VACATION OF AWARD – REFERRAL; MINN. STAT. § 176.521, SUBD. 3 CONSTRUED. Where there is conflicting evidence regarding the employee’s past and current medical diagnoses, causation, medical treatment, permanent partial disability ratings, and payment of any medical treatment prior to and following awards on stipulation, the Workers’ Compensation Court of Appeals may refer the issues to a compensation judge at the Court of Administrative Hearings for factual findings.
Attorneys: Aaron W. Ferguson, Aaron Ferguson Law, Arden Hills, Minnesota, for the Petitioner. Arlen R. Logren, Fitch, Johnson, Larson, P.A., Roseville, Minnesota, for the Respondents.
Referred to Court of Administrative Hearings.
SEAN M. QUINN, Judge
The employee petitions to vacate and set aside two Awards on Stipulation, served and filed on July 29, 2011, and June 19, 2012. In order to fully consider the employee’s petition, we refer the matter to the chief judge of the Court of Administrative Hearings (CAH) under Minn. Stat. § 176.381, subd. 1, for an evidentiary hearing before a compensation judge on the issues set out in the opinion below.
On August 1, 2007, the employee, Danny McClain, suffered an injury to his right wrist while working as a trailer mechanic for the employer, Eagle Intermodal Services, Inc. When throwing heavy semi-tractor trailer tires, the employee heard a pop in his right wrist immediately followed by pain. The employee reported the injury to his employer the next day but did not seek medical care for several months when his pain symptoms became unbearable. The employer and insurer admitted primary liability and began paying various workers’ compensation benefits.
The employee’s initial care included physical examinations, injections to the right wrist, an electromyography (EMG) test, and an MRI scan. On July 1, 2008, the employee was examined by Dr. David Falconer, an orthopedic surgeon, who noted that the employee had been evaluated by Dr. Laurie Koch, an orthopedic hand surgeon. After EMG and MRI testing, Dr. Koch did not report significant findings and “discharged him for chronic pain management speculating on the possibility of chronic regional pain syndrome.” The employee also denied “any blue or red color changes, reactive swelling, passive stiffness in the non-associated joints and persists with ulnar wrist pain.” (Ex. 12.) At that time, Dr. Falconer observed no symptoms of complex regional pain syndrome (CRPS), diagnosed a peripheral tear of the triangular fibrocartilage (TFC), and recommended arthroscopic surgery. After the surgery on July 30, 2008, the employee wore a cast and underwent physical therapy.
On November 18, 2008, a therapist noted that the employee appeared to have sympathetic/chronic pain in addition to pain localized at the right wrist. The employee’s symptoms did not improve and he began complaining of new symptoms in his right elbow, which were treated with injections. Dr. Falconer considered carpel tunnel syndrome as a possible diagnosis, which was later ruled out.
Because of the employee’s ongoing symptoms and the lack of improvement from surgery, Dr. Falconer recommended a second surgery. On August 5, 2009, the employee underwent a fusion surgery at the right wrist, followed by post-operative casting, splinting, and physical therapy. Hypersensitivity was mentioned several times during post-operative therapy. The employee’s right elbow pain also persisted and was treated with additional injections.
The employee’s right wrist symptoms continued to worsen, and a third surgery was recommended by Dr. Falconer. The employer and insurer objected and requested that Dr. Jeffrey Husband perform a medical examination. Dr. Husband’s report, dated May 12, 2010, noted the employee complained of pain, numbness, tingling, and paresthesia, as well as coldness in his right hand and fingers. The employee had diffuse pain that Dr. Husband opined was out of proportion to objective findings. Dr. Husband also noted the earlier 2008 assessment of potential CRPS but did not agree that the employee had such a condition. In light of Dr. Husband’s opinion, the employer and insurer denied the surgery recommended by Dr. Falconer.
The dispute was heard at hearing before a compensation judge on July 30, 2010. The compensation judge found the proposed third surgery to be reasonably required to address the employee’s pain symptoms and awarded the claim. On September 22, 2010, Dr. Falconer performed exploratory surgery of the employee’s right wrist with resection of the posterior and anterior interosseous nerve. Post-operative physical therapy followed.
The employee had slight improvement in his right wrist pain but developed pain in a separate part of his right wrist post-surgery. A functional capacity evaluation (FCE) was conducted in March 2011. The FCE concluded that the employee was limited to lifting five pounds rarely and two pounds occasionally, with no lifting from the floor level with the right hand. He could do simple grasping, but no firm grasping. Fine manipulation using the right hand was limited to occasional. The provider noted the employee was using his left hand to compensate for his right, and that the left hand became weak during the progression of the testing.
Throughout 2011, the employee continued to have significant pain in the right wrist for which he was provided injections and various narcotic pain medications. The employee developed symptoms in his left wrist which were attributed to overuse due to the work injury. He underwent injections to the left wrist with limited results. The employer and insurer denied liability for a left wrist condition.
The parties entered into a stipulation for settlement, and an award on stipulation was issued by a compensation judge on July 27, 2011. Under the terms of the settlement, the employee waived his rights to all future additional workers’ compensation benefits except for medical care for his right wrist, a claimed consequential left wrist injury, and claimed gastrointestinal problems. The employer and insurer agreed to pay for reasonable, necessary, and causally related medical care for the employee’s right wrist, and reserved their primary liability defenses to any future claims for his left wrist or gastrointestinal issues. Chiropractic care, mental health care, and in-patient chronic pain care were closed out. The amount of the settlement was $200,000. The parties stipulated the employee was permanently and totally disabled as of January 27, 2010, and previously paid temporary total disability benefits were recharacterized as permanent total disability benefits. The parties later settled additional claims related to a medical bill and for penalties against the employer and insurer’s late payment of the 2011 settlement award. An award on stipulation was issued on June 19, 2012.
The employee returned to Dr. Falconer on March 31, 2015, for bilateral wrist and right elbow pain, and was treated with injections. At the next visit a few months later, Dr. Falconer noted the only possible additional surgical treatment would be a right wrist implant arthroplasty to treat the ongoing symptoms at the joint.
The employee began treatment with Dr. Peter Parten in April 2016 for right shoulder pain. An MRI scan showed a torn rotator cuff. The employee asserts that the first time he experienced right shoulder problems was in early 2016. The employer and insurer contend that medical records reflect right shoulder complaints during physical therapy in 2008.
In September 2016, the employee was referred to United Pain Clinic, treating primarily with Dr. Gordon Beardwood, and was diagnosed with CRPS. The employee claims this was the first diagnosis. The employer and insurer point to earlier references to CRPS in the medical records from 2008, 2010, and 2011. On October 4 and 10 of 2016, the employee underwent two stellate ganglion blocks, which both provided relief for a few days. A spinal cord stimulator (SCS) was suggested to treat the CRPS. By 2017, the employee underwent a mental health evaluation finding him to be a good candidate for a SCS. The employee continued to treat at United Pain Center through 2023. He was seen by Dr. Falconer for right wrist pain through July 2018, and was prescribed pain medication and physical therapy.
An MRI scan of the right shoulder was performed on June 16, 2019, showing a full-thickness tear of the supraspinatus tendon. On July 23, 2019, the employee underwent right shoulder arthroscopic surgery by Dr. Parten. He performed a rotator cuff tear repair, a bicep tenodesis procedure, and a right shoulder joint decompression with an excision of the distal end of the clavicle and debridement of the labrum. Despite post-operative care and therapy, the employee continued to have difficulty with his right shoulder.
On June 23, 2025, Mark Stock, a CNP at Pain Specialist of Minnesota, diagnosed the employee with right wrist pain, right shoulder pain post rotator cuff surgery, neck pain with right arm radiculopathy, and chronic intractable pain/CRPS of the right upper extremity. CNP Stock prescribed a course of narcotic pain medication.
The employee underwent MRI scans of his spine and right shoulder in August 2025, which showed degenerative changes at multiple levels of the spine as well as a disc herniation impinging the C7 nerve root and post-surgical changes in the shoulder, but no recurrent tear.
Numerous medical experts conducted medical examinations and provided varying medical opinions regarding the employee’s diagnoses, treatments, future treatments, and permanency ratings of his right shoulder, bilateral wrists, and chronic pain symptoms.
In a letter to the employee’s attorney dated February 1, 2018, Dr. Beardwood opined that the employee’s diagnosis was CRPS, which was causally related to the 2007 work injury. Dr. Bearwood disagreed with Dr. Husband’s 2010 medical opinion that the employee did not have CRPS.
On April 16, 2018, Dr. Joel Gedan issued a report following an examination of the employee at the request of the employer and insurer. Dr. Gedan reviewed medical records and pointed to various records throughout the employee’s file where treating doctors, including Dr. Falconer, noted that the employee did not have objective findings of CRPS. Dr. Gedan opined that the employee did not suffer from CRPS. Upon physical examination, he noted normal color and no mottling of the skin, normal temperatures, no swelling, no sweating, or trophic changes. He advised against any CRPS-based medical care, including the past care already provided (stellate ganglion blocks and ongoing narcotics) and the proposed SCS treatment. He also suggested that any care for the employee’s right wrist pain be provided by an orthopedic surgeon, but given the failure of three prior surgeries, there was no reasonable expectation that future surgery would be helpful. He agreed that the employee was disabled due to his ongoing right wrist symptoms. Finally, Dr. Gedan opined that the employee’s symptoms in his right elbow and shoulder were not manifestations of CRPS and needed to be addressed by an orthopedic surgeon.
On May 14, 2020, Dr. Parten stated that the employee’s right shoulder diagnosis was a rotator cuff tear with impingement syndrome, which was not caused by the 2007 work injury. He also opined there was no consequential injury. He rated the employee with a zero percent permanent partial disability (PPD) rating due to the full-thickness rotator cuff tear repair.
On November 1, 2021, in his second medical expert report, Dr. Husband confirmed his opinion that the employee did not suffer from CRPS, that the employee’s past and proposed treatment was not reasonable or necessary, and that the employee’s complaints related to his right elbow and right shoulder were unrelated to the admitted right wrist injury.
On March 2, 2022, Dr. Jack Bert diagnosed the employee with status-post three right wrist surgeries and one right shoulder surgery. He opined that the employee suffered from CRPS of the right arm. The only future care he recommended was ongoing analgesics. He further opined the right wrist injury occurred during the 2007 work accident and the right shoulder condition was a result of attempting work activities with altered body mechanics. He placed significant work restrictions on the employee’s use of his right arm and did not believe the employee was capable of using the right arm for any realistic work activities. Dr. Bert provided various PPD ratings.
On May 2, 2022, Dr. Falconer opined that the employee’s right wrist diagnosis, chronic right wrist pain after three surgeries, was due to a combination of CRPS and orthopedic impingement. Dr. Falconer stated that he was aware that Dr. Parten did not see a causal link between the employee’s right shoulder and his right wrist injury, and deferred to Dr. Parten’s opinion. As to the left wrist, Dr. Falconer opined that the condition was degenerative but “undoubtedly affected by the fact that he is forced to favor and to limit the use of his right wrist.” (Ex. O.) An August 25, 2021, MRI arthrogram of the employee’s left wrist had shown partial tearing of the TFC. He also assigned PPD ratings. Treatment offered by Dr. Falconer has included right wrist replacement surgery as well as pain medication and physical therapy to address ongoing pain.
Dr. L.T. Donovan wrote a report dated December 22, 2022, and two follow-up reports dated May 16, 2024, and August 30, 2024. He opined that the employee suffered a minor sprain of his right wrist at the time of the original injury, that a fourth surgery recommended by Dr. Falconer was neither reasonable nor necessary, that the employee did not have CRPS, that the employee did not have any medical condition related to his right elbow, that the employee’s right shoulder condition was age-related and unrelated to his work injury, that the employee’s left wrist condition was unspecified pain unrelated to his work injury, and that the employee was demonstrating symptom magnification.
Dr. Denis Sipple wrote a report on December 21, 2023, which stated that the employee suffered a right wrist injury in 2007 that led to the development of CRPS and a right shoulder injury, including a rotator cuff tear and frozen shoulder. Dr. Sipple outlined the Budapest criteria supporting his CRPS diagnosis for the employee. He further opined that even with overuse of the left arm due to the right arm pain, the employee had gross function of his left arm and was able to perform daily activities with the left arm. Dr. Sipple also assigned various PPD ratings.
Dr. Louis Saeger wrote a report dated August 9, 2024. Dr. Saeger agreed with Dr. Falconer, Dr. Bert, and Dr. Sipple that the employee’s right wrist injury caused consequential injuries to the left wrist and right shoulder, and that the employee developed CRPS in the right arm. He also opined the employee developed a consequential injury to his right elbow in the nature of a mechanical injury. He suggested platelet-rich plasma injections to treat the elbow.
The employee petitions this court to vacate and set aside the awards on settlement filed in 2011 and 2012, alleging a substantial change in medical condition under this court’s authority set forth in Minn. Stat. § 176.461. The employer and insurer object.
The employee seeks to have vacated the 2011 and 2012 awards on stipulation because his medical condition has substantially changed since the settlements. Pursuant to Minn. Stat. § 176.461, this court may set aside an award on stipulation “for cause.” The term “for cause” includes “a substantial change in medical condition since the time of the award that was clearly not anticipated and could not reasonably have been anticipated at the time of the award.” Minn. Stat. § 176.461(b)(4). The employee claims that he developed CRPS and right shoulder problems that were unknown and unanticipated at the time of the settlements and that he has since become more functionally disabled.
The employer and insurer respond that there was no substantial change in the employee’s medical condition and that any change was clearly anticipated by the parties as the employee’s medical doctors had noticed, treated, and diagnosed the alleged “new” medical conditions prior to the settlements. Further, the employer and insurer assert that at the time of the settlements, the employee was permanently and totally disabled and cannot be considered “more” permanently and totally disabled.
We cannot address the employee’s petition to vacate the awards nor the employer and insurer’s counterarguments until factual findings are made on the nature of the employee’s current medical conditions including diagnoses, PPD ratings, reasonable and necessary medical treatment, and payment for the treatment. This court may refer a matter for factual findings pursuant to Minn. Stat. § 176.521, subd. 3. Referral is appropriate to resolve significant factual disputes, particularly in matters with conflicting expert medical opinions. See Cates v. SPX Serv. Sols., No. WC19-6329 (W.C.C.A. Aug. 5, 2020) (citing Jacobson v. Hennepin Faculty Assocs., No. WC04-210 (W.C.C.A. Nov. 24, 2004)).
To that end, we refer this matter to the chief judge of CAH for assignment to a compensation judge for a full evidentiary hearing and for specific factual findings on the following questions:
Upon the filing of the findings by the assigned compensation judge, either party may appeal. Should there be a timely appeal, the court will consider the appeal and the petition to vacate in the same decision.