W.C. No. 4-381-212Industrial Claim Appeals Office.
April 2, 2003
FINAL ORDER
The claimant seeks review of an order of Administrative Law Judge Jones (ALJ) which denied and dismissed the claim for temporary total disability and medical benefits. We affirm.
We have previously considered this matter. Our Order of Remand dated September 10, 2002, contains a statement of the facts, and that statement is incorporated herein. Our order directed the ALJ to reconsider the medical evidence and testimony pertaining to the issue of causation based on the correct legal standard, and to clarify the basis for accepting or rejecting the medical opinions.
In the Order on Remand the ALJ again credited the opinions of Dr. Cook and Dr. Fernandez, finding the claimant’s back condition was not caused by the limp associated with the compensable knee injury. The ALJ was persuaded by the opinions of these two physicians because the claimant did not demonstrate a limp when she was placed at maximum medical improvement (MMI) in September 1998, and the back pain did not commence until 1999. Instead, the ALJ was persuaded by the opinion of Dr. Cook that the claimant’s back pain is attributable to a non-industrial degenerative condition. In contrast, the ALJ found the opinions of Dr. Yee and Dr. Blanchet unpersuasive because they do not provide “insight into the objective medical evidence used by the doctors to reach their conclusions,” and do not address the medical records showing the claimant was not limping on the date of MMI.
On review, the claimant contends the ALJ’s findings of fact are insufficient to support appellate review of the findings on the issue of causation. The claimant further argues the ALJ erred in crediting the opinions of Dr. Fernandez and Dr. Cook over those of Dr. Yee and Dr. Blanchet. We find no error.
The claimant had the burden to prove that the disability and need for medical treatment was proximately caused by the industrial injury. Resolution of this issue was one of fact for the ALJ. Section 8-41-301(1)(c), C.R.S. 2002; Faulkner v. Industrial Claim Appeals Office, 12 P.3d 844 (Colo.App. 2000).
Because the issue is factual, we must uphold the ALJ’s determination if supported by substantial evidence in the record. Section 8-43-301(8), C.R.S. 2002. This standard of review requires that we defer to the ALJ’s credibility determinations, resolution of conflicts in the evidence, and plausible inferences drawn from the record. Wal-Mart Stores, Inc. v. Industrial Claims Office, 989 P.2d 251 (Colo.App. 1999). Where, as here, the parties present expert medical opinions on the issue of causation, we may not substitute our judgment for that of the ALJ concerning the weight and credibility of such evidence. Cordova v. Industrial Claim Appeals Office, 55 P.3d 186 (Colo.App. 2002). The fact that a medical expert’s opinion is based on a less than complete medical history goes to the weight, not the admissibility of the opinion Industrial Commission v. Albo, 167 Colo. 467, 447 P.2d 1006 (1968). Further, if the testimony of a medical expert contains internal inconsistencies, the ALJ may resolve the conflict by crediting part or none of the testimony. Colorado Springs Motors, Ltd. v. Industrial Commission, 165 Colo. 504, 441 P.2d 21 (1968)
We also note the ALJ is not held to a standard of absolute clarity when entering findings of fact and conclusions of law. It is sufficient for the ALJ to enter findings concerning that evidence which is found to be determinative of the issues, and to indicate the factual and legal bases of the decision. Conflicting inferences and contrary evidence are considered to have been rejected. Magnetic Engineering, Inc. v. Industrial Claim Appeals Office, 5 P.3d 385 (Colo.App. 2000).
The claimant’s assertions notwithstanding, the ALJ’s findings are sufficient to support appellate review. The ALJ expressly credited the opinions of Dr. Cook and Dr. Fernandez over those of Dr. Yee and Dr. Blanchet. Further, the ALJ explained her reasons for doing so, which include the consistency or inconsistency of these opinions with the claimant’s medical records. We have no difficulty determining the bases for the ALJ’s decision.
Further, we perceive no basis for concluding, as a matter of law, that the ALJ erred in crediting the opinions of Dr. Cook and Dr. Fernandez. The fact that Dr. Fernandez saw the claimant on only one occasion and did not have all of Dr. Yee’s notes went to the weight of the opinion, and that was an issue for the ALJ. Similarly, the fact Dr. Cook saw the claimant saw just once and did not have the both reports of Dr. Fernandez was an issue relating to weight of the opinion. We certainly cannot say the lack of information was so critical that the opinions are not based on any evidence. Moreover, as the ALJ expressly found, the opinions of Dr. Yee and Dr. Blanchet are vague and contain practically no references to the claimant’s medical history. Thus, the ALJ was not obligated to find these opinions persuasive as a matter of law.
The claimant is also incorrect in arguing that the opinion of Dr. Fernandez is the only evidence supporting the ALJ’s order. To the contrary, Dr. Cook expressed the view that the claimant’s back pain was the result of the natural progression of the aging process, not an antalgic gait. (Tr. pp. 47, 52). To the extent Dr. Cook’s testimony contained some inconsistencies and ambiguities, the ALJ resolved them against the claimant and in favor of the respondents.
The claimant also asserts the ALJ should have found the Baker’s cyst was caused by the injury. However, by crediting the opinions of Dr. Cook, the ALJ implicitly resolved the conflicts in the evidence against the claimant.
To the extent the claimant makes other arguments, we find them to be without merit.
IT IS THEREFORE ORDERED that the ALJ’s order dated October 31, 2002, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
___________________________________ David Cain
___________________________________ Kathy E. Dean
NOTICE
This Order is final unless an action to modify or vacate this Order is commenced in the Colorado Court of Appeals, 2 East 14th Avenue, Denver, CO 80203, by filing a petition for review with the Court, within twenty (20) days after the date this Order is mailed, pursuant to §8-43-301(10) and § 8-43-307, C.R.S. 2002. The appealing party must serve a copy of the petition upon all other parties, including the Industrial Claim Appeals Office, which may be served by mail at 1515 Arapahoe Street, Tower 3, Suite 350, Denver, CO 80202.
Copies of this decision were mailed April 2, 2003 to the following parties:
Doris Fuhrmeister, P. O. Box 852, Longmont, CO 80502
Associated Professional Home Health, P. O. Box 208, Niwot, CO 80544-0208
Michael J. Steiner, Esq., Pinnacol Assurance — Interagency Mail
Richard E. Samson, Esq., and Gwyneth Ayers, Esq., 515 Kimbark, #105, Longmont, CO 80501 (For Claimant)
Merrily S. Archer, Esq., and Shane A. Wetmore, Esq., 600 17th St., #1600N, Denver, CO 80202 (For Respondents)
By: A. Hurtado