ROBERTSON/STAR BUILDING and INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA, Petitioners-Appellants, vs. JESSE COOHEY, Respondent-Appellee.
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IN THE COURT OF APPEALS OF IOWA
No. 9-820 / 09-0615
Filed November 12, 2009
ROBERTSON/STAR BUILDING and
INSURANCE COMPANY OF THE
STATE OF PENNSYLVANIA,
Petitioners-Appellants,
vs.
JESSE COOHEY,
Respondent-Appellee.
________________________________________________________________
Appeal from the Iowa District Court for Polk County, Eliza J. Ovrom,
Judge.
The petitioners appeal the district court’s ruling on their petition for judicial
review, which affirmed the workers’ compensation commission’s award of
benefits to the respondent. AFFIRMED.
Aaron T. Oliver of Hansen, McClintock & Riley, Des Moines, for appellant.
Thomas M. Wertz and Daniel J. Anderson of Wertz & Dake, Cedar
Rapids, for appellee.
Considered by Eisenhauer, P.J., Potterfield, J., and Mahan, S.J.*
*Senior judge assigned by order pursuant to Iowa Code section 602.9206 (2009).
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MAHAN, S.J.
Robertson/Star Building Systems and its insurer, Insurance Company of
the State of Pennsylvania, appeal the district court’s ruling on their petition for
judicial review, which affirmed the workers’ compensation commission’s award of
benefits to Jesse Coohey. They contend the district court erred in concluding (1)
Coohey’s claim is not barred by the statute of limitations, (2) Coohey’s treatment
is causally related to his 1997 work injury, and (3) Coohey is entitled to attorney
fees. We affirm.
I. Background Facts and Proceedings.
Coohey was working for
Robertson/Star Building Systems on December 9, 1997, when he sustained an
injury to his left arm. The following day, he underwent surgery with Dr. Pape to
install hardware in his arm.
Coohey received healing period and permanent
partial disability benefits for the injury. He was released from work restrictions on
March 17, 1998.
Coohey was terminated from his employment with Robertson/Star Building
Systems in the summer of 1998. He worked for two other employers in the
following years, performing duties that required the repetitive use of both hands.
He suffered a minor injury to his left arm when he slipped and fell while at work in
December 2000.
Although Coohey was released from medical care for his 1997 work injury
in June of 1998, he continued to experience discomfort and ongoing pain in his
left arm. In 2005, he returned to Dr. Pape to have the hardware installed in
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December 1997 removed.
Dr. Pape opined the 1997 work injury was “a
substantial contributing factor” to the hardware-removal surgery.
In June 2006, Coohey filed a petition claiming he was entitled to additional
medical benefits for the 1997 injury. Robertson/Star Building Systems and its
insurance carrier denied the claim, arguing it was barred by the statute of
limitations and that the surgery was not causally related to the 1997 work injury.
Following a hearing, the deputy workers’ compensation commissioner filed an
arbitration decision awarding Cooney medical benefits and $1500 in attorney
fees. The decision was affirmed by the commissioner. On judicial review, the
district court affirmed the agency decision.
II. Scope and Standard of Review. Iowa Code chapter 17A governs our
review of the decisions of the workers’ compensation commissioner. Iowa Code
§ 86.26 (2007); Midwest Ambulance Serv. v. Ruud, 754 N.W.2d 860, 864 (Iowa
2008). Our review of the commissioner’s decision is for errors at law, not de
novo. Finch v. Schneider Specialized Carriers, Inc., 700 N.W.2d 328, 330 (Iowa
2005). The factual findings of the commissioner are reversed only if they are not
supported by substantial evidence. Iowa Code § 17A.19(10)(f); Midwest, 754
N.W.2d at 864. Evidence is substantial if a reasonable mind would accept it as
adequate to reach a conclusion. Heartland Specialty Foods v. Johnson, 731
N.W.2d 397, 400 (Iowa Ct. App. 2007). We will reverse the agency’s application
of the law to the facts if we determine its application was “irrational, illogical, or
wholly unjustifiable.” Meyer v. IBP, Inc., 710 N.W.2d 213, 218 (Iowa 2006). In
reviewing the district court’s decision, we apply the standards of chapter 17A to
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determine whether our conclusions are the same as those reached by the district
court. Clark v. Vicorp Rests., Inc., 696 N.W.2d 596, 603 (Iowa 2005).
III. Statute of Limitations. We first address the petitioners’ claim that
Coohey’s claim for medical benefits is barred by the statute of limitations. They
argue Coohey failed to bring the claim within three years of the last weekly
compensation payment as required by Iowa Code section 85.26 (2005).
Section 85.26(2) reads in pertinent part:
An award for payments or an agreement for settlement provided by
section 86.13 for benefits under this chapter or chapter 85A or 85B,
where the amount has not been commuted, may be reviewed upon
commencement of reopening proceedings by the employer or the
employee within three years from the date of the last payment of
weekly benefits made under the award or agreement. If an award
for payments or agreement for settlement as provided by section
86.13 for benefits under this chapter or chapter 85A or 85B has
been made and the amount has not been commuted, or if a denial
of liability is not filed with the workers’ compensation commissioner
and notice of the denial is not mailed to the employee, in the form
and manner required by the commissioner, within six months of the
commencement
of
weekly
compensation
benefits,
the
commissioner may at any time upon proper application make a
determination and appropriate order concerning the entitlement of
an employee to benefits provided for in section 85.27. The failure
to file a denial of liability does not constitute an admission of liability
under this chapter or chapter 85A, 85B, or 86.
(Emphasis added.) The commissioner concluded Coohey’s claim for medical
benefits was not barred because there was no award for payments or agreement
for settlement, and Robertson/Star Building Systems did not file a denial of
liability.
The petitioners do not dispute there was no denial of liability filed. Rather,
they challenge the commissioner’s interpretation of the law.
They cite the
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following language from our supreme court’s opinion in Beier Glass Co. v.
Brundige, 329 N.W.2d 280, 286 (Iowa 1983), as controlling:
A review of the operation of the statute as a whole lends weight to
our holding the legislature intentionally incorporated our judicial
definitions in section 85.26(2). As revised, “an award for payments
or agreement for settlement . . . for benefits” is a condition
precedent not only to three-year review-reopening, but also to
unlimited medical benefits under section 85.27.
Based on this language, the petitioners argue a claimant is entitled to unlimited
medical benefits if there has been an agency ward of benefits or an agreement
for settlement, neither of which are present here.
The district court rejected the petitioners’ argument, noting section
85.26(2) was amended after the court’s ruling in Beier Glass Co. to include the
language regarding denial of liability, thereby creating an additional situation
under which the commissioner may make a medical benefits determination
beyond the three-year statute of limitations. The petitioners argue on appeal that
the district court’s ruling violates rules of statutory construction and produces an
absurd result. We disagree.
Before engaging in statutory construction, it must be determined the
language of the statute is ambiguous. Holstein Elec. v. Breyfogle, 756 N.W.2d
812, 815 (Iowa 2008).
A statute is ambiguous if reasonable persons could
disagree on its meaning. Id. There is no ambiguity here regarding the language
of section 85.26(2) as amended. Furthermore:
The legislature enacted the workers’ compensation statute primarily
for the benefit of the worker and the worker’s dependents.
Therefore, we apply the statute broadly and liberally in keeping with
the humanitarian objective of the statute. We will not defeat the
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statute’s beneficent purpose by reading something into it that is not
there, or by a narrow and strained construction.
Id. at 815-16. We conclude the commissioner’s application of the law to the facts
in determining Coohey’s claim was not irrational, illogical, or wholly unjustifiable.
II. Causation. The petitioners next contend Coohey’s medical treatment
since his August 2005 surgery to remove the hardware in his arm was not
causally related to the 1997 work injury. They note Coohey suffered work-related
injuries to his left arm after leaving his employment with Robertson/Star Building
Systems, and argue these injuries aggravated or caused a new injury to his left
arm and forearm.
A claimant must prove by a preponderance of the evidence that the injury
is a proximate cause of the claimed disability. Grundmeyer v. Weyerhaeuser
Co., 649 N.W.2d 744, 752 (Iowa 2002). The real issue is whether there was
substantial evidence that the 1997 work injury was a substantial contributing
factor to Coohey’s August 2005 surgery. See, e.g., Blacksmith v. All American,
Inc., 290 N.W.2d 348, 354 (Iowa 1980). Expert testimony is ordinarily necessary
to establish a causal connection between the injury and the disability for which
benefits are sought. Id. The weight to be given the expert’s testimony is for the
finder of fact. St. Luke’s Hosp. v. Gray, 604 N.W.2d 646, 652 (Iowa 2000).
Here, the deputy commissioner weighed the expert opinions and found as
follows, which finding was adopted by the commissioner:
Dr. Pape in his deposition acknowledged the hardware was still in
place and claimant’s fracture was healed. However, Dr. Pape
clearly feels the presence of the hardware contributed to claimant’s
left forearm pain. Neither Dr. Pape, nor Dr. Weston, nor Dr. First
opines that claimant suffered a new traumatic or cumulative injury
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while working for Orbis or M-C Industries. Dr. Pape clearly
attributes claimant’s ongoing pain to the hardware, and the medical
treatment and removal of the hardware in 2005 to the original 1997
injury. Defendants can point to no medical evidence to the
contrary. Defendants can only offer speculation that his work for
other employers might have caused his pain.
Because the expert witness evidence shows the 1997 work injury was a
substantial contributing factor to the August 2005 surgery, we conclude
substantial evidence supports the commissioner’s decision.
IV. Attorney Fees.
Finally, the petitioners contend the commissioner
erred in ordering them to reimburse Coohey for $1500 in attorney fees for their
“failure to admit request for admission number five.” This request for admission
states, “Petitioners did not file a denial of liability pursuant to Iowa Code section
85.26(2).” The petitioners initially denied the request for “lack of knowledge,” and
later amended their response to, “Deny.”
Iowa Rule of Civil Procedure 1.517(3) allows a party an award of attorney
fees where “a party fails to admit the genuineness of any document or the truth of
any matter requested under rule 1.510” and “the party requesting the admissions
thereafter proves the genuineness of the document or truth of the matter.”
Attorney fees will not be ordered, however, where the admission sought was held
objectionable or was of no substantial importance, the party failing to admit had
reasonable grounds to believe the party might prevail on the matter, or there was
good reason for failure to admit. Iowa R. Civ. P. 1.517(3).
The petitioners argue the request for attorney fees should have been
denied because the claim is barred by the statute of limitations. Like the district
court, we have already found the statute of limitations defense is not applicable
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and do not need to revisit our reasoning. We likewise conclude none of the
exceptions to rule 1.517(3) urged by the petitioners is applicable here.
The petitioners also claim such an award is not permissible in the context
of a workers’ compensation claim. Although an award of attorney fees is not
available in such cases, it was not ordered as part of Coohey’s recovery. Rather,
Coohey was awarded attorney fees for a violation of a rule of civil procedure. As
such, it is permitted.
Finally, the petitioners argue the award is inappropriate because there is
no explanation as to how the amount was determined. Coohey provided a list of
itemized expenses to the commissioner, and the commissioner determined which
amount was attributable to the denial of the request for admissions.
We
conclude the amount, $1500, was not irrational, illogical, or wholly unjustifiable.
AFFIRMED.
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