Daza Zaragoza v. Golden Employment Group, Inc.

Daza Zaragoza v. Golden Employment Group, Inc. , No. WC18-6198. (January 31, 2019).

The Employee, Laura Zaragoza, suffered an admitted injury on March 31, 2014, while working at golden Employment Group, the Employer.  She was packing boxes with bottles of shampoo when she felt a pop in her right upper extremity.  She sought treatment at Hennepin County Medical Center (HCMC) complaining of severe right bicep pain with pain radiating into her right shoulder and neck.  She was diagnosed with a partial tear of her right bicep tendon.

She continued following up at HCMC and began physical therapy in May of 2014.  By July 10, 2014, she was diagnosed with a resolved partial bicep tear.  Her last physical therapy appointment occurred on August 1, 2014.  She was recommended for more physical therapy, which she testified to attending, but neither party was able to obtain any physical therapy records from HCMC after August 1, 2014.  HCMC intervened and sought payment for treatment provided through and after August 1, 2014.  HCMC was ordered to attend the hearing but did not appear or submit medical records for treatment provided after August 1, 2014.

Employee also received treatment from Rivera Chiropractic Center for her neck, mid back, and low back.  She received a MRI of her cervical spine and right shoulder, that showed a minimal anterior spur at C4-5 and C5-6 and a mildly curved type II acromion and degenerative changes of the AC joint.

Dr. Christopher Meyer performed three examinations on her and diagnosed her with a disruption of the long head of the bicep tendon and a right shoulder sprain/strain, that were related to the Employee’s injury.  The bicep tendon should have healed within 8-12 weeks, which was consistent with the medical records, and her shoulder strain had resolved by October 28, 2014, the date of his examination.  She also had subjective pain without objective findings and that the chiropractic care was not reasonable or necessary, given the physical therapy.  The Employer and Insurer stopped paying for medical care after November 26, 2014.  In his other reports, he rated her at 1% PPD, which was paid.  He also opined that the treatment for her right shoulder was unrelated but that a MRI ought to be done, but any symptoms of shoulder impingement was not work related.

Employee sought payment of outstanding medical expenses, right shoulder MRI, and approval of right shoulder surgery.  A hearing took place and the compensation judge found that the Employee’s partial bicep tear resolved by July 10, 2014, based on the medical records from HCMC and Dr. Meyer’s IME reports.  The Employee’s right shoulder sprain had resolved by Dr. Meyer’s examination on October 28, 2014 and that the MRI did not show any impingement findings.  The chiropractic care was not reasonable or necessary and the Employee did not sustain a neck injury.  The judge determined that the medical care after July 10, 2014 and October 28, 2014 was not related to the work injury, including the recommended surgery and MRI.  Finally, the judge found the treatment rendered by HCMC through August 1, 2014 was reasonable, necessary, and related to the work injury and ordered the Employer and Insurer to pay this intervention balance, despite HCMC not attending the hearing.

The Employee appealed the denial of the MRI, right shoulder surgery, HCMC’s claim for reimbursement after August 1, 2014, chiropractic treatment, and rejection of her claim of a work-related neck injury.  The Employer and Insurer cross-appealed the award of HCMC’s claim for reimbursement for care on and before August 1, 2014.

On appeal, the Employee argued that the compensation judge should not have accepted Dr. Meyer’s opinion because he was the only doctor to observe symptom magnification.  The WCCA concluded they will not overturn the compensation judge’s choice of medical expert, as Dr. Meyer’s opinion had adequate foundation, as he reviewed all of the available medical records and examined her three separate times.  The WCCA affirmed the compensation judge’s denial.

The Employer and Insurer argued that since HCMC failed to appear at the hearing, as they were ordered to, they forfeited its entire intervention claim.  The Employer and Insurer relied on Minn. Stat. 176.361, subd. 4.  The WCCA noted HCMC intervened for payment before and after August 1, 2014, but did not provide medical records for the care after August 1, 2014.  HCMC was ordered to appear based on its failure to provide records after August 1, 2014.  The compensation judge denied HCMC’s claim for reimbursement for care after August 1, 2014 due to its failure to prove entitlement to reimbursement after that date.  Although the compensation judge did not make an explicit finding of “good cause” for HCMC to not attend the hearing, HCMC not attending was not fatal to its claim for treatment on or before August 1, 2014.  Its attendance was only required for its claim after August 1, 2014.

The compensation judge’s Findings and Order was affirmed in its entirety.