IN THE COMMONWEALTH COURT OF PENNSYLVANIA

Debbie Cardona , :

Petitioner :

: No. 750 C.D. 2017

v. : : Submitted: December 1 , 2017 Workers’ Compensation Appeal : Board ( Pleasant Valley Manor ), :

Respondent :

BEFORE: HONORABLE P. KEVIN BROBSON, Judge

HONORABLE PATRICIA A. McCULLOUGH, Judge HONORABLE BONNIE BRIGANCE LEADBETTER, Senior Judge

OPINION NOT REPORTED

MEMORANDUM OPINION BY JUDGE McCULLOUGH FILED: January 30, 2018

Debbie Cardona (Claimant) petitions for review of the May 16, 2017 order of the Workers’ Compensation Appeal Board (Board), which affirmed the order of a Workers’ Compensation Judge (WCJ) granting a termination and utilization review petition filed by Pleasant Valley Manor (Employer) and denying Claimant ’s review petition.

Facts and Procedural History

Cla imant worked for Employer as a certified nursing assistant

. On June 7, 2010 , Claimant was injured at work when she slipped and fell on a wet floor. Employer issued a Notice of Temporary Compensation Payable (NTCP), describing2

her injury as “contusions to the left hip, left ankle, and lower back, ” (Finding of Fact (F.F.) No. 1 ), and Claimant began receiving total disability benefits. Employer later issued a second NTCP, describing her injury as a lower back strain. (F.F. Nos. 6, 1.)

In November 2012, Employer filed a utilization review request regarding Claimant’s treatment with Kenneth Zahl, M.D.
, from October 12, 2012, and ongoing.
For unknown reasons, two utilization review determinations were generated and the parties agreed that the February 1, 2013 determination by Michael J. Drass, M.D. , was controlling and that the petition to review the second report would be dismissed. In December 2012, Employer filed a termination petition, alleging that Claimant had fully recovered from her injury as of October 25, 2012. In January 2013, Emplo yer filed a suspension petition based upon an offer of employment, alleging Claimant was able to

return to unr estricted work

. (F.F. Nos. 2

- 4; Board’s 5/14/15 op. at 1.)

In February 2013, Claimant filed a review petition, which sought to amend the description of her injury to include a left hip contusion, trochanteric bursitis, left
ITB tendi nitis, left abductor strain, left pes anserine bursitis, L5

- S1 disc herniation with radiculopathy, lumbar radiculitis, left ankle tibial tend i nopathy, left ankle sprain, left peroneal ten dinopathy, Achilles tendi nitis, left ankle synovitis, arthralgia left ankle, post

- traumati c headaches, concussion, concussion syndrome, Reflex Sympathetic Dystrophy ( RSD ) , cervicalgia, and cervi c obrachia l syndrome. The matter was assigned to a WCJ who held multiple hearings. (F.F. No . 5 ; Reproduced Record (R.R.)
at 320a

. )
Claimant testified at a hearing and stated that her job as a certified nursing
assistant involved bathing, lifting, feeding, and caring for nursing home residents, which required frequent bending, kneeling, squatting, and lift ing from 5 to 200 pounds. On the day of her injury, Claimant testified that she walked out of a room to serve3

dinner and slipped and fell on a wet floor, which caused her to twist her whole body, resulting in her left hip, ankle, and head striking the gro und. Claimant stated that she was taken to an emergency room by ambulance where she received x

- rays of h er left
ankle and an air cast. Claimant indicated that she follow ed up with several doctors and received physical therapy, medications, orthotics, MRI s of her left ankle and hip, a Doppler test on her left leg , and a CAT scan of her head. Claimant also testified that she had surgery on her ankle i n January 2011. Claimant stated that she received referrals to Dr. Zahl, a pain management doctor with who m she continue d to treat monthly , and Dr. James Kerrigan, a neurologist. (F.F. No. 6.)

With regard to her treatment with Dr. Zahl, Claimant stated that she had MRIs, blocking injections, and two spinal cord stimulator trials , and had been prescribed vari ous medications. Claimant indicated that the injections help ed somewhat but nothing has given her any lasting benefit. Claimant testified that her ankle was presently swollen and painful to the touch and , consequently , she was unable

to tie her shoe and must leave it open. She stated that she continued to have occasional issues with her hip and that her migraines were lessened by injections she receive d about every six months. Claimant acknowledged that in November 2012 Employer

sent her a job offer to return to work but stated that she had not returned to her pre

injury job because she did not feel she was fully recovered , was in too much pain , and could not stand for an entire shift. (F.F. at 6 ; R.R. at 507a

- 08a .)

Claimant also presented the testim ony of Dr. Zahl, who testified that he
first saw Claimant in October 2011 , at which point she was complaining of left ankle pain with burning and swelling, headaches, and low back pain. Dr. Zahl stated that he diagnosed her wit h RSD or complex regional pain syndrome in her lower limb, cervicobrachial pain syndrome, and other symptoms related to her low back. Dr. Zahl4

testified that the diagnosis was causally related to her June 17, 2010 work injury and began treating her with i njections, medications, and subsequently a spinal cord stimulator. Dr. Zahl indicated that he was currently treating Claimant with medication
and would possibly treat her with a spinal stimulator in the future. He testified that all
of his treatment for Claimant was reasonable and necessary and stated his belief that Claimant had not fully recovered from her work injury and was unable to return to
work. ( F.F. No. 9; Board’s 5/14/15 op. at 3.)

Employer presented the testimony of Michael Raklewicz, M.D., a board

certified orthopedic surgeon, who performed an independent medical examination of Claimant in October 2012. Dr. Raklewicz diagnosed Claimant’s work injury as a hip contusion, which possibly resulted in some trochanteric bursitis, and a left ankle sprain. Dr. Raklewicz opined that, at the time of his examination of Claimant, she had recovered from her ankle and hip contusion an d, because he did not see ev idence of a
back contusion or strain , any such injury had resolved. Dr. Raklewicz testified t hat, in his opinion, Claimant could return to her pre

- injury job without restrictions and that she did not require any further medical treatment. Additionally , Dr. Raklewicz stated that he did not believe Claimant had sustained any injuries not listed in the original injury description. (F.F. No. 8; Board’s 5/14/15 op. at 3

- 4.)

Employer also presented the testimony of Paul Shipkin, M.D., a board

certified neurologist who performed two examinations of Cla imant in February 2011 and May 2013. Dr. Shipkin diagnosed Claimant with a minor left scalp contusion and bruising or contusions involving her left ankle, hip, and low back, resulting from her work injury. Dr. Shipkin opined that Claimant’s headache symptoms were not related to her work injury and stat ed that he saw no evidence of post

- concussion syndrome or RSD. Ultimately, Dr. Shipkin concluded that Claimant had fully recovered from her5

work injury, did not require any further treatment, and was able to return to her pre

injury job without restrictio ns. (F.F. No. 10; Board’s 5/14/15 op . at 4.)

Finally, Employer presented the testimony of Susan Roberts, Employer’s director of human resources. Ms. Roberts testified that she sent a job offer letter to Claimant in November 2012, offering her the positi on she previously held as a certified nursing assistant. Ms. Roberts stated that she was not Claimant’s supervisor and that the nursing supervisor would have to provide any potential modifications of the position’s duties. (F.F. No. 7.)

A. WCJ’s March 28, 2014 Decision and Order By decision and order dated May 28, 2014, the WCJ granted Employer’s termination petition as of October 25, 2012, and denied Claimant’s review petition seeking to amend the injury description

.

The WCJ found Claimant generally credible but noted that she was not “entirely candid with regard to her symptoms.” (F.F. No. 11.) Specifically, the WCJ
stated that, based upon her bearing and demeanor, Claimant’s testimony with regard to her symptoms wa s rejected as not credible. Id.

In considering Dr. Zahl’s testimony, the WCJ noted that Dr. Zahl “relied almost entirely upon [] Claimant’s subjective complaints rather than on objective testing.” (F.F. No. 15.) T he WCJ rejected his testimony for that reason and to the
extent that it was inconsistent with the “more credible testimonies” of Dr. Raklewicz and Dr. Shipkin. Id.

The WCJ found Dr. Raklewicz’s testimony credible, explaining that he was able to “competently and positively explain the basis fo r his opinions” and was “entirely logical and . . . unshaken on cross

- examination.” (F.F. No. 13.) Similarly,6

the WCJ found Dr. Shipkin’s testimony credi ble and persuasive. The WCJ noted that neither Dr. Raklewicz nor Dr. Shipkin had “any financial inte rest in continuing to treat [] Claimant.” (F.F. No. 14.)

Finally, the WCJ considered the testimony of Ms. Roberts and found her generally credible, observing that she merely stated that she sent Claimant the job offer and made no particular claims with regard to it. (F.F. No. 12.)

The WCJ ultimately found that Claimant failed to prove that the injury description should have been amended. Specifically, the WCJ found that Claimant did not prove that she suffered from RSD or post

- concussive syndrome. T he WCJ specifically noted Dr. Raklewicz’s testimony that left hip trochanteric bursitis, ITB tendonitis, and left abductor strain were the same thing and that “arthralgia of the left ankle” simply meant ankle pain
, none of which were present in Claimant

. (F.F. No. 18.) Concluding that Claimant failed to prove that she suffered injuries in excess of
those listed in the N T CP , the WCJ determined that the NTCP accurately described the work injury as a lower back strain and dismis sed Claimant’ s review petition. ( Id. ; Conclusion of Law (C.L.) No. 5.)

Conversely, t he WCJ concluded that Employer proved by sufficient, credible, and competent evidence that Claimant was fully recovered as of October 25, 2012, and terminated benefits as of that date. Furth er, the WCJ found Employer proved that the medical treatment rendered by Dr. Zahl was unreasonable and unnecessary as of that date and granted Employer’s petition to review the uti lization review determination. Finally, the WCJ dismissed Employer’s suspen sion petition as moot. (C.L. Nos. 2

- 4.) Claimant appealed to the Board.

B. Board’s May 14, 2015 Opinion7

On appeal, the Board affirmed in part and remanded in part

. The Board
determined that the WCJ did not err in granting Employer’ s termination peti tion, noting that the testimony of Dr. Raklewicz and Dr. Shipkin , which the WCJ found credible,
constituted sufficient evidence establishing that Claimant had fully recovered from her work injuries. T he Board also found the WCJ did not err in denying Clai mant’s review petition to amend the injury description , as Claimant failed to establish a causal relationship between her work and her injuries with unequivoc al medical evidence.
The Board noted that the WCJ rejected Dr. Zahl’s testimony in favor of Drs. Raklewicz and Shipkin, and, as such, there was no supporting evidence to prove Claimant’s injury description should have be en expanded.

Next, the Board held that the WCJ did not err in determining that Claimant’s medical treatment post

- October 2 5, 2012, was not reasonable and necessary
since the WCJ properly suspended her benefits as of that date. T he Board also addressed Claimant’s argument that the WCJ erred in determining that Employer’s contest was unreasonable with regard to its suspension petition. The Board rejected the argument, observing that Employer was able to present evidence to support a suspension in the form of testimony that Employer offered Claimant a position and that
Claimant was able to return to her full

- time , pre

- injury po sition. (Board’s op. at 6

- 7.)

Finally, the Board addressed Claimant’s contention that the WCJ erred in failing to award litigation costs since she prevailed , in part, on her utilization review petition. The Board agreed that, b ecause the WCJ found that some of Claimant’s
treatment with Dr. Zahl

— the treatment prior to October 25, 2012

— was reasonable and
necessary, Claimant was entitled to at least a portion of her litigation costs. The Board
remanded solely on that issue for the WCJ to apportion the appr opriate costs.8

Claimant then filed a petition for review with this Court. By order dated June 22, 2015, this Court quashed the appeal as interlocutory because the Board ordered a remand for further proceedings. Cardona v. Workers’ Compensation Appeal
Board , (Pa. Cmwlth., No. 960 C.D. 2015, filed June 22, 2015).

C. Proceedings on Remand The parties entered into a stipulation in which Employer agreed to pay $1,032.93 of Claimant’s litigation costs. Th e WCJ approved the stipulation and entered
it into the record.

Claimant appealed to the Board, raising the same issues as in her appeal from the WCJ’s prior order, and filed a motion to make final the Board’s May 14, 2015 opinion pursuant to Shuster v. Workers’ Compensation Appeal Board (Human
Rela tions Commission) , 745 A.2d 1282 (Pa. Cmwlth. 2000). The Board granted the motion and Claimant filed a petition for review with this Court, 1 asserting that the WCJ
erred in (1) determining that Employer met its burden on its termination petition with
subs tantial competent medical evidence; (2) failing to review all of the evidence of
record and, hence, failed to issue a reasoned decision ; (3) denying her review petition
and determining that Claimant failed to meet her burden of proving the injury descripti on should have been expanded; (4) granting Employer’s utilization review petition despite failing to review all of the evidence of record; and (5) finding that Employer’s contest, via the suspension petition, was reasonable.

1 Our scope of review is limited to determining whether findings of fact are supported by substantial evidence, whether an error of law has been committed, or w hether constitutional rights have been violated. Section 704 of the Administrative Agency Law, 2 Pa.C.S. §704; Meadow Lakes Apartments v. Workers’ Compensation Appeal Board (Spencer) , 894 A.2d 214, 216 n.3 (Pa. Cmwlth. 2006).9 Discussion In a workers’ compensation proceeding, the WCJ is the ultimate fact
finder and is the sole authority for determining the weight and credibility of evidence. Lombardo v. Workers’ Compensation Appeal Board (Topps Company, Inc.) , 698 A.2d 1378, 1381 (Pa. Cmw lth. 1997). “As such, the WCJ is free to accept or reject the testimony of any witness, including medical witnesses, in whole or in part.” Id. We
will not disturb t he WCJ’s findings on appeal when they are supported by substantial, competent evidence. Greenwich Collieries v. Workmen’s Compensation Appeal Board (Buck) , 664 A.2d 703, 706 (Pa. Cmwlth. 1995). “Substantial evidence is such relevant evidence which a reasonable mind might accept as adequate to support a finding.” Berardelli v. Workmen’s Comp ensation Appeal Board (Bureau of Personnel, State Workmen’s Insurance Fund) , 578 A.2d 1016, 1018 (Pa. Cmwlth. 1990).

Moreover, where both parties present evidence, it is irrelevant that the
record contains evidence that supports a finding contrary to th at made by the WCJ; rather, the pertinent inquiry is whether evidence exists that supports the WCJ’s findings. Hoffmaster v. Workers’ Compensation Appeal Board (Senco Products, Inc.)
, 721 A.2d 1152, 1155 (Pa. Cmwlth. 1998).

Additionally, on appeal, all i nferences drawn from the evidence shall be taken in favor of the party prevailing before the WCJ. Krumins Roofing and Siding v. Workmen’s Compensation Appeal Board (Libby) , 575 A.2d 656, 659 (Pa. Cmwlth. 1990).

Termination Petition

In Claimant’s first argument, she contends that the WCJ erred in granting Employer’s termination petition because the evidence of Employer’s physician10

witnesses was contradictory, not credible, and insufficient to meet its burden of proof

. With regard to Dr. Raklewicz, Claim ant highlights what she considers to be several
i nconsistencies in his testimony, which rendered it equivocal and not credible. For example, Claimant emphasizes Dr. Raklewicz’s testimony that, although Claimant’s left ankle exhibited a decreased range of motion, he felt that it was minor and Claimant was fully recovered. Claimant counters , “[I]f there was an impairment present on the exam, then obviously Claimant was not fully recovered.” (Claimant’s brief at 26.)
Claimant contends that Dr. Raklewicz di smissed Claimant’s symptoms that were indicative of ongoing symptomatology and disease so that he could render a n opinion
of full recovery

. Claimant also argues that Dr. Raklewicz’s testimony could not have constituted competent evidence because it relied upon an incomplete medical history in that Dr. Raklewicz based some of his opinion on an MRI report instead of the actual
film. Based upon this, Claimant concludes that the WCJ erred in finding Dr. Raklewicz
credible.
Claimant next asserts that Dr. Ship kin’s opinion as to Claimant ’s full
recovery wa s “likewise not worthy of belief, ” citing the fact that he only saw Claimant on two occasions and testified he did not routinely treat patients with “traumatically
induced” RSD. (Claimant’s brief at 27.) Claimant also refers to Dr. Shipkin’s testimony that Claimant did not have R SD , despite acknowledging Claimant appeared to have symptoms that could be associated with RSD, which were decreased muscle strength and some swelling in her left ankle. Claimant further argues that the WCJ should have rejected Dr. Shipkin’s testimony as not credible because there is no method to prove the accuracy of his opinion that Claimant did not suffer from ongoing work

related headaches.

W e agree with the following observat ion of the Board:11

Claimant makes numerous arguments as to why the [WCJ] should have decided differently based on the evidence[; however,] the relevant inquiry in a substantial evidence analysis is not whether the record contains evidence to support fact s other than those made by the [WCJ]; the critical inquiry is whether there is evidence to support the findings actually made.
(Board’s 5/14/15 op. at 5.)

Here, the credible testimony of Dr. Raklewicz and Dr. Shipkin that Claimant was fully recovered f rom her work injury constitute d substantial evidence supporting the WCJ’s termination of Claimant’s benefits. Both doctors performed comprehensive ph ysical examinations of Claimant, as well as a review of her medical records and history, and both doctors explained their findings at length in their reports.

With regard to Claimant ’s argument that Dr. Raklewicz’s testimony relied on incomplete medical records, Claimant proffer s no analogous precedent for her argument that a physician’s entire medical testimony is incompetent when it is based, in part, on a review of an MRI imaging report instead of actually viewing the MRI
films. Instead, Claimant relies upon Newcomer v. Workmen’s Compensat ion Appeal Board ( Ward Trucking Corporation) , 692 A.2d 1062 (Pa. 1997), which is entirely distinguishable from the facts of the present case

.

In Newcomer , a claimant alleged a new shoulder inj ury two years after sustaining a work injury involving an imp act to his abdomen. The claimant presented the testimony of a doctor, who state d that the shoulder problem was caused by the workplace injury. However, t he doctor admitted that he had not reviewed any hospital records from the original injury, was not in volved in any treatment immediately following the injury, and acknowledged that his opinion was based “solely and expressly on the medical history provided by [the claimant].” Id. at 1063. O ur Supreme
Court held that the doctor’s testimony was based on a false medical history and ,12

therefore , legally incompetent, noting that the claimant’s description of the work injury
to the doctor was “patently different ” from his original description of the injury. Id. at 1066. Conversely, here, as noted above, Dr. Raklewicz based his testimony upon a comprehensive review of Claimant’s “extensive” medical records as set forth in his records review report, which listed each of the approximately 42 individual records he reviewed, as well as a physical examination of Cl aimant. (F.F. No. 8 ; R.R. at 223 a

44a .) Thus, an assertion that Dr. Raklewicz’s testimony was based upon incomplete or
inaccurate medical information for failure to review an MRI film is, at best, disingenuous.

Claimant’s argument that the doctors’ testimony was inconsistent or not credible is likewise unavailing. Although Dr. Raklewicz acknowledged that Claimant’s left ankle had a minor decreased range of motion , he specifically stated that this finding did not change his opinion regarding Claimant ’ s full recovery or her ability to return to work because he did not feel that “five degrees less dorsiflexion and plantar flexion is going to impair [Claimant]. . . [u]nless [she were] a sprinter, perhaps.” (R.R. at 195a.) Claimant argues that any continued ankle impairment is relevant to her ability to perform her pre

- injury position as a certified nursing assistant, “who stands on her feet for an entire shift.” (Claimant’s brief at 26.) T his argument, ho wever, merely expresses disagreement with Dr. Raklewicz ’s expert opinion and, as Employer notes, uses that disagreement as the basis of an impermissible challenge to the WCJ’s credibility determination. 2

2 Claimant also argues that the WCJ should not have relied on Dr. Shipkin’s testimony about RSD because he “did not routinely treat patients with traumatically induced RSD.” (Claimant’s brief at 27.) In addition to the fact that Claimant is again impermi ssibly challenging the WCJ’s weight and credibility determinations, Claimant is incorrect. In fact, Dr. Shipkin testified that he actively13 Reasoned Decision In Claimant’s second argument , she avers that the WCJ failed to render a reasoned decision by failing to address all of the evidence of record

— specifically, the utilization review report of Dr. Drass. Claimant further states that the WCJ could not
have reached his conclusions based u pon the evidence he reviewed because he “failed to accurately render findings consistent with the testimony and opinions enunciated by Dr. Zahl, ” and , further, he “mischaracterized” his testimony. (Claimant’s brief at 30

- 31.)
Section 422 of the Workers ’ Compensation Act (Act), 3 states

All parties to an adjudicatory proceeding are entitled to a reasoned decision containing findings of fact and conclusions of law based upon the evidence as a whole which clearly and concisely states and explains the ratio nale for the decisions so that all can determine why and how a particular result was reached

. 77 P.S. §834. A decision is reasoned if it allows for adequate review by this Court under applicable review standards. Daniels v. Workers’ Compensation Appeal B oard (Tristate Transport) , 828 A.2d 1043, 1 052 (Pa. 2003).

treated patients with RSD, most commonly resulting from a stroke and , contrary to Claimant’s argument, the record do es not reveal that Dr. Shipkin was ever questioned regarding his experience in treating patients with “traumatically induced” RSD. Moreover, Claimant makes no attempt to explain the significance of such a distinction. (R.R. at 543a

- 44a, 581a.)

Further more, even if Claimant were correct that Dr. Shipkin was testifying outside of his expertise, we have previously held that “a n expe rt medical witness in a workers’ compensation proceeding is qualified to testify outside of his medical specialty, and any ob jection to that testimony goes to the weight of the evidence, not its competency .” Lombardo , 698 A.2d at 1381. Despite Claimant’s arguments to the contrary, determinations on the weight and credibility of evidence are not reviewable on appeal. See Lomba rdo , 698 A.2d at 1381.

3 Act of June 2, 1915, P.L. 736, as amended , 77 P.S. §834.14

Here, the WCJ explained his reasoning for finding that Claimant had recovered as of October 25, 2012, and that, consequently, her treatment with Dr. Zahl
after that date was unreasonable and unn ecessary. Specifically, the WCJ adopted the opinions of Drs. Raklewicz and Shipkin, both of whom expressed a belief that Claimant was magnifying and being dishonest about her symptoms and that continuing medical treatment was unnecessary. (F.F. Nos. 8, 10.) In adopting their opinion, the WCJ came to the opposite conclusion of Dr. Drass in the utilization revie w report , which stated
that all but one of the treatment s that Claimant was receiving from Dr. Zahl were reasonable and necessary

. (R.R. at 516a

- 23a

. ) Accordingly, the WCJ granted Employer’s petition to review the utilization review determination

. Becau se the WCJ rendered an opinion that was sufficient for appellate review, we reject Claimant’s argument. See Acme Markets, Inc. v. Workers’ Compensation Appeal Board (Brown)
, 890 A.2d 21, 26 (Pa. Cmwlth. 2006) (“ A reasoned decision does not require the WC J to give a line

- by

- line analysis of each statement by each witness, explaining how a particular statement affected the ultimate decision .”)

.

Although Claimant argues that the WCJ “mischaracterized” portions of Dr. Zahl’s testimony to suggest that Dr. Z ahl did not “make certain findings
, ” Claimant does not indicate which portions specifically were mischaracterize d and, consequently, the Court is unable to address the merits of this argument. (Claimant’s brief at 32.)

Review Petition In Claimant’s th ird argument, she asserts that the WCJ erred in denying Claimant’s review petition since all three physicians agreed that Claimant ’s work
i njuries were more expansive than those listed on the NTCP , which list ed only a “strain” in the “lower back area

. ” (R.R. at 89a.) Specifically, Claimant contends that15

Dr. Raklewicz acknowledged her ankle and left hip injuries and that Dr. Shipkin acknowledged that Claimant suffered from a concussion and post

- concussive syndrome. Thus, because these injuries exceed th ose listed in the NTCP, Claimant
argues that the WCJ erred in finding that the injury description should not have be en amended. Claimant also states that the WCJ’s finding that Dr. Zahl’s treatments prior to October 25, 2012, were reasonable and necessary conflicts with the WCJ’s decision not to expand the description as some of Claimant’s treatment with Dr. Zahl was for
her ankle injury and headaches.

As the Board correctly noted, it was Claimant’s burden to establish a causal relationship between the work injury and the additional injuries not listed on the NTCP with unequivocal medical evidence, unless the relationship wa s obvious. See Liveringhouse v. Workers’ Compensation Appeal Board (ADECCO) , 970 A.2d 508, 512 (Pa. Cmwlth. 2009).

Here, in find ing the testimony of Claimant and Dr. Zahl not credible, the WCJ rejected the testimony that Claimant produced to meet her burden. Furthermore, the testimony of Dr. Raklewicz and Dr. Shipkin plainly does not constitute unequivocal
medical evidence establi shing a causal relationship between her work injury and the alleged additional injuries

. The alleged injuries included left hip contusion, trochanteric bursitis, left ITB tendinitis, left abductor strain, left pes anserine bursitis,
L5

- S1 disc herniation with radiculopathy, lumbar radiculitis, left ankle tibial tendinopathy, left ankle sprain, left peroneal tendinopathy, Achilles tendinitis, left ankle synovitis, arthralgia left ankle, post

- traumatic heada ches, concussion, concussion syndrome, RSD , cervicalgia, and cervicobrachial syndrome

.

Although Dr. Raklewicz diagnosed Claimant with a work

- related hip contusion, possibly resulting in trochanteric bursitis, and a mild left ankle sprain, he16

emphasized that Claimant had fully recovered by the time of his examination, noting
that an MRI of Cl aimant’s ankle taken shortly after the injury showed normal findings. (R.R. at 175a.) Dr. Raklewicz also stated that if Claimant had sustained a lower back strain, it had resolved by the time of hi s evaluation. (R.R. at 176a.) Further, Dr.
Raklewicz te stified that Claimant had not sustained work

- related left pes anserine bursitis, an L5

- S1 herniated disc/protrusion with radiculopathy, lumbar radiculitis, left
ankle synovitis, Achilles tendinitis, arthralgia of the left ankle , cervicalgia or cervical
bra chial syndrome

. (R.R. 177a

- 80a.) Dr. Raklewicz also stated he found no evidence of RSD, emphasizing that results of Claimant’s bone scan, which is often used to diagnose RSD, were normal. (R.R. at 164a.)

Similarly, Dr. Shipkin diagnosed Claimant with a minor left scalp
contusion /concussion, and bruising/contusions of the left ankle, hip, and low back areas, which had all resolved. (R.R. at 544a

- 45a , 555a .) Dr. Shipkin stated to a reasonable degree of medical certainty that Claimant’s L5

- S1 lumbar spond ylotic disease predated the injury. (R.R. at 549a.) Additionally, Dr. Shipkin testified that any ongoing headache symptoms that Claimant was experiencing were not caused by the work injury and that claimant did not suffer from concussion or post

- concussi on syndrome , or RSD . (R.R. at 552a

- 56a.) Thus , although both doctors noted Claimant had issues at some point with her head, hip, ankle, and back, both felt that her injuries were fully resolved and/ or unrelated to the work injury. Moreover, we note that Claimant sought to expand the injury description in February 2013, which was after the date that the WCJ ultimately found Claimant had already fully recovered and was no longer in need of additional medical treatment.

Additionally, a s Employer notes, the WCJ found that Clai mant’s
treatment with Dr. Zahl prior to October 25, 2012 , was reasonable and necessary;17

however, the WCJ did not find that all the medical issues for which she was receiving treatment were causally related to her w ork injury. As such, Claimant failed to prove
the additional i njuries were causally connected to her work injury with unequivocal medical evidence and the WCJ properly rejected her petition for review.

Utilization Review Petition In her fourth argument , Claimant contends that the WCJ erred in granting Employer’s utilization review petition by ignoring competent evidence of record establishing the reasonableness and necessity of the treatment rendered. As in her previous arguments, Claimant recites the portions of her own testimony and Dr. Zahl’s testimony which she contends proves that her treatment was reasonable and necessary beyond October 25, 2012, and again delineates why she believes Dr. Raklewicz’s and
Dr. Shi pk in’s testimony was not credible. F or the reasons set forth previously, the argument is dismissed as an impermissible challenge to the WCJ’s credibility
determinations.

Suspension Petition/Reasonable Contest

In Claimant’s final argument, she contends that the evidence Employer present ed was in sufficient to support a suspension of benefits because Employer never offered a position in which her earning power would not have been adversely impact ed by her work injury. Claimant asserts that the position Employer offered was for four days o f work per month , which would have resulted in an income less than her pre

injury position. Thus, Claimant contends that the WCJ erred in finding Employer presented sufficient evidence to warrant its pursuit of the suspension petition.18

In response, Empl oyer asserts that, even if Claimant’s argument regarding the position’s earning power were accepted, Employer still submitted sufficient evidence to merit at least a modification of Claimant’s wage loss benefits. Further, Employer notes that the petition was rendered moot because its termination petition was granted prior to the position’s start date. As such, Employer asserts that the totality
of the circumstances demonstrate s that Employer ’s contest of the suspension petition
was reasonable.

Section 440(a) of the Act states that, if an employer contests liability, it will be liable for the claimant’s costs, including counsel fees, if the matter is resolved
in whole or i n part in the claimant’s favor. 77 P.S. §996. 4 However, section 440(a)
al so states that attorney’s fees may be excluded if the employer presents a reasonable

contest. “Reasonableness of an employer’ s contest depends on whether the contest was prompted to resolve a genuinely disputed issue or merely to harass the claimant

. ”
Th issen v. Workmen’s Compensation Appeal Board (Hall’s Motor Transit) , 584 A.2d 612, 615 (Pa. Cmwlth. 1991). Where the employer presents evidence that lends itself to “contrary inferences,” the employer’s contest will be deemed reasonable. Id.

Here, as the Board noted, Employer was able to present evidence, which, if believed, would have been sufficient at least to warrant a modification of any benefits
to which Claimant would have been entitled. Specifically, Employer presented t he testimony of Ms. Rob erts, who testified that Employer offered Claimant a return to her

pre

- injury position, as well as the testimony o f Dr. Raklewicz and Dr. Shipkin, who
stated that Claimant could return to that position without any restrictions

. We agree
with the Board that this evidence provided Employer a reasonable basis for contesting

4 Section 440 was added by s ection 3 of the Act of February 8, 1972, P.L. 25.19

the issues of whether C laimant was physically able to return to work and whet her there was an open job offer.

Conclusion

Because the WCJ found credible the t estimony of Dr. Raklewicz and Dr. Shipkin, who testified that Claimant was fully recovered and able to return to her pre

injury position, the WCJ did not err in granting Employer’ s termination petition. Additionally, we disagree that the WCJ did not issue a reasoned decision because the WCJ’s opinion allowed for adequate appellate review. We also reject Claimant’s argument that the WCJ erred in denying her review petition to expand the descri ption of her injuries given the WCJ’s finding that Claimant had fully recovered from all
work

- related injuries prior to the filing of the review petition . Further, t he WCJ did not err in granting Employer’s utilization review petition by relying on the competent testimony of Employer’ s physician witnesses, who opined that, because Claimant was fully recovered, further medical treatment was unreasonable and unnecessary. Finally, the WCJ did not err in finding that Employer presented sufficient evidence to warrant its pursuit of the suspension petition.

Accordingly , for the reasons set forth above, the order of the Board is
affirmed.

________________________________ PATRICIA A. McCULLOUGH, Judge

Judge Fizzano Cannon did not participate in this decision.IN THE COMMONWEALTH COURT OF PENNSYLVANIA

Debbie Cardona , :

Petitioner :

: No. 750 C.D. 2017

v. : : Workers’ Compensation Appeal : Board ( Pleasant Valley Manor ), :

Respondent :

ORDER

AND NOW, this 30 th day of January , 201 8 , the May 16, 2017 order of the Workers’ Compensation Appeal Board is hereby affirmed.

________________________________ PATRICIA A. McCULLOUGH, Judge