Contreras v. T.O. Haas ( 2014 )


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  •    Decisions of the Nebraska Court of Appeals
    276	22 NEBRASKA APPELLATE REPORTS
    Ismael Contreras, appellee, v.
    T.O. Haas, LLC, appellant.
    ___ N.W.2d ___
    Filed August 19, 2014.     No. A-13-673.
    1.	 Workers’ Compensation: Appeal and Error. A judgment, order, or award of
    the Workers’ Compensation Court may be modified, reversed, or set aside only
    upon the grounds that (1) the compensation court acted without or in excess of its
    powers; (2) the judgment, order, or award was procured by fraud; (3) there is not
    sufficient competent evidence in the record to warrant the making of the order,
    judgment, or award; or (4) the findings of fact by the compensation court do not
    support the order or award.
    2.	 ____: ____. In determining whether to affirm, modify, reverse, or set aside a
    judgment of the Workers’ Compensation Court, an appellate court reviews the
    trial judge’s findings of fact, which will not be disturbed unless clearly wrong.
    3.	 ____: ____. Regarding questions of law, an appellate court in workers’ compen­
    sation cases is obligated to make its own decisions.
    4.	 Workers’ Compensation: Rules of Evidence. As a general rule, the Nebraska
    Workers’ Compensation Court is not bound by the usual common-law or statutory
    rules of evidence.
    5.	 Workers’ Compensation: Rules of Evidence: Legislature: Due Process.
    Subject to the limits of constitutional due process, the Legislature has granted
    the compensation court the power to prescribe its own rules of evidence and
    related procedure.
    6.	 Workers’ Compensation: Expert Witnesses. In a workers’ compensation case,
    an expert witness must qualify as an expert and the testimony must assist the trier
    of fact to understand the evidence or determine a fact in issue.
    7.	 ____: ____. Expert testimony in a workers’ compensation case must be based on
    a reasonable degree of medical certainty or a reasonable probability.
    8.	 ____: ____. Although expert medical testimony in workers’ compensation cases
    must be based on a “reasonable degree of medical certainty” or “reasonable prob­
    ability,” the testimony need not be couched in those exact, magic words.
    9.	 Workers’ Compensation: Proof. Under the Nebraska Workers’ Compensation
    Act, a claimant is entitled to an award for a work-related injury and disability if
    the claimant shows, by a preponderance of the evidence, that he or she sustained
    an injury and disability proximately caused by an accident which arose out of and
    in the course of the claimant’s employment.
    10.	 ____: ____. To recover workers’ compensation benefits, an injured worker is
    required to prove by competent medical testimony a causal connection between
    the alleged injury, the employment, and the disability.
    11.	 Workers’ Compensation: Expert Witnesses. The Workers’ Compensation Court
    is entitled to accept the opinion of one expert over another.
    12.	 Workers’ Compensation. As the trier of fact, the Workers’ Compensation Court
    is the sole judge of the credibility of the witnesses and the weight to be given
    their testimony.
    Decisions   of the Nebraska Court of Appeals
    CONTRERAS v. T.O. HAAS	277
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    22 Neb. Ct. App. 276
    Appeal from the Workers’ Compensation Court: J. Michael
    Fitzgerald, Judge. Affirmed.
    John W. Iliff, of Gross & Welch, P.C., L.L.O., for appellant.
    William V. Steffens and Jeremiah J. Luebbe, of Steffens Law
    Office, P.C., for appellee.
    Irwin and Bishop, Judges.
    P er Curiam.
    I. INTRODUCTION
    On appeal, T.O. Haas, LLC, asserts that the Workers’
    Compensation Court erred in admitting certain exhibits into
    evidence and in finding that Ismael Contreras is permanently
    and totally disabled. We affirm.
    II. FACTUAL BACKGROUND
    In 2006, Contreras was hired by T.O. Haas as a certified
    tire technician. As a part of Contreras’ job, he was required to
    remove old tires from vehicles, repair tires, and place either
    new or repaired tires back on the vehicles. On August 23,
    2010, Contreras was working at T.O. Haas and was trying
    to change a tire on a “skid steer.” In working with the tire,
    Contreras turned to his left to lower the tire to the ground when
    he felt “a sharp pain go through [his] back.” Contreras reported
    the injury to his supervisor.
    Contreras attempted to return to work the day after his
    injury, but was unable to work for even an hour. Contreras
    has not returned to work at T.O. Haas since the day after he
    incurred the injury to his back. In fact, other than working
    part time delivering newspapers for approximately 2 months
    in 2012, Contreras has not worked anywhere since August
    24, 2010.
    In September 2010, Contreras made an appointment with
    his family physician, Dr. Jason Citta, because the pain in
    his back had not improved since August 23. Dr. Citta pre­
    scribed Contreras pain medication, ordered an MRI, and
    referred him to a physical therapist. During the months of
    September and October, however, Contreras continued to see
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    Dr. Citta and continued to complain about severe back pain.
    Dr. Citta referred Contreras to Dr. Burt McKeag for further
    pain management.
    On October 12, 2010, Contreras saw Dr. McKeag. After Dr.
    McKeag’s examination, he noted the following in his report:
    [Contreras] is involved in litigation with workman’s com­
    pensation. His story and injury are very reasonable, but he
    does tend to have an exaggerated presentation. I reviewed
    his MRI and he does have significant NF stenosis at
    L5/S1 on the left consistent with his symptoms. I feel
    that it is reasonable to proceed with a [lumbar epidural
    steroid injection].
    Dr. McKeag administered the injection to Contreras on
    November 16. Contreras reported that he did not receive any
    significant relief from this injection. As a result of Contreras’
    reports of continued back pain, Dr. Citta referred him to a neu­
    rosurgeon, Dr. Omar Jimenez.
    Dr. Jimenez diagnosed Contreras as suffering from “degen­
    erative disc disease at L4-5 and also at L5-S1 with a large
    herniated disc on the right at L5-S1, which also extends cen­
    trally slightly to the left.” He recommended that Contreras
    undergo back surgery. In March 2011, Contreras had back
    surgery. After the surgery, Contreras reported that he was
    “having significant right SI joint discomfort.” Dr. Jimenez
    prescribed pain medication, including another injection. In
    addition, he advised Contreras to continue to attend physi­
    cal therapy.
    In June 2011, approximately 3 months after his surgery,
    Contreras reported that he was experiencing “excruciating pain
    lateral to [his] incision up in the hip area.” Contreras stated
    that the pain was “disabling.” Dr. Jimenez indicated he was
    “baffled by his symptoms and would like to proceed with
    [an] MRI . . . . It is likely that he may be suffering from sac­
    roiliac joint pain, although he states this is better in addition
    to his trochanter pain.” Ultimately, Dr. Jimenez prescribed
    Contreras additional pain medication and ordered him to be
    more “aggressive in his recuperation.” Dr. Jimenez believed
    that physical therapy would help Contreras heal. However, Dr.
    Jimenez also noted that the MRI revealed “evidence of facet
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    hypertrophy bilaterally at 4-5 and 5-1 . . . which may be an
    issue that may need to be addressed in the future.”
    Contreras returned for a followup visit with Dr. Jimenez in
    August 2011, where he continued to report severe back pain.
    At this appointment, Dr. Jimenez recommended that Contreras
    undergo a spinal fusion surgery. After receiving a second opin­
    ion about the spinal fusion surgery, Contreras elected not to
    undergo the procedure.
    After his August 2011 appointment with Dr. Jimenez,
    Contreras returned to the care of Drs. Citta and McKeag. The
    doctors continued to prescribe pain medication and recom­
    mended physical therapy. Contreras continued to report ongo­
    ing back pain.
    III. PROCEDURAL BACKGROUND
    On December 22, 2010, Contreras filed a petition in the
    Nebraska Workers’ Compensation Court alleging that he had
    been injured in the scope and course of his employment with
    T.O. Haas. Contreras requested that, as a result of his injury,
    he be awarded temporary and permanent disability benefits. He
    also requested that T.O. Haas be ordered to pay for his medi­
    cal bills.
    On March 1, 2013, a trial was held. At the trial, T.O. Haas
    stipulated that Contreras injured his back on August 23, 2010,
    while at work. It also stipulated that the injury to Contreras’
    back required surgery in March 2011. However, T.O. Haas spe­
    cifically disputed the extent of Contreras’ work restrictions and
    loss of earning capacity as a result of his back injury.
    Contreras testified at trial regarding the accident and his
    resulting injury. During his testimony, Contreras indicated that
    he continues to take pain medication for his back on a daily
    basis. In fact, he testified that he has taken some type of pain
    medication for his back continuously since August 23, 2010.
    He also testified that despite this pain medication, he contin­
    ues to suffer from back pain. He explained that during his
    testimony, his back was “throbbing and ha[d] a burning sensa­
    tion.” He rated his pain at “a 7 to an 8” on a scale of 1 to 10.
    Contreras also testified that he has previously been convicted
    of a felony.
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    In addition to Contreras’ testimony, both parties offered
    numerous exhibits, including Contreras’ medical records from
    various doctors. Although we have reviewed this voluminous
    medical evidence in its entirety, we do not detail such evi­
    dence here. Rather, we simply note that there was conflicting
    evidence presented concerning the degree of Contreras’ impair­
    ment, the cause of Contreras’ ongoing back pain after his back
    surgery, and Contreras’ ability to return to any type of employ­
    ment. We will set forth the specific facts as presented at the
    trial as necessary in our analysis below.
    After the parties’ presentation of evidence, the trial court
    entered an extremely detailed, 11-page order in which it evalu­
    ated all of the evidence presented. Ultimately, the court found
    that Contreras reached maximum medical improvement in
    September 2011, after he had decided not to undergo the spinal
    fusion surgery. The court found that prior to September 2011,
    Contreras was entitled to temporary total disability benefits,
    and that after September 2011, he continued to be totally dis­
    abled and, as such, was entitled to permanent total disability
    benefits. The court also awarded Contreras compensation for
    past and future medical expenses.
    T.O. Haas appeals from the trial court’s order.
    IV. ASSIGNMENTS OF ERROR
    On appeal, T.O. Haas assigns the following as errors: (1) The
    trial court erred by admitting certain exhibits into evidence, (2)
    the trial court was clearly wrong in awarding permanent total
    disability when there was insufficient competent and quali­
    fied medical evidence to prove a causal connection between
    Contreras’ injury (and injury-related surgery) and postsurgery
    restrictions, and (3) there was insufficient competent evidence
    to support an award of permanent total disability.
    V. ANALYSIS
    1. Standard of R eview
    [1-3] A judgment, order, or award of the Workers’
    Compensation Court may be modified, reversed, or set aside
    only upon the grounds that (1) the compensation court acted
    without or in excess of its powers; (2) the judgment, order, or
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    award was procured by fraud; (3) there is not sufficient compe­
    tent evidence in the record to warrant the making of the order,
    judgment, or award; or (4) the findings of fact by the compen­
    sation court do not support the order or award. Rader v. Speer
    Auto, 
    287 Neb. 116
    , 
    841 N.W.2d 383
    (2013). In determining
    whether to affirm, modify, reverse, or set aside a judgment of
    the Workers’ Compensation Court, an appellate court reviews
    the trial judge’s findings of fact, which will not be disturbed
    unless clearly wrong. 
    Id. Regarding questions
    of law, an appel­
    late court in workers’ compensation cases is obligated to make
    its own decisions. 
    Id. 2. Admission
    of Exhibits
    22 and 23
    On appeal, T.O. Haas alleges that the trial court erred by
    admitting into evidence portions of exhibit 22, which consists
    of records from Contreras’ physical therapy and a copy of a
    functional capacity evaluation performed on Contreras, and
    portions of exhibit 23, which consists of Contreras’ medical
    records from Dr. McKeag. We will address the admissibility
    of each exhibit; however, first we recount the relevant law that
    overlays our review of the trial court’s determinations regard­
    ing the admission of evidence.
    [4,5] As a general rule, the Nebraska Workers’ Compensation
    Court is not bound by the usual common-law or statutory rules
    of evidence. Neb. Rev. Stat. §§ 48-168(1) (Reissue 2010)
    and 27-1101(4)(d) (Reissue 2008); Veatch v. American Tool,
    
    267 Neb. 711
    , 
    676 N.W.2d 730
    (2004). Subject to the limits
    of constitutional due process, the Legislature has granted the
    compensation court the power to prescribe its own rules of
    evidence and related procedure. § 48-168; Veatch v. American
    
    Tool, supra
    .
    [6,7] The Nebraska Supreme Court has previously clari­
    fied the rules regarding the admissibility of expert testimony
    in workers’ compensation cases. Specifically, the court has
    stated that in a workers’ compensation case, an expert witness
    must qualify as an expert and the testimony must assist the
    trier of fact to understand the evidence or determine a fact
    in issue. Veatch v. American 
    Tool, supra
    . The witness must
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    have a factual basis for the opinion, and the testimony must
    be ­relevant. 
    Id. Expert testimony
    in a workers’ compensa­
    tion case must be based on a reasonable degree of medical
    certainty or a reasonable probability. 
    Id. An expert
    opinion in
    a workers’ compensation case based on a mere possibility is
    insufficient, but the standard also does not require absolute
    certainty. See Paulsen v. State, 
    249 Neb. 112
    , 
    541 N.W.2d 636
    (1996).
    With these rules in mind, we now address T.O. Haas’ asser­
    tions regarding the trial court’s admission of portions of exhib­
    its 22 and 23.
    (a) Exhibit 22
    Exhibit 22 consists of Contreras’ records from physical ther­
    apy, authored by Contreras’ physical therapist, Tyler Sexson.
    In addition, pages 36 through 45 of the exhibit consist of
    the results of a functional capacity evaluation performed on
    Contreras. This evaluation was performed by Sexson. The last
    three pages of the exhibit include Sexson’s responses to ques­
    tions posed by Contreras’ counsel concerning the functional
    capacity evaluation. Sexson’s answers indicate his professional
    opinion that Contreras “provided an accurate p[or]trayal of
    his current pain and limitations during the [functional capac­
    ity evaluation].”
    At trial, T.O. Haas objected on the basis of relevance
    and foundation to the functional capacity evaluation and to
    Sexson’s responses to counsel’s questions about that evalua­
    tion. In response to T.O. Haas’ objection, Contreras asserted
    that the entire exhibit, including the evaluation and Sexson’s
    responses to the questions, was very relevant to its case: “So
    it’s a critical piece of evidence for our case. And it’s certainly
    very relevant. Why wouldn’t the individual who performed the
    [functional capacity evaluation] in question, . . . Sex[s]on, be
    able to tell us why he believes the results are accurate?” The
    trial court overruled T.O. Haas’ objections and allowed the
    exhibit into evidence.
    On appeal, T.O. Haas asserts that the trial court erred in
    admitting pages 36 through 48 of exhibit 22. Specifically, it
    argues that the results of the functional capacity evaluation
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    are not valid because there was some indication of symptom
    magnification. In addition, it argues that Sexson erroneously
    indicated that his opinion about the validity of the results of
    the evaluation was given to a medical degree of certainty, even
    though he is not a medical doctor. T.O. Haas’ assertions have
    no merit.
    The results of Contreras’ functional capacity evaluation
    demonstrate Contreras’ level of impairment and his ability
    to perform a variety of movements and tasks in light of
    his injury. This information is clearly relevant to the trial
    court’s determination about Contreras’ disability and his loss
    of earning capacity. And, although there is some indication that
    Contreras was exaggerating his symptoms during the evalua­
    tion, this does not make the results inadmissible. Rather, this
    is an issue that T.O. Haas could have, and did, raise at trial.
    In fact, T.O. Haas offered the report of a different doctor who
    had evaluated Contreras and who had a very different opinion
    about Contreras’ level of impairment and about the validity of
    the functional capacity evaluation.
    Additionally, although we recognize that in Sexson’s
    responses to counsel’s questions he erroneously indicated that
    he “answer[ed] the . . . questions to a ‘medical degree of cer­
    tainty,’” even though he is not a licensed physician, we do
    not find that this misstatement equates to all of his answers’
    being inadmissible. Sexson is a physical therapist who has
    a great deal of experience in performing functional capac­
    ity evaluations. In addition, he has a great deal of experience
    with Contreras and with Contreras’ injury and abilities because
    he was Contreras’ physical therapist off and on for a 2-year
    period. Sexson is qualified to offer an opinion about whether
    Contreras was exaggerating his symptoms during the func­
    tional capacity evaluation, and such opinion is relevant to the
    trial court’s determination about Contreras’ disability and loss
    of earning capacity.
    T.O. Haas’ assertions regarding the admissibility of pages
    36 through 48 of exhibit 22 are without merit. The exhibit,
    in its entirety, was properly admitted and considered by the
    trial court.
    Decisions of the Nebraska Court of Appeals
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    (b) Exhibit 23
    Exhibit 23 consists of Contreras’ medical records from
    Dr. McKeag. Such records include Dr. McKeag’s notes from
    Contreras’ numerous visits with him from October 2010
    through October 2012. Also included in exhibit 23, on page
    17, is a copy of the page from Contreras’ functional capac­
    ity evaluation with Sexson, which includes Sexson’s sum­
    mary of Contreras’ physical restrictions and recommendation
    that Contreras is “unable to return to prior job duties fully
    within the lightest Sedentary category of Physical Demand.”
    At the bottom of this page is a handwritten note signed by
    Dr. McKeag. That note states: “I agree with the above recom­
    mendations.” Additionally, on page 22 of exhibit 23, there is a
    letter from Contreras’ counsel to Dr. McKeag which asks Dr.
    McKeag to further explain the handwritten note on the func­
    tional capacity evaluation. Dr. McKeag responded to this letter
    by indicating that he did, in fact, “sign off” and agree with the
    recommendations of the functional capacity evaluation. Dr.
    McKeag specifically noted, “I do not personally do [functional
    capacity evaluations]. I do not consider myself to be an expert
    regarding [functional capacity evaluations]. I read the [func­
    tional capacity evaluation] and I basically agree with it, but I
    don’t know what that is worth.”
    At trial, T.O. Haas objected on the basis of relevancy and
    foundation to page 17 of exhibit 23, where Dr. McKeag indi­
    cated his agreement with the recommendations of the func­
    tional capacity evaluation. The trial court overruled the objec­
    tion, stating, “And there’s some doc[tors] that sign off on
    [functional capacity evaluations], even though the doc[tors]
    don’t do them. They — Overruled. This is — This sounds rea­
    sonable to me. [Doctors] can also receive [functional capacity
    evaluations] and make some contradictory statements or hedge
    their bets a little bit. Okay.” T.O. Haas did not object to page
    22 of exhibit 23, which consisted of Dr. McKeag’s further
    explanation of his agreement with the recommendations of the
    functional capacity evaluation.
    On appeal, T.O. Haas argues that the trial court erred in
    overruling its objection to page 17 of exhibit 23. Specifically,
    T.O. Haas alleges that this page of the exhibit was not
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    admissible because Dr. McKeag admitted that he is not an
    expert regarding functional capacity evaluations, because Dr.
    McKeag did not indicate that his agreement with the recom­
    mendations in the functional capacity evaluation was made
    within a reasonable degree of medical probability, and because
    Dr. McKeag’s statement does not assist the trial court in any
    way. T.O. Haas’ assertions have no merit.
    First, we note that at trial, T.O. Haas did not object to page
    22 of exhibit 23, which consisted of Dr. McKeag’s further
    explanation of his agreement with the recommendations of the
    functional capacity evaluation. This page of the exhibit reiter­
    ates that Dr. McKeag “sign[ed] off” on the recommendations
    of the functional capacity evaluation and that he had written,
    “I agree with the above recommendations.” As such, page 22
    contains the same information as page 17. And, page 22 was
    admitted into evidence without objection. Accordingly, even if
    the court erred in admitting page 17, such error would clearly
    be harmless as the same information was included in another,
    uncontested portion of the same exhibit.
    Moreover, we cannot say that the trial court erred in admit­
    ting page 17 of exhibit 23 into evidence. Although Dr. McKeag
    indicated that he is not an expert with regard to functional
    capacity evaluations, presumably because he does not conduct
    this type of testing on his patients, he is clearly qualified to
    provide his opinion with regard to Contreras’ physical health
    and his ability to perform certain tasks. Dr. McKeag, who
    specializes in pain management, saw Contreras on at least 10
    occasions between October 2010 and October 2012. At each
    of these visits, Dr. McKeag evaluated Contreras’ level of back
    pain, and often, he would evaluate Contreras’ ability to perform
    certain movements in light of the pain.
    Given Dr. McKeag’s knowledge of Contreras’ physical
    health, his general agreement with the results and recommen­
    dations of the functional capacity evaluation certainly provide
    relevant information to the trial court. Dr. McKeag was given
    two separate opportunities to contradict the results of the
    evaluation or, at the very least, to decline to agree with those
    recommendations. Dr. McKeag did not indicate any disagree­
    ment with the recommendations other than to note his lack of
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    expertise with functional capacity evaluations in general. Such
    information is associated with the weight of Dr. McKeag’s
    opinion, rather than with its admissibility.
    [8] Finally, we note that although expert medical testimony
    in workers’ compensation cases must be based on a “reason­
    able degree of medical certainty” or “reasonable probability,”
    the testimony need not be couched in those exact, magic
    words. See Edmonds v. IBP, inc., 
    239 Neb. 899
    , 
    479 N.W.2d 754
    (1992). As such, Dr. McKeag’s medical opinion is admis­
    sible even though he did not explicitly state that it was based
    on a reasonable degree of medical certainty or reasonable
    probability. Dr. McKeag’s agreement with the recommenda­
    tions of the functional capacity evaluation must be read in
    conjunction with his medical expertise and with his experience
    as Contreras’ physician. Although Dr. McKeag noted that he is
    not an expert in functional capacity evaluations, nowhere in his
    opinion does he provide any indication that his medical opin­
    ion was not based on a reasonable degree of medical certainty
    or reasonable probability.
    T.O. Haas’ assertions regarding the admissibility of page 17
    of exhibit 23 are without merit. The exhibit, in its entirety, was
    properly admitted and considered by the trial court.
    3. Finding of P ermanent
    and Total Disability
    In the trial court’s order, it concluded that Contreras was
    permanently and totally disabled as a result of the injury he
    suffered while at work on August 23, 2010. In coming to this
    conclusion, the court found that the evidence presented at trial
    demonstrated that Contreras suffered a low-back injury which
    required surgery and which continues to cause him pain. The
    court went on to find that as a result of his injury, Contreras
    is limited in his ability to perform certain work functions, and
    that “[a]t best, [he] would be able to perform some light work
    jobs.” The court also found that there are no light work jobs
    available to Contreras due to the combination of his physical
    restrictions, his lack of education, and his felony conviction.
    The trial court awarded Contreras permanent total disabil­
    ity benefits.
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    On appeal, T.O. Haas alleges that the trial court erred in
    two ways when it concluded that Contreras was permanently
    and totally disabled. First, T.O. Haas alleges that there was not
    competent medical evidence to demonstrate a causal connec­
    tion between Contreras’ back condition after the March 2011
    surgery and the August 2010 injury or between his back condi­
    tion and his physical restrictions as reported in the functional
    capacity evaluation. Second, T.O. Haas alleges that the only
    competent medical evidence presented regarding Contreras’
    physical limitations after surgery demonstrated that Contreras
    was capable of working and had suffered a loss of earning
    capacity of 25 percent.
    (a) Causal Connection Between
    Postsurgery Restrictions
    and Work Injury
    [9,10] Under the Nebraska Workers’ Compensation Act,
    a claimant is entitled to an award for a work-related injury
    and disability if the claimant shows, by a preponderance of
    the evidence, that he or she sustained an injury and disability
    proximately caused by an accident which arose out of and in
    the course of the claimant’s employment. Schlup v. Auburn
    Needleworks, 
    239 Neb. 854
    , 
    479 N.W.2d 440
    (1992). Moreover,
    to recover workers’ compensation benefits, an injured worker
    is required to prove by competent medical testimony a causal
    connection between the alleged injury, the employment, and
    the disability. Owen v. American Hydraulics, 
    254 Neb. 685
    ,
    
    578 N.W.2d 57
    (1998).
    When testing the sufficiency of the evidence to support find­
    ings of facts made by the Workers’ Compensation Court, the
    evidence must be considered in the light most favorable to the
    successful party and the successful party will have the benefit
    of every inference reasonably deducible from the evidence.
    Olivotto v. DeMarco Bros. Co., 
    273 Neb. 672
    , 
    732 N.W.2d 354
    (2007).
    At trial, T.O. Haas stipulated that Contreras injured his
    back on August 23, 2010, while at work. It also stipulated
    that Contreras’ back injury required surgery in March 2011.
    As such, at trial and on appeal, T.O. Haas disputes only
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    the extent of Contreras’ condition after the back surgery.
    T.O. Haas challenges the extent of Contreras’ physical restric­
    tions postsurgery and the resulting loss of earning capacity. To
    state T.O. Haas’ argument more simply, it asserts that there is
    no medical evidence which ties Contreras’ reports of ongoing
    back pain after surgery to the injury he suffered on August 23,
    2010, or to his physical restrictions as reported in the func­
    tional capacity evaluation.
    When we consider the evidence presented at trial in the
    light most favorable to Contreras, we conclude there is suf­
    ficient evidence to demonstrate that Contreras’ condition after
    the March 2011 surgery was causally related to the injury he
    sustained on August 23, 2010, and that this condition caused
    physical restrictions, as reflected in the functional capac­
    ity evaluation.
    On July 29, 2011, approximately 4 months after Contreras’
    back surgery, Dr. Jimenez reported that Contreras was suf­
    fering from a right L5-S1 herniated disk and that Contreras’
    “present back condition” was caused by the workplace acci­
    dent that had occurred in August 2010. Dr. Jimenez also
    reported that Contreras had not yet reached maximum medi­
    cal improvement for his injury. A few days after Dr. Jimenez
    reported these facts, he met with Contreras and recommended
    he “undergo a more aggressive approach” for his back condi­
    tion. Dr. Jimenez recommended a spinal fusion surgery. This
    evidence demonstrates that in the months after the March
    2011 back surgery, Contreras continued to suffer from a seri­
    ous back condition that was a direct result of his August 2010
    workplace injury.
    In addition to the reports of Dr. Jimenez, the medical
    records of Dr. McKeag also indicate that after the back surgery,
    Contreras continued to suffer from severe back pain. Physical
    examinations of Contreras revealed some indication that his
    back condition and resulting back pain affected his ability to
    perform certain movements. And, at trial, Contreras testified
    that the March 2011 back surgery did not resolve his back pain.
    Contreras stated that after the surgery, he felt relief for only a
    “brief time.” Contreras also testified that he has been on some
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    type of pain medication continuously since the August 2010
    accident and that even with this medication, he continues to
    feel pain.
    All of this evidence, taken together, is sufficient to sup­
    port the trial court’s finding that there was a causal connec­
    tion between Contreras’ condition after the back surgery and
    his August 2010 workplace accident. In its brief on appeal,
    T.O. Haas points to evidence in the record which demon­
    strates that Contreras’ postsurgery condition was not a result
    of his workplace accident and that, in fact, Contreras was
    exaggerating his continuing pain and inability to perform
    certain movements. Essentially, T.O. Haas’ argument is about
    the credibility of the various doctors who examined and
    treated Contreras.
    [11,12] We recognize that the trial court was faced with
    conflicting opinions regarding Contreras’ postsurgery condition
    and the cause of that condition. However, we also recognize
    that the Workers’ Compensation Court is entitled to accept the
    opinion of one expert over another. See Zessin v. Shanahan
    Mechanical & Elec., 
    251 Neb. 651
    , 
    558 N.W.2d 564
    (1997).
    As the trier of fact, the Workers’ Compensation Court is the
    sole judge of the credibility of the witnesses and the weight
    to be given their testimony. 
    Id. When the
    record in a workers’
    compensation case presents conflicting medical testimony, an
    appellate court will not substitute its judgment for that of the
    compensation court. Lowe v. Drivers Mgmt., Inc., 
    274 Neb. 732
    , 
    743 N.W.2d 82
    (2007).
    The trial court accepted the opinion of Dr. Jimenez and
    relied on the medical records authored by Dr. McKeag when
    it found that Contreras “has had a low back injury which
    required surgery and continues to have pain. [He] is limited
    on his ability to perform work functions.” Upon our review of
    the record, we conclude that there was sufficient evidence to
    support the trial court’s findings that Contreras’ condition after
    the March 2011 surgery was causally related to the injury he
    sustained on August 23, 2010, and that this condition caused
    physical restrictions, as reflected in the functional capac­
    ity evaluation.
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    (b) Ability to Work
    T.O. Haas also asserts that the trial court erred in awarding
    permanent total disability, because such a finding is only war­
    ranted when the injured party is unable to perform any work
    which he has experience or capacity to perform, “or any other
    kind of work which a person of his mentality an[d] attain­
    ments could do.” Brief for appellant at 27-28 (citing Kleiva v.
    Paradise Landscapes, 
    230 Neb. 234
    , 
    430 N.W.2d 550
    (1988)).
    T.O. Haas claims that the only competent evidence regarding
    Contreras’ loss of earning capacity shows that Contreras is
    capable of working at a medium level of work, and this results
    in a loss of earning capacity of 20 to 25 percent, not total dis­
    ability. However, this argument is contradicted by other evi­
    dence in the record. For example, the functional capacity eval­
    uation conducted by Sexson reveals that Contreras struggled
    to perform many movements and had limited strength. Sexson
    concluded that Contreras was
    unable to function completely within the lightest Physical
    Demand Category, as defined by the U.S. Dept. of Labor,
    of occasional lifting 10 lbs., frequent lifting 5 lbs., and
    constant lifting <5 lbs. He demonstrated deficiencies
    from normal values in all tested strength and mobility
    of upper and lower extremities, and trunk. These impair­
    ments severely limited his ability to perform material and
    non-material handling tasks. He was unable to complete a
    majority of presented tasks due to lower back pain, lim­
    iting his trunk and extremity mobility. All material and
    non-material handling testing elicited pain at the mid to
    lower back.
    After the completion of the functional capacity evalua­
    tion, Sexson opined that the evaluation accurately portrayed
    Contreras’ abilities and that Contreras had performed the tests
    with full participation. In addition, Dr. McKeag indicated
    his agreement with the restrictions and recommendations of
    the evaluation.
    This evidence demonstrates that even after Contreras’
    March 2010 surgery, he had considerable physical restrictions
    as a result of the August 2010 workplace accident. T.O. Haas,
    however, asserts that this evidence does not prove anything
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    about Contreras’ physical restrictions, because the functional
    capacity evaluation was invalid as a result of Contreras’ exag­
    geration of symptoms and because Dr. McKeag’s agreement
    with the evaluation should not be considered.
    In making its arguments, T.O. Haas reiterates its previ­
    ous assertions about why this evidence should have been
    excluded altogether at trial. In our analysis above, we rejected
    T.O. Haas’ arguments and found that both the results of the
    functional capacity evaluation and Dr. McKeag’s agreement
    with those results were properly admitted and considered by
    the trial court. As such, T.O. Haas’ arguments about the valid­
    ity of this evidence are without merit.
    T.O. Haas also asserts that other medical evidence presented
    at trial contradicted the findings of the functional capacity
    evaluation and demonstrated that Contreras was, in fact, exag­
    gerating his symptoms. However, as we stated above, as the
    trier of fact, the Nebraska Workers’ Compensation Court is the
    sole judge of the credibility of the witnesses and the weight
    to be given their testimony, and when the record in a workers’
    compensation case presents conflicting medical testimony, an
    appellate court will not substitute its judgment for that of the
    compensation court. See Lowe v. Drivers Mgmt., Inc., 
    274 Neb. 732
    , 
    743 N.W.2d 82
    (2007); Zessin v. Shanahan Mechanical &
    Elec., 
    251 Neb. 651
    , 
    558 N.W.2d 564
    (1997).
    Based upon the conflicting evidence in the record, the trial
    court noted in its award: “[Contreras] may not be as limited
    as set forth in the functional capacity evaluation but may also
    be limited more than Dr. Gammel finds. At best, [Contreras]
    would be able to perform some light work jobs.” The court
    went on to conclude that there are no light work jobs available
    to Contreras, due to the combination of his physical restric­
    tions, his lack of education, and his felony conviction. The trial
    court awarded Contreras permanent total disability benefits.
    Although the trial court does not specifically refer to the odd-
    lot doctrine, the rationale provided by the trial court is con­
    sistent with that doctrine.
    Under the odd-lot doctrine, “‘“[t]otal disability may
    be found in the case of workers who, while not alto­
    gether incapacitated for work, are so handicapped that
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    292	22 NEBRASKA APPELLATE REPORTS
    they will not be employed regularly in any well-known
    branch of the labor market. The essence of the test is
    the probable dependability with which claimant can sell
    his services in a competitive labor market, undistorted
    by such factors as business booms, sympathy of a par­
    ticular employer or friends, temporary good luck, or the
    superhuman efforts of the claimant to rise above his crip­
    pling handicaps.”’”
    Lovelace v. City of Lincoln, 
    283 Neb. 12
    , 14, 
    809 N.W.2d 505
    ,
    507-08 (2012).
    Whether Contreras is totally or permanently disabled is a
    question of fact, and when testing the trial judge’s findings
    of fact, we consider the evidence in the light most favorable
    to the successful party. Although the trial court’s consider­
    ation of Contreras’ felony conviction (along with his physical
    impairments and lack of education) is not a consideration
    found under this state’s appellate authority currently, we
    find it unnecessary to determine whether such a consider­
    ation results in error, because (1) no assignment of error
    or argument was made on this basis and (2) we find there
    is sufficient evidence in the record to support the Workers’
    Compensation Court’s decision that the employee is totally
    and permanently disabled based on its determination of the
    employee’s physical limitiations combined with the evidence
    as to his limited educational background. The combination of
    those factors alone has been upheld by the Nebraska Supreme
    Court as a basis for total disability. See Money v. Tyrrell
    Flowers, 
    275 Neb. 602
    , 
    748 N.W.2d 49
    (2008) (evidence of
    employee’s significant physical impairments after injury and
    her limited cognitive abilities was sufficient to support trial
    judge’s finding of permanent and total disability). We find
    that to be the case here and affirm the trial court’s award of
    permanent total disability.
    VI. CONCLUSION
    We find no merit to T.O. Haas’ assignments of error. The
    trial court properly admitted into evidence and considered
    exhibits 22 and 23. In addition, there was sufficient evi­
    dence to support the trial court’s conclusion that Contreras is
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    permanently and totally disabled. Accordingly, we affirm the
    trial court’s order in its entirety.
    Affirmed.
    Inbody, Chief Judge, participating on briefs.