting restriction for three months.

Dr. Sue Park saw the employee at M Health Fairview for complaints of recurrent low back pain radiating into his legs and feet on October 29, 2010.  The symptoms occurred after the employee was lifting free weights overhead in a sitting position.  The employee complained of constant numbness in the right fifth toe with intermittent numbness in the back of the calf and bottom of the right foot.  The employee’s pain was the same but less severe as suffered before his 2009 surgery.  On examination, the employee’s paresthesia correlated with the L5-S1 nerve roots.  Dr. Park diagnosed the employee with mild lumbar radiculopathy.

In 2013, the employee claimed an injury to his low back and right lower extremity as a result of lifting a heavy box at work as a cook on July 26, 2013.^[1]  The employee was seen by PA-⁠C Bradley Bastien at Highland Park Family Practice for numbness and tingling in the right lower extremity.  It was noted that the employee had been previously diagnosed with lumbar degenerative disc disease with radiculopathy.  PA-C Bastien restricted the employee to no lifting greater than five pounds for one week.  PA-C Bastien’s diagnosis was lumbar disc radiculopathy causing right foot numbness and tingling.

PA-C Bastien saw the employee again on August 2, 2013.  The pain and tingling in the employee’s right foot was improved and there were no symptoms in the left foot.  The employee’s symptoms worsened when lifting, sitting, and standing too long.  The employee’s diagnosis remained unchanged.

On August 12, 2013, the employee returned to see PA-C Bastien for low back pain, and numbness and tingling in his feet.  The employee reported that his symptoms began after lifting a heavy box at work in July 2013.  The employee’s symptoms would wax and wane but increase after twisting and bending.  An x-ray was done which revealed narrowing at L5-S1 and L3-L4. PA-⁠C Bastien reviewed the x-ray and noted it demonstrated mild back disease but nothing that would cause the employee’s symptoms.  The employee was referred to occupational medicine.

The employee underwent an EMG at St. Paul Neurology Clinic for right lower extremity pain and paresthesia on April 10, 2014.  The employee stated that his symptoms were related to a work injury in 2008-2009.  The testing showed prolongation of the right H reflex which demonstrated residual changes in the employee’s prior right S1 radiculopathy.

Following the EMG, the employee was seen by Dr. Neil Dahlquist for a neurological consultation on May 8, 2014.  The employee complained of a persistent dysesthetic (burning, aching or tingling) sensation down the right leg into the foot after lifting a box of tomatoes at work as a cook in July 2013.  An MRI scan completed at United Hospital revealed a very small disc herniation that abutted the right S1 nerve root.  On examination the employee had decreased sensation in the right S1 distribution with spasm found on both sides of the lumbosacral area in the paraspinal muscles. Based upon his examination, Dr. Dahlquist diagnosed the employee with right S1 radiculopathy. Physical therapy was recommended with a restriction of no lifting over 50 pounds.

On June 18, 2014, the employee was seen by Dr. Patrick Inveen at HealthPartners Family Practice St. Paul for chronic low back pain following an injury eight years earlier.  The low back pain was described as moderate and was aggravated by sitting, lifting, and bending, and radiated down the employee’s right leg to below the knee with numbness on the ball of the right foot. The employee was diagnosed with lumbar disc disease and physical therapy was recommended.

The employee had an initial physical therapy evaluation for lumbar disc disease and S1 pain at NovaCare Rehabilitation on July 3, 2014.  The primary symptoms complained of by the employee were intermittent pain and numbness in the right calf and foot increased by driving.  On September 4, 2014, the employee was discharged from physical therapy after ten visits.

On November 6, 2014, the employee underwent an independent medical examination (IME) by Dr. Jeffrey Dick for the injury he claimed to have sustained while working as a cook in July 2013.  The employee reported numbness in his right foot after lifting a box of tomatoes.  He continued working as a cook but quit because his back hurt.  On physical examination, an absent right Achilles reflex was noted.  Dr. Dick diagnosed the employee with right L5-S1 discectomy and mild residual radiculopathy.  It was Dr. Dick’s opinion that the employee’s diagnosis was caused by the disc herniation in 2009 and related surgery.  Dr. Dick further opined that in July 2013, the employee sustained a temporary aggravation of his pre-existing right S1 radiculopathy which had resolved by the time of the IME.

The employee returned to see Dr. Inveen on January 23, 2015, for right low back and buttock pain.  The employee’s pain was aggravated by bending, sitting, standing, and walking.   He was diagnosed with right lumbar radiculopathy, was given a lifting restriction of 30 pounds, and was referred for physical therapy.

On March 11, 2015, the employee underwent a rehabilitation evaluation for right lumbosacral neuritis or radiculitis, lumbago, and muscle weakness at NovaCare.  The employee’s pain was reported as constant with work activities and sore after half an hour of driving.  The employee related the symptoms to his July 2013 injury.  Through June 23, 2015, the employee attended thirteen physical therapy visits.  The physical therapy notes reflect the employee’s right foot numbness increased with driving.  He was discharged from physical therapy on July 28, 2015.

The employee followed up with Dr. Inveen on March 18, 2015, for chronic severe back pain radiating to his lower extremities.  On examination the employee had bilateral tenderness in the paraspinous muscles.  Dr. Inveen diagnosed the employee with bilateral lumbar radiculopathy and recommended an MRI of the lumbar spine.

On December 16, 2015, the employee was seen at Midway Internal Medicine by Dr. Tony Jhocson complaining of cold toes, right greater than left.  Dr. Jhocson diagnosed the employee with lumbar radiculopathy and referred him to physical therapy.

The employee was seen by Dr. Dick for a second IME on February 18, 2016, again related to the July 2013 work injury.  The employee reported that his right foot symptoms were always present with burning and numbness in the little toe, lateral and plantar foot.  Based upon the examination, Dr. Dick’s opinions were not changed from his original report dated November 6, 2014. It remained Dr. Dick’s opinion that the employee’s 2009, disc herniation and related surgery were the sole cause of his symptoms which were being aggravated daily.  Dr. Dick diagnosed the employee with chronic low back pain, chronic right S1 radiculopathy, and post right disc herniation at L5-S1.

On February 19, 2016, the employee was seen by Dr. Jhocson.  The employee reported that he had suffered a back injury at work while lifting a box in 2013, and that since the injury, his low back pain continued to persist with radiation down the right leg to the foot. Dr. Jhocson diagnosed the employee with lumbar radiculopathy and ordered an MRI scan.  The employee was restricted to lifting 30 pounds and required sitting while working at a cash register.

An MRI scan of the employee’s lumbar spine was performed at HealthPartners Specialty Clinic on March 3, 2016.  The scan revealed multiple levels of degenerative change and posterior disc bulging at L3-4, L4-5, and L5-S1.  At L4-5, a small annular tear was noted in the left foraminal zone, and a tiny right paracentral annular tear and disc protrusion were revealed at L5-S1.

The employee was seen at St. Paul Family Practice by Dr. Yasin Asima on March 31, 2016.  On examination the employee had mild lumbar tenderness and positive straight leg raising on the right. Dr. Asima diagnosed the employee with lumbosacral back pain, continued his existing restrictions, ordered physical therapy, and prescribed gabapentin.

On May 11, 2016, the employee saw Dr. Jhocson reporting that he was unable to sit or stand for long.  He had been attending Metro State University but had to withdraw because of pain associated with class attendance.  Dr. Jhocson, at the employee’s request, authored a letter dated May 11, 2016, stating the employee’s chronic pain prevented him from sitting or standing for prolonged periods of time which did not allow him to continue his studies at Metro State University, and requesting that Metro State reimburse the employee’s tuition.

The employee was evaluated for low back pain by Dr. Andrew Schakel at HealthPartners Interventional Pain Management on May 31, 2016.  When seen by Dr. Schakel, the employee complained of right-sided low back pain radiating to the right foot after a work injury in 2013.  On examination, the employee had nonspecific bilateral tenderness at L4-5 and SI joints. Dr. Schakel’s diagnosis was lumbar facet arthropathy and SI joint dysfunction.  The employee was restricted to lifting no more than 20 pounds, and was to consider work conditioning and diagnostic nerve block injections for radiofrequency ablation.

On April 21, 2017, the employee underwent a right L5 transforaminal epidural injection performed by Dr. Schakel.

The employee was evaluated for right leg symptoms by Dr. Shawn Olson at Physicians Neck and Back Clinic (PNBC) on March 20, 2019.  The employee reported a history of having undergone a L5-S1 discectomy in 2008 with an onset of back and right leg pain in 2013 while working in a kitchen.   He reported the injection done by Dr. Schakel in 2017 had not helped his symptoms at all.  The employee had complaints of pain and numbness over the right posterior calf and lateral foot which worsened when sitting or driving.  Dr. Olson diagnosed the employee with lumbar radiculitis, lumbar degenerative disc disease, and low back deconditioning.  Based upon the examination, Dr. Olson recommended an active rehabilitation program for the employee.

On March 21, 2019, the employee was evaluated for physical therapy at PNBC.  At this time, the employee was working at Amazon delivering packages which required lifting and driving throughout the workday.  The employee stated that his right lower extremity symptoms began within the first minute of sitting in a vehicle and were worse after a full day of driving.  On July 11, 2019, the employee reported a 50 percent improvement in his condition and was discharged from therapy to a home exercise program.

On July 10, 2019, the employee saw Dr. Olson to review his physical therapy progress.  The employee described his symptoms as numbness associated with sitting and driving and localized in the right lateral foot.  Dr. Olson recommended a discharge from physical therapy to an independent exercise program.

In May 2021, the employee began working for Transdev, Inc. (formerly First Student), the employer, as a bus driver.  (Ex. 18.)  He testified at hearing that he would drive long-distance routes and for long-hour days, and that he enjoyed his job.  (T. 34-36.)

The employee was seen by Dr. Malinda Jorgensen at Midway Internal Medicine for left leg pain and stress at work on February 7, 2022.  The employee’s left leg pain was attributed to work stress.  Dr. Jorgenson recommended the employee consult with behavioral health for therapy and look for other possible jobs.

On February 28, 2022, the employee presented at Regions Hospital Emergency Department with worsening chronic left-sided low back pain over the past one to two weeks.  The employee had a history of degenerative disc disease and lumbar radiculitis.  He attributed his current condition to sitting and driving at work increasing his left buttock pain which radiated down the left leg.  PA-C Kellie Ring determined that, based on the employee’s benign neurologic exam, the employee did not need emergent imaging and referred him to a spine specialist.  PA-C Ring released the employee to return to work on March 1, 2022.

The employee was seen at My Medical Clinic by PA-C Brooke Gall for evaluation of low back pain and left leg numbness on March 9, 2022.  PA-C Gall ordered lumbar x-rays to evaluate the employee’s complaints.  The x-rays were performed at Rayus Radiology Maplewood and showed L3-4 disc degeneration/spondylosis with trace retrolisthesis and mild curvature of the spine to the right.  The employee was diagnosed with sciatica^[2] and was referred to physical therapy.

On March 14, 2022, the employee returned to My Medical Clinic reporting that his low back pain and left leg numbness were significantly improved.  His symptoms continued to be exacerbated by driving and alleviated by swimming and stretching.  PA-C Gall released the employee to work limiting his driving to periods of two or three hours.

The employee underwent an initial evaluation for physical therapy at NovaCare for left leg pain and right foot coldness on March 14, 2022.  The employee’s pain was worse with sitting and better with walking, swimming, and stretching.  He attended nine sessions of physical therapy through April 28, 2022.

On March 17, 2022, the employee was seen at My Medical Clinic reporting improvement of his ongoing left leg symptoms.  The employee’s left leg pain occurred with palpation of his left buttock/piriformis.  PA-C Gall noted that the employee had a prior discectomy in 2008 and the trigger for his current bilateral radiculopathy symptoms was unclear.

The employee was next seen at My Medical Clinic by PA-C Gall on March 24, 2022, and on March 31, 2022, by Dr. Bhavana Anand, with no objective change from the prior examination.  Dr. Anand felt the employee would benefit from a functional capacity evaluation and MRI of the lumbar spine.  The employee was released to return to work with a restriction of occasional sitting. 

On May 10, 2022, the employee saw Dr. Jess Olson at HealthPartners Neuroscience Center Physical Medicine with complaints of left leg pain and right foot numbness.  By history, the pain started insidiously a week before February 28, 2022.  Dr. Olson reviewed the employee’s MRI scan from March 3, 2016.  On examination the employee had no tenderness to palpation of the sacroiliac joints or piriformis muscles.  Based upon the examination, Dr. Olson remarked there were “no clear signs as to the cause of [the employee’s] pain on exam.”  (Ex. 4.)  Dr. Olson diagnosed the employee with lumbar radicular pain and ordered an MRI scan.

The employee underwent an MRI scan of the lumbar spine on June 8, 2022, at HealthPartners Specialty Center.  The scan showed mild degenerative changes with no evidence of nerve impingement.  Dr. Olson reviewed the scan and recorded there were no changes when compared to the employee’s 2016 MRI scan.

On June 30, 2022, the employee was seen at TRIA on referral from Dr. Olson for a physical therapy evaluation.  The medical note from the evaluation stated that the employee had chronic low back pain with right foot symptoms with no specific injury.  The employee attended 24 physical therapy sessions through November 4, 2022.

The employee returned to see Dr. Olson complaining of right foot cold and numbness on November 22, 2022.  Dr. Olson believed the employee’s back pain was due to L5-S1 disc irritation possibly impinging the S1 nerve root. He further noted the employee had “no clear signs as to the cause of pain on exam.”  (Ex. 4.)

On December 9, 2022, the employee saw Dr. Franklin Fleming at Como Internal Medicine for pain radiating down his right leg with tingling and numbness in the right foot.  On examination, Dr. Fleming found minimal tenderness over the lumbar spine and sciatic notch. Prednisone was prescribed and an EMG was recommended.

Dr. Paul T. Wicklund performed an IME on December 30, 2022, at the request of the employer and insurer.  In a report dated January 16, 2023, Dr. Wicklund stated that the employee noticed low back pain radiating to the left leg as the result of driving for the employer.  These symptoms, as well as numbness in the sole of the employee’s right foot, came on gradually over a one-week period.  On examination, Dr. Wicklund found an absent right ankle reflex, extension limited to 10 degrees, and straight leg raising to 80 degrees bilaterally.

Based on his examination, Dr. Wicklund diagnosed the employee with low back pain due to a right L5-S1 disc herniation in 2009 resulting in a laminectomy and discectomy. Dr. Wicklund believed the L5-S1 disc herniation was caused by the employee’s lifting weights. He further opined that the employee’s low back complaints on February 28, 2022, were not caused by a specific or Gillette^[3] injury from sitting, driving a bus.  Instead, the employee’s increased low back symptoms on February 28, 2022, were related to his prior and long-standing low back condition.  He further opined that the medical care received by the employee was reasonable and necessary but related to the 2009 L5-S1 disc herniation.  Based upon the 2009 surgery, Dr. Wicklund advised that the employee avoid lifting more than 30 pounds on a repetitive basis.

The employee saw Dr. Alexander Zubkov at the Minneapolis Clinic of Neurology for lumbar pain on January 17, 2023.  The employee gave a history that he had sciatica following a back injury in February 2022.  Dr. Zubkov assessed the employee with lumbar spondylosis and ordered an MRI scan.

On January 18, 2023, the employee underwent an MRI scan at the Minneapolis Clinic of Neurology – Edina.  The scan, as compared to the MRI scan on June 8, 2022, revealed stable mild multilevel lumbar spondylosis and stable dextroconvex lumbar spinal curvature with minimal retrolisthesis at L3-4.  The spondylosis was greatest at L3-4, resulting in a stable borderline central canal and borderline inferior foraminal stenosis left greater than right.

The employee on January 23, 2023, underwent an EMG of the right lower extremity.  Dr. Fleming advised the employee that his EMG showed no evidence of neuropathy, pinched nerve, or nerve damage.

The employee attended physical therapy at the Minneapolis Clinic of Neurology from January 26, 2023, to March 16, 2023.  When discharged, the employee was to continue an independent home exercise program.

On March 14, 2023, the employee was seen by Dr. Olson for pain in the left leg and right foot.  The pain was worse when sitting for a long time.  The employee reported he was studying computer networking.  When studying, the employee’s right foot would become numb and cold. Dr. Olson diagnosed possible Raynaud’s syndrome and ordered a repeat MRI scan.

The employee had an MRI scan at HealthPartners Specialty Center on March 20, 2023.  The scan did not reveal any high-grade spinal canal or neural foraminal stenosis.  Also, no significant change was noted in the employee’s multilevel spondylosis when compared to the scan on June 8, 2022.

On April 18, 2023, the employee received a right L5-S1 transforaminal epidural steroid injection for lumbar radicular pain at HealthPartners Specialty Clinic by Dr. Olson.  The employee’s pain reduced from a level of five to two following the injection.

The employee returned to see Dr. Fleming for back pain on May 8, 2023.  According to the record, an MRI scan of the lumbar spine did not show any nerve impingement and an EMG did not reveal any neuropathy or nerve impairment.  The employee was advised to follow-up with a pain clinic.  If a good explanation for his bilateral leg pain and numbness could not be found, Dr. Fleming would consider referrals to neurology and physical therapy for the employee.

On June 20, 2023, the employee was seen at Village Acupuncture and Massage for right-sided sciatica and foot pain.  The provider recorded that the employee swims one hour per day and walks.  The employee was seen six times at Village Massage through August 2, 2023.  At the last visit, the employee reported no change in his symptoms, and he continued to have pain and numbness.

The employee filed a claim petition seeking workers’ compensation benefits on October 12, 2022.  The employer denied liability and the case was heard before a compensation judge at the Office of Administrative Hearings.   In a Findings and Order served and filed August 12, 2024, the compensation judge found the employee failed to meet his burden of proof to establish a work injury on February 28, 2022, to the lumbar spine causing bilateral radiculopathy.  The compensation judge denied the employee’s claims for temporary total disability benefits and medical expenses.  The pro se 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 pro se employee appeals from the compensation judge’s finding that the employee failed to meet his burden of proof to show that the alleged work injury of February 28, 2022, was a substantial contributing cause to an aggravation or acceleration of his pre-existing low back condition.

To be compensable, an injury must arise out of and in the course of employment, and the employee bears the burden to prove these issues by a preponderance of the evidence.  Minn. Stat. § 176.021, subds. 1 and 1a.  Under the Workers’ Compensation Act, it is not necessary that the employment be the only cause of the condition for which benefits are sought, and an injury is compensable if it can be shown that the employment is a substantial contributing factor in the employee’s condition.  See Salmon v. Wheelabrator Frye, 409 N.W.2d 495, 40 W.C.D. 117 (Minn. 1987); Roman v. Minneapolis St. Ry. Co., 268 Minn. 367, 129 N.W.2d 550, 23 W.C.D. 573 (1964).  An injury is also compensable if the employment is a substantial contributing factor to the aggravation or acceleration of a pre-existing condition.  Wallace v. Hanson Silo Co., 305 Minn. 395, 235 N.W.2d 363, 28 W.C.D. 79 (1975); Vanda v. Minn. Mining & Mfg. Co., 300 Minn. 515, 218 N.W.2d 458, 27 W.C.D. 379 (1974).

The existence of a personal injury may be established based on an employee’s subjective complaints coupled with an opinion of a medical expert that the employee sustained a work-related injury or aggravation.  In this case, the employee did not introduce any medical opinion or report substantiating his claim that on February 28, 2022, he suffered either a specific injury or aggravation or acceleration of a pre-existing medical condition.

The employee argued in his brief on appeal^[4] that his burden of proof was met as his claim was supported by the medical records of Dr. Olson.  However, the question before this court is not whether the evidence might have supported a contrary finding, but whether the finding made by the compensation judge was adequately supported by the record.  Hengemuhle v. Long Prairie Jaycees, 358 N.W.2d 54, 59, 37 W.C.D. 235, 239 (Minn. 1984).  Furthermore, a causation opinion rendered by a treating doctor “may be legally sufficient to initiate a claim but it may not have the persuasiveness necessary to establish a claim in a contested hearing.”  Wienen v. Carlton Cnty., No. WC07-252 (W.C.C.A. May 7, 2008).

The compensation judge received medical records from numerous providers into evidence and considered those records when making his decision.  In the compensation judge’s memorandum, he noted that Dr. Olson on May 10, 2022, observed there was “no clear sign as to the cause of [the employee’s] pain on exam” and, on November 22, 2022, remarked there were “no clear signs as to the cause of pain on exam.”  (Mem. at 12.)  The compensation judge further reflected that “PA-C Gall . . . was contradictory in her medical records.”  (Id.)  This inference made by the compensation judge was based on PA-C Gall’s indication that the employee’s restrictions were work related in a report of workability on March 14, 2022, but, in a medical record dated March 17, 2022, stated that the trigger for the employee’s symptoms was “unclear.”  (Ex. 8.)

On the record before him, the judge accepted Dr. Wicklund’s opinion and considered it more persuasive than the uncertain causation comments made in the medical records of Dr. Olson and PA-C Gall.  It is the role of the compensation judge, as the finder of fact, to make the choice between competing medical opinions.  See Nord v. City of Cook, 360 N.W.2d 337, 37 W.C.D. 364 (Minn. 1985).  Unless the opinion relied upon by the compensation judge did not have an adequate factual foundation, this court generally will affirm the judge’s findings based on that choice.  See, e.g., Smith v. Quebecor Printing, Inc., 63 W.C.D. 566, 573 (W.C.C.A. 2003). Our review of the medical records and evidence support the compensation judge’s adoption of Dr. Wicklund’s opinion.

The employee points to various aspects of the evidence that support his contention that his driving bus for long hours was the cause of his sciatica, disability, and need for medical care beginning in February 2022.  It is possible that the compensation judge could have inferred that the evidence may have permitted a contrary result in this case, but under the scope of this court’s review of findings of fact, the issue before us is only whether there was substantial evidence to support the findings made by the compensation judge.  Where more than one inference may reasonably be drawn from the evidence, the findings of the compensation judge are to be upheld.  Redgate v. Sroga’s Standard Serv., 421 N.W.2d 729, 734, 40 W.C.D. 948, 957 (Minn. 1988).

In this case, there is no causation opinion that the employee’s sitting and driving for the employer caused, aggravated, or substantially contributed to his low back and bilateral radicular symptoms.  In contrast, Dr. Wicklund provided an expert medical opinion that the employee’s symptoms were a manifestation of his 2009 right L5-S1 laminectomy and discectomy.  Substantial evidence supports the judge’s finding that the employee did not meet his burden of proof.  See also Nord v. City of Cook, 360 N.W.2d 337, 37 W.C.D. 364 (Minn. 1985).  We therefore affirm the judge’s findings in their entirety.