W.C. No. 4-315-758Industrial Claim Appeals Office.
March 26, 1999.
FINAL ORDER
The respondents seek review of a final order of Administrative Law Judge Martinez (ALJ) which awarded the claimant medical benefits for medical treatment of her right and left wrists. The respondents contend the evidence does not support the ALJ’s finding of a causal relationship between the need for treatment and the industrial injury. We affirm.
The claimant testified that on November 29, 1994, she fell at work and injured both her wrists. Although the initial medical reports from November and December 1994 do not reflect any complaints involving the right wrist, the report of January 12, 1995, states that the claimant was reporting bilateral wrist pain.
The claimant received conservative treatment for the right wrist, and in 1998 underwent surgery on her left wrist. The surgery was performed by Dr. Goldstein who repaired a triangular fibrocartilage complex tear (TFCC) and carpal tunnel syndrome (CTS). In his deposition, Dr. Goldstein opined that the claimant’s right wrist symptoms, and both aspects of the left wrist surgery, were causally related to the November 1994 industrial injury. (Goldstein depo. pp. 36-37, 39). Dr. Goldstein admitted that his opinions concerning causation were dependent on the reliability of the history given by the claimant. (Goldstein depo. pp. 36-37. 39-40).
The ALJ credited the claimant’s testimony that she injured both wrists when she fell at work. Further, the ALJ credited Dr. Goldstein’s deposition testimony “to the extent that it supports” the finding of a causal relationship between the industrial injury and the need for medical treatment of the right wrist and surgery for the left wrist.
I.
On review, the respondents first contend that the evidence does not support the ALJ’s finding that treatment of the claimant’s right wrist was necessitated by the November 1994 industrial injury. The respondents assert that the claimant’s testimony that she injured her right wrist is incredible is a matter of law because the medical records of the treating physician demonstrate that the claimant did not report right wrist pain until January 1995. The respondents also point out that in July 1995 the treating physician opined that the claimant reached maximum medical improvement, was symptom free, and requested a release to regular employment. The respondents also cite expert medical opinions indicating that the injury did not cause the claimant’s symptoms. We find no error.
The respondents correctly state that the claimant bears the burden of proof to establish that her need for medical treatment was proximately caused by the industrial injury. Section 8-41-301(1)(c), C.R.S. 1998; Snyder v. Industrial Claim Appeals Office, 942 P.2d 1337 (Colo.App. 1997). Resolution of this issue is one of fact for determination by the ALJ. City of Durango v. Dunagan, 939 P.2d 496 (Colo.App. 1997).
Because the question of causation is one of fact we must uphold the ALJ’s order if supported by substantial evidence in the record. Section 8-43-301(8), C.R.S. 1998. Substantial evidence is evidence which would support a reasonable belief in the existence of a fact without regard to conflicting evidence. Metro Moving and Storage Co. v. Gussert, 914 P.2d 411 (Colo.App. 1995). When applying this standard we must defer to the ALJ’s resolution of conflicts in the evidence, his credibility determinations, and the plausible inferences he drew from the evidence. Metro Moving and Storage Co. v. Gussert, supra.
Medical proof of causation is unnecessary where circumstantial evidence warrants an inference that the need for medical treatment is causally related to the industrial injury Rockwell International v. Turnbull, 802 P.2d 1182 (Colo.App. 1990). Where medical evidence is presented, its weight and credibility are matters within the sole province of the ALJ as factfinder. Rockwell International v. Turnbull, supra. Moreover, to the extent the testimony of a particular medical expert is inconsistent, the ALJ may resolve the inconsistency by crediting part or none of the testimony. Monfort Inc. v. Rangel, 867 P.2d 122 (Colo.App. 1993).
The respondents’ argument notwithstanding, the claimant’s testimony that she fell on and injured both wrists is not incredible as a matter of law. Although the medical records do not document a report of right wrist pain until approximately six weeks after the injury, the ALJ was not required to infer that the claimant fabricated her testimony. The claimant’s treating physician admitted that it is possible he failed to record a portion of the claimant’s complaints. (Bair depo. p. 14). Further, the treating physician was contractually tied to the respondent-employer, raising the possibility of bias in his testimony. See AFL-CIO v. Donlon, 914 P.2d 396 (Colo.App. 1995) (purpose of IME procedure is to ameliorate possible bias of the treating physician resulting from the treating physician’s selection by one of the parties). The evidence also indicates that the treating physician charged the respondents for treatment of the claimant’s right wrist problems. Finally, the claimant’s testimony that her right wrist symptoms were caused by the November 1994 industrial injury is corroborated by the testimony of Dr. Goldstein. Under these circumstances, we cannot say the claimant’s testimony is rebutted by such hard, certain evidence that it is incredible as a matter of law. See Halliburton Services v. Miller, 720 P.2d 571 (Colo. 1986).
Neither was the ALJ required to credit the treating physician’s opinion that the claimant’s condition stabilized by July 26, 1995. The medical evidence documents that the claimant continued to have pain in both wrists subsequent to July 1995, and ultimately required surgery on the left wrist. Although there was conflicting expert opinion concerning the cause of the claimant’s ongoing symptoms, resolution of that conflict was a matter for the ALJ. It is true the claimant requested a release to return to regular employment in July 1995, but she explained that the request was motivated by fear of losing her job. The weight and credibility of that testimony was also a matter for the ALJ to assess.
Neither was the ALJ required to infer that the claimant’s subsequent employments caused her need for treatment. Although the claimant indicated that her symptoms increased with activities in the subsequent employments, it was for the ALJ to determine whether the claimant sustained a new injury or was simply experiencing symptoms logically associated with the 1994 injury F. R. Orr Construction v. Rinta, 717 P.2d 96 by (Colo.App. 1985). Dr Goldstein’s testimony and reports support the ALJ’s order because the doctor noted that the claimant’s symptoms pre-dated the employments. (Goldstein Report, March 10, 1998.)
Insofar as the respondents make other arguments concerning this issue, they are purely factual in nature. Therefore, we may not interfere with the ALJ’s order.
II.
Respondents next contend that the evidence does not support the ALJ’s finding that the TFCC and CTS repairs are causally connected to the 1994 industrial injury. The respondents cite the testimony and reports of the medical experts supporting their position. The respondents also contend that Dr. Goldstein’s testimony is “speculative” because he was unable to determine precisely how long the TFCC tear was present, and was unable to state to a reasonable degree of medical probability that the claimant’s CTS is related to the injury. Again, we find no error.
The ALJ recognized that there were inconsistencies in Dr. Goldstein’s deposition testimony. However, the ALJ resolved those inconsistencies in favor of the claimant and found that Dr. Goldstein’s testimony supports the award of medical benefits for the 1998 surgery. Dr. Goldstein’s testimony, when viewed in the light most favorable to the claimant, supports the award. Although the ALJ might have drawn different inferences from Dr. Goldstein’s testimony, it was within his authority to resolve the inconsistencies and award medical benefits. Monfort Inc. v. Rangel, supra.
It is certainly true that there was other expert medical evidence supporting the respondents’ interpretation of the evidence. However, the mere fact that the evidence could support contrary findings and conclusions affords no basis for relief on appeal. May D F v. Industrial Claim Appeals Office, 752 P.2d 589
(Colo.App. 1988).
IT IS THEREFORE ORDERED that the ALJ’s order dated October 2, 1998, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
________________________________ David Cain
________________________________ Bill Whitacre
NOTICE
This Order is final unless an action to modify or vacate the Order is commenced in the Colorado Court of Appeals, 2 East 14th Avenue, Denver, Colorado 80203, by filing a petition to review with the court, with service of a copy of the petition upon 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. 1998.
Copies of this decision were mailed MARCH 26, 1999
the following parties:
Claire Kauffman, PO Box 1147, Clifton CO 81520
Wal-Mart Stores, Inc., d/b/a Sam’s Club, 1040 Independent Ave., Grand Junction, CO 81505-7133
Insurance Company of the State of Pennsylvania, Claims Management Inc., Attn: Jon Causseaux, 3901 Adams Road, Ste. C, Bartlesville, OK 74006-8485
Christopher Seidman, Esq., P.O. Box 3207, Grand Junction, CO 81502 (For Claimant)
Richard Bovarnick, Esq., Harvey D. Flewelling, Esq., 5353 W. Dartmouth Ave. Ste. 400, Denver, CO 80227 (For Respondents)
BY: ______________