Bob Evans Restaurant v. Workers' Compensation Appeal Board11/1/2005
s fully reviewable by the Court. Patterson-Kelly Co. v. Workmen's Compensation Appeal Bd. (Woodrow), 586 A.2d 1043 (Pa. Cmwlth. 1991). In reaching a determination as to equivocality, the record must be viewed as a whole and a final decision should not depend upon isolated expressions or a few words taken out of context. Martin v. Workers' Compensation Appeal Bd. (Red Rose Transit Auth.), 783 A.2d 384 (Pa. Cmwlth. 2001), appeal denied, 568 Pa. 710, 796 A.2d 988 (2002). "Medical evidence is unequivocal if the medical expert, after providing a foundation, testifies that in his medical opinion he believes or he thinks the facts exist." ARMCO, Inc. v. Workmen's Compensation Appeal Bd. (Carrodus), 590 A.2d 827, 829 (Pa. Cmwlth. 1991).Any reservations as to medical details do not affect the admissibility of a medical opinion so long as the expert does not recant the opinion or the belief expressed. Id. However, medical testimony that is less than positive may not constitute legally competent evidence. Lewis v. Commonwealth, 508 Pa. 360, 498 A.2d 800 (1985).
II(a).
With regard to Claimant's fibromyalgia, Dr. Jeffrey Morrison, a family practitioner who treated Claimant from November 9, 2000 through February 1, 2001, stated that Clamant suffers from post-concussive syndrome and subsequent fibromyalgia that is related to her July 17, 1998 work injury. F.F. 28; Dr. Morrison's February 1, 2001 Report; R.R. 606a. Dr. Morrison stated in his report that Claimant has constant pain in her neck, skull, shoulders, lower back and middle back which is consistent with post-concussive syndrome. Id.
In addition, Dr. Stuart Hartman, a physiatrist who examined Claimant on July 10, 2002, stated that after examining Claimant, reviewing her medical records and obtaining a history from her, he felt that Claimant fit the criteria for fibromyalgia. F.F. 33; Dr. Hartman's July 10, 2002 Report at 2; R.R. 627a. Noting that Claimant had no problems prior to her July 17, 1998 fall, but that she has had generalized pain thereafter, Dr. Hartman opined within a reasonable degree of medical certainty that Claimant has post-traumatic fibromyalgia. Id. at 2-3; R.R. 627a-628a.
In Finding of Fact 44, the WCJ stated:
I recognize, as does Dr. Hartman, that there is disagreement in the medical community concerning whether fibromyalgia is caused by trauma. Nevertheless, even if trauma might not be an initiating cause of fibromyalgia, it is plausible that where the disease may be already present, albeit, asymptomatic, it can be aggravated by trauma. Therefore, I find Dr. Hartman's opinion that there is a post-traumatic component to Claimant's fibromyalgia to be credible and persuasive.
WCJ's Decision at 8; R.R. 671a.
We believe that Dr. Hartman's opinion, when viewed in its entirety, constitutes unequivocal medical evidence in support of the WCJ's finding that Claimant suffers from post-traumatic fibromyalgia. As we recognized in Martin and ARMCO, for an opinion to be unequivocal, the medical expert must provide a foundation for his opinion and state that he believes that the facts exist. Here, Dr. Hartman provided an adequate foundation for his opinion and stated within a reasonable degree of medical certainty that Claimant was suffering from post-traumatic fibromyalgia syndrome.
In opposition to Claimant's position that she suffers from post-traumatic fibromyalgia as a result of her work injury, Employer presented medical evidence from Dr. Beutler, a neurosurgeon, and Dr. Teresa Silvaggio, a specialist in occupational medicine, indicating that the record in this case does not support a finding of post-traumatic fibromyalgia related to Claimant's July 1998 work
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