Philadelphia Housing Auth. v. WCAB (Butt) ( 2021 )


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  •           IN THE COMMONWEALTH COURT OF PENNSYLVANIA
    Philadelphia Housing Authority,               :
    Petitioner                  :
    :
    v.                                :
    :
    Workers’ Compensation Appeal                  :
    Board (Butt),                                 :    No. 633 C.D. 2020
    Respondent                    :    Submitted: February 26, 2021
    BEFORE:     HONORABLE RENÉE COHN JUBELIRER, Judge
    HONORABLE ANNE E. COVEY, Judge
    HONORABLE ELLEN CEISLER, Judge
    OPINION NOT REPORTED
    MEMORANDUM OPINION BY
    JUDGE COVEY                                                 FILED: April 22, 2021
    The Philadelphia Housing Authority (Employer) petitions this Court for
    review of the Workers’ Compensation (WC) Appeal Board’s (Board) June 11, 2020
    order reversing Workers’ Compensation Judge (WCJ) Sandra Craig’s (WCJ Craig)
    decision granting Employer’s Petition to Terminate WC Benefits (Termination
    Petition). Employer presents one issue for this Court’s review: whether the Board
    erred by concluding that the opinion of Employer’s expert, Dennis P. McHugh, D.O.
    (Dr. McHugh), was incompetent and insufficient to support the Termination
    Petition. Upon review, this Court reverses.
    Shenecqua Butt (Claimant) was employed as a home inspector for
    Employer.1 In February 2016, Claimant notified Employer that, while working, she
    1
    [Claimant’s] job duties require[d] her to inspect between 18 and 20
    apartments per day, 8 hours a day, 5 days a week, with a [1]-hour
    lunch break. She ha[d] to lift every window in the house, check
    every electrical outlet in the unit, bend and look underneath the sinks
    and toilets to make sure there were no pipes leaking. She walk[ed]
    developed lower back and right leg pain that extended into her foot and caused her
    to limp. Claimant had a long history of lumbar spondylosis and degenerative disc
    disease,2 and also began treating with a rheumatologist for what was eventually
    diagnosed as an autoimmune connective tissue disease (i.e., Sjorgren’s Disease). In
    February 2016, her rheumatologist prescribed physical therapy and a muscle relaxer
    for Claimant’s pain. On March 29, 2016, the rheumatologist completed Family and
    Medical Leave Act (FMLA)3 forms for Claimant to be off work for 8 weeks to
    undergo intensive physical therapy from March 29 to May 24, 2016, which forms
    Claimant mailed to Employer.4 Claimant continued to work her full-duty job until
    April 5, 2016, when she again experienced a sharp pain in her low back that radiated
    into her right foot.
    On April 8, 2016, Claimant treated at the emergency room for
    continued back and leg pain. The emergency room physician gave her a note for
    light-duty work. Claimant took the note to Employer and reported a work injury.
    through the unit and the property perimeter, [went] up and down
    stairs, ben[t], squat[ted] and lift[ed].
    WCJ 8/11/2017 Dec. at 1, Reproduced Record (R.R.) at 450a.
    2
    Spondylosis is a condition caused by degenerative changes affecting the spine. See WCJ
    7/19/2019 Dec. at 6, R.R. at 37a. Degenerative disc disease is a condition that specifically affects
    the discs. See id.
    Claimant suffered past work injuries with Employer including low
    back injuries as a result of motor vehicle accidents on August 3,
    2009 and July 24, 2012. Claimant was also out of work on a
    [m]edical [l]eave of [a]bsence from November 19, 2013 to
    December 14, 2014[,] and again May 1, 2015 through August 30,
    2015.
    WCJ 8/11/2017 Dec. at 4, R.R. at 453a.
    3
    
    29 U.S.C. §§ 2601-2654
    .
    4
    Claimant requested the FMLA forms at her February 2016 office visit, but her
    rheumatologist did not complete them until March 29, 2016. Claimant requested 12 weeks off
    from work, but her rheumatologist would only agree to 8 weeks. Employer approved Claimant’s
    FMLA leave on April 22, 2016, and, as will be discussed below, Claimant worked until April 26,
    2016.
    2
    Claimant worked light-duty for Employer from April 12 to April 26, 2016.
    Claimant’s FMLA leave was approved on April 22, 2016. Also on April 22, 2016,
    Employer denied Claimant’s WC claim. Claimant did not return to work after April
    26, 2016.
    On June 3, 2016, Claimant filed a claim petition, alleging therein that
    she sustained an injury in the “lumbar region of the spine with pain radiating down
    [her] right leg/foot” in the course of her employment on April 8, 2016. WCJ
    8/11/2017 Dec. at 1, Reproduced Record (R.R.) at 450a. Employer opposed the
    claim petition. On July 8, 2016, Claimant amended the claim petition to allege an
    injury date of April 5, 2016, and Employer amended its answer accordingly.
    Following several hearings, on August 11, 2017,5 WCJ Audrey Timm (WCJ Timm)
    granted Claimant’s claim petition and awarded temporary total disability benefits
    beginning April 26, 2016, concluding: “Claimant met her burden of proving that
    she sustained an aggravation[6] of her pre[]existing lumbar degenerative disc
    disease and spondylosis, as well as lumbar radiculopathy as a result of her . . .
    work activities, which [we]re a substantial contributing factor in causing her []
    disability.”7 WCJ 8/11/2017 Dec. at 9, R.R. at 458a (emphasis added). WCJ Timm
    found: “Despite extensive treatment for back pain prior to April 5, 2016, Claimant
    had not been diagnosed with lumbar radiculopathy into the right leg by any of her
    physicians.” 
    Id.
     Accordingly, WCJ Timm held that Claimant’s preexisting lumbar
    5
    According to the record, Employer terminated Claimant’s employment in January 2017.
    See WCJ 7/19/2019 Dec. at 4, R.R. at 35a.
    6
    “It is well settled in Pennsylvania that an ‘aggravation of a pre[]existing condition’ is
    deemed a new injury for purposes of [WC] law[.]” S. Abington Twp. v. Workers’ Comp. Appeal
    Bd. (Becker & ITT Specialty Risk Servs.), 
    831 A.2d 175
    , 181 (Pa. Cmwlth. 2003).
    7
    WCJ Timm’s decision relied on the testimony of Claimant’s orthopedic surgeon Christian
    I. Fras, M.D., (Dr. Fras) with whom Claimant began treating in July 2016. See WCJ 8/11/2017
    Dec. at 9, R.R. at 458a; see also R.R. at 128a-150a.
    3
    degenerative disc disease and spondylosis were aggravated by Claimant’s work in
    April 2016, and her lumbar radiculopathy was a new injury that resulted therefrom.
    On June 5, 2018, Claimant underwent an independent medical
    examination (IME) with Dr. McHugh. As part of Dr. McHugh’s examination he
    reviewed Claimant’s medical records, obtained her medical history and physically
    examined Claimant. In his IME report, Dr. McHugh opined: “[Claimant] is fully
    recovered from the . . . aggravation of the pre[]existing lumbar degenerative
    disc disease, spondylosis and lumbar radiculopathy.” R.R. at 443a (emphasis
    added). Dr. McHugh, who is an orthopedic surgeon, explained: “At this point in
    time, two years removed from the aggravation[,] . . . two years of full treatment along
    with two years of not performing any activities at work[] has brought her back to her
    baseline.” R.R. at 444a. Dr. McHugh declared that no further care was necessary,
    and Claimant could return to full-duty work without restriction related to her April
    2016 work injury. See R.R. at 443a-444a.
    On June 21, 2018, Employer filed the Termination Petition,8 therein
    asserting that Claimant fully recovered from her April 8, 2016 work injury as of June
    5, 2018.    Claimant opposed the Termination Petition.            On February 8, 2019,
    Claimant filed a Petition for Penalties (Penalty Petition), wherein she alleged that
    Employer violated the WC Act (Act)9 by failing to pay her medical bills. Employer
    denied the averments in the Penalty Petition. The Petitions were assigned to WCJ
    Craig for disposition.
    WCJ Craig conducted hearings on the Petitions on June 19, July 26,
    and October 29, 2018, and February 13, 2019.10 On July 19, 2019, WCJ Craig
    granted Employer’s Termination Petition, and denied and dismissed Claimant’s
    8
    Included in the Termination Petition was a request for supersedeas, which WCJ Craig
    denied on August 17, 2018.
    9
    Act of June 2, 1915, P.L. 736, as amended, 77 P.S. §§ 1-1041.4, 2501-2710.
    10
    Claimant presented no evidence to support her Penalty Petition.
    4
    Penalty Petition.      Claimant appealed to the Board, arguing that WCJ Craig
    improperly relitigated Claimant’s work injury description and found Dr. McHugh’s
    opinion credible.
    On June 11, 2020, the Board reversed WCJ Craig’s decision, declaring
    that WCJ Craig erroneously relied on Dr. McHugh’s opinion, which failed to
    recognize Claimant’s judicially established work injury.11 The Board also modified
    WCJ Craig’s decision wherein she ruled that Employer was no longer responsible
    for paying medical expenses related to Claimant’s preexisting degenerative disc
    disease because Dr. McHugh credibly opined that Claimant had fully recovered from
    that condition. Employer appealed to this Court.12
    Employer argues that the Board erred by concluding that Dr. McHugh’s
    opinion that Claimant no longer suffered from lumbar radiculopathy was not
    competent or sufficient to support the Termination Petition. Specifically, Employer
    claims that since Dr. McHugh unequivocally testified that Claimant did not suffer
    from any radiculopathy as of the time of her June 5, 2018 IME, whether Dr. McHugh
    specifically recognized that Claimant’s judicially established April 8, 2016 work
    injury caused new radiculopathy or aggravated her preexisting radiculopathy was of
    no consequence.
    Preliminarily, Section 413(a) of the Act states, in pertinent part:
    A [WCJ] . . . may, at any time, . . . terminate . . . an award
    of . . . [a WCJ], upon petition filed by either party . . . ,
    upon proof that the disability of an injured employe has . .
    . finally ceased . . . . Such . . . termination shall be made
    11
    The Board Chairman dissented.
    12
    “[This Court’s] review determines whether there has been a violation of constitutional
    rights, whether errors of law have been committed, whether board procedures were violated, or
    whether necessary findings of fact are supported by substantial evidence.” Bryn Mawr
    Landscaping Co. v. Workers’ Comp. Appeal Bd. (Cruz-Tenorio), 
    219 A.3d 1244
    , 1252 n.5 (Pa.
    Cmwlth. 2019).
    5
    as of the date upon which it is shown that the disability of
    the injured employe has . . . finally ceased[.]
    77 P.S. § 772. “Under [WC] law, the term ‘disability’ is synonymous with loss of
    earning power.” Donahay v. Workers’ Comp. Appeal Bd. (Skills of Cent. PA, Inc.),
    
    109 A.3d 787
    , 792 (Pa. Cmwlth. 2015).
    Specifically, to succeed in a termination petition, an employer must
    prove by substantial evidence that the claimant’s work-related injury has ceased, or
    any remaining conditions are not related to her work injury. See Baumann v.
    Workers’ Comp. Appeal Bd. (Kellogg Co.), 
    147 A.3d 1283
     (Pa. Cmwlth. 2016). “An
    employer may satisfy this burden by presenting unequivocal and competent medical
    evidence of the claimant’s full recovery from her work-related injuries.”
    Westmoreland Cnty. v. Workers’ Comp. Appeal Bd. (Fuller), 
    942 A.2d 213
    , 217 (Pa.
    Cmwlth. 2008). Medical expert testimony proffered in support of a termination
    proceeding must recognize the claimant’s accepted work-related injury to be
    competent to opine that the claimant has fully recovered therefrom. See Sarmiento-
    Hernandez v. Workers’ Comp. Appeal Bd. (Ace Am. Ins. Co.), 
    179 A.3d 105
     (Pa.
    Cmwlth. 2018); see also Westmoreland Cnty.
    Finally,
    [i]t is well-settled that an employer may not re-litigate, by
    way of a petition to terminate benefits, the original
    medical diagnosis underlying a WCJ’s finding of a
    claimant’s disability as of the date of the compensation
    award. Hebden v. Workmen’s Comp[.] Appeal B[d.]
    (Bethenergy Mines, Inc.), . . . 
    632 A.2d 1302
    , 1304 ([Pa.]
    1993). To do so would violate the doctrine of collateral
    estoppel, which ‘forecloses re-litigation in a later action,
    of an issue of fact or law which was actually litigated and
    which was necessary to the original judgment.’ 
    Id.
    (quoting City of Pittsburgh v. Zoning B[d.] of Adjustment
    of [the City of] Pittsburgh, . . . 
    559 A.2d 896
    , 901 ([Pa.]
    1989)).
    6
    Inservco Ins. Servs. v. Workers’ Comp. Appeal Bd. (Purefoey), 
    902 A.2d 574
    , 578
    (Pa. Cmwlth. 2006).
    Here, Employer presented Dr. McHugh’s June 5, 2018 IME report and
    testimony in support of the Termination Petition. Dr. McHugh recalled Claimant
    informing him that she had experienced low back pain on and off for years but, in
    the spring of 2016, she had increased low back pain that radiated into her right leg
    while going up and down stairs at work. See R.R. at 405a. He testified that Claimant
    described the April 2016 symptoms as the same as she had experienced in the past,
    but to a more intense degree. See 
    id.
     Dr. McHugh described that Claimant had been
    treating with her rheumatologist monthly, and a neurosurgeon every couple of
    months, both of whom gave her injections that afforded her little relief. He stated
    that Claimant’s objective tests since 2009 reflected disc pathology and arthritic
    issues with her low back, and rheumatology records since 2015 showed
    progressively worsening joint pain. See R.R. at 409a-410a. Dr. McHugh reviewed
    Claimant’s March 2016 blood test results that were positive for an autoimmune
    issue, which her doctors felt contributed to her chronic back pain. See R.R. at 410a-
    411a. He recollected that Claimant’s June 8, 2016 lumbar MRI demonstrated
    degenerative disc protrusions and bulges. See R.R. at 411a. Dr. McHugh also
    reviewed Claimant’s physical therapy and other medical records. According to Dr.
    McHugh, an August 9, 2016 EMG conducted by her rheumatologist showed what
    the rheumatologist interpreted as right L5-S1 acute radiculopathy. See 
    id.
     Dr.
    McHugh further recalled that Claimant was considering undergoing lumbar surgery
    in 2018. See R.R. at 420a-421a, 440a.
    Dr. McHugh testified that, during his IME, Claimant complained of low
    back pain that radiated into different areas of her right leg at different times, which
    he attributed to chronic degeneration of her lumbar spine. See R.R. at 406a-407a.
    He described that Claimant exhibited limited lumbar range of motion, due to
    7
    stiffness and her obesity. See R.R. at 413a, 421a-422a. Dr. McHugh stated that
    Claimant did not exhibit a radicular component in her legs at the IME, her subjective
    complaints did not follow any specific dermatomal pathway, and she walked with a
    normal gait. See R.R. at 413a-415a.
    Based upon the IME, Dr. McHugh opined, within a reasonable degree
    of medical certainty that, in April 2016, Claimant “did have an exacerbation of
    the preexisting lumbar degenerative disc disease, the arthritis in her back and
    the lumbar radiculopathy that had pre[-]dated this but had flared up due to
    those work incidents[,]” but that, as of June 5, 2018, Claimant “was fully recovered
    from that flare[-]up and [] she needed no further care related to that work issue.”
    R.R. at 415a (emphasis added). He confirmed that the issues Claimant is currently
    having are related to the degenerative findings and autoimmune issues that pre-date
    her work injury, and her obesity. See R.R. at 417a-418a. Dr. McHugh reiterated
    that Claimant could return to work without continuing treatment or restrictions
    related to her April 2016 work injury, and he executed a physician’s affidavit of
    recovery to that effect. See R.R. at 419a, 422a, 445a-446a.
    Claimant testified that she still experiences low back pain radiating into
    her right leg and foot with tingling and muscle spasms that have improved since she
    stopped working. However, she does not feel capable of returning to her pre-injury
    job due to the walking, squatting, bending and driving it requires.
    Claimant also presented the October 19, 2016 and November 16, 2018
    testimony of orthopedic surgeon Christian I. Fras, M.D. (Dr. Fras). Dr. Fras testified
    that he first treated Claimant on July 26, 2016, and found that her condition was
    consistent with radiculopathy. He recalled that, when he saw Claimant twice in
    August 2016, her symptoms continued, and he diagnosed her with degenerative disc
    disease, spondylosis, and lumbar radiculopathy. See R.R. at 132a, 134a. Dr. Fras
    8
    related that, when Claimant’s symptoms were unchanged in October 2016, Dr. Fras
    referred her for injections to help with pain management.
    Dr. Fras stated that he treated Claimant again on February 27, 2018, at
    which time she still had low back and right leg pain complaints that physical therapy
    and injections had not alleviated. He also treated her on May 1 and July 17, 2018.
    Based on Claimant’s objective tests, medical history and physical examinations, he
    declared that his diagnosis remained the same and he discussed additional treatment
    options, including surgery. Dr. Fras concluded that Claimant continued to suffer
    from her accepted work-related injuries, and she was not capable of returning to her
    pre-injury work but, conceivably, could do a light-duty or sedentary job with
    restrictions. See R.R. at 211a-212a, 237a. Dr. Fras disagreed with Dr. McHugh’s
    opinions to the contrary. See R.R. at 213a.
    “The WCJ is the ultimate factfinder and has exclusive province over
    questions of credibility and evidentiary weight.” Univ. of Pa. v. Workers’ Comp.
    Appeal Bd. (Hicks), 
    16 A.3d 1225
    , 1229 n.8 (Pa. Cmwlth. 2011). “The WCJ,
    therefore, is free to accept or reject, in whole or in part, the testimony of any witness,
    including medical witnesses.”       Griffiths v. Workers’ Comp. Appeal Bd. (Red
    Lobster), 
    760 A.2d 72
    , 76 (Pa. Cmwlth. 2000).
    Here, based on the evidence presented, WCJ Craig found:
    While Claimant’s testimony about her pain and disability
    is not necessarily incredible, the issue of whether she is
    fully recovered from the judicially determined work injury
    of aggravation of pre[]existing lumbar degenerative disc
    disease and spondylosis, and lumbar radiculopathy and
    whether the cause of her current complaints is the work
    injury or the underlying degenerative disc disease itself is
    a medical issue.
    WCJ 7/19/2019 Dec. at 8, R.R. at 39a. Regarding the medical testimony, WCJ Craig
    made the following finding:
    9
    I have carefully reviewed the testimony of Dr. McHugh
    and Dr. Fras. While both doctors have excellent
    qualifications, I find the opinions of Dr. McHugh more
    credible than those of Dr. Fras and reject the opinions of
    Dr. Fras wherever they conflict with those of Dr. McHugh.
    Dr. McHugh’s opinions are supported by Claimant’s
    medical records and by diagnostic studies performed
    before the work injury, which document Claimant’s
    longstanding history of low back complaints and
    treatment. Dr. Fras acknowledged this history. The very
    fact that Claimant visited her rheumatologist on March 29,
    2016 (over a week before her April 8, 2016 work injury)
    for the purpose of having F[M]LA forms completed in
    order to take 12 weeks off work to have physical therapy,
    at which time Claimant ‘was very insistent that she was
    not able to work due to her pain’ and at which time she
    received a work note excusing her from work until May
    24, 2016[,] for physical therapy for chronic back pain,
    indicates how severe her pre-injury condition was.[13]
    WCJ 7/19/2019 Dec. at 8, R.R. at 39a. Thus, WCJ Craig found Dr. McHugh’s
    testimony more credible than Dr. Fras’ testimony to the contrary, and concluded that
    “Employer [] met its burden of proving that Claimant was fully recovered from her
    April 2016 work injury as of June 5, 2018.” WCJ 7/19/2019 Dec. at 9, R.R. at 40a.
    Neither the Board nor the Court may reweigh the evidence or the WCJ’s
    credibility determinations. Sell v. Workers’ Comp. Appeal Bd. (LNP Eng’g), 771
    13
    WCJ Craig clarified:
    In finding credible Dr. McHugh’s opinion that Claimant is
    fully recovered from the April 2016 aggravation of
    preexisting lumbar degenerative disc disease, spondylosis,
    and lumbar radiculopathy, it is not my intention in any way
    to ignore, minimize, or rewrite [WCJ] Timm’s previous
    determination that the work injury caused an aggravation
    of Claimant’s pre[]existing condition. Her pre-injury
    history of low back pain is referenced with regard to my
    rejection of Dr. Fras’ opinion that[,] before April 2016[,]
    Claimant’s low back pain was not severe.
    WCJ 7/19/2019 Dec. at 8 n.2, R.R. at 39a.
    
    10 A.2d 1246
     (Pa. 2001). Specifically, “Section 422(a) [of the Act, 77 P.S. § 834,] does
    not permit a party to challenge or second-guess the WCJ’s reasons for credibility
    determinations. [Thus, u]nless made arbitrarily or capriciously, a WCJ’s credibility
    determinations will be upheld on appeal.”14 Pa. Uninsured Emps. Guar. Fund v.
    Workers’ Comp. Appeal Bd. (Lyle), 
    91 A.3d 297
    , 303 (Pa. Cmwlth. 2014) (quoting
    Dorsey v. Workers’ Comp. Appeal Bd. (Crossing Constr. Co.), 
    893 A.2d 191
    , 195
    (Pa. Cmwlth. 2006) (citation omitted)).
    Furthermore, this Court has held:
    “In performing a substantial evidence analysis, this
    [C]ourt must view the evidence in a light most favorable
    to the party who prevailed before the factfinder [(i.e.,
    Employer)].” “Moreover, we are to draw all reasonable
    inferences which are deducible from the evidence in
    support of the factfinder’s decision in favor of that
    prevailing party.” It does not matter if there is evidence in
    the record supporting findings contrary to those made by
    the WCJ; the pertinent inquiry is whether the evidence
    supports the WCJ’s findings.
    3D Trucking Co., Inc. v. Workers’ Comp. Appeal Bd. (Fine & Anthony Holdings
    Int’l), 
    921 A.2d 1281
    , 1288 (Pa. Cmwlth. 2007) (citations omitted) (quoting
    Waldameer Park, Inc. v. Workers’ Comp. Appeal Bd. (Morrison), 
    819 A.2d 164
    , 168
    (Pa. Cmwlth. 2003)).
    Notwithstanding, the Board held:
    Upon thorough review, we determine that [] WCJ [Craig]
    erred in terminating Claimant’s benefits when Dr.
    McHugh failed to recognize all of Claimant’s work
    injuries, and therefore, failed to opine she recovered
    therefrom. . . . Here, former litigation established
    Claimant’s work injury as an ‘aggravation of her
    14
    Capricious disregard “occurs only when the fact-finder deliberately ignores relevant,
    competent evidence.” Williams v. Workers’ Comp. Appeal Bd. (USX Corp.-Fairless Works), 
    862 A.2d 137
    , 145 (Pa. Cmwlth. 2004). Capricious disregard, by definition, does not exist where, as
    here, WCJ Craig expressly considered and rejected the evidence. 
    Id.
    11
    pre[]existing lumbar degenerative disc disease and
    spondylosis, as well as lumbar radiculopathy.’ ([WCJ
    8/11/2017 Dec. at 9, R.R. at 458a]). Moreover, WCJ
    Timm accepted [that] the lumbar radiculopathy was a new
    finding, rather than an aggravation. However, Dr.
    McHugh testified that Claimant sustained work-related
    exacerbations of her pre[]existing lumbar degenerative
    disc disease, back arthritis, and lumbar radiculopathy, of
    which she fully recovered as of the IME. Notably, Dr.
    McHugh did not accept the entire judicially determined
    work injuries including aggravation of spondylosis or that
    the lumbar radiculopathy was a new injury, rather than a
    pre-existing one which was exacerbated. This is an
    important distinction because if Claimant had
    pre[]existing lumbar radiculopathy, her baseline would be
    different than where she had no prior lumbar
    radiculopathy. Therefore, when Dr. McHugh testified that
    Claimant was back to her baseline, he mischaracterized
    her pre-injury condition. Because [a] defendant is barred
    by res judicata from relitigating [a] claimant’s original
    diagnosis during a termination petition, [Employer] is
    barred here from asserting that Claimant never sustained
    spondylosis and sustained an aggravation of lumbar
    radiculopathy rather than a first-time injury of
    radiculopathy.    Hebden.       Likewise, Dr. McHugh’s
    testimony was insufficient to terminate Claimant’s
    benefits and we must reverse in part. . . .[FN]6
    [FN]6
    Claimant also argues that [] WCJ [Craig]
    erroneously re-litigated Claimant’s description of
    injury as determined in WCJ Timm’s decision, and
    was barred from finding a different injury existed
    by the doctrine of res judicata. While we need not
    reach this issue here where we have reversed for
    other reasons, we do not find Claimant’s argument
    persuasive.      While [Employer] failed to
    acknowledge the full judicially accepted work
    injury description, [] WCJ [Craig] throughout the
    [d]ecision consistently refers back to the original
    injury description found by WCJ Timm. In fact, []
    WCJ [Craig] specifically finds that Claimant fully
    recovered from ‘aggravation of pre[]existing
    lumbar degenerative disc disease and spondylosis,
    and lumbar radiculopathy.’ (Finding of Fact 12).
    Rather, [] WCJ [Craig] erred by accepting the
    12
    insufficient testimony of Dr. McHugh, who failed
    to recognize all of the accepted work injuries.
    Board Op. at 6-8, R.R. at 58a-60a (record citations omitted).
    This Court acknowledges that Dr. McHugh testified that Claimant
    suffered “an exacerbation of the preexisting lumbar degenerative disc disease, the
    arthritis in her back and the lumbar radiculopathy that had predated” April 2016,
    R.R. at 415a (emphasis added), and that he did not specifically use the term
    spondylosis. However, in his June 5, 2018 IME report, Dr. McHugh specifically
    declared: “[Claimant] is fully recovered from the . . . aggravation of the pre[]existing
    lumbar degenerative disc disease, spondylosis and lumbar radiculopathy.” R.R. at
    443a (emphasis added).          Moreover, medical professionals may use the terms
    spondylosis and arthritis interchangeably.15 Because Dr. McHugh clearly accepted
    Claimant’s judicially determined preexisting spondylosis in rendering his opinion,
    the Board erred by concluding otherwise.
    This Court also recognizes that Dr. McHugh appears to have considered
    Claimant’s lumbar degenerative disc disease, spondylosis and lumbar radiculopathy
    as preexisting, and he did not separately refer to Claimant’s lumbar radiculopathy as
    a new injury. See R.R. at 415a, 443a. However, Dr. McHugh ultimately opined with
    unequivocal and competent medical testimony, which WCJ Craig accepted, that
    Claimant fully recovered from all three conditions as of June 5, 2018, and any
    disability (loss of earnings) thereafter was no longer related to her work. The fact
    that Dr. McHugh construed Claimant’s lumbar radiculopathy in these circumstances
    as a preexisting rather than new work injury did not render his testimony
    incompetent.
    15
    Spondylosis has been defined as “degenerative spinal changes due to OSTEOARTHRITIS.”
    Medical          Dictionary,        The         Free          Dictionary,        https://medical-
    dictionary.thefreedictionary.com/spondylosis (last visited Apr. 21, 2021) (emphasis added).
    13
    This Court has held that “a medical expert need not [even] necessarily
    believe that a particular work injury actually occurred[;] . . . the expert’s opinion is
    competent if he assumes the presence of a previously accepted work-related injury
    and finds it to be resolved by the time of his examination.” O’Neill v. Workers’
    Comp. Appeal Bd. (News Corp. Ltd.), 
    29 A.3d 50
    , 57 (Pa. Cmwlth. 2011); see also
    Hall v. Workers’ Comp. Appeal Bd. (Am. Serv. Grp.), 
    3 A.3d 734
     (Pa. Cmwlth.
    2010); To v. Workers’ Comp. Appeal Bd. (Insaco, Inc.), 
    819 A.2d 1222
     (Pa. Cmwlth.
    2003). Here, Dr. McHugh expressly acknowledged that Claimant suffered lumbar
    radiculopathy related to her work activity in April 2016 but, based upon his review
    of Claimant’s history, voluminous medical records, and physical examination,
    concluded that, as of June 5, 2018, she had fully recovered from the judicially
    accepted injuries and her inability to return to work was not related thereto. Thus,
    Dr. McHugh’s opinion was not incompetent in this instance merely because he
    construed Claimant’s lumbar radiculopathy as preexisting rather than a new work
    injury.
    Based on the foregoing, the Board erred by reversing WCJ Craig’s
    decision on the basis that Dr. McHugh’s opinion was incompetent and insufficient
    to support Employer’s Termination Petition. Viewing the evidence in a light most
    favorable to Employer, and drawing all reasonable inferences in Employer’s favor,
    as we must, we find that substantial record evidence supported WCJ Craig’s
    findings. Accordingly, the Board’s order is reversed.
    _________________________________
    ANNE E. COVEY, Judge
    14
    IN THE COMMONWEALTH COURT OF PENNSYLVANIA
    Philadelphia Housing Authority,         :
    Petitioner            :
    :
    v.                          :
    :
    Workers’ Compensation Appeal            :
    Board (Butt),                           :   No. 633 C.D. 2020
    Respondent              :
    ORDER
    AND NOW, this 22nd day of April, 2021, the Workers’ Compensation
    Appeal Board’s June 11, 2020 order is reversed.
    _________________________________
    ANNE E. COVEY, Judge