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Bob Evans Restaurant v. Workers' Compensation Appeal Board11/1/2005
. Stein's opinions are consistent with earlier diagnoses by other doctors.
Employer, however, points out several inconsistencies between the various statements of the many doctors in this case. As discussed above, in determining whether a medical opinion is unequivocal, the medical evidence must be viewed as a whole and a final decision should not depend on isolated expressions or words taken out of context. Martin. "Not every utterance coming from a medical witness on a medical subject matter must be certain, positive, and without any reservation." 783 A.2d at 389.
To reiterate, as we noted in Martin and ARMCO, medical evidence is unequivocal if the expert witness, after providing a foundation, states that in his or her medical opinion, he or she thinks that the facts exist. Based on our review of Dr. Hawthorne's and Dr. Stein's reports, we reject Employer's contention that Dr. Stein's conclusion that Claimant has a work-related cognitive disorder lacks a proper foundation and is not supported by the record. Both Dr. Hawthorne and Dr. Stein examined Claimant and performed neuropsychological tests on her. Both doctors opined that Claimant has a cognitive disorder related to her July 17, 1998 fall. As a result, we conclude that the reports of Dr. Hawthorne and Dr. Stein provide competent medical evidence in support of the WCJ's findings that Claimant has a cognitive disorder related to post-concussive syndrome resulting from her July 17, 1998 fall at work. Id.
III.
Employer's third argument is essentially that the WCJ's evaluation of the medical evidence in the present case is arbitrary and capricious and thus the WCJ's decision does not meet the "reasoned decision" requirements of Section 422(a) of the Act, 77 P.S. ยง834. Specifically, Employer asserts that the WCJ's explanation for disregarding Dr. Beutler's opinion that Claimant's fibromyalgia was not work-related, i.e., that Dr. Beutler's practice is exclusively limited to spinal surgery and therefore that fibromyalgia and post-concussive syndrome are outside of the doctor's area of expertise, runs afoul of Section 422(a). Employer also contends that the WCJ's explanation for his rejection of Dr. Silvaggio's opinion that trauma does not cause fibromyalgia, i.e., that Dr. Silvaggio never examined Claimant but nevertheless opined that Claimant had fully recovered, is irrational, in view of Dr. Silvaggio's comprehensive review of the medical evidence in this case.
In Kasper, we reaffirmed that a WCJ's credibility findings and determinations as to the weight to be accorded to the evidence are binding on appeal unless they are arbitrary and capricious. Like the claimant in Kasper, Employer in the present case invites this Court to second-guess the WCJ's reasons for his determinations as to credibility and weight of the evidence. However, as we noted in Kasper, we do not interpret the "reasoned decision" requirement in Section 422(a) of the Act as a license to second-guess or individually scrutinize the WCJ's reasons for his credibility determinations.
In his deposition, Dr. Beutler stated that at the present, his practice is limited exclusively to spinal surgery. Dr. Beutler's Deposition at 4; R.R. 362a. We do not interpret Finding of Fact 30 as a statement that Dr. Beutler was not competent to render an opinion as to Claimant's fibromyalgia or post-concussion syndrome. Rather, the WCJ stated that he did not assign any weight to Dr. Beutler's opinion because his primary area of expertise is spinal surgery. In Finding of Fact 43, the WCJ also noted that he rejected Dr. Beutler's opinion on the ground that it differed too much from the larger body of evidence provided by the doctors who have treat
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