STACE F. KROOK, Employee/Appellant,
v.
GAUTHIER INDUS. and AMERICAN COMPENSATION INS., Employer-Insurer,
and
MN DEP'T OF HUMAN SERVS., Intervenor.
Minnesota Workers Compensation
Workers' Compensation Court of Appeals
February 10, 1999
HEADNOTES
CAUSATION
- SUBSTANTIAL EVIDENCE. Where the employee's
doctor's testimony was equivocal regarding whether a
specific work incident caused both a ganglion cyst and a
ligament tear and the IME opined that it did not, the
compensation judge was supported by substantial evidence in
finding that only the cyst was caused by the work incident.
Affirmed.
Determined by Wheeler, C.J., Johnson, J., and Hefte, J.
Compensation Judge: Peggy A. Brenden.
OPINION
STEVEN
D. WHEELER, Judge
The
employee appeals from the compensation judge's
determination that the lunotriquetral ligament tear injury to
his left wrist was not causally related to any work activity
with the employer. We affirm.
BACKGROUND
The
compensation judge made the following findings of fact which
are not contested by either party:
1. Prior to March 1996, the employee had no symptoms or
limitations associated with the functioning of his left
wrist.1
2. On or about March 13, 1996, while in the course of
carrying a bundle of steel bars weighing approximately 100
pounds, the employee experienced a "giving way" of
his left wrist. At the time the incident occurred the
employee's left wrist was in a flexed and pronated
position.
3. The employee experienced immediate pain and swelling
in the area of his left wrist following the incident on or
about March 13, 1996.
4. As a result of the work incident on or about March
13, 1996, the employee sustained a post-traumatic synovial
cyst. (See Employee Exhibit B: 11/15/96 note and
Employee Exhibit G: 7/3/97 note.)
The
employee did not seek immediate medical assistance for the
injury that he sustained on March 13. The employee
testified that after the March 1996 incident the swelling
eventually went down but a lump remained below his thumb on
his left wrist. (T. 81-82.) The first medical care
he received was from Dr. David Lundberg, a specialist in
family medicine at the Olmsted Medical Group, on November 6,
1996. At that time the employee indicated that he had
injured his left hand/wrist on three separate occasions
within the prior seven months - - at work while lifting, in a
fist fight and while falling face first on his
driveway.
2 Shortly thereafter, on November
15, 1996, the employee was seen by Dr. Robert Kurland, an
orthopedic specialist also at the Olmsted Medical
Group. The employee gave Dr. Kurland a similar history
of three recent traumas to his left hand/wrist.
[3] Dr.
Kurland's diagnosis was post-traumatic synovial
cyst. Following an ultrasound diagnostic examination to
determine the size of the cyst, excision surgery of the
ganglion cyst was performed on November 27, 1996 by Dr.
Kurland.
Following
the surgery the employee continued to complain of problems
with his left wrist. Eventually, in May 1997, the
employee was referred by Dr. Kurland to the Mayo Clinic for
examination. He was first seen on May 5, 1997 by Dr. M.
L. Jurisson. Thereafter, he was referred to Dr. Allen T.
Bishop, an orthopedic surgeon specializing in hand
surgery. On May 16, 1997, a left wrist arthrogram with
Lidocaine was performed which disclosed a tear of the
lunotriquetral ligament. During the procedure, when the
Lidocaine was injected, the employee reported almost
immediate complete left wrist pain relief. This relief,
however, lasted for only two hours. As a result of the
findings from the arthrogram Dr. Bishop recommended a
diagnostic wrist arthroscopy, which was performed on June 18,
1997. During this procedure, Dr. Bishop found "a
large amount of inflamed synovium and cartilage or
ligamentous tissue attached to the lunate and
triquetrum." The loose tissue was debrided using a
shaver device. An arthroscopic inspection of the
lunotriquetral ligament disclosed that it was
"moderately unstable from the radiocarpal side"
while the "dorsal and palmar ligamentous portions
appeared to be intact." All other areas of
inspection apparently were found to be normal. The
operative report indicates that Dr. Bishop "felt that
the [employee's] mechanical symptoms were to a large
extent due to the flap of lunotriquetral ligament within the
joint and the reactive synovitis rather than the
lunotriquetral ligament instability which was mild to grade 2
based on Geissler's classification theme." As a
result, Dr. Bishop indicated that it was not necessary at
that...
