W.C. No. 4-805-040.Industrial Claim Appeals Office.
July 2, 2010.
FINAL ORDER
The claimant seeks review of an order of Administrative Law Judge Stuber (ALJ) dated April 12, 2010, that denied and dismissed the claimant’s request for authorization of right shoulder surgery recommended by Dr. Walden. We affirm.
The claimant suffered a previous work-related injury to his right shoulder and neck on May 5, 2004. A June 9, 2004, magnetic resonance arthrogram (MRA) of the right shoulder revealed a partial tear or fraying of the infraspinatus tendon. Dr. Stockelman suggested surgery to repair the rotator cuff tear, but the claimant declined the surgery. On August 25, 2009, while working for the present employer, a co-worker assaulted the claimant. The claimant was shoved and the force from the shove was applied to the claimant’s right shoulder. The ALJ found that the claimant had proved by a preponderance of the evidence that he suffered an injury arising out of and in the course of his employment. Although the ALJ found the August 25, 2009 assault compensable, he denied and dismissed the claimant’s request for authorization of recommended right shoulder surgery. The ALJ credited Dr. Roth’s opinion that the need for the requested surgery was not due to the work injury. The claimant brings this appeal.
The claimant contends the ALJ erred in denying the requested surgery. The claimant argues that he had proved by a preponderance of the evidence that his preexisting shoulder injury had been sufficiently aggravated by a new compensable work injury and that it is reasonably necessary for him to undergo shoulder surgery to relieve or cure the effects of the aggravated injury.
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In order to impose liability for medical treatment, the ALJ must find the need for treatment was proximately caused by an injury arising out of and in the course of the employment. Section 8-41-301(1)(b), C.R.S. The determination of whether the claimant proved causation is one of fact for the ALJ Faulkner v. Industrial Claim Appeals Office, 12 P.3d 844 (Colo. App. 2000).
To prove causation, it is not necessary to establish that the industrial injury was the sole cause of the need for treatment. Rather, it is sufficient if the injury is a “significant” cause of the need for treatment in the sense that there is a direct relationship between the precipitating event and the need for treatment. Reynolds v. U.S. Airways, Inc, W. C. Nos. 4-352-256, 4-391-859, 4-521-484 (May 20, 2003). Thus, if the industrial injury aggravates or accelerates a preexisting condition so as to cause a need for treatment, the treatment is compensable. Joslins Dry Goods Co. v. Industrial Claim Appeals Office, 21 P.3d 866 (Colo. App. 2001); H H Warehouse v. Vicory, 805 P.2d 1167 (Colo. App. 1990); Seifried v. Industrial Commission, 736 P.2d 1262 (Colo. App. 1986).
Here, the ALJ expressly credited the opinion of Dr. Roth, who concluded that the claimant’s mechanism of injury in the assault would not cause injury to the undersurface of the infraspinatus tendon and that all of the claimant’s right rotator cuff pathology preexisted the work injury. The ALJ also found that the findings revealed by the MRA taken following the assault were the same as the findings revealed by the MRA taken in 2004 after the first accident. In addition, the ALJ noted surveillance video of the claimant riding his motorcycle and bowling. The video did not show any pain behavior demonstrated with the use of the claimant’s right arm. The ALJ concluded that the claimant failed to establish that the surgery recommended by Dr. Walden was reasonably necessary to cure or relieve him from the effects of his work related injury.
As noted by the ALJ, the mere occurrence of a compensable injury does not require the ALJ to find that all subsequent medical treatment was caused by the industrial injury. Fairchild v. GCR Tire Center, W. C. No. 4-632-507 (February 02, 2006). To the contrary, the range of compensable consequences of an industrial injury is limited to those which flow proximately and naturally from the injury. Standard Metals Corp. v. Ball, 172 Colo. 510, 474 P.2d 622 (1970); § 8-41-301(1)(c), C.R.S.
It is the claimant’s burden to prove a causal relationship between the industrial injury and the medical condition for which he seeks benefits. Snyder v. Industrial Claim Appeals Office, 942 P.2d 1337 (Colo. App. 1997). The question of whether an industrial injury is the cause of a subsequent need for medical treatment is largely one of fact for determination by the ALJ City of Durango v. Dunagan, 939 P.2d 496 (Colo. App. 1997).
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Consequently, we must uphold the ALJ’s order if supported by substantial evidence in the record. Section 8-43-301(8), C.R.S. In this regard, it was the prerogative of the ALJ to assess the weight and credibility of the medical testimony offered on the issue of causation. Rockwell International v. Turnbull, 802 P.2d 1182 (Colo. App. 1990).
The claimant’s arguments notwithstanding, substantial evidence supports the ALJ’s determination that, although the claimant suffered a compensable injury in the assault, that event was not the cause of the claimant’s need for medical treatment in the form of right shoulder surgery. Dr. Roth, performed a medical records review in response to the request for prior authorization of surgery recommended by Dr. Walden. Exhibit 8 at 28. Dr. Roth recommended the insurer deny the request for authorization of the surgery because the surgery was not due to the work injury. Exhibit 8 at 34. Dr. Roth concluded that the claimant’s mechanism for injury would not cause injury to the undersurface of the infraspinatus tendon and that all of the claimant’s right rotator cuff pathology preexisted the work injury. Exhibit 8 at 34. In addition, the claimant concedes in his brief that MRA of the claimant’s right shoulder the claimant underwent after the assault in 2009 showed no changes from the MRA imaging done on 2004 following his first injury.
In our view, Dr. Roth’s testimony and the comparison of the MRA imaging provides ample support for the ALJ’s factual findings that the compensable accident did not cause, aggravate, or accelerate the claimant’s need for the right shoulder surgery. The existence of evidence which, if credited, might permit a contrary result affords no basis for relief on appeal. Cordova v. Industrial Claim Appeals Office, 55 P.3d 186 (Colo. App. 2002). The claimant relies heavily on the temporal relationship between the onset of symptoms and the industrial injury. Although this evidence was relevant, the ALJ was not compelled to presume causation between the injury and the need for surgery because of the mere temporal relationship between the claimant’s assault and reported symptoms Fairchild v. GCR Tire Center, W. C. No. 4-632-507 (February 02, 2006). In our opinion, the ALJ’s findings are supported by substantial evidence in the record and the order is consistent with the applicable law.
IT IS THEREFORE ORDERED that the ALJ’s order dated April 12, 2010 is affirmed.
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INDUSTRIAL CLAIM APPEALS PANEL
____________________________________ Curt Kriksciun
____________________________________ Thomas Schrant
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STEVEN McINTYRE, COLORADO SPRINGS, CO, (Claimant).
KI, L.L.C., C/O: NANA REGIONAL CORPORATION, FT CARSON, CO, (Employer).
ACE USA/ESIS, Attn: WESLEY JOHNSON, TAMPA, FL, (Insurer).
McDIVITT LAW FIRM, PC, Attn: KIRK WHITEHEAD, ESQ./MATTHEW C. GIZZI, ESQ., COLORADO SPRINGS, CO, (For Claimant).
CLIFTON, MUELLER BOVARNICK, PC, Attn: HOLLY M. BARRETT, ESQ., DENVER, CO, (For Respondents).
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