SUPERIOR COURT OF NEW JERSEY

APPELLATE DIVISION

DOCKET NO. A-5547-18

PATRICIA COSTANZO,

Petitioner-Appellant,

v.

MERIDIAN REHAB,

Respondent-Respondent.

__________________________

Argued June 2, 2021 – Decided June 17, 2021

Before Judges Haas and Mawla.

On appeal from the Department of Labor and 

Workforce Development, Division of Workers' 

Compensation, Case No. 2017-14400.

Danielle S. Chandonnet argued the cause for appellant 

(Shebell & Shebell, LLC, attorneys; Raymond P. 

Shebell, Sr. of counsel; Danielle S. Chandonnet, on the 

brief).

Carla P. Aldarelli argued the cause for respondent 

(Capehart & Scatchard, PA, attorneys; Carla P. 

Aldarelli, of counsel; Maura Burk, on the brief).

PER CURIAM

NOT FOR PUBLICATION WITHOUT THE

APPROVAL OF THE APPELLATE DIVISION

This opinion shall not "constitute precedent or be binding upon any court." Although it is posted on the 

internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3.
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Petitioner Patricia Costanzo appeals from the July 9, 2019 order of the 

Division of Workers' Compensation, which denied her motion for additional 

medical and temporary benefits related to her left knee. We affirm.

The procedural history and facts are fully set forth in the comprehensive 

written decision rendered by Judge of Compensation Salvatore Martino 

following a five-day trial. Therefore, we need only recite the most salient details 

here.

On April 1, 2016, petitioner was working as a recreational aide for 

respondent Meridian Rehab. While performing her duties, she slipped, fell 

forward to the ground, and landed on both knees. She felt pain in her left knee. 

Petitioner filed a claims petition and respondent accepted her claim for treatment 

for her left knee.

An MRI was taken of petitioner's left knee on June 14, 2016. The MRI 

report revealed no meniscus tear, no ligament tear, and no fracture. There was 

preexisting thinning of the patellofemoral cartilage and preexisting 

osteoarthritis in the knee. 

Respondent paid for petitioner's left knee treatment, which consisted of 

medications, physical therapy, cortisone injections, and a series of Viscoelastic 

injections. Petitioner thereafter resumed her regular work for respondent.
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Petitioner testified that she suffered a right knee meniscus tear in August 

2017 while walking on a beach.1 She underwent a right knee arthroscopic 

meniscectomy that same month.

In January 2018, petitioner underwent another MRI on her left knee. 

Unlike the June 2016 MRI, the new MRI showed that petitioner now had a torn 

medial meniscus tear with a displaced fragment in her left knee. She also had a 

torn anterior cruciate ligament (ACL) tear in the same knee. Her preexisting 

arthritis was still present in the knee.

In February 2018, petitioner filed a motion seeking to require respondent 

to pay for additional treatment for her left knee. Respondent denied liability and 

the matter proceeded to trial before Judge Martino.

Petitioner testified that she was experiencing pain in her left knee. She 

denied injuring the knee on the beach in August 2017 and denied any other 

incident involving her knee. Judge Martino found that while petitioner 

"answered the majority of the questions [posed to her] in a straightforward 

manner[,] [t]here were a few occasions when . . . [p]etitioner seemed to be 

1

 This injury was not compensable because it did not occur during the course of 

petitioner's employment. 
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evasive in responding to counsel's questions. And she seemed to minimize the 

effect that her right knee condition had on her activities."

Petitioner also presented the testimony of Cary Skolnick, M.D., who was 

accepted by the court as an expert in the field of orthopedic surgery. Based upon 

his examination of petitioner, Dr. Skolnick opined that the tears in petitioner's 

left knee were related to the injury she sustained when she fell on the ground in 

April 2016. 

In rendering this opinion, Dr. Skolnick conceded that neither the meniscus 

tear nor the ACL tear were present in the June 2016 MRI. However, he insisted 

that petitioner's medial meniscus was "elongated" when her knee struck the 

ground and that it gradually tore over time. Dr. Skolnick also claimed that 

petitioner's ACL was stretched in the incident to the point where there were just 

a few fibers holding it together. Eventually, the remaining fibers broke and the 

tear became apparent on the MRI. Dr. Skolnick also testified that even though 

petitioner suffered from preexisting arthritis in the left knee before the April 

2016 fall, the fact that her left knee struck the ground caused the arthritis to 

worsen to the point where additional treatment was needed.

Judge Martino found that Dr. Skolnick's opinions were not credible. The 

judge explained that the expert's testimony was simply not logical and he "did 
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not directly address the questions posed to him." Dr. Skolnick's demeanor on 

the stand further weakened his credibility because he "became abrupt and . . . 

somewhat argumentative with . . . [r]espondent's attorney" during crossexamination. Judge Martino also noted that the facts Dr. Skolnick used as the 

basis for his opinions were "tenuous."

The judge was more impressed with the testimony provided by 

respondent's expert, Shawn D. Sieler, M.D. Dr. Sieler testified that petitioner 

suffered only a left knee contusion in the April 2016 fall, received appropriate 

treatment for that injury, and fully recovered. Contrary to Dr. Skolnick's claims, 

Dr. Sieler stated that a meniscus or ACL "cannot tear spontaneously" and the 

tears found on the January 2018 MRI "can only be explained by some subsequent 

traumatic incident."

Dr. Sieler found no evidence of any "elongation" or "stretching" of the 

structures within petitioner's left knee on the June 2016 MRI and testified that 

the arthritis found in both MRIs preexisted the April 2016 accident. Thus, Dr. 

Sieler concluded that petitioner "remain[ed] at maximal medical improvement 

from the contusion injury of the left knee" and that the conditions she now 

sought treatment for were not caused by the April 2016 incident.
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Judge Martino found that Dr. Sieler's testimony was credible and 

persuasive. The judge explained that Dr. Sieler's "testimony was in accord with 

his written expert opinion. His testimony was logical and direct. He answered 

questions clearly and directly." Moreover, unlike Dr. Skolnick, respondent's 

expert's testimony was supported by the MRIs submitted in evidence.

As a result, Judge Martino concluded:

The [c]ourt finds that the testimony elicited in 

this matter and the underlying facts of this case 

establishes and confirms that . . . [p]etitioner currently 

suffers from left knee pathology. However as the 

[c]ourt has previously indicated, [Dr. Sieler's] opinion 

is more credible and persuasive regarding the causal 

relation between the current status of . . . [p]etitioner's 

left knee and the original injury. The [c]ourt has given 

due weight to the credentials of [Dr.] Skolnick, but 

finds the opinions of Dr. Sieler to be more logical and 

convincing in this particular matter with regard to the 

progression of . . . [p]etitioner's left knee complaints 

and pathology.

While it is clear that more severe pathology 

currently exists as compared to the time period closer 

to the injury date, there does not appear to be a 

reasonable connection between the mechanism of the 

injury and the current state of her pathology. The 

[c]ourt rejects the opinion of [Dr.] Skolnick as his 

opinion regarding the causal relationship between . . . 

[p]etitioner's current physical condition and the 

accident is not supported by a reliable factual basis and 

is speculative. Petitioner's expert simply could not 

meet the burden required to establish the causal 
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connection between the original injury and the current 

condition of . . . [p]etitioner's knee.

Based upon the foregoing findings of fact and 

law, the [c]ourt finds that . . . [p]etitioner has failed to 

establish[ ] by objective, reasonable evidence that a 

need [exists] for additional treatment regarding a "work 

related" injury to [her] left knee.

This appeal followed.

On appeal, petitioner contends that "sufficient objective medical evidence 

was presented at trial to meet petitioner's burden to establish the need for 

treatment as necessary and related to the work injury." She also asserts that 

Judge Martino erred in assessing Dr. Skolnick's credibility. We disagree with 

both of these contentions.

The New Jersey Workers' Compensation Act is "humane social legislation 

designed to place the cost of work-connected injury upon the employer who may 

readily provide for it as an operating expense." Tocci v. Tessler & Weiss, Inc., 

28 N.J. 582, 586 (1959). The Act must be liberally construed "in order that its 

beneficent purposes may be accomplished." Torres v. Trenton Times 

Newspaper, 64 N.J. 458, 461 (1974). However, this canon of liberal 

construction of the Act "does not extend to 'the evaluation of credibility or of 

weight or sufficiency of evidence.'" Lindquist v. City of Jersey City Fire Dep't.,
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175 N.J. 244, 258 (2003) (quoting Oszmanski v. Bergen Point Brass Foundry, 

Inc., 95 N.J. Super. 92, 95 (App. Div. 1967)).

Pursuant to N.J.S.A. 34:15-1, a compensable workers' compensation 

injury must be caused by an accident "arising out of and in the course of" the 

worker's employment. An employer is required to "furnish to the injured worker 

such medical, surgical and other treatment, and hospital service as shall be 

necessary to cure and relieve the worker of the effects of the injury and to restore 

the functions of the injured member or organ where such restoration is possible

. . . ." N.J.S.A. 34:15-15. However, there must be evidence that the issues 

complained of are indeed the "effects" of the injury that occurred, and "a 

successful petitioner in workers' compensation generally must prove both legal 

and medical causation when those issues are contested." Lindquist, 175 N.J. at 

259. "Medical causation means the injury is a physical or emotional 

consequence of work exposure" and "that the disability was actually caused by 

the work-related event." Ibid.

"It is the petitioner's burden to establish a causal link between the 

employment and the disease." Kiczula v. Am. Nat'l Can Co., 310 N.J. Super. 

293, 303 (App. Div. 1998). "The link must be proven by a preponderance of the 

evidence," ibid., and the focus is on "the proof of a causal connection between 
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working conditions and the harm." Giambattista v. Thomas A. Edison, Inc., 32 

N.J. Super. 103, 112 (App. Div. 1954). "The standard is one of reasonable 

probability; i.e., whether or not the evidence is of sufficient quality to generate 

a belief that the tendered hypothesis is in all likelihood the truth." Lister v. J.B. 

Eurell Co., 234 N.J. Super. 64, 72 (App. Div. 1989).

In reviewing decisions of judges in the Division of Workers' 

Compensation, "[t]he factual findings of the compensation court are entitled to 

substantial deference." Ramos v. M & F Fashions, 154 N.J. 583, 594 (1998). 

We limit our inquiry 

to whether the findings made by the Judge of Workers' 

Compensation could reasonably have been reached on 

sufficient credible evidence present in the record, 

considering the proofs as a whole, with due regard to 

the opportunity of [the] one who heard the witnesses to 

judge of their credibility and with due regard to his 

expertise.

[Ibid. (quoting Bradley v. Henry Townsend Moving & 

Storage Co., 78 N.J. 532, 534 (1979)).]

We may not substitute our own factfinding for that of the judge of 

compensation. Lombardo v. Revlon, Inc., 328 N.J. Super. 484, 488 (App. Div. 

2000). We must defer to the factual findings and legal determinations made by 

the judge of compensation "unless they are 'manifestly unsupported by or 

inconsistent with competent relevant and reasonably credible evidence as to 
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offend the interests of justice.'" Lindquist, 175 N.J. at 262 (quoting Perez v. 

Monmouth Cable Vision, 278 N.J. Super. 275, 282 (App. Div. 1994)). While 

the judge of compensation has "expertise with respect to weighing the testimony 

of competing medical experts and appraising the validity of [the petitioner's] 

compensation claim," Ramos, 154 N.J. at 598, the judge must "carefully 

explain[] why he considered certain medical conclusions more persuasive than 

others." Smith v. John L. Montgomery Nursing Home, 327 N.J. Super. 575, 579 

(App. Div. 2000). 

Against this backdrop, and mindful of our standard of review, we affirm 

substantially for the reasons expressed by Judge Martino in his thorough written 

decision. We add only the following brief comments.

Contrary to petitioner's contentions on appeal, there was ample evidence 

in the record to support the judge's conclusion that the current condition of 

petitioner's left knee was not related to the injury she suffered when she fell at 

work in April 2016. At that time, petitioner suffered only a contusion. The MRI 

taken in June 2016 revealed no meniscus tear and no ACL tear. Although the 

MRI showed that petitioner had arthritis in the knee, this was a preexisting 

condition.
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As Dr. Sieler testified, and Judge Martino found, the meniscus and ACL 

tears that the January 2018 MRI showed did not occur at the time of the April 

2016 accident and did not spontaneously occur on their own. There was no 

medical evidence that the arthritis in her left knee had worsened as the result of 

the April 2016 fall. Therefore, the judge properly concluded that petitioner was 

not entitled to additional treatment to her left knee because her current condition 

was not caused by a work-related incident.

We also reject petitioner's claim that the judge erred in according greater 

weight to the testimony of Dr. Sieler than the testimony of Dr. Skolnick. 

Compensation judges have "expertise with respect to weighing the testimony of 

competing medical experts." Ramos, 154 N.J. at 598. This court "may not 

'engage in an independent assessment of the evidence as if it were the court of 

first instance.'" Sager v. O.A. Peterson Constr., 182 N.J. 156, 164 (2004) 

(quoting State v. Locurto, 157 N.J. 463, 471 (1999)). Compensation judges who 

see and hear the testimony are in the best position to assess the demeanor and 

credibility of the expert witnesses. Ibid. 

A "judge of compensation 'is not bound by the conclusional opinions of 

any one or more, or all of the medical experts.'" Kaneh v. Sunshine Biscuits, 

321 N.J. Super. 507, 511 (App. Div. 1999) (quoting Perez v. Capitol 
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Ornamental, Concrete Specialties, Inc., 288 N.J. Super. 359, 367 (App. Div. 

1996)). "That [the judge] gave more weight to the opinion of one physician as 

opposed to the other provides no reason to reverse th[e] judgment." Bellino v. 

Verizon Wireless, 435 N.J. Super. 85, 95 (App. Div. 2014) (alterations in 

original) (citing Smith, 327 N.J. Super. at 579). 

Here, Judge Martino fully articulated his reasons for crediting Dr. Sieler's 

testimony over that provided by Dr. Skolnick. We discern no basis for 

disturbing his well-reasoned conclusion.2

Affirmed.

2

 Although the judge briefly noted that he had observed Dr. Skolnick provide 

more credible testimony on prior occasions, this was a fleeting comment and 

not, as petitioner now asserts, a basis for reversal. As summarized above, the 

judge's reasons for giving more weight to Dr. Sieler's expert opinions were 

squarely based upon the testimony both experts gave at the trial in this matter.