The employee appealed the compensation judge’s denial of a referral to Dr. Andrews. The employee sustained an admitted injury on July 4, 2003 when throwing a heavy log off a roof. He injured his right shoulder and upper back.
Subsequently, the employee underwent multiple tests. The employee had an unremarkable cervical spine MRI and a normal EMG. The employee’s MRI of his thoracic spine showed minimal early disc degeneration, while a CT scan of the bilateral scapulae showed possible evidence of scapulothoracic impingement.
The employee underwent multiple consultations and treatments, including an arthroscopic surgery of his right shoulder with Dr. Freehill and medical branch blocks to the thoracic spine by Dr. Andrews. The employee was eventually referred to Dr. Elghor, who provided steroid and trigger point injections. The employee did not experience relief from these treatments.
The employee did not seek medical treatment from 2003 to 2013, when he returned to Dr. Elghor. Dr. Elghor first referred the employee to Dr. Collins or Dr. Derr, but Dr. Collins was not taking new patients and Dr. Derr did not accept workers’ compensation patients. Dr. Elghor then referred the employee back to Dr. Andrews. The insurer denied this referral. The employee filed a medical request for the referral. However, the request was denied at an AC. A compensation judge heard the issue on January 20, 2016. The compensation judge stated this referral was not reasonable and necessary medical treatment under Minn. Stat. § 176.135.
The employee appealed the compensation judge’s denial of a referral to Dr. Andrews. The employee argued that the judge committed a mistake of fact in finding the employee “saw” Dr. Collins in 2014, and that the judge erred in finding his referral was not reasonable and necessary medical treatment.
The WCCA notes that the standard of review on appeal is whether the compensation judge’s determination is supported by substantial evidence; findings of fact are to be upheld unless clearly erroneous. The WCCA stated that the compensation judge did erroneously find the employee “saw” Dr. Collins. However, such finding was harmless error. To determine whether an error is harmless, the WCCA “analyzes whether the error is a significant factor in the compensation judge’s conclusions.” If the error is not a significant factor, then the WCCA is not required to take any action. See Engelhart v. Liston Gen. Contracting, Inc., 72 W.C.D. 753, 759 n.1 (W.C.C.A. 2012) (citing Johnson v. Arctic Cat, Inc., 64 W.C.D. 106, 110 (W.C.C.A. 2004). Since the compensation judge did not rely on this finding in determining whether the referral to Dr. Andrews was reasonable and necessary, the error was harmless.
Determining whether a medical treatment is reasonable and necessary is a question of fact. The WCCA indicated that substantial evidence supported the compensation judge’s determination that the employee’s referral was not reasonable and necessary since Dr. Elghor did not provide an explanation for the referral. The WCCA affirmed the compensation judge’s decision.