The employee worked as a commercial truck driver. On April 4, 2014 when the employee exited his truck, he fell and landed don his back. He also reported hearing a “crunching” sound in his neck. The employee reported his injury to the employer. The employee requested a winter layoff from the employer, which was granted. The employee saw Dr. Hawkins on March 12, 2015 after returning to work on March 2, 2015. Dr. Hawkins recommended an epidural steroid injection. The employee saw Dr. Ghose on April 10, 2015 for an independent medical evaluation. The insurer denied the employee’s claim for the injection due to Dr. Ghose’s IME report stating the injury was not a substantial contributing factor to the employee’s current condition. After this exam, Dr. Ghose received additional records that contradicted some of the employee’s statements. Based on these records, Dr. Ghose filed an IME addendum concluding that the employee was not truthful regarding past medical history, the history provided to his post-injury medical providers was inaccurate, and that although the recommended injection was reasonable and necessary, it was not causally related to the April 4, 2014 injury.
Based on Dr. Ghose’s opinion, the employer and insurer denied the employee’s claim for the epidural steroid injection. The employee received the injection on October 28, 2015, through his wife’s medical insurance.
A compensation judge heard this claim and found the employee was never pain free from the date of the work injury on April 4, 2014 through October 28, 2015, when he received the injection. The compensation judge also found the employee credible with respect to his post-injury symptoms and that the work injury was a substantial contributing factor to the employee’s ongoing cervical pain symptoms, disability, and need for medical treatment after April 4, 2014. The compensation judge held in favor of the employee and award payment. The employer and insurer appealed this decision.
The employer and insurer argue that the compensation judge’s findings and order are clearly erroneous and unsupported by substantial evidence in the records. They contend that the medical evidence relied upon in the record is inadequate, the judge erred in accepting the employee’s testimony and finding he testified credibly due to previously providing inaccurate information. The WCCA affirmed the compensation judge’s findings and order.
The WCCA’s decision emphasizes that it is the trier of fact’s function to assess a witness’s credibility. The compensation judge was able to observe the employee’s demeanor and was provided with his medical records, including the IME report. Accordingly, the WCCA determined the record adequately supports the compensation judge’s credibility assessment, and there was sufficient medical evidence in the record supporting the judge’s conclusion that the work injury was a substantial contributing factor to his ongoing symptoms.
The employer and insurer also argued that the compensation judge relied on inadequate treatment records and false information in determining whether the April 4, 2014 injury was a substantial contributing factor to the employee’s condition. The WCCA notes that in the compensation judge’s memorandum, he considers the employee’s pre-existing condition and prior medical history but concluded based on the weight of the evidence that the employee’s condition substantially worsened after the work injury, and was a substantial contributing factor in the employee’s need for ongoing treatment. The WCCA emphasize that questions of causation are determined by the compensation judge, and that it is not necessary to show that the work injury was the sole cause of the employee’s disability. The WCCA held that the medical evidence and testimony relied upon by the compensation judge was sufficient to support his determination that the employee suffered a compensable work injury.