In Crosby v. Tak Commc’ns, Inc., the Court reviewed an award of medical and other expenses when, as argued by the employer and insurer, the underlying medical opinion was based on speculation and conjecture. The Court disagreed with employer and insurer, and affirmed the award.
The employee, Crosby, was a cable installer who sustained a concussion and injury to his spine when struck on the head by a closing overhead garage door. With ongoing concussive symptoms, Crosby was referred to a neurologist, Dr. Rupert Exconde in 2012. Crosby underwent spinal therapy for spondylolysis which did not relieve his persistent pain. He then had a surgical consult, which determined that surgery was not indicated. MMI was determined to be reached on September 12, 2012. Crosby filed a worker’s compensation claim and was awarded a ppd rating of 15.6723%, adopting the opinion of Dr. Exconde.
In November 2013, Crosby relocated to North Carolina for approximately two years, during which time he did not seek medical treatment for his neck or back, but later testified to having ongoing pain during that time. He returned to Minnesota in late 2014 and in April 2015, injured his left knee. Crosby sought treatment for hip, knee, groin, and ongoing back pain.
In April 2016, Crosby went back to Dr. Exconde for further evaluation of his back pain. Following multiple surgeries, in 2017 Crosby was re-evaluated by Dr. Exconde (report filed in 2018). Dr. Exconde opined that the 2012 work injury was a substantial contributing factor for the employee’s neck and back pain, and the treatment received from 2015 to 2017 was causally related.
An IME was conducted by Dr. Cederberg in late 2017. It found that employee reached MMI in November 2012, noting that the employee had returned to work without restrictions and the gap in treatment between 2013 and 2015.
Relying primarily on the testimony of the employee that he had never fully recovered from the injury and suffered ongoing pain, the submitted opinions and treatment records of Dr. Exconde, and other medical records in evidence, the compensation judge found the claimed treatment to be reasonable, necessary, and causally related to the employee’s work injury.
Employer and insurer argued two points of law: (1) Dr. Exconde’s opinion lacked foundation, and (2) the award is not supported by substantial evidence in the record.
Foundation for Dr. Exconde’s Opinions
Employee treated with Dr. Exconde right after his injury in 2012, and again in 2017 (with a report filed in 2018). The employer and insurer argue that Dr. Exconde’s 2018 report should have been rejected by the judge because it is not a narrative report and does not specifically address more recent physical therapy and chiropractic treatment claimed by the employee. But “narrative form” is not required, and thus irrelevant. The Court also found that Dr. Exconde was aware of the “unaddressed therapy and treatment” when he wrote his report, even though it was not specifically identified. Employer and insurer argued that there were other things not specifically identified in the report, including for example, the circumstances of the return to work, but since these issues were specifically addressed in the report, the argument failed.
Because Dr. Exconde treated the employee since 2012, had knowledge of the employee’s history and the work injury, and had reviewed some of the employee’s treatment records from other providers, the Court found that Dr. Exconde did have adequate foundation for his opinion even though he only reviewed some, and not all, of employee’s treatment records from other providers.
The employer and insurer argued that because (1) Crosby returned to work under the direction of his treating physicians in August 2012, (2) the work was physically demanding and required long hours, and (3) he had been placed at MMI, therefore (i) Crosby’s injury had resolved in 2012, and (ii) the symptoms treated in 2015 were unrelated to the 2012 work injury. Accordingly, they argued that the judge erred by failing to address these facts in her decision.
The Court disagreed, finding that Dr. Exconde’s opinion and the employee’s testimony constituted substantial evidence to support the decision. A compensation judge’s decision need not cite to every fact in the record. Regardless, the memorandum shows that the judge was aware of and did consider these facts. Because the judge’s findings were not manifestly contrary to the weight of the evidence and were reasonably supported by the evidence as a whole, the decision was not disturbed.