JUDY KAY CECIL , Respondent - Appellant, vs. EMC INSURANCE COMPANIES and EMC RISK SERVICES , Petitioners - Appellees .
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IN THE COURT OF APPEALS OF IOWA
No. 8-473 / 07-1812
Filed August 13, 2008
JUDY KAY CECIL,
Respondent-Appellant,
vs.
EMC INSURANCE COMPANIES
and EMC RISK SERVICES,
Petitioners-Appellees.
________________________________________________________________
Appeal from the Iowa District Court for Polk County, Karen A. Romano, Judge.
An injured employee appeals from the district court’s ruling on judicial review
reversing the workers’ compensation commissioner’s award of temporary partial
disability and industrial disability benefits. THE DISTRICT COURT’S DECISION ON
JUDICIAL REVIEW IS REVERSED; THE DECISION OF THE COMMISSIONER IS
AFFIRMED
IN
PART,
REVERSED
IN
PART,
AND
REMANDED
WITH
INSTRUCTIONS.
Martin Ozga of Max Schott and Associates, P.C., Des Moines, for appellant.
Dorothy L. Kelley, Des Moines, for appellees.
Considered by Sackett, C.J., and Huitink and Mahan, JJ.
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HUITINK, J.
An injured employee appeals from the district court’s ruling on judicial review
reversing the workers’ compensation commissioner’s award of temporary partial
disability and industrial disability benefits. The district court’s ruling on judicial review is
reversed, and the decision of the workers’ compensation commissioner is affirmed in
part, reversed in part, and remanded with instructions.
I. Background Facts and Proceedings
Judy Cecil was employed by Employers Mutual Insurance Companies (EMC) as
a medical case manager from April 27, 1998, to December 31, 2003. Her job involved
daily travel for which she was assigned an employer-owned fleet or rental car. On
November 17, 2003, Cecil submitted an employee injury report indicating she
experienced various aches and pains attributable to driving company owned or rental
cars during her five and one-half year employment at EMC. Cecil did not return to work
after November 18 and, as noted earlier, left EMC on December 31, 2003. Within a
month of her departure from EMC, Cecil began working part-time as a medical case
manager at Stubbe & Associates, Inc.
On June 10, 2004, Cecil filed an original notice and petition with the workers’
compensation commission. Cecil’s alleged injury dates were February 17, 2003, and
November 17, 2003. Cecil also alleged that she suffered a “cumulative injury to her
hands, wrist, neck, and back from work activities driving company fleet and rental cars”
with resulting disability from “02/17/03 to present and continuing.”
The deputy workers’ compensation commissioner who presided at the contested
case proceeding concluded Cecil “sustained cumulative injury to her hands, wrists, and
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neck which arose out of and in the course of her employment with EMC.” The presiding
deputy, however, rejected Cecil’s claim that she sustained permanent, temporary, or
industrial disabilities resulting from her earlier-described cumulative injury.
On appeal, the deputy authorized to make the final agency decision adopted
some but not all of the presiding deputy’s findings and conclusions.
The appeal
decision includes the following:
As the presiding deputy made no reference to any impressions
made from observations of the demeanor of any witness at hearing, I am
not bound by the credibility assessments made by the presiding deputy.
The presiding deputy chose to ignore the claimant’s uncontroverted
testimony at hearing that she many times asked EMC management to
accommodate for the restrictions imposed by the treating authorized
physician, shortly before she retired. These include requests to provide
an ergonomically suitable car to drive and to limit work to three days per
week. She states that EMC refused each time. These indeed were the
restrictions of Dr. Prevo. Defendants offered no evidence that they
accommodated for these restrictions. Claimant then sought and obtained
part-time employment elsewhere that fit into Dr. Prevo’s restrictions.
Although these restrictions were later lifted, claimant was unable to move
to full-time work when that happened because her new employer does not
have full-time work available to her and EMC has not offered to return
claimant back to work. The presiding deputy then improperly concluded
that claimant was not forced to leave EMC and that any financial loss
claimant has sustained was her fault.
This conclusion is clearly
erroneous.
I agree with the presiding deputy that the cumulative trauma work
injury of November 17, 2003, is not a cause of permanent physical
impairment. However, due to EMC’s refusal to accommodate for her
temporary restrictions, claimant was forced to transfer jobs and take
retirement earlier from EMC than she had planned. In doing so, she lost
insurance rights and pension income which she states is about $400 less
per month. I find these long lasting adverse financial impacts were the
result of the cumulative trauma work injury of November 17, 2003. Again,
this aspect was largely overlooked by the presiding deputy.
....
I find that the work injury of November 17, 2003 is a cause of a 25
percent loss of earning capacity. This entitles claimant to 125 weeks of
permanent partial disability benefits pursuant to Iowa Code section
85.34(2)(u).
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Iowa Code section 85.33(3) provides that if suitable work is not
offered by the employer, and the employee elects to perform suitable work
with a different employer, the employee shall be compensated with
temporary partial disability benefits. Claimant provided calculations for
this benefit which are likewise not contradicted in the record. Claimant is
therefore entitled to such benefits.
EMC was therefore ordered to pay Cecil 125 weeks permanent partial disability
benefits from May 8, 2004, the day the record indicates Cecil reached maximum
medical improvement. EMC was also ordered to pay Cecil temporary partial disability
benefits from January 1, 2004, through May 7, 2004.
On February 12, 2007, EMC filed a petition for judicial review. EMC alleged the
appeal decision prejudiced its substantial rights and should be reviewed for the
following reasons:
A. The Decision of the Agency is in violation of constitutional or statutory
provisions.
B. The Decision of the Agency is based upon an erroneous interpretation
of the law, and is contrary to law.
C. The Decision of the Agency is unreasonable, arbitrary and capricious,
and is a wholly unjustified application of the law.
D. The Decision of the Agency is not supported by substantial evidence in
the record when the record is viewed as a whole.
The trial court’s October 11, 2007 ruling on EMC’s petition for judicial review includes
the following:
Cecil began formally working for Stubbe on January 1, 2004 and
was not given work restrictions to drive her own car and only work 3 days
a week by Dr. Prevo until January 5, 2004. Cecil did not have any
physician-imposed restrictions when she filled out her workers’
compensation employee injury report or when she gave her notice of
retirement. Therefore, [the deputy’s] factual determination that Cecil was
forced to retire because EMC refused to accommodate her physicianimposed restrictions is erroneous and not supported by substantial
evidence in the record.
....
On May 7, 2004, Dr. Prevo placed Cecil at maximum medical
improvement and released her to work in a fully duty capacity as a
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medical case manager. Cecil does not have any physician-imposed
restrictions at present, and she testified that she is able to return to fulltime work. Deputy Walshire appeared to base his industrial disability
award on the fact that Cecil is actually earning less not because she
accepted a part-time position with Stubbe and forfeited many of her
retirement benefits with EMC, which is an erroneous interpretation of the
law. Industrial disability is awarded on the basis of a loss in earning
capacity, not on the loss of earnings that an injured employee will
experience. Second Injury Fund of Iowa, 544 N.W.2d at 266 (citing
Thilges v. Snap-On Tools Corp., 528 N.W.2d 614, 616-17 (Iowa 1995)).
Based on the industrial disability factors, Cecil’s testimony, the
medical records and opinions, and the fact that Cecil was released to work
in a full-duty capacity as a medical case manager, the only reasonable
determination is that Cecil does not have an industrial disability. Cecil’s
earning capacity has not been affected by this injury because she is
capable of working full-time as a medical case manager with no
restrictions, a job that she is more than qualified for and has significant
experience in performing. Therefore, [the deputy’s] conclusion that Cecil’s
injury resulted in a 25 percent loss of earning capacity entitling her to 125
weeks of permanent partial disability benefits is not supported by
substantial evidence and constitutes a misapplication of the law to the
facts in the record.
....
As previously discussed, the chronological facts do not support this
determination. By the time that EMC would have been required to offer
Cecil suitable work based on her physician-imposed restrictions, Cecil had
already retired from EMC. Therefore, [the deputy’s] determination that
Cecil was entitled to temporary partial disability benefits is not supported
by substantial evidence in the record and constitutes a misapplication of
the law to the facts in the record.
The trial court accordingly reversed the deputy’s decision awarding Cecil temporary
partial disability benefits and industrial disability benefits.
On appeal, Cecil claims the commissioner’s decision awarding industrial
disability and temporary partial disability benefits is supported by substantial evidence.
II. Standard of Review
Our review of a final decision of the commissioner, like that of the district court, is
for correction of errors of law. Second Injury Fund v. Shank, 516 N.W.2d 808, 812
(Iowa 1994). In determining whether the district court erred in exercising its power of
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judicial review, we apply the standards of Iowa Code section 17A.19(10) (2003) to the
agency’s action to determine whether our conclusions are the same as those of the
district court.
Williamson v. Wellman Fansteel, 595 N.W.2d 803, 806 (Iowa 1999);
E.N.T. Assocs. v. Collentine, 525 N.W.2d 827, 829 (Iowa 1994). The agency’s findings
are akin to a jury verdict, and we broadly apply them to uphold the agency’s decision.
Shank, 516 N.W.2d at 812.
We will uphold the agency’s action against a claim it is unsupported by
substantial evidence in the record made before the agency when the record is viewed
as a whole if a reasonable person could accept the evidence as adequate to reach the
findings made by the agency. Iowa Code § 17A.19(10)(f); Pointer v. Iowa Dep’t of
Transp., 546 N.W.2d 623, 625 (Iowa 1996).
Evidence is not insubstantial merely because it would have supported contrary
inferences.
Nor is evidence insubstantial because of the possibility of drawing two
inconsistent conclusions from it. The ultimate question is not whether the evidence
supports a different finding but whether the evidence supports the findings actually
made. City of Hampton v. Iowa Civil Rights Comm’n, 554 N.W.2d 532, 536 (Iowa
1996). Therefore, if the agency’s findings of fact are supported by substantial evidence,
those findings are binding on us. Id.
III. Credibility Findings
As a preliminary matter, we address EMC’s argument that the commissioner
erred in rejecting the deputy’s credibility findings. The deputy’s proposed findings are
not a consideration on our review because its decision is not final agency action subject
to judicial review. See Myers v. F.C.A. Servs., Inc., 592 N.W.2d 354, 358 (Iowa 1999).
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In addition, the commissioner possesses discretion to accept or reject testimony based
on credibility. See Terwilliger v. Snap-on Tools Corp., 529 N.W.2d 267, 273 (Iowa
1995).
IV. Temporary Partial Disability
Under section 85.33(3), an employee is entitled to temporary partial disability
benefits if the employee is temporarily partially disabled as defined in section 85.33(2)
and “[i]f suitable work is not offered by the employer for whom the employee was
working at the time of the injury and the employee who is temporarily disabled elects to
perform work with a different employer. . . .”
These benefits are paid until “the
employee has returned to work or is medically capable of returning to employment
substantially similar to the employment in which the employee was engaged at the time
of injury, whichever occurs first.” Iowa Code § 85.33(1).
As noted earlier, the deputy commissioner found Cecil was subject to work
restrictions while employed at EMC and obtained other suitable employment because
EMC refused to accommodate those restrictions. Although the trial court concluded
otherwise, our review of the record discloses conflicting but nevertheless substantial
evidence supporting the deputy’s findings of fact. The relevant medical records and
reports prepared by Cecil’s examining and treating physicians while she was still
employed at EMC can be reasonably interpreted as imposing work restrictions including
driving an ergonomically suitable automobile and limiting her work hours to three days
per week.
The same can be said of the evidence concerning EMC’s refusal to
accommodate those restrictions as well as Cecil’s motives for obtaining other
employment.
Cecil testified EMC repeatedly refused her requests for appropriate
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accommodations and she sought and accepted other employment compatible with the
foregoing work restrictions as a result of EMC’s refusal to accommodate her.
We also reject EMC’s arguments concerning the amount of temporary partial
disability benefits awarded. The record indicates the deputy’s calculation of the amount
of Cecil’s weekly benefit was based on stipulated documentation of Cecil’s earnings as
well as her testimony concerning her work schedule. Although EMC cites evidence
contradicting Cecil’s claims concerning the number of hours she actually worked, our
reading of the record indicates the deputy resolved the resulting factual issues in Cecil’s
favor and it is not for us to say otherwise.
We accordingly reverse the trial court and affirm the deputy’s decision awarding
Cecil temporary partial disability benefits.
V. Industrial Disability
Industrial disability means reduced earning capacity.
McSpadden v. Big Ben
Coal Co., 288 N.W.2d 181, 192 (Iowa 1980). Many factors are considered, including
bodily impairment, the employee’s age, intelligence, education, qualifications, and
experience, and the injury’s effect on the employee’s ability to find suitable work. WalMart Stores, Inc. v. Caselman, 657 N.W.2d 493, 495 (Iowa 2003). The lack of an
impairment rating is not determinative. Trade Prof’ls, Inc. v. Shriver, 661 N.W.2d 119,
123 (Iowa 2003); Haynes v. Second Injury Fund, 547 N.W.2d 11, 14 (Iowa Ct. App.
1996). Finally, “the level of post-injury earnings is important evidence of whether the
injury impaired the worker’s capacity to earn.”
N.W.2d 258, 266 (Iowa 1995).
Second Injury Fund v. Nelson, 544
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We agree with the trial court’s conclusion that the deputy’s award of industrial
benefits solely based on Cecil’s loss of earnings is an erroneous interpretation of the
law. See Second Injury Fund of Iowa, 544 N.W.2d at 266. We, however, disagree with
the trial court’s conclusion that the only reasonable determination based on the record
before us is that Cecil does not have an industrial disability.
Under these
circumstances, we believe the appropriate remedy is to set aside the commissioner’s
findings concerning Cecil’s industrial disability, and remand to the commissioner for a
redetermination of Cecil’s industrial disability, if any, based on evidence of all of the
foregoing factors disclosed by the record made in the original contested case
proceeding. See, e.g., Ellingson v. Fleetguard, 599 N.W.2d 440, 445 (Iowa 1999).
The district court’s ruling on judicial review is reversed, and the decision of the
workers’ compensation commissioner is affirmed in part, reversed in part, and
remanded with instructions.
THE DISTRICT COURT’S DECISION ON JUDICIAL REVIEW IS REVERSED;
THE DECISION OF THE COMMISSIONER IS AFFIRMED IN PART, REVERSED IN
PART, AND REMANDED WITH INSTRUCTIONS.
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