This appeal arises pursuant to the Texas Workers’ Compensation Act, TEX. LAB. CODE ANN. § 401.001 et seq. (1989 Act). A contested case hearing was held on May 26, 1999. With respect to the issue before her, the hearing officer determined that appellant’s (claimant) compensable injury of ________, does not extend to an acute tear of the anterior cruciate ligament (ACL) or tears of the medial and lateral menisci. In his appeal, the claimant essentially argues that the extent-of-injury determination is against the great weight of the evidence. In its response, the respondent (self-insured) urges affirmance.
DECISION
Affirmed.
The parties stipulated that the claimant sustained a compensable injury, a sprain of his left knee, on ________, in the course and scope of his employment as a stocker for (employer). The claimant testified that his initial treatment for his injury was with Dr. G at the emergency room. Dr. G told the claimant that he had a possible meniscal tear and referred him to Dr. H, an orthopedic surgeon. The claimant had his first appointment with Dr. H on June 10, 1998. In progress notes of that date, Dr. H states:
I think further conservative measures and observations are necessary in this patient. I am not impressed that he has a meniscal tear. His ligament structures are all stable.
Dr. H’s July 1, 1998, progress notes state that the claimant’s condition is improving with conservative care, that he has full flexion and extension, and that his medial and collateral ligaments “have definite endpoint and are stable.” On July 29, 1998, Dr. H noted that the claimant is having less discomfort; that he is “not aware of any locking or giving out sensations”; that he has full flexion and extension; that his ligament structures anteriorly, posteriorly, medially and laterally are stable; and that “[c]repitus is not appreciated in the patellofemoral joint or the medial lateral condyle.” Dr. H’s September 9, 1998, progress notes indicate that the claimant’s examination “is completely within normal limits.”
The claimant testified that on (alleged date of injury), he was at church throwing a football with a child. He stated that the child threw the ball over his head, that he jumped up to catch it, and that when he landed “his knee went out.” He returned to Dr. H, who ordered an MRI, which revealed a tear of the posterior horn of both the medial and lateral menisci and an acute ACL tear. On December 29, 1998, Dr. H performed surgery on the claimant’s left knee. In a March 15, 1999, letter to the Texas Workers’ Compensation Commission, Dr. H stated, as follows:
On November 4th, while the patient was involved in more rigorous activity, his left knee gave out on him. He was aware of some instability and discomfort similar to what he had experienced earlier that year. Indeed, an MRI was performed at this time, which should [sic] both a tear of his medial and lateral meniscus, but also an acute rupture of his [ACL]. The pathophysiology and the mechanism of injury that has been described in [claimant’s] case is consistent with that kind of complex injury. That is, a patient will tear a meniscus, which leads to further instability and puts additional stress on the [ACL], and then with more rigorous activity, more extensive damage will occur.
It is my impression, and within reasonable medical probability, this is indeed what happened in [claimant’s] case.
His left knee, which was in a predisposed and weakened condition from an injury which occurred on the 22nd of May, when stressed, gave out in such a way as to permit [claimant] to sustain a more serious injury to the internal structures of his knee.
The self-insured retained Dr. M to conduct a records review. In his report of April 26, 1999, Dr. M states:
Therefore, based on reasonable medical probability, there was no evidence of any significant internal derangement or evidence of any significant meniscal pathology from his injury of ________.
On (alleged date of injury), the claimant sustained an injury while playing baseball [sic], resulting in a tear of the [ACL], and evidence of a tear of the medial and lateral meniscus. Based on reasonable medical probability, this event occurred as an isolated event from the injury at that time, and there would be no evidence to support the claim that a pre-existing condition predisposed [claimant] to a significant injury while playing baseball. Therefore, based on reasonable medical probability, I would again feel that all of the pathology found on the MRI most likely occurred from the baseball accident and not from the work-related injury of ________.
The claimant contends that the hearing officer erred in determining that the compensable injury did not extend to the acute ACL tear and the tears of the lateral and medial menisci. The claimant had the burden to prove the nature and extent of his compensable injury. Johnson v. Employers Reinsurance Corp., 351 S.W.2d 936 (Tex. Civ. App.-Texarkana 1961, no writ). The hearing officer is the sole judge of the weight, credibility, relevance, and materiality of the evidence. Section 410.165(a). As the fact finder, it is the hearing officer’s responsibility to resolve the conflicts and inconsistencies in the evidence and to determine what facts have been established. We will reverse the hearing officer’s extent-of-injury determination only if it is so against the great weight and preponderance of the evidence as to be clearly wrong or manifestly unjust. Pool v. Ford Motor Co., 715 S.W.2d 629, 635 (Tex. 1986); Cain v. Bain, 709 S.W.2d 175, 176 (Tex. 1986).
The hearing officer determined that the claimant did not sustain his burden of proving a causal connection between his compensable injury and the ACL tear or the lateral and medial meniscal tears. It is apparent from a review of the hearing officer’s decision that she simply was not persuaded by the claimant’s evidence that the ________, work-related injury weakened the claimant’s knee and predisposed him to the more significant injury he sustained while throwing a football with a child at church. The hearing officer was acting within her province as the fact finder in rejecting Dr. H’s opinion to that effect and in giving more weight to the opinion of Dr. M, who attributed the claimant’s injury to the incident at church and rejected the theory advanced by Dr. H as not being supported by the claimant’s medical records, which demonstrated that the claimant enjoyed a nearly complete recovery from the May 22nd compensable left knee injury. The claimant argues that the hearing officer should have given more weight to Dr. H’s opinion rather than to Dr. M’s opinion because Dr. M conducted a records review only and did not examine him. The decision of how much weight to give to the respective opinions of Drs. H and M was a matter left to the discretion of the hearing officer as the fact finder. She could have discounted Dr. M’s opinion because he did not examine the claimant; however, she was not required to do so. The hearing officer resolved the conflicts and inconsistencies in the evidence against the claimant. Nothing in our review of the record demonstrates that the hearing officer’s determination that the compensable injury did not extend to an ACL tear and the lateral and medial meniscal tears is so against the great weight of the evidence as to be clearly wrong or manifestly unjust; therefore, no sound basis exists for us to reverse that determination on appeal. Pool; Cain.
The claimant asks that we remand and reopen the record to permit him to submit medical evidence from two other left knee injuries he allegedly sustained while working for the employer prior to his ________, compensable injury. He argues that such evidence would more clearly demonstrate the weakened condition of his left knee and his predisposition for left knee injuries. The claimant had an obligation to present whatever evidence he considered was relevant to his case at the hearing. We will not provide him another opportunity to prove his case, particularly, where, as here, the evidence was known to the claimant at the time of the hearing and was not offered.
The hearing officer’s decision and order are affirmed.
Elaine M. Chaney – Appeals Judge
CONCUR:
Gary L. Kilgore – Appeals Judge
Tommy W. Lueders – Appeals Judge