PATRICIA COSTANZO VS. MERIDIAN REHAB (DEPARTMENT OF LABOR AND WORKFORCE DEVELOPMENT) ( 2021 )


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  •                                 NOT FOR PUBLICATION WITHOUT THE
    APPROVAL OF THE APPELLATE DIVISION
    This opinion shall not "constitute precedent or be binding upon any court." Although it is posted on the
    internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3.
    SUPERIOR COURT OF NEW JERSEY
    APPELLATE DIVISION
    DOCKET NO. A-5547-18
    PATRICIA COSTANZO,
    Petitioner-Appellant,
    v.
    MERIDIAN REHAB,
    Respondent-Respondent.
    __________________________
    Argued June 2, 2021 – Decided June 17, 2021
    Before Judges Haas and Mawla.
    On appeal from the Department of Labor and
    Workforce Development, Division of Workers'
    Compensation, Case No. 2017-14400.
    Danielle S. Chandonnet argued the cause for appellant
    (Shebell & Shebell, LLC, attorneys; Raymond P.
    Shebell, Sr. of counsel; Danielle S. Chandonnet, on the
    brief).
    Carla P. Aldarelli argued the cause for respondent
    (Capehart & Scatchard, PA, attorneys; Carla P.
    Aldarelli, of counsel; Maura Burk, on the brief).
    PER CURIAM
    Petitioner Patricia Costanzo appeals from the July 9, 2019 order of the
    Division of Workers' Compensation, which denied her motion for additional
    medical and temporary benefits related to her left knee. We affirm.
    The procedural history and facts are fully set forth in the comprehensive
    written decision rendered by Judge of Compensation Salvatore Martino
    following a five-day trial. Therefore, we need only recite the most salient details
    here.
    On April 1, 2016, petitioner was working as a recreational aide for
    respondent Meridian Rehab. While performing her duties, she slipped, fell
    forward to the ground, and landed on both knees. She felt pain in her left knee.
    Petitioner filed a claims petition and respondent accepted her claim for treatment
    for her left knee.
    An MRI was taken of petitioner's left knee on June 14, 2016. The MRI
    report revealed no meniscus tear, no ligament tear, and no fracture. There was
    preexisting    thinning   of   the   patellofemoral   cartilage   and   preexisting
    osteoarthritis in the knee.
    Respondent paid for petitioner's left knee treatment, which consisted of
    medications, physical therapy, cortisone injections, and a series of Viscoelastic
    injections. Petitioner thereafter resumed her regular work for respondent.
    A-5547-18
    2
    Petitioner testified that she suffered a right knee meniscus tear in August
    2017 while walking on a beach. 1 She underwent a right knee arthroscopic
    meniscectomy that same month.
    In January 2018, petitioner underwent another MRI on her left knee.
    Unlike the June 2016 MRI, the new MRI showed that petitioner now had a torn
    medial meniscus tear with a displaced fragment in her left knee. She also had a
    torn anterior cruciate ligament (ACL) tear in the same knee. Her preexisting
    arthritis was still present in the knee.
    In February 2018, petitioner filed a motion seeking to require respondent
    to pay for additional treatment for her left knee. Respondent denied liability and
    the matter proceeded to trial before Judge Martino.
    Petitioner testified that she was experiencing pain in her left knee. She
    denied injuring the knee on the beach in August 2017 and denied any other
    incident involving her knee.        Judge Martino found that while petitioner
    "answered the majority of the questions [posed to her] in a straightforward
    manner[,] [t]here were a few occasions when . . . [p]etitioner seemed to be
    1
    This injury was not compensable because it did not occur during the course of
    petitioner's employment.
    A-5547-18
    3
    evasive in responding to counsel's questions. And she seemed to minimize the
    effect that her right knee condition had on her activities."
    Petitioner also presented the testimony of Cary Skolnick, M.D., who was
    accepted by the court as an expert in the field of orthopedic surgery. Based upon
    his examination of petitioner, Dr. Skolnick opined that the tears in petitioner's
    left knee were related to the injury she sustained when she fell on the ground in
    April 2016.
    In rendering this opinion, Dr. Skolnick conceded that neither the meniscus
    tear nor the ACL tear were present in the June 2016 MRI. However, he insisted
    that petitioner's medial meniscus was "elongated" when her knee struck the
    ground and that it gradually tore over time. Dr. Skolnick also claimed that
    petitioner's ACL was stretched in the incident to the point where there were just
    a few fibers holding it together. Eventually, the remaining fibers broke and the
    tear became apparent on the MRI. Dr. Skolnick also testified that even though
    petitioner suffered from preexisting arthritis in the left knee before the April
    2016 fall, the fact that her left knee struck the ground caused the arthritis to
    worsen to the point where additional treatment was needed.
    Judge Martino found that Dr. Skolnick's opinions were not credible. The
    judge explained that the expert's testimony was simply not logical and he "did
    A-5547-18
    4
    not directly address the questions posed to him." Dr. Skolnick's demeanor on
    the stand further weakened his credibility because he "became abrupt and . . .
    somewhat argumentative with . . . [r]espondent's attorney" during cross -
    examination. Judge Martino also noted that the facts Dr. Skolnick used as the
    basis for his opinions were "tenuous."
    The judge was more impressed with the testimony provided by
    respondent's expert, Shawn D. Sieler, M.D. Dr. Sieler testified that petitioner
    suffered only a left knee contusion in the April 2016 fall, received appropriate
    treatment for that injury, and fully recovered. Contrary to Dr. Skolnick's claims,
    Dr. Sieler stated that a meniscus or ACL "cannot tear spontaneously" and the
    tears found on the January 2018 MRI "can only be explained by some subsequent
    traumatic incident."
    Dr. Sieler found no evidence of any "elongation" or "stretching" of the
    structures within petitioner's left knee on the June 2016 MRI and testified that
    the arthritis found in both MRIs preexisted the April 2016 accident. Thus, Dr.
    Sieler concluded that petitioner "remain[ed] at maximal medical improvement
    from the contusion injury of the left knee" and that the conditions she now
    sought treatment for were not caused by the April 2016 incident.
    A-5547-18
    5
    Judge Martino found that Dr. Sieler's testimony was credible and
    persuasive. The judge explained that Dr. Sieler's "testimony was in accord with
    his written expert opinion. His testimony was logical and direct. He answered
    questions clearly and directly." Moreover, unlike Dr. Skolnick, respondent's
    expert's testimony was supported by the MRIs submitted in evidence.
    As a result, Judge Martino concluded:
    The [c]ourt finds that the testimony elicited in
    this matter and the underlying facts of this case
    establishes and confirms that . . . [p]etitioner currently
    suffers from left knee pathology. However as the
    [c]ourt has previously indicated, [Dr. Sieler's] opinion
    is more credible and persuasive regarding the causal
    relation between the current status of . . . [p]etitioner's
    left knee and the original injury. The [c]ourt has given
    due weight to the credentials of [Dr.] Skolnick, but
    finds the opinions of Dr. Sieler to be more logical and
    convincing in this particular matter with regard to the
    progression of . . . [p]etitioner's left knee complaints
    and pathology.
    While it is clear that more severe pathology
    currently exists as compared to the time period closer
    to the injury date, there does not appear to be a
    reasonable connection between the mechanism of the
    injury and the current state of her pathology. The
    [c]ourt rejects the opinion of [Dr.] Skolnick as his
    opinion regarding the causal relationship between . . .
    [p]etitioner's current physical condition and the
    accident is not supported by a reliable factual basis and
    is speculative. Petitioner's expert simply could not
    meet the burden required to establish the causal
    A-5547-18
    6
    connection between the original injury and the current
    condition of . . . [p]etitioner's knee.
    Based upon the foregoing findings of fact and
    law, the [c]ourt finds that . . . [p]etitioner has failed to
    establish[ ] by objective, reasonable evidence that a
    need [exists] for additional treatment regarding a "work
    related" injury to [her] left knee.
    This appeal followed.
    On appeal, petitioner contends that "sufficient objective medical evidence
    was presented at trial to meet petitioner's burden to establish the need for
    treatment as necessary and related to the work injury." She also asserts that
    Judge Martino erred in assessing Dr. Skolnick's credibility. We disagree with
    both of these contentions.
    The New Jersey Workers' Compensation Act is "humane social legislation
    designed to place the cost of work-connected injury upon the employer who may
    readily provide for it as an operating expense." Tocci v. Tessler & Weiss, Inc.,
    
    28 N.J. 582
    , 586 (1959). The Act must be liberally construed "in order that its
    beneficent purposes may be accomplished."              Torres v. Trenton Times
    Newspaper, 
    64 N.J. 458
    , 461 (1974).             However, this canon of liberal
    construction of the Act "does not extend to 'the evaluation of credibility or of
    weight or sufficiency of evidence.'" Lindquist v. City of Jersey City Fire Dep't.,
    A-5547-18
    7
    
    175 N.J. 244
    , 258 (2003) (quoting Oszmanski v. Bergen Point Brass Foundry,
    Inc., 
    95 N.J. Super. 92
    , 95 (App. Div. 1967)).
    Pursuant to N.J.S.A. 34:15-1, a compensable workers' compensation
    injury must be caused by an accident "arising out of and in the course of" the
    worker's employment. An employer is required to "furnish to the injured worker
    such medical, surgical and other treatment, and hospital service as shall be
    necessary to cure and relieve the worker of the effects of the injury and to restore
    the functions of the injured member or organ where such restoration is possible
    . . . ." N.J.S.A. 34:15-15. However, there must be evidence that the issues
    complained of are indeed the "effects" of the injury that occurred, and "a
    successful petitioner in workers' compensation generally must prove both legal
    and medical causation when those issues are contested." Lindquist, 
    175 N.J. at 259
    .    "Medical causation means the injury is a physical or emotional
    consequence of work exposure" and "that the disability was actually caused by
    the work-related event." 
    Ibid.
    "It is the petitioner's burden to establish a causal link between the
    employment and the disease." Kiczula v. Am. Nat'l Can Co., 
    310 N.J. Super. 293
    , 303 (App. Div. 1998). "The link must be proven by a preponderance of the
    evidence," ibid., and the focus is on "the proof of a causal connection between
    A-5547-18
    8
    working conditions and the harm." Giambattista v. Thomas A. Edison, Inc., 
    32 N.J. Super. 103
    , 112 (App. Div. 1954). "The standard is one of reasonable
    probability; i.e., whether or not the evidence is of sufficient quality to generate
    a belief that the tendered hypothesis is in all likelihood the truth." Lister v. J.B.
    Eurell Co., 
    234 N.J. Super. 64
    , 72 (App. Div. 1989).
    In reviewing decisions of judges in the Division of Workers'
    Compensation, "[t]he factual findings of the compensation court are entitled to
    substantial deference." Ramos v. M & F Fashions, 
    154 N.J. 583
    , 594 (1998).
    We limit our inquiry
    to whether the findings made by the Judge of Workers'
    Compensation could reasonably have been reached on
    sufficient credible evidence present in the record,
    considering the proofs as a whole, with due regard to
    the opportunity of [the] one who heard the witnesses to
    judge of their credibility and with due regard to his
    expertise.
    [Ibid. (quoting Bradley v. Henry Townsend Moving &
    Storage Co., 
    78 N.J. 532
    , 534 (1979)).]
    We may not substitute our own factfinding for that of the judge of
    compensation. Lombardo v. Revlon, Inc., 
    328 N.J. Super. 484
    , 488 (App. Div.
    2000). We must defer to the factual findings and legal determinations made by
    the judge of compensation "unless they are 'manifestly unsupported by or
    inconsistent with competent relevant and reasonably credible evidence as to
    A-5547-18
    9
    offend the interests of justice.'" Lindquist, 
    175 N.J. at 262
     (quoting Perez v.
    Monmouth Cable Vision, 
    278 N.J. Super. 275
    , 282 (App. Div. 1994)). While
    the judge of compensation has "expertise with respect to weighing the testimony
    of competing medical experts and appraising the validity of [the petitioner's]
    compensation claim," Ramos, 
    154 N.J. at 598
    , the judge must "carefully
    explain[] why he considered certain medical conclusions more persuasive than
    others." Smith v. John L. Montgomery Nursing Home, 
    327 N.J. Super. 575
    , 579
    (App. Div. 2000).
    Against this backdrop, and mindful of our standard of review, we affirm
    substantially for the reasons expressed by Judge Martino in his thorough written
    decision. We add only the following brief comments.
    Contrary to petitioner's contentions on appeal, there was ample evidence
    in the record to support the judge's conclusion that the current condition of
    petitioner's left knee was not related to the injury she suffered when she fell at
    work in April 2016. At that time, petitioner suffered only a contusion. The MRI
    taken in June 2016 revealed no meniscus tear and no ACL tear. Although the
    MRI showed that petitioner had arthritis in the knee, this was a preexisting
    condition.
    A-5547-18
    10
    As Dr. Sieler testified, and Judge Martino found, the meniscus and ACL
    tears that the January 2018 MRI showed did not occur at the time of the April
    2016 accident and did not spontaneously occur on their own. There was no
    medical evidence that the arthritis in her left knee had worsened as the result of
    the April 2016 fall. Therefore, the judge properly concluded that petitioner was
    not entitled to additional treatment to her left knee because her current condition
    was not caused by a work-related incident.
    We also reject petitioner's claim that the judge erred in according greater
    weight to the testimony of Dr. Sieler than the testimony of Dr. Skolnick.
    Compensation judges have "expertise with respect to weighing the testimony of
    competing medical experts." Ramos, 
    154 N.J. at 598
    . This court "may not
    'engage in an independent assessment of the evidence as if it were the court of
    first instance.'" Sager v. O.A. Peterson Constr., 
    182 N.J. 156
    , 164 (2004)
    (quoting State v. Locurto, 
    157 N.J. 463
    , 471 (1999)). Compensation judges who
    see and hear the testimony are in the best position to assess the demeanor and
    credibility of the expert witnesses. 
    Ibid.
    A "judge of compensation 'is not bound by the conclusional opinions of
    any one or more, or all of the medical experts.'" Kaneh v. Sunshine Biscuits,
    
    321 N.J. Super. 507
    , 511 (App. Div. 1999) (quoting Perez v. Capitol
    A-5547-18
    11
    Ornamental, Concrete Specialties, Inc., 
    288 N.J. Super. 359
    , 367 (App. Div.
    1996)). "That [the judge] gave more weight to the opinion of one physician as
    opposed to the other provides no reason to reverse th[e] judgment." Bellino v.
    Verizon Wireless, 
    435 N.J. Super. 85
    , 95 (App. Div. 2014) (alterations in
    original) (citing Smith, 327 N.J. Super. at 579).
    Here, Judge Martino fully articulated his reasons for crediting Dr. Sieler's
    testimony over that provided by Dr. Skolnick.         We discern no basis for
    disturbing his well-reasoned conclusion. 2
    Affirmed.
    2
    Although the judge briefly noted that he had observed Dr. Skolnick provide
    more credible testimony on prior occasions, this was a fleeting comment and
    not, as petitioner now asserts, a basis for reversal. As summarized above, the
    judge's reasons for giving more weight to Dr. Sieler's expert opinions were
    squarely based upon the testimony both experts gave at the trial in this matter.
    A-5547-18
    12