Opinion ID: 2179973
Heading Depth: 1
Heading Rank: 6

Heading: sufficiency of evidence of work related injury

Text: Park Place's first assignment of error challenges the sufficiency of the evidence to support the single judge's finding that Swanson suffered a compensable, work-related injury. Park Place argues that Swanson's injury was the result of the natural progression of his preexisting back condition. Park Place adduced evidence before the single judge to support that conclusion. As noted above, Swanson had a history of back problems, and Park Place offered the opinion of Dr. Charles Taylon, a neurosurgeon, who opined that [a]ny back problems that [Swanson] had [after the accident] are clearly a continuation of the problem he was having just a short time before the accident. Dr. Taylon further opined that there was no evidence that the accident had anything to do with Swanson's subsequent need for surgery and questioned whether the accident had anything to do with Swanson's back pain. However, as also noted above, Swanson offered the opinion of Dr. Ripa, his treating physician, who opined that Swanson's motor vehicle accident ... exacerbated his low back condition and resulted in the necessary medical treatment including the surgery. In a workers' compensation case involving a preexisting condition, the claimant must prove by a preponderance of evidence that the claimed injury or disability was caused by the claimant's employment and is not merely the progression of a condition present before the employment-related incident alleged as the cause of the disability. Winn v. Geo. A. Hormel & Co., 252 Neb. 29, 560 N.W.2d 143 (1997); Cox v. Fagen Inc., 249 Neb. 677, 545 N.W.2d 80 (1996). Such claimant may recover when an injury, arising out of and in the course of employment, combines with a preexisting condition to produce disability, notwithstanding that in the absence of the preexisting condition, no disability would have resulted. Id. In short, the lighting up or acceleration of preexisting conditions by accident is compensable. Hale v. Vickers, Inc., 10 Neb.App. 627, 634, 635 N.W.2d 458, 468 (2001). This case presents conflicting expert opinions on whether Swanson's postaccident surgery was necessitated by his accident or was the natural progression of a preexisting back condition. The single judge accepted Dr. Ripa's opinion and determined that Swanson suffered a compensable work-related injury. Where the record presents nothing more than conflicting medical testimony, an appellate court will not substitute its judgment for that of the compensation court. Frank v. A & L Insulation, 256 Neb. 898, 594 N.W.2d 586 (1999). Park Place offers two arguments against Dr. Ripa's opinion. First, Park Place argues that Dr. Ripa's opinion lacked appropriate foundation because, according to Park Place, Swanson did not provide Dr. Ripa with a complete and truthful medical history. Second, Park Place contends that the evidence of Dr. Ripa's opinion is inconsistent and unreliable. We note, initially, that Park Place's arguments are essentially foundational objections to Dr. Ripa's expert opinion testimony. However, the exhibits setting forth Dr. Ripa's opinion were received into evidence without objection. Because it did not make a proper foundational objection before the single judge, Park Place failed to preserve its foundational arguments for our review. See, Berggren v. Grand Island Accessories, 249 Neb. 789, 545 N.W.2d 727 (1996); Paulsen v. State, 249 Neb. 112, 541 N.W.2d 636 (1996). However, even if we consider Park Place's arguments, they are without merit. First, Park Place relies on Swanson's deposition, in which Swanson stated that while he had reported prior back trouble to Dr. Ripa, Swanson had not reported any prior leg pain. However, at trial, Swanson testified that his deposition was inaccurate and that he had in fact told Dr. Ripa about his prior leg pain. Park Place's brief asserts that the plaintiff admits that he did not provide Dr. Ripa with any information regarding his prior back and leg problems. Brief for appellants at 11. This is not an accurate statement of the record. Both Swanson's deposition and his trial testimony indicate that Dr. Ripa was informed of Swanson's prior back pain. Swanson's deposition indicates that Dr. Ripa was not informed of any prior leg pain associated with the back pain, but Swanson testified at trial that Dr. Ripa had been informed of Swanson's leg pain, and Swanson testified that his deposition was incorrect. As the trier of fact, the single judge of the compensation court is the sole judge of the credibility of witnesses and the weight to be given their testimony. Zavala v. ConAgra Beef Co., 265 Neb. 188, 655 N.W.2d 692 (2003). Swanson was impeached at trial with his inconsistent deposition testimony, and the credibility of that testimony was a matter for the single judge to decide. The single judge's decision to accept Dr. Ripa's opinion was not clearly wrong because of the conflict in Swanson's testimony. Park Place also relies on the presence in the record of two separate opinion letters from Dr. Ripa to Swanson's attorney, both dated April 7, 2000, which, as set forth above, contain different language relating Swanson's preexisting condition to the need for his surgery. One letter reads as follows: I was asked by ... Swanson to write you regarding our opinion on his MRI scan from 12-19-97 compared to the most recent MRI scan that led to his surgery. The two MRI scans are relatively similar in appearance. It would thus be my medical opinion that most likely the ongoing current medical treatment is related, at least in some degree, to his original radiographic abnormalities but may well have been exacerbated in his motor vehicle accident in May, 1999. I am sorry we can't be more specific than that. Please contact us if further information is required. (Emphasis supplied.) The other letter states as follows: I was asked by ... Swanson to write you regarding our opinion on his MRI scan from 12-19-97 compared to the most recent MRI scan that led to his surgery. The two MRI scans are relatively similar in appearance. It is my opinion however that based upon history provided and the physical examinations of Mr. Timothy L. Swanson that his motor vehicle accident of May 1999 exacerbated his low back condition and resulted in the necessary medical treatment including the surgery that was required to relieve his disk herniation and nerve root compression. Please contact us if further information is required. (Emphasis supplied.) Park Place argues that these letters conflict and should be disregarded because they are inconsistent. However, the text of the two letters expresses essentially the same conclusion with respect to Swanson's medical condition. One letter expresses the opinion that Swanson's preexisting condition may well have been exacerbated in his accident, and the other letter states that Swanson's accident exacerbated his low back condition. While one letter states Dr. Ripa's opinion on causation in more definitive language, there is nothing in either letter that is directly contradictory to the other. Furthermore, the two letters express qualitatively different foundations for the two opinions. One letter mentions only a comparison of MRI scans, while the other letter expresses an opinion based on MRI scans and medical history and physical examinationsproviding a potential explanation for the differing language, if not substance, of the opinions. Given these circumstances, we cannot say the single judge was clearly wrong in relying on Dr. Ripa's definitively stated opinion about the cause of Swanson's injuries. Even if the letters were read to conflict to any degree, where the testimony of the same expert is conflicting, resolution of the conflict rests with the trier of fact, the single judge, who in this case resolved that conflict against Park Place. See, Brandt v. Leon Plastics, Inc., 240 Neb. 517, 483 N.W.2d 523 (1992); Doggett v. Brunswick Corp., 217 Neb. 166, 347 N.W.2d 877 (1984); Watson v. Alpo Pet Foods, 3 Neb.App. 612, 529 N.W.2d 139 (1995). Cf. Noordam v. Vickers, Inc., 11 Neb.App. 739, 659 N.W.2d 856 (2003). The single judge of the Workers' Compensation Court is the sole judge of the credibility of the witnesses and the weight to be given their testimony, even where the issue is not one of live testimonial credibility. See Aken v. Nebraska Methodist Hosp., 245 Neb. 161, 511 N.W.2d 762 (1994). Park Place's arguments regarding Dr. Ripa's opinion, and the sufficiency of the evidence, were resolved against Park Place by the single judge, and the single judge's findings were not clearly wrong. Therefore, Park Place's first assignment of error is without merit.