Henson v. Belger Cartage Service

NOT DESIGNATED FOR PUBLICATION No. 129,411 IN THE COURT OF APPEALS OF THE STATE OF KANSAS GENIA HENSON, surviving spouse of ANDREW HENSON, Appellant, v. BELGER CARTAGE SERVICE, INC., Appellee. MEMORANDUM OPINION Appeal from Workers Compensation Board. Submitted without oral argument. Opinion filed October 30, 2026. Affirmed. Jan L. Fisher, of McCullough, Wareheim and LaBunker, of Topeka, for appellant. Timothy A. Emerson, of Wallace Saunders, Chartered, of Wichita, for appellee. Before COBLE, P.J., BRUNS and ISHERWOOD, JJ. PER CURIAM: In 2008, Andrew Henson suffered a chest crushing injury arising out of and in the course of his employment with Belger Cartage Service, Inc. Due to the injury, he suffered a heart attack just days later and was ultimately awarded workers compensation benefits for permanent and total disability. Thirteen years later, Henson died and his spouse filed a claim for survivors benefits under the Kansas Workers Compensation Act (the Act), K.S.A. 44-501 et seq. An administrative law judge (ALJ) entered an award denying Henson's wife any death benefits, and both parties appealed to the Kansas Workers Compensation Board 1 (Board). The Board held Henson's wife was barred from compensation because Henson's death did not occur within five years of the work injury, and she failed to prove that Henson's death was the compensable natural and probable consequence of the original work injury. Henson's wife petitioned this court for judicial review of the Board's order. After review, we affirm the Board's order denying Henson's wife survivor's benefits as discussed herein. FACTUAL AND PROCEDURAL BACKGROUND Genia and Andrew Henson married in 1979 and remained married until Andrew's death in 2021. For clarity, we will refer to the two by their first names. In 2008, Andrew was working at Belger Cartage Service (Belger) when he was crushed as a large crate slammed into him and pinned him between the crate and a printing press. As a result, Andrew suffered crush injuries to his chest, back, and internal organs. This damage included a dissection or laceration to his right coronary artery, which led to a subsequent heart attack. Andrew's work-related injury was deemed compensable and resulted in an award of permanent total disability. See Henson v. Belger Cartage Service, Inc., No. 107,026, 2012 WL 3000389, at *1 (Kan. App. 2012) (unpublished opinion). According to Genia, Andrew never returned to his pre-accident health. She testified he quit smoking after his heart attack, but he did not breathe well after his work accident, nor did he ever regain his strength. From the time of this accident in 2008 until his death in 2021, Andrew was under the care of cardiologist Dr. Hussam Farhoud. During his treatment, Dr. Farhoud diagnosed Andrew with coronary artery disease, congestive heart failure, and atrial 2 fibrillation. In 2008, Dr. Farhoud placed a pacemaker in Andrew, which was replaced in 2017. Heart conditions were not the only thing that ailed Andrew. He had diabetes, which was poorly controlled. Andrew also had bullous pemphigoid, a skin condition which caused blisters all over his body. In early 2020, Dr. Farhoud noted Andrew had venous insufficiency in his lower extremities with non-healing ulcers. Dr. Farhoud testified that Andrew's cardiac condition improved over the years he provided treatment, and that his heart function was stable with treatment. Dr. Farhoud explained that Andrew's heart ejection fraction had returned to normal after the defibrillator was placed. He further testified that Andrew had paroxysmal atrial fibrillation initially after his accident which later became permanent atrial fibrillation and venous stasis in his legs. But Dr. Farhoud did not relate Andrew's permanent atrial fibrillation and venous stasis to his work-related accident. At the last clinic visit on May 26, 2021, Dr. Farhoud found Andrew cardiac-stable: congestive heart failure controlled, ejection fraction 55 to 60 percent, defibrillator showing normal heart function, and appropriate anticoagulant therapy. On August 6, 2021, Andrew began home health care to care for his bullous pemphigoid. At that time, Andrew had numerous ongoing diagnoses, including congestive heart failure, atrial fibrillation, coronary artery disease, diverticulitis with perforation, stage-3 chronic kidney disease, bullous pemphigoid, type 2 diabetes mellitus, morbid obesity, colostomy, gout, gastro-esophageal reflux disease, hyperlipidemia, and obstructive sleep apnea. The medical records from Andrew's August 2021 home health care treatment do not indicate the care he was receiving was hospice care. Rather, Andrew was taking all his heart and diabetes medications, and the primary focus was providing skilled nursing care to help with his blistering skin condition. 3  On August 24, 2021, Andrew was hospitalized for diverticulitis that caused bowel perforation and sepsis. He had surgery to remove 90 percent of his colon, but doctors were unable to close his surgical wound, and he was diagnosed with kidney cancer. Dr. Farhoud saw Andrew during this hospitalization, explaining he was consulted because Andrew had, "atrial fibrillation with rapid ventricular response and he was hypertensive requiring inotropes to control blood pressure." Dr. Farhoud did not know if Andrew's sepsis resolved prior to his death. Eventually, Andrew was transferred to a rehabilitation center. Genia testified he was too weak to walk and had difficulty breathing. He struggled to sleep because of that difficulty in breathing and the blisters on his skin. Shortly after being transferred to the rehabilitation center, Andrew had to be admitted to the hospital because he was hypoglycemic. Genia testified that he was in the intensive care unit for a few days and while there his surgical wound from his colon surgery was closed. On September 15, 2021, Andrew began hospice care at home. Genia testified that Andrew made that decision because he could not "go anywhere" or "do anything" due to his physical condition. She said Andrew told her "he just was existing." Andrew discontinued all medical treatment except for palliative care. His condition continued to deteriorate, and on November 7, 2021, he died in their home. Dr. Farhoud testified that he did not see Andrew or consult on his case during Andrew's final hospitalization in September 2021. Dr. Farhoud did not believe that hospital stay was related to his cardiac condition, and he did not believe during that stay Andrew saw any other cardiologist. 4  Dr. Jason Hampl is a family physician who primarily practices geriatrics, and he is the medical director for the hospice provider Andrew used. Dr. Hampl was the medical certifier for Andrew's death. He testified that in certifying a hospice patient's death he relies on the condition listed first on the hospice paperwork and does not review the patient's chart or consult the visiting nurse. Andrew's certificate of death lists his cause of death as congestive heart failure and coronary artery disease. Andrew's hospice care plan listed congestive heart failure as the principal diagnosis, with atrial fibrillation, chronic kidney disease, bullous pemphigoid, type 2 diabetes, morbid obesity, and other conditions noted. One month after Andrew's death, Genia filed a claim for survivor's benefits, asserting that his death was caused by his work injury. Four months later, Genia's counsel sought Dr. Farhoud's opinion on whether Andrew's death was caused by, or a natural and probable consequence of, his 2008 work injury. Through Heartland Cardiology's CEO, Dr. Farhoud conveyed—and later signed in an April 25, 2022 statement, which he reaffirmed in July 2023—that Andrew's death was natural and "was not caused by or contributed to by his work." Dr. Farhoud testified he continued to believe Andrew's death was not caused by his work accident. His opinions were based on the medical treatment he provided to Andrew since 2008. During his deposition, when Dr. Farhoud was asked if Andrew's death was the natural and probable consequence of Andrew's 2008 work accident, he opined that Andrew's death was related to sepsis and a perforated bowel. He explained that Andrew had normal heart function at his last visit, but that the sepsis, infection, and acute illness exacerbated his heart failure and reduced his ejection fraction during the final hospitalization—that is, the bowel perforation and infection worsened the heart, not the reverse. 5  At the request of Genia's attorney, Dr. Stephen Schuman reviewed Andrew's medical records and offered his opinions regarding Andrew's overall medical condition and death. Dr. Schuman is board certified in internal medicine and cardiology. He typically does approximately one medical legal evaluation per week with upwards of three or four per week more recently. Approximately 70 percent of his medical legal work is for plaintiffs or claimants with the other 30 percent for defendants or respondents. Dr. Schuman reviewed Andrew's medical records—including the 2008 injury and heart-attack records, Dr. Farhoud's records, and the hospice records—and spoke with Genia, but of course had no opportunity to examine Andrew. Dr. Schuman set forth his findings in his report dated May 17, 2023. He testified most heart attacks involve only the left ventricle of the heart, but Andrew's 2008 heart attack was a myocardial infarction of the left ventricle with extension into the right ventricle. Dr. Schuman explained that right-ventricular involvement is more serious because the heart cannot pump blood adequately, an effect that may appear later, as with Andrew. Dr. Schuman testified Andrew's right ventricular infarction also caused his need for a pacemaker, and that his atrial fibrillation "usually reflects severe heart muscle damage, severe heart failure." Dr. Schuman testified Andrew's deep vein venous deficiency in his legs was caused by his 2008 heart attack because the right ventricle infarction and resulting right- sided heart failure causes blood not to pump properly and it backs up in the veins of the legs. Dr. Schuman explained the deep vein venous deficiency in Andrew's legs led to his development of venous stasis ulcers on his legs. In his report, Dr. Schuman concluded that Andrew's 2008 heart attack, need for a pacemaker and later a defibrillator, and heart failure were all caused by his 2008 work- 6 related injury. He opined that Andrew's heart failure weakened his ability to withstand and recover from his other illnesses, that his hospice admission and death reflected terminal heart failure, and that he died a cardiac death, in agreement with the certificate of death. Dr. Schuman concluded the "February 4, 2008, work injury caused his myocardial infarction, which included the right ventricular infarction, which caused him to develop heart failure, which worsened over the years and was the ultimate cause of his death on November 7 of 2021." Dr. Schuman opined the February 4, 2008, work-related accident was the prevailing factor causing Andrew's myocardial infarction and congestive heart failure, which was the prevailing factor causing his death. In Genia's survivor's claim, before the ALJ, Belger argued that the claim should be dismissed because it was time barred under K.S.A. 44-520a (2000 Furse). It contended that the statute requires that a written claim be filed within one year after the death of the injured employee if death results from the injury within five years after the date of such accident. On January 13, 2025, the ALJ entered an award holding that the claim was time barred under K.S.A. 44-520a (2000 Furse) (repealed 2011) because Andrew's death occurred more than five years after his work-related injury. However, the order also concluded that if the claim were not time barred then Genia was entitled to survivor's benefits because Andrew's death was the natural and probable consequence of the work- related accident. Both parties appealed the ALJ's order to the Board for review. In a divided order, three Board members affirmed the finding that the claim was time barred but disagreed that Andrew's death was caused by his work injury. Instead, the majority of the Board 7 found Dr. Farhoud's testimony more credible since he had provided Andrew significant treatment over the course of his life. The Board stated: "The Board finds Claimant's death was not the natural and probable consequence of his work-related accident. Between the work-related accident and his death, Claimant suffered multiple serious medical conditions, especially in the last year of his life. Dr. Farhoud, Claimant's cardiologist for thirteen years was the most knowledgeable about his heart condition and opined Claimant's death was not due to the work accident or his cardiac condition. As stated in Casco [v. Armour Swift-Eckrich, 283 Kan. 508, 516, 154 P.3d 494 (2007)] expert medical testimony linking the causation of the second injury to the primary injury is required. In this case, there is expert medical testimony not linking the primary injury, Claimant's heart condition to the secondary injury, his death." Two Board members dissented, concluding there is no provision in K.S.A. 44- 520a(a) (2000 Furse) barring compensability for a death that occurs after five years from the date of injury. Rather, they determined that time frames in the statute relate to the window to file a claim, not that claims are barred if they fall outside of five years. Regarding the cause of Andrew's death, the dissenting opinion offered the following one- sentence conclusion: "The undersigned Board Members also conclude the ALJ was correct in determining Claimant's death was the natural and probable, or direct and natural result, of his 2008 work-related accident, as well-explained by the ALJ ending on page 25 of her decision." Genia timely petitioned this court for judicial review of the Board's decision. Additional facts will be introduced in the analysis, as necessary. 8  ANALYSIS On petition for judicial review, Genia raises two issues with the Board's order. First, she argues that the Board erred in concluding that K.S.A. 44-520a (2000 Furse) bars a claim for survivor's benefits when the death did not occur within five years of the work-related accident. Second, she argues that the Board erred when it ruled Andrew's death was not a natural and probable result of his prior work-related accident. We address each of Genia's arguments in turn. I. The Board did not err by concluding that the claim was time-barred. First, Genia argues that the Board erred in concluding that K.S.A. 44-520a (2000 Furse) bars a claim for survivor's benefits when the death did not occur within five years of the work-related accident. She asserts that K.S.A. 44-520a (2000 Furse) concerns only the requirement of a written claim for compensation, and that it is not a statute of limitations. She also stressed that K.S.A. 44-520a (2000 Furse) is a procedural statute and so its repeal in 2011 means that it was inapplicable here. In response, Belger argues that the Board properly held that Genia's claim for benefits was time-barred because the law in effect at the time of Andrew's injury barred claims brought more than five years after the injury. Applicable Legal Principles Under K.S.A. 44-556(a), appellate review of a decision from the Board is governed by the Kansas Judicial Review Act, K.S.A. 77-601 et seq. See K.S.A. 77- 603(a). The scope of judicial review is limited by K.S.A. 77-621, and, relative to this appeal, K.S.A. 77-621(c)(4) permits a court to grant relief from the Board's determination only when it erroneously interpreted or applied the law. 9  Resolution of this argument requires us to interpret K.S.A. 44-520a (2000 Furse). Appellate courts exercise unlimited review over questions involving the interpretation or construction of a statute, extending no deference to an agency's statutory interpretation. Hanson v. Kansas Corp. Comm'n, 313 Kan. 752, 762-63, 490 P.3d 1216 (2021); see K.S.A. 77-621. The statute at issue here is K.S.A. 44-520a(a) (2000 Furse), which, at the time of Andrew's injury, provided: "(a) No proceedings for compensation shall be maintainable under the workmen's compensation act unless a written claim for compensation shall be served upon the employer by delivering such written claim to him or his duly authorized agent, or by delivering such written claim to him by registered or certified mail within two hundred (200) days after the date of the accident, or in cases where compensation payments have been suspended within two hundred (200) days after the date of the last payment of compensation; or within one (1) year after the death of the injured employee if death results from the injury within five (5) years after the date of such accident." (Emphasis added.) With this language in mind, we turn to Genia's argument. K.S.A. 44-520a (2000 Furse) was a time bar for claims. A review of pertinent authority leads us to conclude that the Board correctly held that K.S.A. 44-520a (2000 Furse) is a time bar for claims under the Act because such a holding is consistent with Kansas Supreme Court precedent. In Forcade v. List & Clark Construction Co., 172 Kan. 119, 238 P.2d 549 (1951), the worker's death occurred more than three years after the accident, and the death-benefit claim was denied under the version of K.S.A. 44-520a then in effect, which required that 10 death occur within three years of the accident. The Kansas Supreme Court held that claim was barred because the claimant's death occurred more than three years after the original accident, explaining that the 1927 amendment set a specific time beyond which an employer would not be liable, giving employers certainty that a case was fully determined. 172 Kan. at 121-23. Our Supreme Court applied the same rationale in Brooks v. Kansas Power & Light Co., 182 Kan. 177, Syl., 318 P.2d 1036 (1957), holding a claim not compensable where the worker died just over three years after the accident. See also Tapp v. Ferrell Construction Co., No. 95,004, 2006 WL 2337246, at *3 (Kan. App. 2006) (unpublished opinion) (holding K.S.A. 44-520a is a time limitation and does not violate a claimant's constitutional rights of equal protection because "legislature's objective of the stated time limitation in K.S.A. 44-520a(a) is to provide certainty to employers by providing a cut- off date for death benefits"). Genia asks us to disagree with these prior Kansas Supreme Court decisions, arguing that such an interpretation of K.S.A. 44-520a is no longer consistent with the appellate courts' view of statutory interpretation. But we must decline that invitation and instead apply the Kansas Supreme Court's prior interpretation of K.S.A. 44-520a as a time limitation of the compensability of claims under the Act. See State v. Patton, 315 Kan. 1, 16, 503 P.3d 1022 (2022) (holding the Kansas Court of Appeals is duty bound to follow Kansas Supreme Court precedent unless there is some indication that the Supreme Court is departing from its previous position). So, K.S.A. 44-520a (2000 Furse) applies here, under which any death that was caused by a claimant's work-related injury was compensable for the five years following the injury. Here, assuming that Andrew's death was caused by his work injury that occurred on February 4, 2008 (an assumption we will refute in Issue II of this opinion), then Genia had until February 4, 2013, to have a compensable claim for Andrew's death. 11 But here, Andrew died on November 7, 2021, nearly 14 years after his work injury. This claim falls outside of K.S.A. 44-520a's time limits. Under K.S.A. 44-535, K.S.A. 44-520a (2000 Furse) is applicable to Genia's claim, so the claim is time barred. Genia attempts to avoid this result by arguing that K.S.A. 44-520a (2000 Furse) is procedural in nature, and so its repeal in 2011 means that it is not applicable to her. See K.S.A. 44-520a. L. 2011, ch. 55, § 29. We disagree. "In workers compensation cases, the law in effect at the time of the injury governs the rights and obligations of the parties." Osborn v. Electric Corp. of Kansas City, 23 Kan. App. 2d 868, 874, 936 P.2d 297 (1997) (citing Lyon v. Wilson, 201 Kan. 768, 774, 443 P.2d 314 [1968]; Johnson v. Warren, 192 Kan. 310, Syl. ¶ 2, 387 P.2d 213 [1963]). Genia argues that only her substantive rights are determined by the laws in effect at the time of the injuries. We agree that is true. See Welty v. U.S.D. No. 259, 48 Kan. App. 2d 797, 801-02, 302 P.3d 1080 (2012) (holding substantive rights of a workers compensation claimant are determined by the laws in effect at the time of the injuries). And typically, "[a] statute of limitations is a procedural bar to the right to pursue a remedy for an accrued cause of action after a period of time." Oxy USA, Inc. v. Red Wing Oil, 51 Kan. App. 2d 1028, 1034, 360 P.3d 457 (2015) (citing Harding v. K.C. Wall Products, Inc., 250 Kan. 655, 668, 831 P.2d 958 [1992]). However, the Act is complete and exclusive, containing many of its own rules. Jones v. Continental Can Co., 260 Kan. 547, 557, 920 P.2d 939 (1996); see, e.g., K.S.A. 44-506. The Act "is complete and exclusive within itself in establishing procedures covering every phase of the right to compensation, and such procedures are not subject to supplementation by rules borrowed from the Code of Civil Procedure." Crow v. City of Wichita, 222 Kan. 322, 332, 566 P.2d 1 (1977). 12  Within the Act, there is a statute that specifically fixes the law of compensation applicable to any claimants—K.S.A. 44-535. At the time of Andrew's injury, K.S.A. 44- 535 provided: "The right to compensation shall be deemed in every case, including cases where death results from the injury, to have accrued to the injured workman or his dependents or legal representatives at the time of the accident, and the time limit in which to commence proceedings for compensation therefor shall run as against him, his legal representatives and dependents from the date of the accident." Under the plain language of this statute, an individual's right to compensation under the Act, including the time limit under which to bring a claim, is set at the date of the accident. So, here, that date is February 4, 2008. And, as analyzed above, on that date, K.S.A. 44-520a (2000 Furse) operated as a time bar for compensation of any claims more than five years after the injured worker's death. Accordingly, the Board correctly held that Genia's claim for death benefits was time-barred. Because her claim was untimely, we need not continue our analysis. However, in the interest of completeness, we opt to address the merits of Genia's claim. II. The Board did not err when it ruled Andrew's death was not a natural and probable result of his prior work-related injury. Second, Genia argues that the Board erred when it ruled Andrew's death was not a natural and probable result of his prior work-related accident. She asserts that the Board should have decided the same as the ALJ and concluded that Andrew's death naturally flowed from his work injury. She argues that Dr. Farhoud's testimony was unreliable and there was no medical testimony from any medical provider that any of the several other medical conditions mentioned by the Board led to Andrew's death. Instead, she claims his death was a direct result of his work injury approximately 13 years prior. 13  In response, Belger argues that the Board correctly determined that Andrew's death was not a natural and probable consequence of the workplace injury and that its determination is supported by substantial competent evidence. Specifically, Belger argues that Dr. Farhoud treated Andrew for more than 13 years for cardiac conditions related to his work injury and for others not related to his injury. Given this personal treatment, Belger argues that Dr. Farhoud's testimony was the most credible and that it was Andrew's multitude of other health problems that led to his death, not his prior work injury. Standard of Review and Guiding Principles As in Issue I, appellate review is governed by the Kansas Judicial Review Act. Relief from the Board's factual findings is available only under K.S.A. 77-621(c)(7) and (d)—where a finding is not supported by substantial evidence viewed in light of the record as a whole. See Herrera-Gallegos v. H. & H Delivery Service, Inc., 42 Kan. App. 2d 360, 362-63, 212 P.3d 239 (2009). Summarized, the scope of judicial review under K.S.A. 77-621(c)(7) and (d) requires an appellate court to examine, without reweighing, whether evidence supporting a decision has been so undermined by other evidence that it is insufficient to support the Board's conclusion. Olds-Carter v. Lakeshore Farms, Inc., 45 Kan. App. 2d 390, 395, 250 P.3d 825 (2011). While the Board is authorized to make different credibility determinations than those made by the ALJ, the Board is required to give its reasons for disagreeing with the ALJ to aid appellate review. Kotnour v. City of Overland Park, 43 Kan. App. 2d 833, 837, 233 P.3d 299 (2010). 14  The Board's findings were supported by substantial competent evidence. For the worsening of a prior injury or death to be compensable post-award under the Act, it must be a natural and probable result of the previous work injury. As fully stated by the Kansas Supreme Court: "When a primary injury under the Workmen's Compensation Act is shown to have arisen out of the course of employment every natural consequence that flows from the injury, including a new and distinct injury, is compensable if it is a direct and natural result of a primary injury." Jackson v. Stevens Well Service, 208 Kan. 637, Syl. ¶ 1, 493 P.2d 264 (1972). This rule is "not intended to apply to a new and separate accidental injury" and applies "to a situation where a claimant's disability gradually increased from a primary accidental injury." Stockman v. Goodvear Tire & Rubber Co., 211 Kan. 260, 263, 505 P.2d 697 (1973). "Whether an injury is a natural and probable result of previous injuries is generally a fact question." Logsdon v. Boeing Co., 35 Kan. App. 2d 79, 82, 128 P.3d 430 (2006). As Logsdon explained, 35 Kan. App. 2d at 83, "our courts have struggled to understand and consistently apply the rule." Kansas courts have allowed compensability where a subsequent injury is a direct and natural consequence of the primary injury, but have denied it where the subsequent injury resulted from a new and separate intervening accident. 35 Kan. App. 2d at 83-84. The panel explained that "[t]he more straightforward situations are those where a primary injury itself causes subsequent further injury to the same or other body parts; in these cases there is usually no 'intervening' trauma or accident and the subsequent claim is allowed." 35 Kan. App. 2d at 83. But the more difficult cases arise "where some 15 intervening accident or trauma has aggravated a prior injury." 35 Kan. App. 2d at 83. The case at hand is one of those more difficult cases. It is undisputed that Andrew struggled with cardiac issues until his death. The question is whether his work injury, which caused his first heart attack, led to his death 13 years later. As is often the case in workers compensation disputes, here, there were conflicting experts on either side of the litigation. Dr. Farhoud treated Andrew from the time of his first heart attack until his death. The Board concluded that Dr. Farhoud's testimony was more credible because he was in a unique position to determine whether the death was caused or contributed to by Andrew's 2008 work injury. Even Genia seemed to agree to Dr. Farhoud's distinct position in assessing her husband's cause of death. In the letter Genia sent to Dr. Farhoud after Andrew's death, it stated, "Since you treated Andrew for 13 years, you are in a unique position to determine whether Andrew's death was a result of—or contributed to by—his work-related heart condition." Dr. Farhoud treated Andrew from February 13, 2008, to his final visit on May 26, 2021. At the outset of that treatment, Dr. Farhoud noted several cardiac-related risk factors for Andrew, including smoking, being over 45 years old, and obesity. Specifically, the Board found that Andrew received extensive cardiac treatment from Dr. Farhoud from his 2008 heart attack until his death, but that in the last year of his life he developed multiple serious intervening conditions—diverticulitis requiring removal of 90 percent of his colon, kidney cancer, and sepsis—that resulted in his death. The majority of the Board found the 2008 injury not sufficiently linked to Andrew's death given those intervening conditions, crediting Dr. Farhoud—who personally treated Andrew, as opposed to performing a single records review—that the sepsis and bowel perforation were the ultimate cause of death and were not caused by the work injury. It concluded that Andrew's death did not arise out of and in the course of his employment. 16  On review of the Board's decision, we conclude that there was sufficient evidence to support the Board's conclusions. Throughout his assessment of the case, Dr. Farhoud maintained that Andrew's heart had improved after the accident, but then other conditions began to impact his cardiac function. The disconnect here is that while there is testimony that Andrew's heart failure led to his death, there were significant other comorbidities that worsened Andrew's cardiac function. Genia does not point us to any testimony that Andrew's perforated bowel, diabetes, kidney disease, bullous pemphigoid, and kidney cancer were directly linked to Andrew's work injury 13 years prior. Instead, the physician who treated him testified that his work injury was not his cause of death. Although his death certificate lists the cause of death as congestive heart failure and coronary artery disease, had his heart been the only medical issue he faced a conclusion that the 2008 injury caused his death might be supported by substantial competent evidence. But the record as a whole shows that Andrew was suffering from many other ailments that contributed to his death. The Board's credibility decision to rely on the testimony of Andrew's cardiologist, who had treated him for 13 years, over Dr. Schuman's testimony—who only reviewed Andrew's medical file and was hired by Genia—was not erroneous. A careful review of all the evidence in the record reveals that there was no evidence that sufficiently undermined the Board's conclusion. Olds-Carter, 45 Kan. App. 2d at 395. While there was certainly opposing evidence, the Board sufficiently explained why they credited some evidence over others, and this court may not reweigh evidence, make credibility determinations, or engage in de novo review. See K.S.A. 77-621(d). 17  Accordingly, we conclude that the Board did not err in finding that Andrew's death was not a natural and probable result of the work-related injury. Affirmed. 18