Johnson v. St. Paul Eye Clinic, P.A

Johnson v. St. Paul Eye Clinic, P.A., No. WC18-62-6203 (W.C.C.A. January 18, 2019).

Employer and Insurer appealed a determination that a proposed right shoulder surgery was reasonable, necessary, and causally related to an admitted work injury.  The compensation court also addressed an issue of a consequential left shoulder injury.  Although the court found for the Employee on both shoulders, the left shoulder injury and left shoulder surgery was not appealed. Therefore, the WCCA limited its opinion to the issues of the right shoulder.

Employee sustained an admitted right shoulder injury on February 9, 2016. An MRI of the right shoulder showed a small, full-thickness tear of the supraspinatus tendon, which was subsequently surgically repaired by Dr. Peter Daly.  Employee continued to have right shoulder pain following her surgery.

Employee had a second opinion with Dr. Glenn Ciegler on May 8, 2017, where a MRI arthrogram of the right shoulder was reviewed, noting possible fraying of the supraspinatus tendon.  Dr. Ciegler did not believe it required surgical intervention.

On July 13, 2017, the Employee had a follow-up visit with Dr. Daly, who diagnosed the Employee with a right shoulder partial undersurface supraspinatus tear.  Dr. Daly proposed that the tear should be surgically repaired.

On August 30, 2017, at the request of the Employer and Insurer, the Employee underwent an IME with Dr. Michael D’Amato.  Dr. D’Amato found the complaints of right shoulder pain and limited range of motion was exaggerated and concluded the right shoulder condition had healed.  Surgery was not recommended.

On February 17, 2018, at the request of Employee’s counsel, the Employee underwent an IME with Dr. Paul Wicklund.  Dr. Wicklund concluded the Employee’s right shoulder injury arose out of employment activities on February 9, 2016, but that right shoulder surgery is not necessary or reasonable.

On appeal, Employer and Insurer disputed whether substantial evidence supported the compensation judge’s determination that the right shoulder surgery was reasonable, necessary, and causally related to the work injury.  The WCCA rejected the arguments of the Employer and Insurer, reasoning that “it is well established that a compensation judge’s choice among conflicting expert medical opinions must be upheld unless the opinion lacked adequate factual foundation.” Mattick v. Hy-Vee Food Stores, 898 N.W.2d 616, 621, 77 W.C.D. 617, 624 (Minn. 2017).  The WCCA further notes that a determination of expert opinions rests with the compensation judge, subject to review for abuse of discretion.  In looking at the facts, the WCCA reasoned that by Drs. Ciegler, Wicklund, and D’Amato considering the right shoulder surgery to be unnecessary creates a record of conflicting expert opinions that requires analysis and resolution by the compensation judge.  The WCCA did not find the compensation judge abused her discretion by giving greater weight to the opinion of Dr. Daly, or Dr. Wicklund on causation. The decision by the compensation judge was affirmed.