JOHN F. FISCHER, Judge.
T1 Claimant Mitch Howard seeks review of a Workers' Compensation Court three-
judge panel order that affirmed the trial court's order denying his request for medical treatment to his left shoulder. Based on our review of the record on appeal and applicable law, we vacate the order appealed and remand the case for further proceedings consistent with this Opinion.
BACKGROUND
2 Claimant worked as a utility driver for Employer ACI Distribution South. He sustained a work-related injury on July 21, 2004, when, while working with a trainee to load an 8' x 10' piece of glass onto a truck, he attempted to keep the glass from dropping and breaking after the trainee lost his grip. Claimant continued to work for Employer until August 2004, approximately two or three weeks after his accident. He then went to work for City Hass Company, where he drove a truck and performed "light installation" that included lifting up to forty pounds. Claimant filed his Form 8 on September 1, 2004, alleging that he had sustained injury to his neck, back, shoulders and "the whole left side of his body" as a result of his July 21, 2004 injury. Employer admitted that Claimant sustained injury to his neck and back but denied the remaining alleged injuries. This appeal only concerns Claimant's shoulder injury claim.
T3 On March 21, 2005, the trial court appointed Dr. Thomas as an independent medical examiner (IME) to evaluate Claimant and provide his opinion regarding (1) whether Claimant was temporarily totally disabled as a result of injury to his neck, left shoulder, low back and middle back; (2) whether Claimant had reached maximum medical improvement (MMI) or was in need of additional medical treatment; and (8) the recommended treatment, if any. Dr. Thomas provided his opinion and was subsequently deposed. It was the opinion of Dr. Thomas that Claimant suffered from "cervical degenerative disk disease with cervical and left shoulder pain" but was not temporarily totally disabled. Dr. Thomas found that Claimant sustained "an acute injury in [ste ] top of chronic degeneration of his cervical spine creating aggravation in not only the posterior neck, but into the left shoulder." He recommended "therapeutic epidural steroid injection into the C-6 interspace of the cervical spine" followed by a course of physical therapy. This diagnosis was based on Dr. Thomas's determination that Claimant's "main complaint" was his cervical spine and that his left shoulder complaints and "intrascapular pain" were "most likely generated from his cervical spine."
T4 On March 8, 2006, the trial court appointed Dr. Bradford Boone as IME to provide his opinion on the causation of Claimant's left shoulder complaints, to refer Claimant for additional testing if necessary, and to determine whether Claimant was in need of additional medical treatment for his left shoulder. After he provided his written report, Dr. Boone was also deposed by the parties. Dr. Boone testified:
I think [Claimant is] nonphysiologic and a lot of his complaints don't make any sense. I think he does have a shoulder problem, it's more degenerative in nature. He's got a little bone spur osteophyte on the under-surface of his AC joint, which is why his shoulder is sore, but it's hard to relate that to his work seenario.
Further, Dr. Boone stated that "most im-pingements are not traumatic in nature and are degenerative and age-related." However, Dr. Boone acknowledged that Claimant's shoulder "needs to be worked up further," to be certain that his shoulder injury was not work related. Nonetheless, Dr. Boone did not refer Claimant for further medical testing and evaluation.
T5 Claimant filed a Form 9 seeking authorization for medical treatment in the form of diagnostic testing for his left shoulder and referral to an orthopedic surgeon. The matter was set for trial on March 5, 2007. At the trial, Claimant testified that he first
sought treatment for his injuries on July 27, 2004, six days after his accident. His initial treatment records admitted as history indicate a diagnosis of lumbar strain but also note that he complained of pain running from the lumbar area into the left shoulder and neck. Claimant also testified regarding an August 2001 work-related injury to his left shoulder, neck and back before being employed by ACI, but stated that he had recovered from that injury. In addition to the medical evidence from IMEs Thomas and Boone, the trial court also admitted conflicting medical reports from Claimant's expert Dr. Hastings and Employer's expert Dr. Hallford.
16 On March 8, 2007, after both parties rested and the trial was concluded, the trial court entered the following order:
THAT on or about JULY 21, 2004, claimant was employed by [ACI Distributing] and such employment was subject to and covered by the provisions of the Workers' Compensation Act of the State of Oklahoma; and on said date claimant sustained accidental personal injury to the NECK, LEFT SHOULDER, and BACK arising out of and in the course of claimant's employment.
In this order, the trial court also directed Employer to furnish Claimant with an independent medical examination of his left shoulder with Dr. Dukes. The trial court reserved Claimant's request for additional medical treatment for future hearing.
T7 The trial court entered a separate order on March 12, 2007, appointing Dr. Dukes as an IME and directing him to provide his opinion regarding the causation of Claimant's left shoulder complaints and whether they were work related. The trial court also requested Dr. Dukes, if he found the complaints to be work related, to determine whether Claimant was in need of additional medical treatment to his left shoulder and to make specific recommendations regarding any treatment.
[8 IME Dr. Dukes examined Claimant on May 3, 2007, and determined that his shoulder had been injured, and that Claimant's symptoms were probably the result of a "lifting-type injury ... consistent with a work injury." He advised the trial court that he was unable to state an opinion regarding Claimant's need for additional medical treatment without further diagnostic treatment, specifically an MRI arthrogram. Dr. Dukes re-examined Claimant following the MRI and stated that in his opinion Claimant "has a left shoulder rotator cuff tendinitis and acromio-clavicular [AC] joint arthropathy," requiring treatment in the form of "a left shoulder arthroscopy with subacromial decompression and distal clavical excision."
[ 9 At a hearing on October 1, 2007, Claimant requested authorization for surgery to his left shoulder by Dr. Dukes and TTD from the date of surgery. Employer denied any need for shoulder treatment related to Claimant's on-the-job injury and argued that his shoulder complaints were the result of pre-existing condition, i.e., the 2001 injury, and intervening injury resulting from age-related degeneration and Claimant's three years of subsequent employment after leaving ACI. The only evidence introduced at the October hearing in addition to that contained in the record of the March 2007 trial was (1) The report of Claimant's expert Dr. Hastings dated June 2007, wherein he again concluded that the work-related incident on July 21, 2004, was the major cause of Claimant's shoulder injury and that Claimant needed further evaluation and medical treatment, including the surgery recommended by Dr. Dukes; (2) the two reports from IME Dr. Dukes previously discussed, and, (8) the deposition of Dr. Dukes. In his deposition, Dr. Dukes confirmed the findings of injury stated in his post MRI report, testified that the injury was consistent with the work-related injury described by Claimant, and, stated his medical opinion that this July 21, 2004, injury accounted for at least part of Claimant's current shoulder complaints. The trial court advised the parties that it would consider the new evidence as well as the record made at the March 2007 trial.
{10 On October 4, 2007, the trial court entered a one-page order denying Claimant's request for surgery to his left shoulder by Dr. Dukes. Paragraph one of the order, the only substantive paragraph, states:
THAT claimant's request for surgery to his LEFT SHOULDER with Dr. Dukes is denied as it is not as a result of claimant's JULY 21, 2004 injury.
Claimant appealed to a three-judge panel, which affirmed the trial court's order without modification, after finding it to be neither contrary to law nor against the clear weight of the evidence. Claimant now seeks review in this Court.
STANDARD OF REVIEW
T11 Issues of causation and need regarding requested medical treatment are questions of fact for the Workers' Compensation Court. Berg v. Parker Drilling Co., 2004 OK 72, ¶¶ 12-13, 98 P.3d 1099, 1101. On review, this Court must sustain an order of the Workers' Compensation Court if it is supported by any competent evidence. Id. at ¶ 13, 98 P.3d at 1099. See also Parks v. Norman Mun. Hosp., 1984 OK 58, ¶ 12, 684 P.2d 548, 552 (holding that "[all findings of fact made in the trial tribunal's decision under review are conclusive and binding unless they have been ascertained to lack support in competent evidence."). Appellate review of the Workers' Compensation Court's legal rulings is de novo. Conaghan v. Riverfield Country Day Sch., 2007 OK 60, ¶ 7, 163 P.3d 557, 560 ("review of the workers' compensation court's legal rulings is plenary, independent and non-deferential").
ANALYSIS
[4] "12 The dispositive issues in this appeal concern the legal rulings by the trial court on Claimant's objections to Employer's expert medical evidence. Absent a more specific statute or rule, the Oklahoma Evidence Code applies to proceedings in the Workers' Compensation Court. Scruggs v. Edwards, 2007 OK 6, ¶ 14, 154 P.3d 1257, 1263. The Evidence Code was "intended as a complete code on the admissibility of evidence." 2 L. Whinery, Oklahoma Evidence, Commentary on the Law of Evidence, § 2.12, 31 (1994). The fundamental principle on admissibility is set out in section 2402 of the Code: "All relevant evidence is admissible. ... Evidence which is not relevant is not admissible." 12 O.S.2001 § 2402.
{13 Article VI of the Evidence Code defines which witnesses are competent to testify regarding relevant evidence: "Every person is competent to be a witness except as otherwise provided in this Code." 12 O.S.2001 § 2601. In this case, we consider evidence from a class of witnesses who are qualified as experts by "knowledge, skill, experience, training or education" to testify as to their opinions regarding a fact in issue. 12 O.S.2001 § 2702.
{ 14 The evaluation of expert opinion evidence involves four considerations. First, is the witness "qualified as an expert by knowledge, skill, experience, training or education." 12 0.8.2001 § 2702. Second, will the expert's opinion "assist the trier of fact to understand the evidence or determine a fact in issue," that is, is it relevant. Id. Third, even if relevant, should the expert's opinion be excluded on "hearsay or other legal grounds." Scruggs 2007 OK 6 at ¶ 15, 154 P.3d at 1263. Fourth, does the expert's opinion pass the test announced in Daubert v. Merrell Dow Pharms, Inc., 509 U.S. 579, 592, 118 S.Ct. 2786, 2796, 125 L.Ed.2d 469 (1993), the purpose of which is to determine "whether the reasoning or methodology underlying the testimony is valid and whether that reasoning or methodology properly can be applied to the facts in issue." Scruggs, 2007 OK 6 at ¶ 11, 154 P.3d at 1262.
115 The Daubert Court abandoned the "general acceptance" test announced in Frye v. United States, 54 App. D.C. 46, 293 F. 1013, 1014 (1923), and previously used in the federal courts for 70 years to evaluate the admissibility of scientific evidence.
In its place, the Supreme Court developed a four-pronged but flexible test to determine "the scientific validity and thus the evidentiary relevance and reliability-of the principles that underlie a proposed submission ... The focus, of course, must be solely on principles and methodology, not on the conclusions that they generate."
Daubert, 509 U.S. at 595, 118 S.Ct. at 2797, 125 L.Ed.2d 469.
€16 Once properly admitted, expert witnesses can have different opinions with varying degrees of persuasive effect. Conaghan, 2007 OK 60 at ¶ 17, 163 P.3d at 563. "The fact that physicians could have admissible opinions with varying probative value prior to Daubert has not been changed by applying Daubert to proceedings in the Workers' Compensation Court." Scruggs, 2007 OK 6 at ¶ 21, 154 P.3d at 1265. Cross-examination and presentation of contrary evidence "are the traditional and appropriate means of attacking shaky but admissible evidence." Daubert, 509 U.S. at 596, 113 S.Ct. at 2798. However, an appellate court is not concerned with determining the credibility of competing experts' opinions, the existence of any competent evidence is the relevant inquiry in appeals from the Workers' Compensation Court. Parks, 1984 OK 53 at ¶ 12, 684 P.2d at 552.
I. The Legal Basis for Claimant's Objections
{17 During the March 2007 trial, Claimant's attorney did not challenge the qualifications of Dr. Boone or Dr. Hallford. Consequently, they were qualified to present opinion evidence in this case. Claimant's objections were to the substance of these witnesses' evidence and were framed in the alternative. Claimant first objected to the competency of the expert evidence and if that objection was overruled, Claimant objected to its probative value.
118 Historically, in proceedings in the workers' compensation court, a "competency" objection was "directed to the exhibit's admissibility on hearsay or other legal grounds." Lacy v. Schlumberger Well Serv., 1992 OK 54, ¶ 6, 839 P.2d 157, 159. A "probative value" objection was "used to challenge the evidence for insufficiency as legal proof of (a) medical findings with respect to the presence or absence of compensable disability, or of (b) the compensable impairment's rating." Id. "Thus, an objection to the 'competence' of medical evidence has a separate and distinct meaning from a probative value objection." Id. at ¶ 6, 889 P.2d at 160. However, "competency" as it relates to admissibility has a different meaning than "competent evidence" required to support a decision of the Workers' Compensation Court. Parks, 1984 OK 53 at ¶ 12, 684 P.2d at 552. "'[Clompetency' when used as an objection refers to the evidence's legal admissibility ... the term 'competent' as used in the Parks test refers to the legal sufficiency, on any ground of evidence which supports an order of the Workers' Compensation Court." Lacy, 1992 OK 54 at ¶ 7, 839 P.2d at 160.
"Competent evidence is that which is relevant and material to the issue to be determined." In re Death of Gray, 2004 OK 63, ¶ 19, 100 P.3d 691, 696.
In other words,
competent evidence is that which is probative" of some element of the case. Consequently, the analysis of Claimant's competency and probative value objections invokes different evidentiary rules.
A. The Applicable Law
119 Although Claimant's shoulder injury occurred in 2004, the sole issue decided in Seruggs requires that we resolve Claimant's evidentiary objections based on the amendments to the Workers' Compensation Code enacted in 2005. Scruggs, 2007 OK 6 at ¶ 22, 154 P.3d at 1265 (concluding that retroactive application of 85 O.S. Supp.2005 §§ 3(17) and 17(A)(1) was proper because "[these] amendments made no substantive change in the law.").
B. Dr. Hallford's Evidence
[20 Claimant's competency and probative value objections to the February 2005 and February 2006 medical reports authored by Dr. Hallford were based on the assertion that his 2006 report did not mention the shoulder or address > whether Claimant "needs treatment on the shoulder." Claimant's objections were overruled and these reports were admitted.
121 We view Claimant's competency objection as based on relevance, arguing that Dr. Hallford's failure to address the cause of Claimant's shoulder injury, the essential issue in the case, renders the reports incapable of making a fact in issue more or less probable. However, Claimant's objection regarding omissions in the patient history contained in Dr. Hallford's reports is unsupported by the record. In both reports, Dr. Hallford discusses Claimant's shoulder complaints. In the 2005 report, he concludes those complaints "date back to" Claimant's 2001 injury and recommends that any claim for additional treatment to the shoulder be pursued through the prior claim. The 2006 report
notes the previous history regarding the 2001 injury, and finds "no additional permanent impairment of any kind" to Claimant's left shoulder.
122 Claimant's probative value objection to Dr. Hallford's reports is based on the same argument. Regarding the weight of evidence supporting a decision of the Workers' Compensation Court, review on appeal is limited to the search for any competent evidence to support that decision. The existence of any competent evidence requires affirmance of the Workers' Compensation Court's decigion. Only an argument that there is absolutely no evidence to support the decision raises the possibility that the decision may be reversed or modified. Parks, 1984 OK 53 at ¶ 9, 684 P.2d at 551. Dr. Hallford's reports were properly admitted, and they contain some evidence to support denial of Claimant's request for medical treatment. Consequently, the trial court did not err in also overruling Claimant's probative value objection to Dr. Hallford's reports.
C. Dr. Boone's Evidence
123 Claimant asserted three specific objections regarding the evidence provided by Dr. Boone: (1) Dr. Boone's opinion was based on inaccurate factual history;
(2) Dr. Boone's opinion that Claimant's shoulder injury was not caused by the July 2004 incident was not based objective medical findings; and (8) Dr. Boone was biased. In specific support of the last two objections, Claimant relied on two facts: (1) Dr. Boone did not refer Claimant for any additional evaluation despite testifying that he could not be certain that Claimant's shoulder injury was not work-related without additional tests; and (2) Dr. Boone's testimony that Claimant was a "spook," and a "[flull of erap kind of guy." The trial judge did not rule on the admissibility of Dr. Boone's evidence, stating that she had not read Dr. Boone's deposition but "if I agree with what you say, I'm not sure that that doesn't make it incompetent. But I will consider it as a probative value objection."
124 First, Dr. Boone's admitted failure to order the necessary tests to rule out the possibility that Claimant's shoulder injury did in fact result from the July 2004 incident may constitute the kind of omission of a critical medical finding necessary for Dr. Boone's opinion to constitute objective medical evidence. Claimant's brief cites LaBarge v. Zebco, 1988 OK 147, 769 P.2d 125, which held that a physician's report that failed to meet the requirements of Rule 20 specifying ten issues that must be addressed in a medical expert's report constituted "no evidence" supporting the employer's defense.
LaBarge, 1988 OK 147 at ¶ 8, 769 P.2d at 128. LaBarge is typical of a line of cases concerned with the adequacy of the evidence in the record supporting a decision of the Workers' Compensation Court. See Garza, 2008 OK 111, 83 P.3d 851 (remanding an award as not based on competent evidence because the expert's report omitted a critical medical fact-the discovery of a non-work-
related bacterial cause for claimant's gastritis); and Hammons, 2003 OK 7, 64 P.3d 1108 (vacating an order based on an expert's report that failed to address any effect of claimant's pre-existing condition contrary to requirements of controlling case law and the Guidelines of the American Medical Association made applicable pursuant to Rule 21 of the Workers' Compensation Court Rules). Consequently, if additional tests were required to confirm Dr. Boone's diagnosis, his report may not constitute competent evidence necessary to support the denial of further medical treatment. Parks, 1984 OK 53 at ¶ 12, 684 P.2d at 552. In that cireum-stance, Dr. Boone's report would not be relevant because it would not tend to make a fact in issue more or less probable. 12 0.8.2001 § 2401. Therefore, it would not be admissible, and Claimant's competency objection should have been sustained before the probative value of the evidence was addressed.
T 25 Second, whatever Dr. Boone may have meant by his assessment of Claimant as a "spook," and a "[flull of crap kind of guy," this record provides no basis on which to conclude that those assessments result from the scientifically reliable methodology required by Daubert As additional support for his argument that Dr. Boone was biased and, therefore, incapable of providing the independent medical opinion he was appointed by the trial court to provide, Claimant points to Dr. Boone's testimony that additional evaluation of Claimant's spine "wouldn't hurt." However, Dr. Boone testified that, even though he had been authorized by the trial court to do so, he had not referred Claimant to his brother Dr. Tyler Boone for a spine evaluation "because I like my brother." Claimant argues that these "findings" do not constitute objective medical evidence but reflect bias and a personality problem between Dr. Boone and Claimant. "A doctor's opinion must be predicated on a history consisting of a set of facts substantially consistent with those in evidence, failure of which renders the report of no value." Gaines v. Sun Refinery and Mktg., 1990 OK 33, ¶ 16, 790 P.2d 1073, 1078. If Dr. Boone's "findings" are not "of a type reasonably relied upon by experts in the particular field," Claimant's competency objection should have been sustained on this basis as well. 12 O.S.Supp.2002 § 2703.
126 Because the trial court failed to rule on Claimant's objection to the admissibility of Dr. Boone's evidence, we are unable to determine whether that evidence is part of the record considered by the trial court. Absent that ruling, this Court cannot determine what evidence may be considered in assessing the existence of any competent evidence to support the order appealed." The trial court is required to rule on such objections "prior to any award being entered or denied.
Lacy, 1992 OK 54, n. 35, 839 P.2d 157, 164 n. 35; Gaines, 1990 OK 33, n. 5, 790 P.2d 1073, 1080 n. 5. Consequently, the "vacuity" of Dr. Boone's evidence and its admissibility must be specifically determined by the trial court on remand. Hammons, 2003 OK 7 at n. 15, 64 P.3d 1108 at n. 15.
127 The importance of these rulings is critical. ACI argues that the order should be affirmed for two reasons. First, ACI argues that there is competent evidence to support a finding that Claimant's shoulder injury resulted from his pre-July 2004 injury while working for another employer. See-ond, it argues that there is competent evidence to support a finding that any aggravation of the pre-July 2004 injury occurred during Claimant's subsequent term of employment with another employer.
11 28 ACI is correct with respect to the first of these arguments. Dr. Hallford's reports provide that evidence. In Dr. Hallford's opinion, Claimant's neck and shoulder complaints "date back to" the 2001 injury. However, only Dr. Boone provides any evidence regarding the second possibility-that Claimant's current complaints result from age-related degeneration possibly aggravated after Claimant left ACI's employment. As Claim
ant correctly argues, the trial court's order does not disclose which of these was the finding of the trial court, and the basis on which Claimant's request for treatment was denied. If the trial court relied on Dr. Boone's evidence, and that evidence should have been excluded, no evidence in this ree-ord supports the conclusion that Claimant's current injury resulted from a post-ACI employment injury. "Meaningful review is facilitated by an order from the trial tribunal from which the specific basis for its decision to grant or deny a claim can be determined." Dunkin v. Instaff Personnel, 2007 OK 51, ¶ 15, 164 P.3d 1057, 1061. Fundamentally, the trial court's order lacks the specificity required by Dunkin, thus preventing meaningful review by the panel and this Court. For this additional reason, this case must be remanded for further proceedings.
CONCLUSION
1 29 The order of the Workers' Compensation Court three-judge panel is vacated. This case is remanded to the trial court for further proceedings consistent with this Opinion.
130 VACATED AND REMANDED FOR FURTHER PROCEEDINGS.
GABBARD, P.J., concurs, and RAPP, J., concurs in result.