Opinion
No. 5-452 / 04-1625
Filed June 15, 2005
Appeal from the Iowa District Court for Polk County, Dale B. Hagen, Judge.
Betty Grimes appeals the district court's affirmance of the workers' compensation commissioner's decision denying her request for workers' compensation benefits. AFFIRMED.
Joseph Walsh of Hedberg, Owens Hedberg, Des Moines, for appellant.
Jean Dickson Feeney of Betty, Neuman McMahon, L.L.P., Davenport, for appellee.
Considered by Sackett, C.J., and Huitink and Vaitheswaran, JJ.
I. Background Facts Proceedings
In 1994 Betty Jo Grimes began to experience skin rashes, burning in her mouth and lips, pain in her scalp and nose, ear drainage, and shortage of breath. Grimes attributed these problems to her 1994 exposure to the chemical perchlorethylene in the course of her employment at Federal Mogul's Burlington, Iowa, sparkplug factory.
Grimes consulted or was referred to a number of physicians for treatment of these symptoms. In 1998 Dr. Nancy Sprince, an occupational medicine specialist, diagnosed Grimes with "restrictive airway disease," a condition in which environmental factors cause constriction of the bronchial tubes. In Dr. Sprince's opinion, Grimes's exposure to chemicals while working at Federal Mogul was a contributing factor to the development of her illness. On April 25, 1999, Grimes became ill at work and, on the advice of Dr. Sprince, quit her job at Federal Mogul.
On September 25, 2002, Grimes filed a petition with the workers' compensation commissioner requesting an award of benefits based on her injury and disability caused by her exposure to chemicals in the course of her employment at Federal Mogul. Federal Mogul denied Grimes's claims that her injury arose out of or in the course of her employment, and the matter proceeded to a contested case hearing before a deputy workers' compensation commissioner. The record made at that hearing includes Dr. Sprince's deposition testimony. In her deposition, Dr. Sprince testified concerning her examination, diagnosis, and treatment of Grimes's illness. She also testified that Grimes's exposure to chemicals while working at Federal Mogul was a substantial contributing factor in the development of Grimes's restrictive airway disease.
The contested case hearing record also included medical records and reports from several other physicians who examined and/or treated Grimes. These records indicate not all of the physicians who examined and treated Grimes shared Dr. Sprince's causation opinion. Records from Grimes's visit to the Mayo clinic in 1997 state that physicians there felt that an allergic reaction could have set off the symptoms Grimes first experienced in 1994, and that stress-related maladjustments could have perpetuated the symptoms. Dr. Joel Kline monitored Grimes's exposure to machine oils and found no evidence of occupational asthma. Dr. Lawrence Fuortes reported that Grimes may suffer from a panic disorder and that she could be having a chemophobic reaction. Dr. Dale Minner, an occupational medicine specialist, opined that Grimes suffered from a "disability syndrome," and that there was no connection between her symptoms and her exposure to chemicals at work. Also, Dr. Randall Hanson opined that there was no workplace etiology causing Grimes's symptoms.
The deputy commissioner's resulting decision states:
In this case the preponderance of the objective medical evidence weighs against claimant's stated and sincerely held belief that her variety of symptoms arise from a workplace chemical exposure. Given that circumstance, it cannot be found that the claimant has either a work injury or an occupational disease arising out of and in the course of her employment.
The deputy's decision was affirmed by the workers' compensation commissioner on intragency appeal. On judicial review, the district court found the commissioner's decision was supported by substantial evidence. The court's decision notes, "While one medical doctor does attribute Grimes's symptoms to a workplace exposure, numerous other medical doctors did not find any allergy or known cause for her symptoms, which could be attributed to the workplace." Grimes appeals.
II. Standard of Review
Our review is governed by the Iowa Administrative Procedure Act, Iowa Code chapter 17A (2003). Acuity Ins. v. Foreman, 684 N.W.2d 212, 216 (Iowa 2004). We review the district court's decision by applying the standards of chapter 17A to the agency action to determine if our conclusions are the same as those reached by the district court. University of Iowa Hosps. Clinics v. Waters, 674 N.W.2d 92, 95 (Iowa 2004).
III. The Merits
Generally, expert testimony is necessary to establish a causal connection between the injury and the disability for which benefits are sought. Grundmeyer v. Weyerhaeuser Co., 649 N.W.2d 744, 752 (Iowa 2002). The commissioner, as fact finder, determines whether to accept or reject expert testimony, and if accepted, what weight to give it. Trade Prof'ls, Inc. v. Shriver, 661 N.W.2d 119, 123 (Iowa 2003). "Expert opinion testimony, even if uncontroverted, may be accepted or rejected in whole or in part by the trier of fact." Sanchez v. Blue Bird Midwest, 554 N.W.2d 283, 285 (Iowa Ct.App. 1996).
If the commissioner "disregards uncontroverted expert medical evidence he must say why he has done so." Catalfo v. Firestone Tire Rubber Co., 213 N.W.2d 506, 510 (Iowa 1973). If not, a reviewing court has no way to determine if the commissioner acted arbitrarily or misapplied the law. Id.
Grimes contends the commissioner committed an error of law by rejecting Dr. Sprince's uncontroverted medical testimony without specifying a reason for rejecting that testimony. As noted earlier, the record indicates that Dr. Sprince's deposition was the only testimonial evidence from a medical expert included at the contested case hearing. Grimes therefore argues that since Dr. Sprince's was the only medical expert testimony provided at the hearing, the commissioner was required to specify the reasons for rejecting Dr. Sprince's opinions.
We note that our appellate courts have referred to uncontroverted expert medical testimony in similar circumstances. See IBP, Inc. v. Al-Gharib, 604 N.W.2d 621, 622 (Iowa 2000); Sondag v. Ferris Hardware, 220 N.W.2d 903, 908 (Iowa 1974); James v. Sheller-Globe Corp., 510 N.W.2d 170, 174 (Iowa Ct.App. 1993). It is clear, however, that the rule actually refers to uncontroverted expert medical evidence, not just testimony by medical experts. See McIlravy v. North River Ins. Co., 653 N.W.2d 323, 333 n. 4 (Iowa 2002); McSpadden v. Big Ben Coal Co., 288 N.W.2d 181, 186 (Iowa 1980); Catalfo, 213 N.W.2d at 510.
Here, the medical evidence was not uncontroverted. Several medical experts opined concerning the cause of Grimes's injuries or illness. The commissioner was free to accept or reject these opinions and, if accepted, to determine what weight to give each opinion. See Trade Prof'ls, 661 N.W.2d at 123. The commissioner properly considered all of the expert medical evidence in this case, and determined the preponderance of the objective medical evidence weighed against an award of benefits.
Grimes claims the commissioner's decision is not supported by substantial evidence. We may reverse, modify, or grant other relief if a party shows the agency's action is "[b]ased upon a determination of fact clearly vested by a provision of law in the discretion of the agency that is not supported by substantial evidence in the record before the court when that record is viewed as a whole." Iowa Code § 17A.19(10)(f). "Substantial evidence" is defined as:
[T]he quantity and quality of evidence that would be deemed sufficient by a neutral, detached, and reasonable person, to establish the fact at issue when the consequences resulting from the establishment of that fact are understood to be serious and of great importance.
Iowa Code § 17A.19(10)(f)(1); Clark v. Vicorp Restaurants, Inc., ___ N.W.2d ___, ___ (Iowa 2005).
Factual findings regarding the award of benefits are within the commissioner's discretion, and so we are bound by the commissioner's findings of fact if they are supported by substantial evidence. Mycogen Seeds v. Sands, 686 N.W.2d 457, 464-65 (Iowa 2004).
We conclude substantial evidence supports the commissioner's factual findings in this case. Considering the evidence in the record when viewed as a whole, the opinion of most medical experts was that Grimes's problems were not related to her work. Several physicians opined that Grimes's problems were the result of a panic disorder, chemophobia, or a disability syndrome. There were no medical tests linking Grimes's reactive airway disease to the chemical exposure during her work at Federal Mogul.
We affirm the decision of the district court and the workers' compensation commissioner.