Opinion
W.C. No. 4-815-815.
November 7, 2011.
FINAL ORDER
The claimant seeks review of an order of Administrative Law Judge Walsh (ALJ) dated May 18, 2011, that denied and dismissed the claimant's claim for workers' compensation benefits. We affirm.
The following facts are taken from the record and the ALJ's findings of fact. The claimant worked as a secretary to the principal at the employer's facility. The claimant's job duties included filing of student documents, data entry, administrative duties, and serving as a receptionist. On November 19, 2009, the claimant was bending over a file cabinet to perform her filing duties, when she heard a pop in her back, and she felt the sudden onset of acute back pain that went across her back and in both of her lower extremities. For several days prior to this incident, the claimant had been filing continuously, and this duty entailed a lot of bending, kneeling, and twisting activities. The claimant reported her injury, and she was sent for medical treatment. A subsequent MRI demonstrated that the claimant had an annular tear.
As pertinent here, approximately 23 years prior to suffering low back pain on November 19, 2009, the claimant suffered a lumbar spine injury. As a result of this injury, the claimant underwent surgery, a hemilaminotomy with decompression.
On March 23, 2011, a hearing was held on the issues of compensability, medical benefits, authorized provider, and temporary benefits. During the hearing, the claimant testified that after her surgery approximately 23 years ago and prior to the incident on November 19, 2009, she did not have any problems with her low back, she felt no back pain, and she did not seek any medical treatment for her back for the last 15 years. Tr. at 13-14, 30. The claimant also submitted the deposition testimony of her independent medical examiner, Dr. Hall. Dr. Hall opined that it is more probable that the claimant sustained an on-the-job injury. Hall Depo. at 16-17.
During the hearing, the respondents' independent medical examiner, Dr. Richman, testified. During his testimony, Dr. Richman opined that prior to the November 19 incident, the claimant suffered from degenerative disc disease, which is a long term degenerative process that occurs over time. Tr. at 76-77. Dr. Richman further testified that even though the claimant denied having any problems since her surgery 23 years ago, it is unusual for someone to have no back pain 23 years following a laminectomy. Tr. at 77-78. Dr. Richman opined that the claimant did not suffer a work-related injury on November 19, reasoning that there was no trauma and no specific activity that would lead to any increased risk for the development of disabling low back pain. Tr. at 79-80. Dr. Richman also opined that the claimant's back pain after bending forward was coincidental, and the claimant would have experienced symptoms that day whether she was at work or not. He reasoned that the cause of her low back pain was her significant degenerative disc disease and spondylosis. Tr. at 81. Moreover, Dr. Richman testified that the occurrence of an annular tear can be painful, but most of the time it is not. He further testified that it was possible that the claimant sustained the annular tear on November 19, but that there was no way to pinpoint the exact date. Tr. at 95-96. He also testified that what caused the claimant's pre-existing degenerative arthritic condition to become symptomatic was idiopathic. Tr. at 98.
On May 18, 2011, the ALJ entered his findings of fact, conclusions of law, and order. In his order, the ALJ found Dr. Richman's opinions to be persuasive and credible. As pertinent here, the ALJ found that Dr. Richman opined that there "was no work activity or work related trauma, or occupational disease or hazard that presents any more risk than normal daily activities." Findings of Fact at 3 ¶ 7. The ALJ further found that Dr. Richman testified that the claimant's prior back surgery would have caused her lumbar spine to further deteriorate over time due to the anatomical changes created by the surgery. The ALJ noted that Dr. Richman found that the claimant had additional risk factors for the development of subsequent low back pain, including being deconditioned and overweight. Findings of Fact at 3 ¶ 8. The ALJ then concluded that the claimant failed to establish by a preponderance of the evidence that she suffered an injury arising out of and in the course of her employment. Conclusions of Law at 5 ¶ 10. As such, the ALJ denied and dismissed the claimant's claim for workers' compensation benefits.
I.
On appeal, the claimant contends that the ALJ erred, as a matter of law, in concluding that the claimant's claim was not compensable. The claimant argues that the ALJ's order is not supported by the evidence. The claimant specifically argues that the ALJ erred in basing his order solely on the opinions of Dr. Richman, who opined that the claimant's back injury was caused idiopathically, had nothing to do with her activities, and since the claimant did not suffer trauma, her claim was not compensable. The claimant contends that there is no case law which supports this hypothesis that in order to have a compensable injury, there must be trauma. The claimant further contends that it was error for the ALJ to base his decision on an improper definition of a compensable injury. We are not persuaded by the claimant's arguments.
A claimant has the burden to prove that her injury was proximately caused by an injury arising out of and in the course of her employment. Section 8-41-301(1)(b) and (c), C.R.S. Whether the claimant has met that burden of proof is a factual question for resolution by the ALJ, and his factual findings must be upheld if supported by substantial evidence in the record. Dover Elevator Co. v. Industrial Claim Appeals Office, 961 P.2d 1141 (Colo. App. 1998). Substantial evidence is that quantum of probative evidence which a rational fact finder would accept as adequate to support a conclusion without regard to the existence of conflicting evidence. See F.R. Orr Construction v. Rinta, 717 P.2d 965 (Colo. App. 1985).
Additionally, if a pre-existing condition is the precipitating cause of an injury that occurs in the workplace, "the resulting disability is compensable if the conditions or circumstances of employment have contributed to the accident or to the injuries sustained by the employee." National Health Labs. v. Industrial Claim Appeals Office, 844 P.2d 1259, 1260-61 (Colo. App. 1992) (holding that a worker's epileptic seizure while driving was compensable where the worker was required to operate automobile in the course and scope of her employment because vehicular travel constitutes a special hazard).
Here, we conclude that the ALJ did not abuse his discretion in concluding that the claimant failed to establish by a preponderance of the evidence that she suffered an injury arising out of and in the course of her employment. Contrary to the claimant's argument, the ALJ did not base his decision on an improper definition of a compensable injury under the Act. Rather, the ALJ's order did, in fact, correctly cite the law. In particular, the ALJ ruled that the claimant has the "burden to prove by a preponderance of the evidence that there is a direct causal relationship between the employment and the injuries." Order at 4 ¶ 5. See § 8-43-201(1), C.R.S. The ALJ specifically ruled that the "arising out of" test is one of causation," and that "it requires that the injury have its origin in an employee's work-related functions, and be sufficiently related thereto so as to be considered part of the employee's service to the employer." Conclusions of Law at 4 ¶ 4. See § 8-41-301, C.R.S.
Additionally, we recognize that the ALJ credited and cited to the opinions of Dr. Richman, who opined that since there was no trauma, the claimant's claim was not compensable. Tr. at 79-80; Findings of Fact at 3 ¶ 7. We read nothing in the order, as suggested by the claimant, however, that demonstrates the ALJ mistakenly ruled that the law governing compensability requires a claimant to have suffered trauma. Again, as explained above, the ALJ cited to the correct law and definitions governing compensability, and the order demonstrates that his analysis of the compensability of the claimant's claim used this law and these definitions under the Act. See Shafer Commercial Seating, Inc. v. Industrial Claim Appeals Office, 85 P.3d 619 (Colo. App. 2003) (ALJ presumed to have considered relevant legal principles when entering an order). In particular, the ALJ concluded that the claimant failed to establish by a preponderance of the evidence that she suffered an injury arising out of and in the course of her employment. Conclusions of Law at 5 ¶ 10.
Further, the ALJ's ruling that the claimant did not sustain a compensable injury is supported by substantial evidence and is binding on review. Section 8-43-301(8), C.R.S. As noted above, the ALJ expressly credited Dr. Richman's opinions that the claimant's back pain was caused by her preexisting lumbar spine degenerative disc disease and that she did not suffer any work-related injury. The ALJ found that Dr. Richman testified that the claimant's "described mechanism of injury (bending over) did not put the Claimant at any increased risk for a back injury as compared to her activities of daily living, and the temporal relationship between her back pain and job duties does not establish a causal relationship between the two." Findings of Fact at 3 ¶ 10. The ALJ noted that Dr. Richman cited multiple scientific studies in support of this opinion. Id. Additionally, the ALJ found that Dr. Richman opined that the claimant's prior surgery 23 years ago "would have caused her lumbar spine to further deteriorate over time due to the anatomical changes created by surgery," and that the claimant "had additional risk factors for the development of subsequent low back pain, including being deconditioned and overweight." Findings of Fact at 3 ¶ 8.
Additionally, the claimant contends that the ALJ abused his discretion in solely relying on the opinions of Dr. Richman and not mentioning Dr. Hall's opinions in his order. Further, the claimant argues that there is no support for Dr. Richman's opinion that regardless of what the claimant was doing on November 19, she would have sustained a tear in her lower back. Moreover, the claimant argues that when questioned during the hearing, Dr. Richman testified that Dr. Hall did not perform a causation analysis. The claimant asserts that the ALJ abused his discretion in finding Dr. Richman credible when Dr. Richman did not even read Dr. Hall's causation report or deposition. Generally, the weight and credibility to be afforded expert medical opinion is a matter within the sole discretion of the finder of fact. Rockwell International v. Turnbull, 802 P.2d 1182 (Colo. App. 1990). We may not substitute our judgment by reweighing the evidence in an attempt to reach a result that is different from that of the ALJ. See Sullivan v. Industrial Claim Appeals Office, 796 P.2d 31, 32-33 (Colo. App. 1990) (reviewing court is bound by resolution of conflicting evidence, regardless of the existence of evidence which may have supported a contrary result); see also Rockwell Int'l v. Turnbull, 802 P.2d at 1183 (ALJ, as fact-finder, is charged with resolving conflicts in expert testimony). The ALJ weighed the conflicting medical evidence and credited the opinions of Dr. Richman. Id. Given the ALJ's consideration of the evidence, we therefore may not disturb the ALJ's order that the claimant failed to establish by a preponderance of the evidence that her claim was compensable.
IT IS THEREFORE ORDERED that the ALJ's order issued May 18, 2011, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
________________________ John D. Baird
________________________ Kris Sanko
SANJUANITA MEDEIROS, BRADLEY ROAD, COLORADO SPRINGS, CO, (Claimant).
PINNACOL ASSURANCE, Attn: HARVEY D. FLEWELLING, ESQ., DENVER, CO, (Insurer)
STEVEN U. MULLENS, P.C., Attn: ROBERT W. TURNER, ESQ., COLORADO SPRINGS, CO, (For Claimant).
RUEGSEGGER, SIMONS, SMITH STERN, LLC, Attn: VITO A. RACANELLI, ESQ., DENVER, CO, (For Respondents).