COURT OF APPEALS

DECISION

DATED AND FILED

August 23, 2022

Sheila T. Reiff

Clerk of Court of Appeals

NOTICE

This opinion is subject to further editing. If 

published, the official version will appear in 

the bound volume of the Official Reports. 

A party may file with the Supreme Court a 

petition to review an adverse decision by the 

Court of Appeals. See WIS. STAT. § 808.10 and 

RULE 809.62. 

Appeal No. 2021AP1155 Cir. Ct. No. 2020CV5816

STATE OF WISCONSIN IN COURT OF APPEALS

DISTRICT I

KINA MURFF,

PLAINTIFF-APPELLANT,

V.

LABOR AND INDUSTRY REVIEW COMMISSION, AURORA HEALTH CARE METRO,

INC. AND SENTRY CASUALTY COMPANY,

DEFENDANTS-RESPONDENTS.

APPEAL from an order of the circuit court for Milwaukee County: 

CARL ASHLEY, Judge. Affirmed. 

Before Brash, C.J., Donald, P.J., and Dugan, J.

¶1 BRASH, C.J. Kina Murff appeals the decision of the circuit court 

affirming the decision of the Labor and Industry Review Commission (LIRC), 

which dismissed her application for worker’s compensation benefits. LIRC rejected 

Murff’s claim that her back condition was caused or aggravated by an injury she 
No. 2021AP1155

2

sustained while working for Aurora Health Care Metro, Inc. in April 2010. The 

circuit court upheld LIRC’s decision. Upon review, we affirm.

BACKGROUND

¶2 Murff began working for Aurora in June 2008. She worked full time 

at St. Luke’s Medical Center as a third-shift housekeeper. Her duties included 

cleaning and restocking bathrooms, carrying dirty linens to the laundry chute, 

dusting offices, mopping floors, and picking up garbage. 

¶3 Murff asserts that she sustained a work injury on April 9, 2010. She 

explained that she was on a ladder in a closet, reaching to get a box from a shelf. 

When she grabbed the box to lift it down from the shelf, she stated she heard 

something “pop” in her lower back. She said she experienced “throbbing pain” and 

“numbness” as a result. She reported the incident to her supervisor at the end of her 

shift. 

¶4 Murff filed for worker’s compensation benefits in 2016. The claim

alleged several periods of temporary total disability between 2014 and 2018, for 

which she was seeking lost wages in an amount totaling over $70,000. The claim 

also stated that Murff would require prospective medical treatment, and had 100% 

loss of earning capacity. 

¶5 Murff advanced three theories for recovery in her worker’s 

compensation claim: (1) that the work incident in April 2010 was a direct cause of 

her back problems; (2) that if not a direct cause, it was probable that the work 

incident precipitated, aggravated, and accelerated a pre-existing degenerative 

condition beyond its normal progression; or (3) that Murff’s job duties while 
No. 2021AP1155

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working for Aurora were a material contributory causative factor of her back 

condition’s onset or progression. 

¶6 A hearing before an administrative law judge (ALJ) was held in June 

2019. Murff testified about the work injury to her back that she allegedly sustained. 

Murff maintained that she never had any of the issues she suffers from prior to 

working for Aurora. In fact, Murff testified that in order to get the job with Aurora, 

she had to pass an “extensive” physical exam, which included testing her physical 

capacity to perform the required duties. However, there is no evidence of any preemployment physical exam in the record. 

¶7 Murff further testified that even before the work injury incident, 

approximately three to four months after her employment with Aurora began, she 

started experiencing back pain. She eventually went to see her doctor, Dr. Ricardo 

Sinense, regarding the pain; she testified that she discussed her job duties with 

Dr. Sinense. Dr. Sinense’s report of that visit described a variety of health 

problems, including neuritis, but it did not reference that these issues were workrelated, and he did not complete a WKC-16-B form—the Department of Workforce 

Development’s form for workplace injury claims. Dr. Sinense referred Murff to a 

neurologist, Dr. Anjum M. Razzaq. 

¶8 Murff saw Dr. Razzaq in March 2010, about two weeks prior to her 

claimed work injury incident. Dr. Razzaq’s report described Murff’s symptoms as 

“intermittent numbness involving the left foot as well as severe headache, neck pain, 

right shoulder pain and back pain.” He described the numbness as being “insidious 

in origin,” and noted that Murff was at that time taking Gabapentin, Vicodin, 

Tramadol, and Meloxicam. 
No. 2021AP1155

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¶9 Dr. Razzaq ordered an MRI of Murff’s head, right shoulder, cervical 

spine, and lumbar spine. The MRI was eventually completed on April 22, 2010—

approximately two weeks after the injury incident. Dr. Razzaq observed that the 

results of the MRI were “unremarkable”; it showed “minimal facet degeneration,” 

but no evidence of disc herniation. Furthermore, Dr. Razzaq noted that Murff had 

not previously informed him that this was a work-related issue; he discovered this 

when a registered nurse “showed up” at his office and asked him to call her 

regarding Murff’s “now reported work[-]related injury.” When Dr. Razzaq 

questioned Murff about it, she explained that she “forgot to mention it” and told him 

“not to worry about it and just complete [the] evaluation.” Dr. Razzaq opined in his 

report that he did not consider Murff’s case as qualifying for worker’s compensation 

benefits. 

¶10 Murff also saw Dr. Sinense again after the injury incident. He issued 

work restrictions for Murff that included not lifting anything over ten pounds, and 

no pushing or pulling. These restrictions were to stay in place only until April 22, 

2010. Aurora could not accommodate the restrictions, so Murff began collecting 

short-term disability benefits. She returned to work on May 10, 2010, resuming her 

normal work duties. 

¶11 Murff eventually left her employment with Aurora in January 2012

claiming she could no longer work due to her back pain, and that Aurora could not 

accommodate her restrictions. However, Aurora argued that Murff had no 

restrictions when she returned to work in May 2010, and worked for over nineteen 

months after the injury incident without further restrictions, until she “stopped 

showing up for work” in January 2012. 
No. 2021AP1155

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¶12 Over the years, Murff saw various doctors for back pain, leg, knee, 

and hip pain, as well as for a myriad of other health issues. This extensive medical 

history was submitted for review relative her worker’s compensation claim, 

summarized as follows.

¶13 First, evidence was presented that in May 2008—about a month prior 

to Murff starting work for Aurora—Murff visited the emergency room complaining 

of numbness in her left arm and leg; she was admitted based on concerns she was 

having a stroke. Instead, the doctor who treated her opined that the cause of her 

numbness was “more likely related to musculoskeletal pain originating from her left 

shoulder.” 

¶14 After seeing Dr. Sinense and Dr. Razzaq in March and April 2010 as 

described above—shortly before and after the work incident—Murff’s next medical 

record was for an emergency room visit for chest pain in September 2010. It was 

noted that she was given a musculoskeletal exam at that time, and reported back 

pain. 

¶15 Then in January 2011, almost a year after the work incident, Murff 

began seeing Dr. Waleed S. Najeeb. Her first appointment with Dr. Najeeb was for 

an asthma evaluation and pelvic pain, and he noted that Murff had “no back pain, 

muscle aches or localized joint pain.” However, two days after that appointment, 

Murff went to the emergency room for “constant aching pain over her left upper 

mid and lateral back with intermittent sharp pain.” The record notes that there was 

“[n]o clear inciting event” for the pain and that Murff stated she had “never 

experienced pain like this before.” Murff subsequently saw Dr. Priya Asija in 

December 2011 for “lumbar pain that was aching and sharp,” without any numbness 
No. 2021AP1155

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or tingling in her legs. Murff told Dr. Asija that the pain had been present for one 

week, and that it was not work related. 

¶16 Murff saw Dr. Najeeb again in January 2012, and brought paperwork 

relating to short-term disability benefits. Dr. Najeeb observed that Murff was 

“screaming from pain with just touching the knee[.]” He noted in a subsequent 

appointment the following month that Murff had complained of back and knee pain 

“for four months” but there was “[n]o history of injury to the extremity.” An MRI 

of her lumbar spine performed at the end of January 2012 showed some 

degenerative changes. 

¶17 Dr. Najeeb referred Murff to a pain management doctor, Dr. Anil 

Warrier, whom she saw in March 2012. Dr. Warrier’s notes describe Murff’s 

condition as back pain that she had “off and on for about 2 years” which was 

“spontaneous in onset. She does not recall any preceding trauma or unusual 

activities.” Dr. Warrier observed the “mild degenerative changes” in Murff’s back 

and opined that she had chronic musculoskeletal pain syndrome, prescribing 

analgesics as necessary and physical therapy. 

¶18 Dr. Najeeb also referred Murff to Dr. Kathryn D. Gaines in April 2012 

for “left-sided weakness.” Dr. Gaines noted Murff’s complaints of pain in her left 

shoulder, back, arm, and leg. Dr. Gaines also opined that Murff’s “clinical findings 

and exam are confounded by the fact that [Murff] is unable to provide full 

oppositional testing,” which the doctor attributed partly to pain, but suggested it was 

also due in part to “poor effort.” 

¶19 Later in April 2012, Murff saw Dr. Nikhil Patel for a neurological 

evaluation. Dr. Patel described Murff’s pain as being in her “whole back” and 

radiating down to her left lower extremity. According to Dr. Patel’s report, Murff 
No. 2021AP1155

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told him that the onset of the pain was “sudden” after a “work related injury in 

2/2010.” Murff received steroid injections and nerve blocks for her back pain, as 

well as for shoulder tenderness, in May and June 2012. 

¶20 In September 2013, Murff again went to the emergency room with 

back pain, which the doctor found was likely due to her degenerative joint disease. 

She visited the emergency room again in November 2013 for abdominal pain, which 

she believed was related to her kidneys and thought she needed a transplant; the 

doctor concluded it was constipation. 

¶21 In December 2013, Murff saw Dr. Pamela Y. Thomas-King for 

treatment for low back pain. Dr. Thomas-King noted that Murff’s pain had begun 

over three years prior “after a work-related accident.” Dr. Thomas-King assessed 

Murff as having a degenerative disc condition as well as hyperlipidemia, diabetes, 

and asthma. Dr. Thomas-King made no recommendations for medication, physical 

therapy, or psychological services. 

¶22 Murff then saw Dr. Mohammed K. Heder later in December 2013 for 

a second opinion. Dr. Heder reviewed Murff’s MRI, noting that it showed no disc 

herniation, and that these findings “did not explain [Murff’s] pain.” Dr. Heder 

further stated that he was unable to fill out the disability form Murff had “due to 

lack of information.” He also suspected that Murff suffered from post-traumatic 

stress disorder. 

¶23 In February 2014, Murff was treated by Dr. Yash S. Pannu. Dr. Pannu 

ordered a new MRI, which showed mild to moderate degenerative changes. Murff 

had a back procedure performed by Dr. Thomas-King in March 2014, and another 

procedure performed by Dr. Pannu in November 2014. Dr. Pannu also performed 

back surgery on Murff in June 2016 to repair a fractured vertebrae. Dr. Pannu later 
No. 2021AP1155

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recommended lumbar fusion in September 2017. Murff’s treatment during this time 

also included pain medication and joint injections, as well as a trial of a spinal cord 

stimulator. 

¶24 Murff also continued treatment with Dr. Najeeb during this time for 

pain management for her lower back, as well as diabetic neuropathy and 

fibromyalgia. Additionally, she was diagnosed with depression and anxiety, and 

was referred to a psychiatrist. Murff also received physical therapy for her 

condition; a note from her therapist in November 2017 indicated that she showed 

signs of “inconsistent performance”: that she was “ambulating with good gait” until 

the therapist mentioned testing, at which time Murff “immediately began limping, 

slowed her cadence, [and] demonstrated abnormalities of gait.” The therapist noted 

that an occupational therapist had also seen similar inconsistent performance. 

¶25 Murff was involved in a motor vehicle accident in December 2017. 

She went to the emergency room for back pain, but x-rays showed no acute 

fractures. 

¶26 A CT scan of Murff’s lumbar spine done in February 2018 showed 

advanced degenerative changes. A Functional Capacity Evaluation was done in 

December 2018, which noted that Murff’s “subjective complaints” were “in 

proportion with objective findings” relating to her back condition, and that “no 

significant exaggerated pain behaviors were observed[.]” The evaluation stated that 

Murff should be limited to sedentary work. 

¶27 Murff obtained WKC-16-B forms from several of her treating 

physicians which related her back problems back to the work incident of April 2010: 

Dr. Najeeb, Dr. Pannu, Dr. Thomas-King, and Dr. Patel. Aurora thus engaged Dr. 

Alvin K. Krug to perform an independent medical exam of Murff. Dr. Krug’s first 
No. 2021AP1155

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exam was performed in November 2016. Dr. Krug noted the inconsistencies 

between Murff’s assertions about the work injury event and her symptoms and what 

was reflected in the medical records, including the fact that the onset of her 

symptoms occurred before the incident, as she was already on pain medication at 

that time. Furthermore, the MRI done shortly after the work incident showed only 

minimal degenerative changes, but no injury. He opined that Murff’s back problems 

were “structurally minimal, but symptomatically quite high,” and were more likely 

psychological. He therefore concluded that all three of her theories relating to 

causation—that the work incident was a direct cause of her back pain; that it 

precipitated, aggravated, and accelerated a pre-existing degenerative condition 

beyond its normal progression; or that her work duties were a material contributory 

causative factor of the onset or progression of her back pain—should be rejected. 

¶28 Dr. Krug performed another exam of Murff in January 2018, after her 

back surgeries. He maintained his opinion regarding causation, and again opined

that her subjective pain complaints were disproportionate to the objective findings. 

He cited the American Psychiatric Association Guidelines as supporting his 

suspicion of malingering. Dr. Krug performed an additional medical records review 

in May 2019, opining that Murff had given “false and misleading information to her 

providers as to the onset of her condition.” He stated that these additional records 

also supported his opinion regarding malingering. 

¶29 Regardless of causation, Dr. Krug assessed Murff at 60% total 

permanent partial disability. Nevertheless, a vocational evaluation determined that 

because Murff had been found capable of doing sedentary work, she would sustain 

no loss of earning capacity for worker’s compensation purposes. 
No. 2021AP1155

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¶30 The ALJ, however, found that Murff was entitled to worker’s 

compensation benefits. He found Dr. Krug’s reports to have “diminish[ed] ... 

credibility,” particularly noting the “large gap in time” between the work incident 

in April 2010 and Dr. Krug’s exams in November 2016 and January 2018; the ALJ 

did not reference the additional records review Dr. Krug performed in May 2019. 

Rather, the ALJ “credit[ed] the treating physicians” who had related Murff’s back 

pain to the work incident, and found that Murff had “sustained a work-related injury 

to her back[.]” 

¶31 LIRC reversed that decision. As we discuss further below, LIRC 

found credibility issues with the opinions of the treating physicians who related 

Murff’s back problems to the work incident. LIRC also noted problems with 

Dr. Krug’s opinion. However, LIRC ultimately determined that Murff had not met 

her burden of proving her claim. 

¶32 Murff then filed a complaint with the circuit court appealing LIRC’s 

decision. The court noted that despite the WKC-16-B forms from some of her 

treating physicians opining that her back problems were work-related, they 

“displayed varying etiologies and level of disability.” The court further observed 

that although the record “could support a benefit award,” that is not the proper 

standard for the court’s review, and explained that the record also supported LIRC’s 

finding of legitimate doubt as to Murff’s claim. Therefore, the court affirmed 

LIRC’s determination. This appeal follows.

DISCUSSION

¶33 In its decision, LIRC rejected all three of Murff’s theories for recovery 

regarding causation of her back condition. On appeal, this court reviews LIRC’s 

factual findings and legal conclusions, not those of the circuit court. Mueller v. 
No. 2021AP1155

11

LIRC, 2019 WI App 50, ¶17, 388 Wis. 2d 602, 933 N.W.2d 645. We may only set 

aside an order issued by LIRC if (1) LIRC acted “without or in excess of its powers”; 

(2) the order was “procured by fraud”; or (3) the findings of fact by LIRC do not 

support the order. See WIS. STAT. § 102.23(1)(e) (2019-20);

1

see also Patrick 

Cudahy Inc. v. LIRC, 2006 WI App 211, ¶5, 296 Wis. 2d 751, 723 N.W.2d 756. 

“In a worker’s compensation hearing, the employee has the burden of proving the 

elements of his or her claim, and on appeal he or she also has the burden to show 

that LIRC’s decision should be overturned.” Kowalchuk v. LIRC, 2000 WI App 

85, ¶8, 234 Wis. 2d 203, 610 N.W.2d 122. 

¶34 We review LIRC’s legal conclusions de novo; however, we defer to 

LIRC’s findings of fact “if they are supported by credible and substantial evidence.” 

Mueller, 388 Wis. 2d 602, ¶17. Credible evidence is that which is “sufficient to 

exclude speculation or conjecture.” Bumpas v. DILHR, 95 Wis. 2d 334, 343, 290 

N.W.2d 504 (1980). “Evidence that is relevant, probative, and credible, and which 

is in a quantum that will permit a reasonable factfinder to base a conclusion upon 

it,” is substantial evidence. Princess House, Inc. v. DILHR, 111 Wis. 2d 46, 54, 

330 N.W.2d 169 (1983). The burden of showing that LIRC’s decision was not 

supported by credible and substantial evidence “is on the party seeking to set aside 

LIRC’s findings and order.” Xcel Energy Servs., Inc., v. LIRC, 2013 WI 64, ¶48, 

349 Wis. 2d 234, 833 N.W.2d 665.

¶35 In fact, it is “‘an elementary principle’ that the claimant has the burden 

of proving beyond a legitimate doubt all the facts essential to the recovery of 

compensation.” Leist v. LIRC, 183 Wis. 2d 450, 457, 515 N.W.2d 268 (1994) 

 

1

 All references to the Wisconsin Statutes are to the 2019-20 version unless otherwise 

noted.
No. 2021AP1155

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(citation omitted). To that end, “[i]t is LIRC’s duty to deny benefits if it finds that 

a legitimate doubt exists regarding the facts necessary to establish a claim.” Id. “A 

legitimate doubt comprises ‘some inherent inconsistency ... or conflict in the 

testimony.’” Kowalchuk, 234 Wis. 2d 203, ¶8 (citation omitted; ellipses in 

original). 

¶36 However, LIRC “cannot reject a medical opinion unless there is 

something in the record to support its rejection.” Leist, 183 Wis. 2d at 460. LIRC 

is not “require[d] ... to provide countervailing medical expert opinions to support a 

legitimate doubt,” but it may not “rel[y] on its own ‘cultivated intuition’” to reach a 

conclusion regarding a claim for benefits. Id. at 461-62.

¶37 Murff argues that she has presented a prima facie case that the injury 

incident of April 2010 was the cause of her back problems, based on the reports of 

the doctors who stated that the injury incident, or her work duties in general, were a 

causative factor of her condition. In support of her argument, she cites E.F. Brewer 

Co. v. DILHR, 82 Wis. 2d 634, 264 N.W.2d 222 (1978), where our supreme court 

stated that “two items of evidence” in the record for that case—the testimony of the 

claimant and his doctor’s report—are “sufficient to support the award of 

compensation,” even though the claimant’s statement was undoubtedly “selfserving,” and the doctor’s report “in respect to the circumstances of the initial injury 

and pain is but a recapitulation” of the claimant’s self-serving statement. Id. at 637. 

¶38 However, this was not the entirety of the court’s analysis in that case. 

The court went on to observe that there was competing evidence in the record of a 

pre-existing condition which pre-dated the work-related incident by “five or six 

months,” and that “if given full credence,” that evidence “would be inconsistent 

with the employee’s claim of work-connected disability.” Id. at 639. The court 
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stated that the department “chose to disbelieve those statements,” which was 

“simply a matter of credibility.” Id. 

¶39 Murff also cites to Beecher v. LIRC, 2004 WI 88, 273 Wis. 2d 136, 

682 N.W.2d 29, for the premise that if a claimant presents a prima facie case, that 

“represents a burden of production that, in the absence of adequate rebuttal 

evidence, satisfies the burden of persuasion on the issue involved.” Id., ¶52. 

However, this statement in Beecher was in the context of discussing the odd-lot 

doctrine, a “judge-made exception to the general rule that permanent total disability 

awards under worker’s compensation law are based on proof of total loss of earning 

capacity.” Id., ¶44. The court explained:

[W]here a claimant makes a prima facie case that he 

has been injured in an industrial accident and, because of his 

injury, age, education, and capacity, he is unable to secure 

any continuing and gainful employment, the burden of 

showing that the claimant is in fact employable and that jobs 

do exist for the injured claimant shifts to the employer.

Id., ¶32 (citation omitted; alteration in Beecher). The Beecher court went on to 

conclude that this burden shift to the employer is “only as to the sub-issue of whether 

a job exists that the claimant can do” as it relates to that claimant’s claim for total 

disability benefits, and that “[t]he burden of persuasion on the other aspects of the 

claimant’s case for permanent total disability benefits remains, as always, with the 

claimant.” Id., ¶55. 

¶40 Here, the matter of total permanent disability benefits is not at issue; 

the ALJ’s award was for temporary total disability. In fact, he specifically stated 

that a ruling regarding loss of earning capacity would be “premature” because 

evidence was presented that Murff was continuing her education at that point, which 
No. 2021AP1155

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would have an effect on her future earning capacity. Thus, Beecher is inapposite in 

this case. 

¶41 Indeed, the issue here is whether Murff proved her claim, since LIRC 

determined that she did not. It is the function of LIRC, not this court, to “determine

the credibility of evidence or of witnesses, and ... to weigh the evidence and to 

decide what should be believed.” E.F. Brewer, 82 Wis. 2d at 636-37. Furthermore, 

a reviewing court may not “substitute [its] judgment for [LIRC]’s.” Beecher, 273 

Wis. 2d 136, ¶20. Moreover, if “different inferences can reasonably be drawn from 

the evidence, then a question of fact is presented and the inference actually drawn 

by [LIRC], if supported by any credible evidence, is conclusive.” Vocational, Tech. 

& Adult Ed., Dist. 13 v. DILHR, 76 Wis. 2d 230, 240, 251 N.W.2d 41 (1977).

¶42 In this case, LIRC weighed the reports of Murff’s treating physicians 

who indicated that the work incident was a causative factor in her back problems, 

and found them not to be credible for various reasons.2 For example, Dr. Najeeb 

found the work incident to be a direct cause of Murff’s back issues, but did not 

accurately describe the incident in his report, stating that Murff had been “lifting a 

heavy box above the shelves” rather than getting a box down from a shelf. This led 

LIRC to conclude that Dr. Najeeb misunderstood the nature of the work incident. 

¶43 With regard to the report from Dr. Thomas-King, she initially stated 

that the work incident was a direct cause of Murff’s back problems “given the 

patient’s history,” and aggravation of a pre-existing condition was not applicable. 

Her report also indicated that the work incident was at least a material contributory 

causative factor of the onset or progression of Murff’s condition, again noting “the 

 

2

 We note that none of Murff’s treating physicians testified at the hearing before the ALJ. 
No. 2021AP1155

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patient’s history.” However, Dr. Thomas-King later amended her report to change 

her causation opinion to the incident being only a material contributory causative 

factor; furthermore, she provided no explanation for this change. LIRC also 

observed that the report contained no information relating to Murff’s job duties, nor 

any information relating to how those duties could have resulted in an occupational 

work injury. 

¶44 Dr. Pannu’s report indicated the work incident was a direct cause of 

Murff’s back problems as well, and accurately described that incident. However, 

LIRC observed that Dr. Pannu’s report did not reference Murff being treated for 

similar symptoms prior to the work incident, which it believed indicated that 

Dr. Pannu did not have a complete medical history for Murff. 

¶45 Dr. Patel’s report—which required the assumption by LIRC that the 

report was prepared by Dr. Patel, as his name was not typed on the report—indicated 

that the work incident aggravated a pre-existing condition. However, the report did 

not include Murff’s name, nor did it list Aurora as the employer. Additionally, the 

wrong date was listed for the work incident, and the incident was also 

mischaracterized as “lifting a heavy object overhead” as opposed to reaching to lift 

a box off the shelf. 

¶46 Aside from these issues with the reports of her treating physicians, 

LIRC’s decision emphasizes that the evidence demonstrates that Murff was 

developing the same symptoms of tingling, numbness, and pain prior to the work 

incident that she complained of after the incident. Furthermore, there was no 

objective evidence of injury to her back at the time of the incident in the MRI that 

was done shortly thereafter. Moreover, while LIRC recognized that Murff had mild 

degenerative changes in her back while she remained employed with Aurora, it 
No. 2021AP1155

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points out that her condition did not become significantly worse until several years

after she left Aurora, which was nearly two years after the alleged injury incident. 

LIRC determined that this time frame presented a legitimate doubt as to whether her 

condition is work-related. 

¶47 LIRC also concedes that Murff’s job duties could have been a material 

contributory causative factor to the onset or progression of her back problems. 

However, it could not definitively make this finding due to the lack of a credible 

medical opinion about such causation, as well as the “very scant” evidence in the 

record as to her actual work activities. 

¶48 LIRC acknowledges that Dr. Krug, the independent medical examiner 

for Aurora, did not provide “the most persuasive opinion” regarding the material 

contributory causative factor theory. Dr. Krug stated that the “relatively short 

period of time” that Murff had worked for Aurora did not support this theory, but 

failed to explain why her time in that workplace—approximately three and one-half 

years—could not have caused or contributed to her condition. Dr. Krug also 

characterized Murff as a malingerer, which LIRC found to be without foundation, 

because this was not noted in any of the reports relating to Murff’s mental health 

issues. 

¶49 Murff urges us to take LIRC’s findings relating to Dr. Krug’s report 

as a concession that proves LIRC erred in its decision, based on her citation to E.F. 

Brewer. See id., 82 Wis. 2d at 637. However, as we stated above, the totality of 

the court’s discussion in E.F. Brewer emphasized that the credibility analysis of all

of the evidence is firmly within the province of LIRC, see id. at 636-37, and the 

inferences drawn by LIRC from competing evidence, if those inferences are 
No. 2021AP1155

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supported by the evidence, are conclusive, see Vocational, Tech. & Adult Ed., Dist. 

13, 76 Wis. 2d at 240.

¶50 Moreover, LIRC was not required to provide a “countervailing 

medical expert opinion[]” to support its conclusion that there was legitimate doubt 

as to Murff’s claim. See Leist, 183 Wis. 2d at 461. Rather, there just needs to be 

“something in the record” to support its rejection of a medical opinion. Id. at 460. 

LIRC explained what caused it to doubt the veracity of the opinions of the doctors 

who had indicated the work incident was a cause of Murff’s back problems. Indeed, 

these findings were “simply a matter of credibility.” See E.F. Brewer, 82 Wis. 2d 

at 639. 

¶51 LIRC also referenced the evidence in the record which indicated that 

the onset of Murff’s condition began prior to the work incident, that her condition 

did not appear to worsen for quite some time after the incident, and that she had a 

host of other physical and mental health issues that were likely factors in her 

condition. Additionally, LIRC noted the evidence that was lacking in the record, 

such as a more detailed description of Murff’s job duties that would support a 

finding that they were a material contributory causative factor to her back condition. 

¶52 After reviewing the record, we conclude that LIRC’s findings, and its 

ultimate conclusion that legitimate doubt existed as to Murff’s claim, are supported 

by credible and substantial evidence and the reasonable inferences LIRC drew from 

that evidence. See Kowalchuk, 234 Wis. 2d 203, ¶8; Vocational, Tech. & Adult 

Ed., Dist. 13, 76 Wis. 2d at 240. Therefore, we conclude that Murff did not meet 

her burden of proving the elements of her claim. See Kowalchuk, 234 Wis. 2d 203, 

¶8. Accordingly, we affirm the circuit court’s order which upheld LIRC’s decision 

dismissing Murff’s claim for worker’s compensation benefits. 
No. 2021AP1155

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By the Court.—Order affirmed. 

Not recommended for publication in the official reports.