Court Opinion

ID: 9388283
Source: CourtListenerOpinion
Date Created: 2023-04-20 15:08:03.133751+00
Date Added: 2024-06-11T17:18:19.257938
License: Public Domain

IN THE COMMONWEALTH COURT OF PENNSYLVANIA

Theresa Lugo Thomas,                   :
                        Petitioner     :
                                       :
              v.                       : No. 444 C.D. 2022
                                       : Submitted: February 10, 2023
Trinity Health Corporation             :
(Workers’ Compensation                 :
Appeal Board),                         :
                         Respondent    :

BEFORE:      HONORABLE PATRICIA A. McCULLOUGH, Judge
             HONORABLE ANNE E. COVEY, Judge
             HONORABLE STACY WALLACE, Judge

OPINION NOT REPORTED

MEMORANDUM OPINION
BY JUDGE WALLACE                                  FILED: April 20, 2023

      Theresa Lugo Thomas (Thomas) filed a Petition for Review (Petition) of the
April 13, 2022 order of the Workers’ Compensation Appeal Board (Board) that
affirmed the Workers’ Compensation Judge’s (WCJ) October 19, 2021 Decision and
Order granting Trinity Health Corporation’s (Employer) Petition to Terminate
Compensation Benefits (Termination Petition). Thomas argues on appeal the Board
erred in affirming the WCJ’s decision to grant Employer’s Termination Petition
where Employer’s medical expert did not acknowledge Thomas’s accepted injury.
We affirm.
                      I. Background and Procedural History
      Thomas worked as a registered nurse for Employer. WCJ Decision, 4/19/21
(WCJ Dec.) ¶ 2.a. On November 18, 2019, in the course of her employment, she
slipped and fell on wet leaves. Board Opinion, 4/13/22 (Bd. Op.) at 1. Thomas went
to the hospital and received a diagnosis of a contusion of the right hand, a leg
contusion, and a lumbar strain. WCJ Dec. ¶ 2.a. A February 5, 2020 Notice of
Compensation Payable (NCP) accepted a “November 18, 201[9] right shoulder, right
hand, right upper arm strain or sprain, and a right thigh contusion.” Id. ¶ 1. After
the injury, Thomas had surgery on her right rotator cuff, physical therapy for her
shoulder, and injections in her hand and elbow. Id. ¶ 2.b., c.
      On September 15, 2020, Thomas filed a Petition to Review Compensation
Benefits (Review Petition) that alleged the NCP “was materially incorrect because
it failed to recognize [her] right wrist ligament tear status post-surgery, right
shoulder rotator cuff tear, and aggravation of underlying cervical degenerative disc
disease.” Bd. Op. at 1. On December 21, 2020, Employer filed the Termination
Petition that alleged Thomas had fully recovered as of October 22, 2020. The WCJ
considered the Review Petition and Termination Petition together.
      At the proceedings before the WCJ, Thomas testified and presented testimony
from three physicians: Rowena McBeath, M.D., Ph.D. (Dr. McBeath), Kenneth
Kearns, M.D. (Dr. Kearns). and Gerald E. Dworkin, O.D. (Dr. Dworkin).
      Dr. McBeath is a board-certified orthopedic surgeon with a specialty in hand
surgery. WCJ Dec. ¶ 3.a. Dr. McBeath examined Thomas and performed two
surgeries on her right hand. Id. ¶ 3.b., d. Dr. McBeath opined Thomas had not fully
recovered from her work injury. Id. ¶ 3.g.

                                          2
      Dr. Kearns is a board-certified orthopedic surgeon with a fellowship in
shoulder and hand surgery. Id. ¶ 4.a. Dr. Kearns performed a physical examination
of Thomas and reviewed her Magnetic Resonance Imaging (MRI) scan. Under Dr.
Kearns’s care, Thomas received injections, therapy and surgery on her shoulder. Id.
¶ 4.b., e. On Thomas’s last visit on November 30, 2020, Dr. Kearns determined she
was not fully recovered from her work injury. Id. ¶ 4.f.
      Dr. Dworkin is board certified in physical medicine and rehabilitation. Id. ¶
5.a. He examined Thomas on June 18, 2020, and January 13, 2021, and reviewed a
June 29, 2020 cervical spine MRI and an Electromyography (EMG) test. Id. ¶¶ 6.d.,
5.c. Dr. Dworkin opined Thomas was not fully recovered from her cervical spine
injuries. Bd. Op. at 5.
      Employer presented the testimony of Dr. Ruht. Dr. Ruht is board certified in
orthopedic surgery. Id. ¶ 7.a. He performed an independent medical evaluation
(IME) of Thomas on October 21, 2020. Bd. Op. at 5. He did not believe Thomas
suffered a work-related shoulder injury. WCJ Dec. ¶ 7.a.i. However, giving Thomas
the “benefit of the doubt,” Dr. Ruht found if Thomas did have a shoulder injury, it
was minor and she had fully recovered. Id. As to Thomas’s right wrist and right
thigh, Dr. Ruht opined that any injury had ceased and Thomas had fully recovered.
Id. ¶ 7.a.iv.-v. Further, Dr. Ruht found Thomas had fully recovered from “all
accepted and alleged work related injuries.” Id. ¶ 7.a.vii. (emphasis added).
       By decision and order dated October 19, 2021, the WCJ partially granted
Thomas’s Review Petition and granted Employer’s Termination Petition. Thomas
appealed the WCJ’s decision to grant Employer’s Termination Petition. The Board
affirmed, and Thomas filed a Petition in this Court. Thomas raises the following
issue on appeal: “Whether the Board erred in affirming the WCJ’s termination of

                                         3
benefits where the Employer’s medical expert refused to recognize the accepted
injury?” Petitioner’s Br. at 4.
                                     II. Discussion
      In a workers’ compensation appeal, we are limited to determining whether the
necessary findings of fact are supported by substantial evidence, whether the Board
committed an error of law, or whether the Board’s decision violates a party’s
constitutional rights. See Elberson v. Workers’ Comp. Appeal Bd. (Elwyn, Inc.), 936
A.2d 1195, 1198 n.2 (Pa. Cmwlth. 2007). Substantial evidence is such relevant
evidence that a reasonable mind might accept as adequate to support a conclusion.
Republic Steel Corp. v. Workmen’s Comp. Appeal Bd. (Shinsky), 421 A.2d 1060,
1062 (Pa. 1980).     Questions of credibility, conflicting medical evidence and
evidentiary weight fall within the WCJ’s authority, and the WCJ is free to accept the
testimony of any witness, including medical witnesses, in whole or in part. Ingrassia
v. Workers’ Comp. Appeal Bd. (Universal Health Servs., Inc.), 126 A.3d 394, 399
n.5 (Pa. Cmwlth. 2015). The WCJ is the ultimate factfinder, but a WCJ must provide
reasons for accepting or rejecting evidence. Ingrassia, 126 A.3d at 402-03.
      In a termination petition, the burden of establishing a work injury has fully
ceased is on the employer. Udvari v. Workmen’s Comp. Appeal Bd. (USAir, Inc.),
705 A.2d 1290 (Pa. 1997).         The Board found the WCJ accepted “competent
testimony” from Dr. Ruht that Thomas had fully recovered from her work-related
injury. Bd. Op. at 7. The WCJ accepted Dr. Ruht’s opinions over Dr. McBeath’s
“based on the delayed onset of the thumb and elbow complaints, the prior medical
history related to the thumb, as well as Dr. McBeath’s inability to opine whether
[another incident] was the cause of [Thomas]’s ongoing wrist complaints.” WCJ
Dec. ¶ 9. The WCJ found the opinions of Dr. Ruht more competent and credible

                                          4
than Dr. Kearns “based on the multiple normal shoulder examinations . . . .” Id. ¶
10. The WCJ found the opinions of Dr. Ruht more competent and credible than Dr.
Dworkin “based on the numerous normal examinations of the cervical spine . . . and
the lack of objective findings in the MRI or EMG to support Dr. Dworkin’s opinions
. . . .” Id. ¶ 11.
       Thomas argues the WCJ erred in finding Dr. Ruht’s opinions credible because
Dr. Ruht did not even believe all of Thomas’s injuries occurred. A medical expert,
however, need not believe that a particular work injury actually occurred. To v.
Workers’ Comp. Appeal Bd. (Insaco, Inc.), 819 A.2d 1222, 1225 (Pa. Cmwlth.
2003). Rather, a medical expert’s opinion is competent if he assumes the presence
of an injury and finds it to be resolved by the time of the IME. Id.; Jackson v.
Workers’ Comp. Appeal Bd. (Res. for Hum. Dev.), 877 A.2d 498, 503 (Pa. Cmwlth.
2005). In this case, Dr. Ruht did not believe Thomas suffered a work-related
shoulder injury. WCJ Dec. ¶ 7.a.i. Nevertheless, Dr. Ruht gave Thomas the benefit
of the doubt and determined that even if she suffered a shoulder injury, it was minor
and had resolved by the time of the IME. Id. The Board noted Dr. Ruht “not only
acknowledged the work-related right shoulder strain, he opined that [Thomas] fully
recovered from it.” Bd. Op. at 7. Since Dr. Ruht assumed the presence of Thomas’s
injury and found the injury had resolved, Dr. Ruht’s testimony was competent.
       The WCJ found the testimony of Dr. Ruht more competent and credible than
Dr. McBeath, Dr. Kearns, and Dr. Dworkin. Id. ¶¶ 9-11. The Board determined that
the WCJ accepted the “competent testimony” of Dr. Ruht to support a finding that
Thomas had fully recovered from her work-related injury.             Bd. Op. at 7.
Accordingly, we agree with the Board’s determination the WCJ did not err in
considering Dr. Ruht’s testimony.

                                         5
                                  III.   Conclusion
      For the foregoing reasons, we conclude the Board did not err when it affirmed
the WCJ’s order granting Employer’s Termination Petition. Accordingly, we affirm
the Board’s order.

                                             ______________________________
                                             STACY WALLACE, Judge

Judge Fizzano Cannon did not participate in the decision of this case.

                                         6
         IN THE COMMONWEALTH COURT OF PENNSYLVANIA

Theresa Lugo Thomas,                  :
                       Petitioner     :
                                      :
             v.                       : No. 444 C.D. 2022
                                      :
Trinity Health Corporation            :
(Workers’ Compensation                :
Appeal Board),                        :
                         Respondent   :

                                    ORDER

     AND NOW, this 20th day of April 2023, the April 13, 2022, order of the
Workers’ Compensation Appeal Board is AFFIRMED.

                                      ______________________________
                                      STACY WALLACE, Judge