This case arises out of an appeal by the employee from a compensation judge’s findings that the employee sustained a temporary aggravation of a pre-existing condition, that the injury had resolved by March of 2012, and any medical treatment after that date was not causally related to the injury.
The employee sustained a left shoulder and low back injury in March of 2012 while working for ISD 492. The employee was an aide for emotionally and behaviorally disabled children and was injured while trying to restrain a student.
X-rays of the lumbar spine revealed minimal retrolisthesis of L2 on L3, L3 on L4, L4 on L5 with diffuse lumbar vertebral osteophytes and prominent aortioliac vascular calcifications. The employee returned March 28, 2012 reporting worsening pain in his shoulder and decreased low back pain. Just over a month post-injury, the employee was diagnosed with tearing and impingement in his left shoulder and treated for these conditions and received a lidocaine injection. The low back wasn’t mentioned at this time. In June of 2012 at a PT consultation, the employee noted a low back strain at the time of injury, but stated it seemed to be improving.
In July of 2012, the employee underwent shoulder surgery. The employee underwent PT and was released to work without restrictions in September of 2012. In January of 2013, the employee sought treatment for his low back. The nurse noted no treatment since the March 2012 injury. An MRI in February of 2013 indicated degenerative disc disease, mild foraminal stenosis, and central canal stenosis. The employee returned to the doctor in July 2013 after an increase in low back pain after sneezing. The doctor reviewed an MRI and noted a focal disc protrusion at L4-5 and possible right L5 nerve root impingement but noted the employee had no correlating clinical symptoms.
The employee treated with a steroid injection at that time and was referred for a neuro consult with Dr. Marsh, who recommended facet injections or surgery. He opined that the employee’s work injury was a substantial aggravating factor of the medical condition- and that the disc protrusion could have happened at the time of the work injury, and that some of the changes could have evolved after the injury and before the February 2013 MRI.
The employee reported an increase in low back pain in February of 2014 stepping out of the shower. In March 2014 the employee underwent an IME with Dr. Friedland and was diagnosed with chronic multilevel lumbar degenerative disc disease, and that the employee’s March 2012 work injury was a minor and temporary aggravation of a longstanding and pre-existing disc disease that had resolved by March 28, 2012. In February of 2014 the employee filed a medical request for approval for a treatment plan with conservative treatment and a possible laminectomy or fusion as recommended by the neurologist.
After a hearing, the compensation judge found the employee sustained a temporary aggravation of a pre-existing lumbar spine condition as a result of the March 2012 injury that resolved a week later, and denied the request for additional low back treatment. The employee appealed.
The employee argued, in part, that Dr. Marsh was a neurological surgical specialist whose opinon had “more insight and more intellectual analysis” than Dr. Friedland’s opinion.
The W.C.C.A. found that the compensation judge, as the trier of fact, is charged with the resolution of conflicts of expert medical testimony. Where there is adequate foundation for the opinions adopted by the judge, the court will normally uphold the compensation judge’s choice among medical experts. Thus, the W.C.C.A. affirmed the compensation judge’s findings and the subsequent denial of low back treatment after March 28, 2012.