W.C. No. 3-063-046Industrial Claim Appeals Office.
July 24, 1997
FINAL ORDER
The respondents seek review of a final order of Administrative Law Judge Martinez (ALJ), which reopened the claim for benefits and ordered the respondents to provide additional medical treatment. We affirm.
The claimant sustained a compensable back injury in April 1989. Ultimately, this injury resulted in the fusion of his spine at L5 — S1. The claimant was placed at maximum medical improvement (MMI) by his treating physician, Dr. Fisher, on September 17, 1991.
Thereafter, the claimant sought and received additional treatment for his back commencing in November 1992. The treatment occurred every year thereafter, and included epidural injections.
The respondents declined to pay for the epidural injections, and the claimant filed a petition to reopen based on worsened condition. Relying on the testimony of Dr. Fisher, the ALJ found that the claimant’s need for the epidural injections is causally related to the April 1989 injury. The ALJ recognized that the claimant engaged in “various activities at work and at home” which resulted in increased lower back pain, but found that these activities merely produced pain and were not “independent and unrelated new injuries.”
On review, the respondents assert that the ALJ erred in reopening the claim and awarding additional medical benefits. Essentially, the respondents argue that the evidence does not establish that the claimant’s need for additional treatment is causally related to the 1989 industrial injury. Rather, the respondents assert that the claimant sustained a new injury or occupational disease while working as a truck driver subsequent to September 1991. Alternatively, the respondents assert that the claimant sustained a new injury or injuries while performing various activities including raking his lawn, coughing, and driving a friend’s truck. We are not persuaded.
The ALJ has authority to grant a petition to reopen where the effects of the industrial injury require additional medical treatment. Dorman v. B W Construction Co., 765 P.2d 1033
(Colo.App. 1988). An ALJ has wide discretion in determining whether to grant a petition to reopen, and we may not interfere with his decision absent an abuse of discretion. Osborne v. Industrial Commission, 725 P.2d 63 (Colo.App. 1986).
It is certainly true that the evidence must show that there is a causal relationship between the industrial injury and the worsened condition necessitating additional treatment. Valdez v. United Parcel Service, 728 P.2d 340 (Colo.App. 1986). Causation is established if the claimant proves that the need for treatment is a natural and proximate result of the industrial injury, and is uninfluenced by efficient intervening causes. Standard Metals Corp. v. Ball, 172 Colo. 510, 474 P.2d 622 (Colo.App. 1970). The question of whether a particular condition is causally connected to the industrial injury or an intervening cause is essentially one of fact for determination by the ALJ. City of Durango v. Dunagan, ___ P.2d ___ (Colo.App. No. 96CA0973, May 1, 1997); F. R. Orr Construction v. Rinta, 717 P.2d 965
(Colo.App. 1985).
Because the issue of causation is factual in nature, we must uphold the ALJ’s determination if supported by substantial evidence in the record. Section 8-43-301(8), C.R.S. (1996 Cum. Supp.). Further, when medical evidence of causation is presented, it is for the ALJ to assess the weight, credibility, and inferences to be drawn from such evidence. Rockwell International v. Turnbull, 802 P.2d 1182 (Colo.App. 1990). To the extent such testimony contains inconsistencies, the ALJ may resolve them by crediting all, part, or none of the testimony Colorado Springs Motors, Ltd. v. Industrial Commission, 165 Colo. 504, 441 P.2d 21 (1968); El Paso County Department of Social Services v. Donn, 865 P.2d 877 (Colo.App. 1993).
The respondents’ argument notwithstanding, the evidence supports the ALJ’s finding that the claimant’s worsened condition and need for additional treatment are attributable to the consequences of the 1989 injury, and not subsequent intervening events. Dr. Fisher testified that the post-MMI incidents were “fairly minimal proportional contributors” to the claimant’s worsened condition, and that if he were to assign any percentage figure to these events as causative factors, it would be “an arbitrary figure.” (Fisher Depo. p. 19). Moreover, Dr. Fisher stated that the claimant did not have a “great result from his lumbar surgery,” and the condition that he was treating was “caused by the original injury.” (Fisher Depo. p. 26).
These portions of Dr. Fisher’s testimony, taken with the claimant’s testimony, support the ALJ’s finding that there was no efficient intervening cause of the claimant’s worsened condition. To the contrary, a plausible interpretation of Dr. Fisher’s testimony is that the post-MMI events, including the claimant’s employment activities, caused a symptomatic aggravation of the 1989 injury, but were not the cause of the overall deterioration of the claimant’s disc. Since this conclusion is amply supported by substantial evidence, there is no basis for interfering with the ALJ’s order. Cf. Becher v. City Market, Inc.,
W.C. No. 3-059-095, 3-108-379 (September 16, 1994) (the fact that employment evoked symptoms caused by a prior injury does not require the ALJ to conclude that there has been a compensable “aggravation” of the prior injury). The mere fact that the ALJ might have interpreted Dr. Fisher’s testimony differently does not afford a basis for review. Rockwell International v. Turnbull, supra.
In reaching this result, we have considered the respondents’ assertion that the ALJ simply failed to consider whether the claimant’s post-MMI employment activities caused a new injury or occupational disease. However, an ALJ is not held to a crystalline standard in expressing findings of fact. To the contrary, the ALJ is merely required to make findings concerning that evidence which he deems dispositive of the issues involved. The order is sufficient if it indicates the basis of the ALJ’s ruling. Riddle v. Ampex Corp., 839 P.2d 489 (Colo.App. 1992).
Here, we reject the assertion that the ALJ did not consider whether the claimant sustained a new injury or occupational disease. The ALJ expressly stated that he considered the claimant’s “various activities at work and at home” which caused increased back pain. (Finding of Fact 6). Since the ALJ found that the claimant’s back pain was ultimately the result of the 1989 injury, he necessarily discounted the evidence which would support a contrary conclusion. Thus, the findings are sufficient to indicate the basis of the order.
IT IS THEREFORE ORDERED that the ALJ’s order dated March 12, 1997, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
______________________________ David Cain
______________________________ Kathy E. Dean
NOTICE
This Order is final unless an action to modify or vacatethe Order is commenced in the Colorado Court of Appeals, 2 East14th Avenue, Denver, Colorado 80203, by filing a petition toreview with the court, with service of a copy of the petitionupon the Industrial Claim Appeals Office and all other parties,within twenty (20) days after the date the Order was mailed,pursuant to §§ 8-43-301(10) and 307, C. R. S. (1996 Cum. Supp.).
Copies of this decision were mailed July 24, 1997 to the following parties:
Ronald J. Blair, P.O. Box 67, Loma, CO 81524
Ryder Service Corp., Attn: Laura Lindmark, P.O. Box 1026, Tustin, CA 92681-1026
Old Republic Insurance Company, P.O. Box 2200, Greensburg, PA 15601
David J. Dworkin, Esq. Melissa Loman, Esq., 3900 E. Mexico, Ste. 1300, Denver, CO 80210, (For the Respondents).
Christopher Seidman, Esq., P.O. Box 3207, Grand Junction, CO 81502, (For the Claimant).
By: ________________________________