the claimant as well as the treating physician and IME consultant were conducted.  The treating physician causally related the shoulder and elbow to the work accident, but also admitted on cross-examination that the injuries could also be caused by the claimant’s open heart surgery as the muscles involved in the shoulder injury align with the chest wall that had to be disturbed for the heart surgery.  The Law Judge noted in a reserved decision that the claimant proceeded on the theory of consequential injuries and not direct injuries.  The Judge noted that it was the claimant’s burden to establish a causal relationship of the consequential injury to the underlying injury and the work accident.  The Judge noted that the treating physician admitted that the injuries could have been caused by immobilization following heart surgery.