O. Brown v. WCAB (The SD of Philadelphia) ( 2020 )


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  •            IN THE COMMONWEALTH COURT OF PENNSYLVANIA
    Odessa Brown,                                 :
    Petitioner               :
    :
    v.                              :
    :
    Workers’ Compensation                         :
    Appeal Board (The School                      :
    District of Philadelphia),                    :   No. 601 C.D. 2019
    Respondent                :   Submitted: January 24, 2020
    BEFORE:       HONORABLE RENÉE COHN JUBELIRER, Judge
    HONORABLE ANNE E. COVEY, Judge
    HONORABLE CHRISTINE FIZZANO CANNON, Judge
    OPINION NOT REPORTED
    MEMORANDUM OPINION
    BY JUDGE FIZZANO CANNON                           FILED: July 14, 2020
    Odessa Brown (Claimant) petitions for review of the April 24, 2019
    opinion and order of the Workers’ Compensation Appeal Board (Board) affirming
    the decision of the workers’ compensation judge (WCJ) to grant petitions filed by
    the School District of Philadelphia (Employer) to suspend/modify Claimant’s
    workers’ compensation benefits (benefits), and, later, to terminate these benefits as
    of June 15, 2016.1 Upon review, we affirm.
    Claimant, a cleaner for Employer, sustained injuries at work on
    December 16, 2011 when she fell while cleaning steps. WCJ’s Decision and Order
    1
    We note that Claimant does not challenge the Board’s affirmance of the WCJ’s decision
    to grant Employer’s petition to suspend/modify her benefits.
    at 3, Findings of Fact (F.F.) 1, 3(a) and 3(j), Reproduced Record (R.R.) at 115.2
    Employer accepted Claimant’s injury as compensable with a description of “right
    knee, right wrist, right calf; contusion.” F.F. 1. This description was later expanded
    to include “contusion to the right knee with osteochondral[3] injury and lateral
    meniscal[4] tear.” F.F. 1
    Claimant underwent arthroscopic surgery on her right knee in 2012 and
    a total knee replacement in 2015. F.F. 3(b). As of October 2016, Claimant was
    treating with Dr. Koenigsberg and Dr. Collier and attending physical therapy, but
    received no benefit from physical therapy or the surgeries. F.F. 3(c), 3(d) & 3(e).
    Claimant has fallen a few other times following her knee replacement surgery. F.F.
    3(h). Claimant believes that her right knee pain worsened following the knee
    replacement, and that such pain is consistent and unbearable. F.F. 3(m).
    On August 5, 2016, Employer submitted a petition to terminate
    Claimant’s benefits as of June 15, 2016, contending that Claimant had attained full
    recovery. Petition to Terminate Benefits at 1, R.R. at 1. Claimant submitted an
    answer, asserting that she remained totally disabled as a result of her work injury.
    Answer at 1, R.R. at 4. During an initial hearing before the WCJ on August 29,
    2016, Employer requested supersedeas and submitted surveillance video footage of
    2
    We note that Claimant failed to paginate the reproduced record by adding a small “a”
    following each page number in accordance with Pennsylvania Rule of Appellate Procedure 2173.
    3
    The term “osteochondral” means “relating to or composed of bone and cartilage.”
    Osteochondral, MERRIAM-WEBSTER ONLINE DICTIONARY, https://www.merriam-webster.com/
    medical/osteochondral (last visited July 13, 2020).
    4
    The term “meniscal” means “of or relating to a meniscus,” which is defined as “a fibrous
    cartilage within a joint especially of the knee.” Meniscal, MERRIAM-WEBSTER ONLINE
    DICTIONARY, https://www.merriam-webster.com/medical/meniscal (last visited July 13, 2020);
    see also Meniscus, MERRIAM-WEBSTER ONLINE DICTIONARY, https://www.merriam-
    webster.com/dictionary/meniscus#medicalDictionary (last visited July 13, 2020).
    2
    Claimant in conjunction with this request. Transcript of Testimony (T.T.), 8/29/16
    at 5, Certified Record (C.R.) at 71.5 On February 3, 2017, Employer submitted a
    petition to modify or suspend Claimant’s benefits in order to account for Claimant’s
    post-injury wages.6 Petition to Modify/Suspend Benefits at 1, R.R. at 6. This
    petition was assigned to the WCJ for disposition along with Employer’s termination
    petition. Assignment Notice, 2/6/17, C.R. at 28. Claimant submitted an answer
    acknowledging receipt of post-injury wages, but nevertheless asserting a
    miscalculation occurred as to her average weekly wages. Answer at 1, R.R. at 10.
    On May 1, 2017, the WCJ conducted a hearing with respect to
    Employer’s petitions in which both Claimant and Employer participated. T.T.,
    5/1/17 at 1-2, C.R. at 75-76. Claimant testified that she was not capable of resuming
    her former position due to the condition of her knee, as she could not manage tasks
    such as walking up and down steps, pushing a cart and mopping. T.T., 5/1/17 at 11-
    12, C.R. at 85-86. Claimant indicated that she continues to have “consistent” and
    “crazy” knee pain all day long that is “just unbearable,” and that she manages her
    pain with prescription medication. T.T., 5/1/17 at 12-13, C.R. at 86-87. However,
    Claimant admitted that she is only partially disabled, as she is still able to clean her
    house, and that she does not need to use a cane. T.T., 5/1/17 at 15-17, C.R. at 89-
    91.
    On June 5, 2017, the WCJ held a further hearing with respect to
    Employer’s petitions. T.T., 6/5/17 at 1, C.R. at 104. Claimant testified that she still
    5
    We note that citations to the Certified Record reference the page numbers of the PDF
    document, as the Certified Record is not paginated.
    6
    It appears from the record that Claimant operated a home daycare for her grandchildren
    immediately after her work injury, for which she received compensation, but that Claimant failed
    to report these wages to Employer. See F.F. 3(i); T.T., 5/1/17 at 10-11, C.R. at 84-85.
    3
    experienced swelling in her right knee, but that “[i]t comes and goes.” T.T., 6/5/17
    at 5, C.R. at 108. The WCJ observed both of Claimant’s knees during the hearing
    and remarked that “[t]here’s clear swelling to the . . . right side of the right leg.”
    T.T., 6/5/17 at 6-7, C.R. at 109-10.
    On January 3, 2018, the WCJ issued a decision and order granting
    Employer’s petitions to suspend/modify Claimant’s benefits as of December 16,
    2011, and to terminate Claimant’s benefits as of June 15, 2016.7 WCJ’s Decision &
    Order at 8, R.R. at 120. The WCJ rendered the following findings of fact based on
    his review of deposition testimony provided by Eugene Elia, M.D., a board-certified
    orthopedic surgeon, on behalf of Employer. F.F. 5 & 5(a); see also T.T., 11/30/16
    at 1, R.R. at 12. Dr. Elia saw Claimant on two occasions—once on May 8, 2013 and
    again on June 15, 2016. F.F. (5)b. Claimant informed Dr. Elia that she sustained an
    injury at work on December 16, 2011 when she slipped and fell in a stairwell,
    injuring her right wrist and right knee. F.F. 5(c) & 5(t). On May 29, 2012, Claimant
    underwent a right knee arthroscopy, which she claimed provided no relief. F.F. 5(d).
    As of May 2013, Dr. Elia did not believe Claimant had fully recovered
    from her work-related knee injury. F.F. 5(f). Claimant complained of difficulty
    standing for extended periods of time and walking for more than one hour. F.F. 5(e).
    However, Claimant’s complaints regarding her wrist had completely resolved. F.F.
    5(f). In June 2016, Dr. Elia learned from Claimant that she had undergone a right
    knee replacement on March 20, 2015, but that this surgery afforded her no relief and
    that she experienced continued swelling and pain whether standing, walking or at
    rest. F.F. 5(h), 5(i) & 5(j). Claimant still had no complaints regarding her wrist.
    7
    The suspension/modification of Claimant’s benefits dates back to December 16, 2011,
    the date of Claimant’s work injury, and appears to have been based upon a stipulation of the parties
    that was not entered into the record. See F.F. 10.
    4
    F.F. 5(k). Claimant was not working at this time and did not report serving as
    caretaker for her grandchildren. F.F. 5(l). Dr. Elia’s physical examination of
    Claimant’s right knee revealed a small amount of effusion,8 trace synovitis9 and also
    some tenderness, though Claimant had no crepitus10 and had good range of motion.
    F.F. 5(m) & 5(n). Trace synovitis and trace effusion are normal findings following
    a knee replacement and are not associated with pain. F.F. 5(q). Claimant’s muscle
    strength was slightly diminished, but she displayed no atrophy and no instability was
    noted. F.F. 5(o). & 5(p). Examination of Claimant’s right wrist produced no
    objective findings. F.F. 5(r).
    Dr. Elia additionally reviewed notes provided by Andrew Collier, Jr.,
    M.D., the board-certified orthopedic surgeon who performed Claimant’s knee
    replacement surgery. F.F. 5(s); T.T., 11/30/16 at 12, R.R. at 12. These notes
    indicated that although Claimant continued to complain of pain, “[X]-rays showed a
    well seated prosthesis without any difficulty.” F.F. 5(s). Relative to the 2011 work
    injury, Dr. Elia diagnosed Claimant with a resolved right wrist contusion, a resolved
    right calf contusion and a right knee contusion including an osteochondral injury and
    8
    Dr. Elia testified that effusion “is known as water on the knee, or synovitis.” T.T.,
    11/30/16 at 10, C.R. at 246. The term “synovitis” is defined as inflammation of a synovial
    membrane, which is the connective-tissue membrane that secretes synovial fluid and lines
    ligamentous surfaces of joint capsules, tendon sheaths where free movement is necessary and
    bursae. Synovitis, MERRIAM-WEBSTER ONLINE DICTIONARY, https://www.merriam-webster.com/
    dictionary/synovitis (last visited July 13, 2020); Synovial membrane, MERRIAM-WEBSTER ONLINE
    DICTIONARY, https://www.merriam-webster.com/medical/synovial%20membrane (last visited
    July 13, 2020).
    9
    See supra note 8.
    10
    The term “crepitus” is defined as “a crackling sound or grating feeling produced by bone
    rubbing on bone or roughened cartilage, detected on movement of an arthritic joint.” Crepitus,
    OXFORD REFERENCE, https://www.oxfordreference.com/view/10.1093/oi/authority.20110803095
    647308 (last visited July 13, 2020).
    5
    torn meniscus with a failed arthroscopic surgery necessitating a right knee
    replacement. F.F. 5(t). Following his examination of Claimant, Dr. Elia initially
    thought Claimant continued to have difficulty with her right knee and would
    probably not improve. F.F. 5(u). However, Dr. Elia based this opinion solely on
    Claimant’s subjective complaints and, “[o]bjectively[,] . . . Claimant was doing
    really well with regard to her knee.” F.F. 5(v) & 5(x). Claimant did not require any
    further treatment related to her work injuries. F.F. 5(w). After drafting his 2016
    report, Dr. Elia received additional records, including updated notes from Dr. Collier
    indicating his opinion that Claimant’s right knee “was doing pretty well,” displaying
    no synovitis or effusion, and that Claimant exhibited good range of motion and a
    nonantalgic gait.11 F.F. 5(y). & 5(z). Dr. Collier’s August 2016 note indicated that
    Claimant’s X-rays “looked good” with no signs of loosening. F.F. 5(aa).
    Dr. Elia also reviewed surveillance video footage of Claimant captured
    on May 27, 2016, June 9, 2016 and June 15, 2016, which showed Claimant getting
    in and out of her SUV without difficulty, driving, going up and down steps without
    difficulty and walking normally with no limp. F.F. 5(bb) & 5(cc). Dr. Elia noted
    that Claimant’s actions in the surveillance video footage were in marked contrast to
    how she presented during the examination, thereby indicating symptom
    magnification on Claimant’s part. F.F. 5(dd) & 5(ee). This surveillance footage,
    coupled with Dr. Elia’s extensive experience with knee replacement surgery from
    which he could “absolutely say 100 [%] of . . . patients get some kind of relief,” led
    Dr. Elia to modify his prior opinion to full recovery with the ability to return to work
    without restrictions. T.T., 11/30/16 at 24, R.R. at 18; F.F. 5(ee) & 5(ff).             Dr. Elia
    11
    The term “antalgic” is defined as “marked by or being an unnatural position or movement
    assumed by someone to minimize or alleviate pain or discomfort (as in the leg or back).” Antalgic,
    MERRIAM-WEBSTER ONLINE DICTIONARY, https://www.merriam-webster.com/medical/antalgic
    (last visited July 13, 2020).
    6
    therefore opined that Claimant’s issues with her right knee have completely
    resolved. F.F. 5(hh).
    The WCJ rendered the following findings of fact based on his review
    of deposition testimony provided by Dr. Collier on behalf of Claimant. F.F. 4 &
    4(a); see also T.T., 3/27/17 at 1, R.R. at 40. Dr. Collier first treated Claimant on
    October 17, 2013, at which point her chief complaint was her right knee. F.F. 4(b).
    Claimant related to Dr. Collier how she injured her knee at work on December 16,
    2011 when she slipped and fell on some stairs. F.F. 4(c). Claimant had arthroscopic
    surgery on her right knee on May 29, 2012. F.F. 4(d) & 5(d). Despite initially
    attempting to pursue conservative treatment, Dr. Collier eventually performed a total
    right knee replacement on Claimant on March 20, 2015. F.F. 4(e); T.T., 11/30/16 at
    12, C.R. at 248. Dr. Collier next saw Claimant on August 18, 2016, at which point
    he did not consider Claimant fully recovered, as she “still had symptoms and could
    not do certain things.”    F.F. 4(f) & 4(g).     Dr. Collier also viewed the same
    surveillance video footage showing Claimant moving around without a limp or any
    other difficulty. F.F. 4(h) & 4(j). However, the videos did not change Dr. Collier’s
    opinion that Claimant had not yet fully recovered and that she could not return to
    work in her pre-injury position. F.F. 4(i) & 4(k). Dr. Collier further opined that
    Claimant could continue to care for her grandchildren, notwithstanding the fact that
    she had not fully recovered. F.F. 4(l); T.T., 3/27/17 at 15, C.R. at 128.
    As of January 24, 2017, Claimant had a good range of motion and a
    normal gait. F.F. 4(m). Dr. Collier saw Claimant only sporadically after her surgery
    and not as frequently as he would have liked, including an eight-month span in which
    he did not see Claimant at all. F.F. 4(n). A bone scan indicated that Claimant’s
    prosthesis in her knee was not loose and the scan was otherwise normal. F.F 4(p).
    7
    Claimant’s right leg muscles exhibited no atrophy, thereby indicating she was
    engaging in some activity. F.F. 4(r). Dr. Collier could adduce no physiological
    explanation for Claimant’s ongoing complaints of right knee pain. F.F. 4(s). Dr.
    Collier believed Claimant had improved after her knee replacement, despite what
    she told Dr. Elia, as patients who receive total knee replacements usually suffer some
    pain, but not to the degree complained of by Claimant. F.F. 4(t). & 4(u).
    The WCJ deemed the testimony of Dr. Elia credible and persuasive,
    due to the doctor’s extensive review of the records, thorough physical examinations
    of Claimant and years of experience as an orthopedic surgeon treating injuries such
    as those suffered by Claimant. F.F. 6. The WCJ further determined that surveillance
    video footage established that Claimant is able to function normally.
    Id. Moreover, the
    WCJ noted that Dr. Elia’s examination of Claimant did not produce any objective
    findings and that he could provide no explanation for Claimant’s ongoing subjective
    complaints.
    Id. In contrast,
    the WCJ found the testimony of Dr. Collier to be neither
    credible nor persuasive. F.F. 7. The WCJ noted there was no objective medical
    basis for Dr. Collier’s belief that Claimant was not fully recovered.
    Id. The WCJ
    highlighted Dr. Collier’s admission that he could not identify a physiological cause
    for Claimant’s ongoing subjective complaints.
    Id.
    The WCJ
    further noted that
    Claimant’s subjective complaints were out of proportion for someone who had
    undergone a total knee replacement.
    Id. The WCJ
    determined that Claimant’s testimony was neither credible
    nor persuasive, noting that her testimony was not supported by the medical evidence.
    F.F. 8. Further, the WCJ concluded that “[C]laimant’s statement that she obtained
    no relief at all from her symptoms after undergoing the total knee replacement was
    incredible as both experts in this matter testified that every patient who has a total
    8
    knee replacement will at least have some relief of symptoms.”
    Id. The WCJ
    also
    stated that his observations of Claimant when she testified before him in court
    contributed to his finding of a lack of credibility. F.F. 9. The WCJ therefore found
    that Employer is entitled to a suspension/modification of Claimant’s temporary total
    disability benefits as of December 16, 2011, per the terms of the prior stipulation of
    the parties,12 and that the carrier must be reimbursed the $13,871.64 it overpaid to
    Claimant due to Claimant’s failure to provide her wage records in violation of the
    stipulation. F.F. 10. The WCJ further found, “upon review of the evidence in full,
    that [Claimant] . . . had fully recovered from the accepted work injury by June 15,
    2016.” F.F. 11. Finally, the WCJ determined that Employer presented a reasonable
    contest. F.F .12.
    Claimant appealed to the Board, arguing that the WCJ failed to render
    a reasoned decision in accordance with Section 422(a) of the Workers’
    Compensation Act (Act),13 77 P.S. § 834. Claimant’s Appeal at 1, R.R. at 121. On
    April 24, 2019, the Board issued an opinion and order affirming the decision of the
    WCJ. Board’s Opinion & Order at 6, R.R. at 148. The Board determined that
    Claimant failed to establish that the WCJ did not issue a reasoned decision,
    disagreeing with her contention that the WCJ failed to sufficiently explain his
    reasons for crediting Dr. Elia over Dr. Collier in concluding that Claimant fully
    recovered from her work injuries. Board’s Opinion & Order at 2, R.R. at 144. The
    Board indicated that Section 422(a) of the Act requires only that the WCJ provide
    12
    The parties previously stipulated that Claimant had recovered her earning capacity
    immediately after her work injury, presumably as noted above through her operation of a home
    daycare for her grandchildren for which she received compensation. See F.F. 3(i); T.T., 5/1/17 at
    10-11, C.R. at 84-85; Board’s Opinion & Order at 1, R.R. at 143.
    13
    Act of June 2, 1915, P.L. 736, as amended, 77 P.S. §§ 1-1041.4, 2501-2710.
    9
    an objective basis for crediting the deposition testimony of one medical expert over
    another, and that it does not authorize the Board to make its own independent finding
    as to whether the WCJ’s credibility determinations are correct. Board’s Opinion &
    Order at 4, R.R. at 146 (citing Lehigh Cty. Vo-Tech Sch. v. Workmen’s Comp. Appeal
    Bd. (Wolfe), 
    652 A.2d 797
    (Pa. 1995)). Further, noting that determinations regarding
    credibility and weight to be accorded evidence are the prerogative of the WCJ, the
    Board “determine[d] that the WCJ provided sufficient bases for crediting Dr. Elia
    over Dr. Collier to meet the reasoned decision requirements of the Act” and that the
    WCJ’s credibility determinations were neither arbitrary nor capricious. Board’s
    Opinion & Order at 4-5, R.R. at 146-47.
    Specifically, the Board highlighted that the WCJ based his credibility
    determination on Dr. Elia’s extensive records review, thorough physical
    examinations of Claimant, years of experience as an orthopedic surgeon treating
    injuries similar to those suffered by Claimant, and failure to find an objective
    explanation for Claimant’s ongoing subjective complaints. Board’s Opinion &
    Order at 5, R.R. at 147. Further, the Board noted that although surveillance videos
    alone cannot sustain a party’s burden of proof, credible surveillance evidence may
    assist a party in meeting its burden where, as here, Claimant’s testimony was
    impeached and medical evidence supported a full recovery.
    Id. The Board
    also
    pointed out that the WCJ’s observation that Claimant’s right knee appeared swollen
    during the final hearing “does not negate the WCJ’s credibility determinations with
    respect to the medical experts.”
    Id. Before this
    Court,14 Claimant argues that the WCJ erroneously credited
    the expert medical testimony provided by Dr. Elia and, therefore, failed to issue a
    14
    “This Court’s review in workers’ compensation appeals is limited to determining
    whether necessary findings of fact are supported by substantial evidence, whether an error of law
    10
    reasoned decision pursuant to Section 422(a) of the Act. See Claimant’s Brief at 11-
    12. Claimant contends that the reasons provided by the WCJ in crediting the
    deposition testimony of Dr. Elia cannot provide the basis of a reasoned decision.
    Id. at 12.
    Further, Claimant asserts that Dr. Elia’s “last medical report found her
    disabled, stating objective signs and subjective symptoms,” and that his thorough
    physical examinations of Claimant indicated she had not fully recovered.
    Id. (citing Dr.
    Elia’s Letter, 6/5/16 at 5, R.R. at 35). Claimant contends that “[Dr. Elia’s] years
    of practice in his profession treating injuries of the kind suffered by [C]laimant were
    a sham.”
    Id. Claimant also
    contends that “[o]nce [Dr.] Elia [saw] the innocuous
    videotape of [C]laimant, all of a sudden [C]laimant is no longer having symptoms,
    no longer having objective findings, no longer having attained maximum medical
    improvement and her prognosis for full recovery goes from ‘poor’ to ‘cured.’”
    Id. This Court
    has observed that “there is no requirement in the law that
    the WCJ’s decision be ‘well-reasoned’ in the sense that a reviewing court agrees
    with the reasoning offered; the requirement is that the decision be ‘reasoned’ within
    the meaning of Section 422(a) of the Act.” Green v. Workers’ Comp. Appeal Bd.
    (US Airways), 
    28 A.3d 936
    , 940 (Pa. Cmwlth. 2011). Section 422(a) of the Act
    provides in relevant part:
    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
    rationale for the decisions so that all can determine why
    and how a particular result was reached. The [WCJ] shall
    specify the evidence upon which the [WCJ] relies and state
    was committed, or whether constitutional rights were violated.” Whitfield v. Workers’ Comp.
    Appeal Bd. (Tenet Health Sys. Hahnemann LLC), 
    188 A.3d 599
    , 605 n.6 (Pa. Cmwlth. 2018); see
    also Section 704 of the Administrative Agency Law, 2 Pa. C.S. § 704.
    11
    the reasons for accepting it in conformity with this section.
    When faced with conflicting evidence, the [WCJ] must
    adequately explain the reasons for rejecting or discrediting
    competent evidence. Uncontroverted evidence may not be
    rejected for no reason or for an irrational reason; the
    [WCJ] must identify that evidence and explain adequately
    the reasons for its rejection. The adjudication shall
    provide the basis for meaningful appellate review.
    77 P.S. § 834 (emphasis added). “[A] decision is ‘reasoned’ for purposes of Section
    422(a) if it allows for adequate review by the [Board] without further elucidation
    and if it allows for adequate review by the appellate courts under applicable review
    standards. A reasoned decision is no more, and no less.” Daniels v. Workers’ Comp.
    Appeal Bd. (Tristate Transp.), 
    828 A.2d 1043
    , 1052 (Pa. 2003). “[T]he purpose of
    a reasoned decision is to spare the reviewing court from having to imagine why the
    WCJ believed one witness over another.” Dorsey v. Workers’ Comp. Appeal Bd.
    (Crossing Constr. Co.), 
    893 A.2d 191
    , 196 (Pa. Cmwlth. 2006).
    In Daniels, our Supreme Court distinguished between judicial review
    of credibility determinations based upon deposition testimony submitted to the WCJ
    as opposed to a WCJ’s evaluation of live testimony. 
    Daniels, 828 A.2d at 1052-53
    .
    Regarding review of a WCJ’s consideration of deposition testimony, the Court noted
    that “absent the circumstance where a credibility assessment may be said to have
    been tied to the inherently subjective circumstance of witness demeanor, some
    articulation of the actual objective basis for the credibility determination must be
    offered for the decision to be a ‘reasoned’ one which facilitates effective appellate
    review.”
    Id. at 1053.
    Nevertheless, we have held previously:
    [E]ven where a WCJ has based a credibility determination
    on a cold record, substantial deference is due. We must
    view the reasoning as a whole and overturn the credibility
    determination only if it is arbitrary and capricious or so
    12
    fundamentally dependent on a misapprehension of
    material facts, or so otherwise flawed, as to render it
    irrational.
    Casne v. Workers’ Comp. Appeal Bd. (STAT Couriers, Inc., and State Workers’ Ins.
    Fund), 
    962 A.2d 14
    , 19 (Pa. Cmwlth. 2008). “Determining the credibility of the
    witnesses is the quintessential function of the fact finder. . . . It is not an exact
    science, and the ultimate conclusion comprises far more than a tally sheet of its
    various components.” 
    Dorsey, 893 A.2d at 195-96
    (“declin[ing] [the c]laimant’s
    invitation to dissect and analyze each of the WCJ’s reasons for his credibility
    determination”). “[T]he WCJ is entitled to accept or reject the testimony of any
    witness, including a medical witness, in whole or in part.” Soja v. Workers’ Comp.
    Appeal Bd. (Hillis-Carnes Eng’g Assocs.), 
    33 A.3d 702
    , 708 (Pa. Cmwlth. 2011).
    Claimant asserts that the explanation supplied by the WCJ in crediting
    the deposition testimony of Dr. Elia fails to provide the basis of a reasoned decision
    pursuant to Section 422(a) of the Act. Claimant’s Brief at 12. We disagree. As
    noted above, where a WCJ reviews a deposition transcript of expert medical
    testimony, the WCJ must articulate an actual objective basis in support of any
    corresponding credibility determination in order to permit effective appellate review.
    Gumm v. Workers’ Comp. Appeal Bd. (Steel), 
    942 A.2d 222
    , 228 (Pa. Cmwlth.
    2008). “Although there are countless objective factors that may support a credibility
    determination, these factors must be identified and enunciated.”
    Id. Nevertheless, “Section
    422(a) [of the Act] does not permit a party to challenge or second-guess the
    WCJ’s reasons for credibility determinations.”
    Id. Further, the
    “reasoned decision
    [standard] does not require the WCJ to give a line-by-line analysis of each statement
    by each witness, explaining how a particular statement affected the ultimate
    13
    decision.”
    Id. Thus, “[u]nless
    made arbitrarily or capriciously, a WCJ’s credibility
    determinations will be upheld on appeal.”
    Id. Here, the
    objective basis for the WCJ’s credibility determination is
    supported by the record. The WCJ deemed the testimony of Dr. Elia credible and
    persuasive due to the doctor’s extensive records review, thorough physical
    examinations of Claimant and years of experience as an orthopedic surgeon treating
    injuries such as those suffered by Claimant. F.F. 6. Further, the WCJ noted that Dr.
    Elia’s examination of Claimant did not produce any objective findings or
    explanation for Claimant’s subjective complaints.
    Id. See Gumm,
    942 A.2d at 228
    (concluding that the WCJ provided an objective basis in support of his credibility
    determination based on review of deposition testimony where his “reason [was]
    confirmed in a review of the medical testimony and in a review of the accepted
    testimony of [the c]laimant”); 
    Dorsey, 893 A.2d at 196
    (holding that the WCJ
    provided actual objective bases in support of his credibility determination where he
    explained that claimant’s physician did not review as many records as did
    employer’s physician and that claimant’s physician advised he would need knee
    replacement surgery in the future, where these reasons “permit[ted] verification
    during appellate review” and each “alone [was] sufficient to support a credibility
    finding”).
    In particular, the WCJ’s explanation that Dr. Elia’s examination of
    Claimant did not reveal objective findings in support of her subjective complaints is
    supported by Dr. Elia’s testimony that Claimant experienced normal amounts of
    effusion and synovitis following her knee replacement surgery that were not
    associated with pain and exhibited good range of motion, a nonantalgic gait and no
    atrophy or instability. See F.F. 5(m), 5(n), 5(o), 5(p), 5(r), 5(q), 5(y) & 5(z). Dr.
    14
    Elia further testified that he could “absolutely say 100 [%] of . . . patients get some
    kind of relief with the knee replacement surgery,” and that, despite Claimant’s
    subjective complaints, he “[a]ctually . . . thought she was doing pretty well
    objectively by [his] examination of her knee.” T.T., 11/30/16 at 17 & 24, C.R. at
    253 & 260; F.F. 5(gg). Even Dr. Collier could adduce no physiological explanation
    for Claimant’s ongoing complaints of right knee pain and noted that Claimant’s X-
    rays revealed a well-seated prosthesis. F.F. 5(s). Further, Dr. Collier testified that
    he was “kind of at a loss as to why [Claimant was] having pain still,” that he “[could
    not] explain it,” and that after total knee replacement surgery “you may have some
    [pain], but usually not to this degree.” T.T., 3/27/17 at 37-38 & 40, C.R. at 150-51
    & 153. Thus, we agree with the Board that the WCJ provided sufficient bases for
    crediting the deposition testimony of Dr. Elia.
    Claimant further challenges the WCJ’s credibility determination on the
    basis that Dr. Elia was improperly influenced by the surveillance video footage in
    opining that Claimant was no longer disabled. See Claimant’s Brief at 12. We
    acknowledge that “films alone are inadequate to sustain the evidentiary burden of
    showing that a claimant’s disability has been reduced.” Hartzell v. Workmen’s
    Comp. Appeal Bd. (Bowen McLaughlin, York Div.), 
    515 A.2d 1009
    , 1011 (Pa.
    Cmwlth. 1986); see also 
    Soja, 33 A.3d at 706
    & 708 (noting, where an employer
    files a petition to terminate a claimant’s benefits, that “a video is inadequate evidence
    standing alone” to satisfy employer’s burden of proof and “must be examined by a
    physician or vocational specialist who can offer evidence of what kind of jobs the
    claimant can do, other than his pre-injury job”). However, “[s]urveillance testimony
    may be used to impeach credibility and to establish facts.” 
    Soja, 33 A.3d at 708
    (affirming the denial of claimant’s claim petition for benefits where surveillance
    15
    video “contradicted . . . evidence that his symptoms of pain were ongoing”);
    
    Hartzell, 515 A.2d at 1010-11
    (holding, where an expert medical witness first opined
    that claimant’s disability continued following a physical examination of claimant
    but then changed his diagnosis after viewing a surveillance videotape, that the
    altered opinion nevertheless constituted substantial competent evidence as “the
    videotape corroborated the inconsistencies which the physical examination
    revealed”).
    Here, in explaining his decision to credit the testimony of Dr. Elia, the
    WCJ noted that “the video surveillance of [] Claimant establishes she is able to
    function normally.” F.F. 6. Dr. Elia testified that he reviewed the surveillance
    videos, including footage revealing that on June 15, 2016, Claimant was walking
    down the street with a normal gait and exhibited no trace of a limp or difficulty
    standing or crossing the street. T.T., 11/30/16 at 23, C.R. at 259. Dr. Elia stated that
    the surveillance video footage did not correspond with Claimant’s presentation
    during her appointment later that same day, and that his review of these videos
    changed his opinion as noted in the June 15, 2016 independent medical examination
    report.
    Id. Further, Dr.
    Elia testified that the surveillance video footage “suggested
    a strong case [for] symptom magnification, which [he] felt had occurred in [his]
    examination on June 15th, and because of seeing this contrast, [he] modified [his]
    results to the fact that she had completely recovered from all her injuries and could
    return back to her previous position without restrictions.” T.T., 11/30/16 at 24, C.R.
    at 260. Thus, the WCJ properly utilized the surveillance video footage to impeach
    Claimant’s credibility and, thereby, to provide a basis for his decision to credit the
    deposition testimony of Dr. Elia. See 
    Soja, 33 A.3d at 708
    . We therefore agree with
    the Board that the WCJ provided objective bases for his decision to credit the
    16
    testimony of Dr. Elia, thereby rendering his decision “reasoned” for purposes of
    Section 422(a) of the Act.15
    Claimant next asserts that the WCJ and the Board “capriciously
    disregarded the effect of [C]laimant’s objective evidence of continuing disability
    which the [WCJ] himself declared.” Claimant’s Brief at 15. Claimant notes that at
    the final hearing on June 5, 2017, she showed both her knees to the WCJ, who read
    into the record that “there’s clearly swelling to the anterior aspect and primarily to
    the right lateral side[.]”
    Id. Claimant maintains
    that the WCJ’s observation
    precludes a finding of full recovery. We disagree.
    The WCJ’s mere observation of swelling in Claimant’s right knee does
    not establish a lack of full recovery or that Claimant is incapable of performing her
    pre-injury job. Moreover, the law is well-settled that “[t]he WCJ is the ultimate
    finder of fact and the exclusive arbiter of credibility and evidentiary weight.”
    
    Daniels, 828 A.2d at 1052
    ; see also 1912 Hoover House Rest. v. Workers’ Comp.
    Appeal Bd. (Soverns), 
    103 A.3d 441
    , 446 (Pa. Cmwlth. 2014) (stating that “the WCJ,
    as fact finder, has exclusive province over questions of credibility and a reviewing
    court is not to reweigh the evidence or review the credibility of witnesses”). Here,
    the WCJ stated that he “observed [Claimant’s] demeanor when she testified before
    [him] in court,” and that “[t]hese observations contribute[d] to [his] finding of a lack
    15
    Claimant also asserts that Dr. Elia’s “last medical report found her disabled, stating
    objective signs and subjective symptoms,” and that his thorough physical examinations of
    Claimant indicated she had not fully recovered. Claimant’s Brief at 12 (citing Dr. Elia’s Letter,
    6/5/16 at 5, R.R. at 35). However, Claimant’s summation of Dr. Elia’s opinion based on his June
    15, 2016 letter is misleading. In an addendum letter dated July 27, 2016, Dr. Elia stated that after
    reviewing the surveillance video footage of Claimant, his “conclusion should be updated from
    [his] previous assessment of maximum medical improvement and light duty work” to reflect that
    Claimant’s “workplace injuries [have] completely resolved and no further treatment is indicated,”
    such that Claimant “could return back to her full time position as a maintenance employee for
    [Employer].” Dr. Elia’s Addendum Letter, 7/27/16 at 1, R.R. at 37.
    17
    of credibility” with respect to her testimony. F.F. 9. See also 
    Daniels, 828 A.2d at 1052-53
    (holding that “in a case where the fact-finder has had the advantage of
    seeing the witnesses testify and assessing their demeanor, a mere conclusion as to
    which witness was deemed credible, in the absence of some special circumstance,
    could be sufficient to render the decision adequately ‘reasoned,’” as “[s]uch a
    credibility determination may involve nothing more than the fact-finder’s on-the-
    spot, and oftentimes instinctive, determination that one witness is more credible than
    another”).
    Moreover, the WCJ specifically credited the testimony of Dr. Elia that
    Claimant had fully recovered and, as discussed above, provided objective bases for
    his decision to credit the same. Claimant fails to establish that the WCJ arbitrarily
    or capriciously disregarded any evidence, including the testimony and opinion of Dr.
    Collier that Claimant is not fully recovered. We agree with the Board “that the
    WCJ’s observation that Claimant’s right knee appeared swollen during the final
    hearing does not negate the WCJ’s credibility determinations with respect to the
    medical experts.” Board’s Opinion & Order at 5, R.R. at 147. The credible
    testimony of Dr. Elia supports a finding of Claimant’s full recovery.16
    Accordingly, we affirm.
    __________________________________
    CHRISTINE FIZZANO CANNON, Judge
    16
    Claimant also asserts that the WCJ committed an error of law in concluding that
    Employer satisfied its burden of proof to terminate Claimant’s benefits, because Employer failed
    to provide unequivocal medical testimony establishing Claimant’s full recovery in support of its
    termination petition, all medical documentation reviewed by Dr. Elia evidences her continuing
    disability and the surveillance video footage does not satisfy Employer’s burden of proof.
    Claimant’s Brief at 13-14. We note, however, that we need not address this argument, as Dr. Elia
    credibly opined that Claimant’s issues with her right knee had completely resolved. See F.F. 5(hh)
    & 6.
    18
    IN THE COMMONWEALTH COURT OF PENNSYLVANIA
    Odessa Brown,                          :
    Petitioner           :
    :
    v.                         :
    :
    Workers’ Compensation                  :
    Appeal Board (The School               :
    District of Philadelphia),             :   No. 601 C.D. 2019
    Respondent         :
    ORDER
    AND NOW, this 14th day of July, 2020, the April 24, 2019 order of the
    Workers’ Compensation Appeal Board is AFFIRMED.
    __________________________________
    CHRISTINE FIZZANO CANNON, Judge