W.C. No. 4-393-485Industrial Claim Appeals Office.
June 11, 1999.
FINAL ORDER
The claimant seeks review of an order of Administrative Law Judge Martinez (ALJ) which denied and dismissed the claim. We affirm.
The claimant filed a workers’ compensation claim which alleged a work-related injury on July 31, 1998, when a transmission fell off a jack and hit his left knee. The claimant continued to perform his regular job duties for two weeks. On August 14, 1998, the claimant sought medical treatment at the St. Mary’s Hospital Emergency Room. The claimant was subsequently examined by Dr. Fisher and Dr. Woodyard. Dr. Fisher opined that the claimant suffered a medial meniscus tear, which is consistent with the alleged industrial injury. Dr. Woodyard testified that insofar as the claimant has a medial meniscus tear, it is not consistent with the industrial injury described by the claimant. Instead, Dr. Woodyard opined that the claimant’s condition was more likely caused by gout.
On conflicting lay and medical evidence the ALJ found the claimant failed to prove a compensable injury. In support, the ALJ credited the testimony of Dr. Woodyard. The ALJ also found that the claimant did not report the alleged injury to his employer on July 31, and expressly denied being injured when the transmission fell. The ALJ further found that the emergency room records indicate the claimant denied any trauma to the knee immediately preceding the request for treatment, and that contrary to the claimant’s testimony, the claimant had a history of bilateral knee injuries. Therefore, the ALJ found the claimant’s testimony concerning the injury was incredible, and relied on the contrary testimony of the respondents’ witnesses, Thomas and Nancy Weber.
On review, the claimant first contends the ALJ’s findings of fact are insufficient to permit appellate review because the ALJ failed to address Dr. Fisher’s opinions on the cause of the injury. The claimant argues that without specific findings concerning Dr. Fisher’s testimony it is unclear whether the ALJ resolved the conflicts between the opinions of Dr. Fisher and Dr. Woodyard. We reject this argument.
The ALJ is presumed to have considered all relevant evidence See Dravo Corp. v. Industrial Commission, 40 Colo. App. 57, 569 P.2d 345 (1977). However, the ALJ is not required to make specific findings of fact concerning every piece of evidence, but only the evidence he found determinative of the issues. General Cable Co. v. Industrial Claim Appeals Office, 878 P.2d 118
(Colo.App. 1994); Jefferson County Public Schools v. Dragoo, 765 P.2d 636 (Colo.App. 1988). In fact, opinions not specifically credited are implicitly rejected. Cooper v. Industrial Claim Appeals Office, ___ P.2d ___ (Colo.App. No. 98CA1343, March 18, 1999).
Where the medical evidence is subject to conflicting inferences it is the ALJ’s sole prerogative to resolve the conflict. Metro Moving Storage Co. v. Gussert, 914 P.2d 411
(Colo.App. 1995). Furthermore, the ALJ may resolve the conflict based upon his credibility determinations and is not required to explain the basis for those determinations. Wells v. Del Norte School District C-7, 753 P.2d 770 (Colo.App. 1987), cf. Regional Transportation District v. Jackson, 805 P.2d 1190 (Colo.App. 1991) (ALJ’s credibility determinations adequately informs reviewing court how ALJ resolved conflicts in the evidence).
Here, there was a direct conflict between Dr. Woodyard and Dr. Fisher concerning the cause of the claimant’s left knee problems. The ALJ resolved the conflict in favor of Dr. Woodyard. Under these circumstance, we presume the ALJ was not persuaded by the contrary opinions of Dr. Fisher, and therefore, it is unnecessary to remand the matter for additional findings. See Riddle v. Ampex Corp., 839 P.2d 489 (Colo.App. 1992) (ALJ’s findings sufficient if basis for order apparent).
However, the claimant contends the ALJ erroneously credited the opinions of Dr. Woodyard because Dr. Woodyard’s opinions do not meet the legal standard for expert medical testimony. The claimant also contends that without Dr. Woodyard’s testimony the only remaining medical evidence on the cause of the claimant’s knee condition is Dr. Fisher’s opinion that it is work-related. Therefore, the claimant argues that there is not substantial evidence in the record to support the ALJ’s order. We disagree.
To establish a compensable injury the claimant must prove to a “reasonable probability” that there is a causal connection between the need for treatment and the employment. Morrison v. Industrial Claim Appeals Office, 760 P.2d 654 (Colo.App. 1988). Where the claimant presents medical evidence, the physician’s opinion must be based on “reasonable medical probability,” but not “reasonable medical certainty.” Ringsby Truck Lines, Inc. v. Industrial Commission, 30 Colo. App. 224, 491 P.2d 106 (1971) Morrison v. Industrial Claim Appeals Office; supra. However, a medical expert’s testimony is not incompetent merely because the expert does not use the phrase “reasonable medical probability” in articulating her opinions. See Beudoin Construction Co. v. Industrial Commission, 626 P.2d 711 (Colo.App. 1981); Beach v. Wheat Ridge Fire Protection District, W.C. No. 3-977-580
(September 4, 1992).
In this case, Dr. Woodyard testified that she is a physician, board certified in family practice. (Tr. p. 25). The claimant did not object to Dr. Woodyard’s qualifications to render medical opinions. See C.R.E. 103(a)(1). Under these circumstances, the ALJ could reasonably infer that Dr. Woodyard’s opinions concerning the cause of the claimant’s knee problems were based upon the standard of reasonable medical probability.
In reaching this conclusion we recognize the letter dated September 2, 1998, from claimant’s counsel to Dr. Woodyard where Dr. Woodyard was asked if she could provide a diagnosis of the claimant’s knee problems “within a reasonable degree of medical certainty.” Dr. Woodyard was also asked whether she could state “within a reasonable degree of medical certainty” whether the claimant’s condition was caused or aggravated by his work. Because the standard for expert medical testimony is not “reasonable medical certainty,” but the lower standard of “reasonable medical probability,” Dr. Woodyard’s inability to state an opinion to the level of medical “certainty,” did not compel the ALJ to find that Dr. Woodward’s testimony failed to meet the legal standard for expert medical testimony.
Moreover, Dr. Woodyard’s testimony is consistent with Dr. Brown’s medical report dated August 18, 1998, in which he indicated that the etiology of the claimant’s knee pain is “unclear” and that it could be attributable to several possible causes including gout. Consequently, there is substantial medical evidence in addition to Dr. Woodyard’s opinions which support the ALJ’s order.
IT IS THEREFORE ORDERED that the ALJ’s order dated January 15, 1999, 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, 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 this Order is mailed, pursuant to section 8-43-301(10) and 307, C.R.S. 1998.
Copies of this decision were mailed June 11, 1999 the following parties:
Joseph H Sanders, 565 Grand Valley Road, Grand Junction, CO 81504
A-1 Truck Repair, Attn: Nancy Weber, PO Box 1994, Grand Junction CO 81502
Business Insurance Co, PO Box 101630, 2000 S Colorado Blvd, Ste 11150, Denver, CO 80250
Luke A Brennan, Esq, PO Box 579, Grand Junction CO 81502 (For the Claimant)
Michael Perales, Esq, 999 18th St, Ste 3100, Denver, CO 80202 (For Respondents)
BY: A, Pendroy