HABIB JOHNSON, Employee/Appellant, v. MYDATT SERVS., INC., d/b/a BLOCK BY BLOCK, and ARCH INS. GRP., admin’d by GALLAGHER BASSETT, Employer-Insurer/Respondents, and REGIONS HOSP., Intervenor.

The employee appeals the compensation judge’s findings and ultimate conclusions that he failed to prove the October 27, 2022, work injury substantially caused or substantially aggravated his mental health conditions and that he failed to prove consequential injuries to the low back and left hip.  We affirm.

Habib Johnson, the employee, began working for Mydatt Services, Inc., doing business as Block by Block, the employer, as a safety ambassador on May 16, 2022.  His job duties included cleaning graffiti and picking up trash throughout assigned areas in St. Paul and Minneapolis.  On October 27, 2022, the employee was traveling for work on a bicycle when he was hit on his left side by a motor vehicle coming out of a parking garage.  He refused medical treatment at the time of the incident and continued to work for the employer for several months after the injury.

The employee treated for left knee pain with Jessi Phillips, D.C., at Physician’s Group from December 7, 2022, through February 28, 2023.  During this time, the employee only reported left knee pain and denied symptoms of low back or left hip pain.  An MRI scan of the left knee taken on February 14, 2023, was read to show a lateral meniscus tear and an ACL tear, but the image was of low quality.  In March and April 2023, the employee was evaluated at Summit Orthopedics for left knee pain.  The employee reported multiple events where his left knee felt unstable and gave way, “at times with resultant fall.”  (Ex. 27.)  A brace, physical therapy, and a repeat MRI scan were recommended. 

Another evaluation for left knee pain was performed by Dr. Allen Hunt at Twin Cities Orthopedics on May 22, 2023.  In the review of symptoms section of Dr. Hunt’s report under musculoskeletal, the symptoms listed included decreased range of motion, leg pain, shooting pain, joint stiffness, joint locking, and back pain.  (Ex. 29.)  This was the only mention of back pain at that appointment and there was no treatment directed for back pain.  The diagnosis of a meniscus tear and an ACL tear and the recommended conservative treatment were directed only to the employee’s left knee injury.  (Id.)  On August 23, 2023, Dr. Hunt recommended surgery for the employee’s left knee pain and limited him to sedentary work only until the surgery.

On July 26, 2023, Dr. Mark Engasser performed an independent medical evaluation of the employee at the request of the employer and insurer.  The employee reported low back pain in addition to knee pain, which he attributed to using crutches.  Dr. Engasser stated that crutches had not been prescribed for the employee and that use of crutches inhibited his recovery.  He concluded that the employee was a candidate for left knee surgery and found no evidence of a low back injury, either directly or as a consequence of the left knee injury.  Dr. Engasser did not address the alleged left hip injury.  (Ex. 3.)

In October 2023, the employee was assessed as having adjustment disorder with mixed anxiety and depressed mood by a licensed counselor at Nystrom & Associates.  He discontinued counseling after one additional appointment.  On December 26, 2023, the employee was evaluated by Dr. Ali Ebrahimi at Associated Clinic of Psychology.  No clinical diagnosis was assessed, and Dr. Ebrahimi opined that there was no need for any ongoing active treatment.  He noted that the employee walked in with a cane and indicated that the employee could benefit from discussing his issues regarding anesthesia with a therapist before undergoing surgery.  The employee’s qualified rehabilitation consultant assisted the employee with finding counseling to address this issue.

In April 2024, the employee began seeing a therapist at Care Counseling.  He reported to the therapist that his stress and anxiety were caused by instability with housing and finances after his work injury.  He was initially diagnosed with an adjustment disorder and later with post-traumatic stress disorder (PTSD).  The employee also sought treatment for increased low back, left hip, and left knee pain at Regions Hospital emergency room on April 23, 2024.

In May 2024, the employee had an MRI scan of the left knee which showed a lateral meniscus tear and intact ligaments.  On May 6, 2024, the employee was evaluated by Dr. Hunt and at that time mentioned left hip and back pain with his knee pain.  Dr. Hunt ordered a wheeled seated walker and crutches.  On June 13, 2024, the employee again treated with Dr. Hunt for severe left knee pain and also for left hip and back pain.  Dr. Hunt ordered left hip and low back MRI scans. The left hip scan showed a labrum tear and the low back scan showed L4-5 and L5-S1 disc protrusions.

In October of 2024, the employee started treating with Dr. Baubak Azar at his primary care clinic, Entira Family Clinics.  Dr. Azar referred the employee to Dr. Jackson Maddux for low back pain, who the employee saw on December 23, 2024.  Dr. Maddux determined that the employee’s low back pain was caused by a left hip labral tear.  He referred the employee to Dr. Ryan Fader at Allina Orthopedics for further evaluation of the labral tear.  Dr. Fader saw the employee on January 2, 2025, and recommended physical therapy and consideration of injections.  He did not recommend surgery for the left hip.

On April 25, 2025, the employee was seen at the United Hospital Emergency Department, reporting right-sided back pain after a fall.  He reported three falls in the past two weeks that he believed were consequential to his work-related left knee injury.  On May 12, 2025, he was again examined by Dr. Maddux, who made no low back diagnosis.

On June 18, 2025, John O’Neil, Ph.D., performed an independent psychological evaluation at the request of the employer and insurer.  After completing an in-person diagnosis assessment, a case records review, and a mental status examination, he noted that the employee self-reported sadness and anxiety related to domestic issues, self-sufficiency, and financial issues.  The employee decided not to complete any written psychological testing.  Dr. O’Neil diagnosed adjustment disorder with mixed anxiety and depressed mood, moderate cannabis use disorder, and antisocial personality traits.  Dr. O’Neil concluded that these diagnoses were neither caused nor aggravated by the employee’s work injury.  He also noted that the employee did not have any mental health treatment until a year after the injury.

On June 23, 2025, Dr. John Steubs performed an independent medical evaluation at the request of the employer and insurer.  He reviewed the employee’s medical records and noted that the employee had reported worsening back, hip, and knee pain in April 2024.  The employee reported left hip pain with a sensation of giving way and low back spasms.  During the examination, the employee was able to transfer from the wheelchair to the examination table without difficulty.  Dr. Steubs reviewed surveillance videos of the employee and indicated that the employee may have misrepresented his physical capabilities.  (Ex. 9.)  He diagnosed a left knee lateral muscle tear and found there were “no objective finding[s] to support [the] current complaints of hip and lower back pain.”  (Id.)  Dr. Steubs recommended a left knee arthroscopy and partial lateral meniscectomy as well as continued use of crutches until surgery.  Without surgery, Dr. Steubs recommended continued use of crutches and participation in physical therapy.

In a letter dated July 1, 2025, Dr. Fader issued a narrative report at the request of the employee’s attorney.  Dr. Fader found that the employee had a tear of the acetabular labrum and mild osteoarthritis in his left hip, and a likely contusion of his left hip.  Dr. Fader indicated that the employee reported that he “sustained multiple injuries to his knee at this time along with the onset of left hip pain.”  (Ex. JJ.)  He concluded that it was more likely than not that the employee’s work injury substantially contributed to his current symptoms.

The employee was examined by Dan Sipple, D.O., at the request of his attorney, on July 1, 2025.  Dr. Sipple conducted a physical examination.  The report did not indicate how he evaluated the employee’s mental status other than to note a review of the medical records.  He listed the employee’s diagnoses as a left hip labral tear, an L4-5 disc herniation, a meniscal tear and a partial ACL tear of his left knee, PTSD, and adjustment disorder.  In response to a written question from the employee’s attorney regarding any consequential injury, subsequent treatment, or aggravation of a mental health condition, Dr. Sipple stated that the employee has PTSD as a result of the accident.  He concluded that the diagnoses he had listed were consistent with the employee’s work injury.  Dr. Sipple also noted that the employee’s fear of anesthesia was inhibiting his ability to undergo surgery.

On July 10, 2025, Dr. Azar issued a report in response to a letter from the employee’s attorney.  He listed the employee’s injuries as labrum tear of the left hip, meniscus tear of the left knee, and a back injury.  As to whether the employee had suffered any consequential injuries, Dr. Azar stated that the employee had “suffered consequential injuries, listed above,” referring to all three diagnoses.  (Ex. KK.)  He also opined that the employee had been totally disabled since he stopped working for the employer and that his work restrictions were related to his work injuries.

In a report dated December 2, 2025, Dr. Steubs acknowledged that the employee stated that the left knee pain, altered gait, and use of crutches led to his low back pain.  Dr. Steubs maintained that the employee’s work injury was not a substantial factor of the employee’s low back condition.  Dr. Steubs also reiterated that the left hip condition, reported over a year later, was unrelated to the work injury.

Dr. O’Neil also completed an updated psychological report indicating that his review of additional records did not change his opinions.

A hearing took place on December 30, 2025, before a compensation judge.  The parties stipulated that the employee sustained a work-related left knee injury on October 27, 2022.  The compensation judge adopted the opinions of Dr. Engasser and Dr. Steubs and concluded the employee failed to prove he sustained consequential left hip or low back injuries as a result of the work injury.  The judge also adopted the opinion of Dr. O’Neil and concluded that the employee failed to prove that the work injury caused or substantially aggravated any mental health condition.  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).  When the findings are supported by substantial evidence, the Workers’ Compensation Court of Appeals must defer to the compensation judge.  Lagasse v. Horton, 982 N.W.2d 189, 202 (Minn. 2022).  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.”  N. States Power Co. v. Lyon Food Prods., Inc., 304 Minn. 196, 201, 229 N.W.2d 521, 524 (1975); see also Smith v. Carver Cnty., 931 N.W.2d 390, 79 W.C.D. 495 (Minn. 2019).

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); see also Busch v. Advanced Maint., 659 N.W.2d 772, 778-79 (Minn. 2003).

On appeal, the employee argues that a number of the compensation judge’s findings of fact were made in error, resulting in two flawed ultimate conclusions: first, that the employee failed to prove the October 27, 2022, work injury substantially caused or substantially aggravated his mental health conditions, and second, that the employee failed to prove he sustained consequential injuries to the low back and left hip.^[1]

The employee contends that the opinions of Drs. O’Neil, Steubs, and Engasser lacked foundation and therefore the compensation judge erred by relying on their opinions over those of Drs. Sipple, Fader, and Azar.

At the hearing, the employee objected to Dr. O’Neil’s opinion as lacking foundation because he did no psychological testing.  “An expert opinion lacks adequate foundation when the opinion does not include the facts upon which the expert is relying in forming the opinion, there is no explanation of the basis for the opinion, or the facts assumed by the expert are not supported by the evidence.”^[2]  Dr. O’Neil interviewed the employee and reviewed his case records.  His opinion was based on “enough facts to form a reasonable opinion that [was] not based on speculation or conjecture.”^[3]  Here, Dr. O’Neil had adequate foundation for his opinion.

The employee also asserts that Dr. O’Neil’s opinion should not have been adopted by the compensation judge because he is not board certified in forensic psychology.  This assertion goes to the competency of Dr. O’Neil as an expert witness.  Competency of an expert witness “depends upon both the degree of the witness’ scientific knowledge and the extent of the witness’ practical experience with the matter which is the subject of the offered testimony.”^[4]  The qualifications of the expert witness go to the weight to be given to the opinion by the compensation judge, and not to admissibility.^[5]  Here, Dr. O’Neil is a licensed psychologist with extensive experience.  His diagnostic clinical interview of the employee, case records review, and mental status examination, along with his experience and training, provide a level of knowledge sufficient to establish his competence to render an expert opinion.^[6]  The compensation judge did not err by accepting the opinion of Dr. O’Neil in considering whether the employee’s work injury caused aggravations of his underlying anxiety, depression, PTSD, or adjustment disorder.

The employee contends for the first time on appeal that the opinion of Dr. Steubs lacked foundation because Dr. Stuebs was unaware of the employee’s falls and did not review the mental health records.  The employee also contends for the first time on appeal that the opinion of Dr. Engasser lacked foundation because he evaluated the employee before the symptoms increased.  When there is no objection to an expert medical opinion at the hearing, allegations of defects go to the weight of the opinion.^[7]  Based on the facts and the record in this case, the compensation judge did not err by accepting the opinions of Dr. Steubs and Dr. Engasser when considering whether the employee sustained consequential left hip and low back conditions as a result of his work injury.

The nature and extent of the employee’s injuries were issues of ultimate fact for the compensation judge.^[8]  The compensation judge considered the multiple expert medical opinions to determine whether the employee had sustained any aggravations or consequential injuries, and to that end, she based her ultimate findings of fact not on one medical opinion but from the entire record as a whole.  This included competing and conflicting medical opinions and testimony from the employee.^[9]  As it is well established, the compensation judge has discretion to choose from competing and conflicting expert medical opinions and is free to accept or reject all or part of any medical opinion.^[10] 

In determining whether the employee had shown that his work injury caused aggravations of his underlying anxiety, depression, PTSD, or adjustment disorder, the compensation judge considered the opinions of Drs. O’Neil, Ebrahimi, and Sipple. 

Based on his diagnostic clinical interview of the employee, a case records review, and a mental status examination, Dr. O’Neil diagnosed the employee as having adjustment disorder with mixed anxiety and depressed mood, moderate cannabis use disorder, and antisocial personality traits, and concluded that these diagnoses were neither caused nor aggravated by the employee’s work injury.  Dr. O’Neil concluded that the employee did not have a PTSD diagnosis because the work injury was not a level of severity that met the criteria for a PTSD diagnosis.  He also determined that the employee’s cannabis use disorder and antisocial personality traits diagnoses pre-existed his work injury and were not aggravated by the work injury.  Noting that the employee did not seek any mental health treatment until a year after the work injury, Dr. O’Neil attributed his adjustment disorder to psychosocial stressors, including unemployment, financial stress, legal issues, and limited social support.  He also opined that the employee’s psychological diagnoses did not preclude the employee from full-time employment without restrictions.

As the compensation judge noted in her memorandum, Dr. Ebrahimi did not diagnose the employee with any psychological condition related to his work injury.  The judge also noted that Dr. Sipple did not conduct any mental health testing supporting his diagnoses of PTSD and adjustment disorder.  The compensation judge compared the medical opinions and chose to adopt the opinion of Dr. O’Neil as well-founded and persuasive.  Substantial evidence supports the compensation judge’s finding that the employee failed to prove he sustained a substantial aggravation of his underlying anxiety, depression, PTSD, and adjustment disorder as a result of the October 27, 2022, work injury.  We affirm.

In considering the employee’s claims for consequential injuries to his low back and left hip, the compensation judge considered the opinions of Drs. Azar, Sipple, Fader, Engasser, and Steubs.  Dr. Azar was of the opinion that the employee’s low back and hip conditions were a consequence of the accident, but the compensation judge noted that Dr. Azar’s written opinion was unclear as to whether he meant the employee’s low back and left hip conditions were related to the direct impact on the day of injury or were the result of the left injury knee injury and resulting disability.  The judge chose not to rely on Dr. Azar’s opinion after she determined that Dr. Azar did not explain the basis for attributing the employee’s low back and left hip conditions to the work injury and did not specifically indicate which conditions he considered to be directly related to, or consequential to, the work injury.

The compensation judge also chose not to rely on Dr. Sipple’s and Dr. Fader’s expert medical opinions.  The employee asserts that this choice was an error because the judge misinterpreted their opinions regarding causation of the employee’s diagnoses.  Dr. Sipple’s and Dr. Fader’s opinions were not clearly stated,^[11] however, the weight to be given each opinion is a function of the factfinder.  The choice between conflicting medical experts’ opinions is a decision for the compensation judge and is upheld on appeal when the opinions have adequate foundation and the acceptance of those opinions was not an abuse of discretion.^[12]  Here, the compensation judge relied on Dr. Engasser’s expert medical opinion that the employee’s low back condition was not a direct result of, or consequence to, the left knee injury.  We note that Dr. Engasser issued his report subsequent to a documented fall.  Nevertheless, Dr. Engasser did not find there was “any problem with his low back either directly due to the injury of October 27, 2022, or consequentially.”  (Ex. 3.)  It was reasonable for the compensation judge to rely on Dr. Engasser’s expert medical opinion.

Moreover, the judge also relied on Dr. Steubs’ expert medical opinion.  Dr. Steubs opined in his June 23, 2025, report that there were no objective findings in connection with the employee’s left hip or low back.  In an updated report, Dr. Stuebs acknowledged that the employee had stated that his left knee pain, altered gait, and use of crutches from the left knee injury led to his low back pain, but continued to hold the same opinion given, in part, that these symptoms did not appear until over a year later.  It was reasonable for the compensation judge to rely on Dr. Steubs’ expert medical opinion.

Based upon the entire record before us, it was not unreasonable for the compensation judge to rely on the adequately-founded expert opinions of Drs. Engasser and Steubs.  Substantial evidence supports the compensation judge’s finding and ultimate conclusion that the employee failed to prove he sustained a consequential injury to his low back or left hip as a result of his October 27, 2022, work injury.  We affirm.

The employee also asserts that the compensation judge limited his ability to present his mental injury claim and violated his right to a fair hearing by preventing lines of questioning and the presentation of complete evidence.  We disagree.  At the hearing, the judge raised questions about the relevancy of topics involving the employee’s loss of his second job, an insurer representative’s opinion on whether the employee’s job was seasonal, and the effect of the employee’s need for crutches and a wheelchair.  The compensation judge has broad discretion to determine the admissibility of evidence, and we see no abuse of discretion in this case.^[13]  We affirm the judge’s evidentiary rulings.

Finally, the employee claims that the compensation judge refused to acknowledge the employee’s mental health condition and its impact on his behavior by finding that his recollection of medical treatment and factual events was unreliable.^[14]  We disagree.

The burden rests with the employee to prove, by a preponderance of the evidence, that an injury is compensable.  The employee’s proposition that the judge in this case refused to acknowledge his mental health conditions is without merit.  The employee’s mental health conditions and his claims that they were causally related to the work injury were presented on the record and reviewed in the judge’s findings and order.  Assessment of sufficient medical evidence to support or impeach witness testimony is the function of the compensation judge.  Credibility findings are determinations uniquely reserved for the compensation judge.^[15]  The compensation judge could reasonably find that the employee’s recollection was unreliable.

There was sufficient medical evidence in the record to support the judge’s conclusions.  Because the judge’s findings are not manifestly contrary to the weight of evidence and are reasonably supported by the evidence as a whole, we affirm under the substantial evidence standard of review.^[16]