Opinion
No. 6-084 / 05-0800
Filed March 15, 2006
Appeal from the Iowa District Court for Black Hawk County, Thomas N. Bower, Judge.
Decedent's administrators appeal the district court decision that affirmed the workers' compensation commissioner's conclusion that decedent's injuries were not work-related. AFFIRMED.
Thomas J. Currie of Tom Riley Law Firm, P.L.C., Cedar Rapids, and David P. Odekirk of Dunakey Klatt, P.C., Waterloo, for appellants.
Kevin R. Rogers and Megan S. Fereday of Swisher Cohrt, P.L.C., Waterloo, for appellees.
Considered by Sackett, C.J., and Mahan, J., and Beeghly, S.J.
Senior Judge assigned by order pursuant to Iowa Code section 602.9206 (2005).
I. Background Facts Proceedings
Jerry Clark was employed as an outdoor laborer for Sheehan Pipeline Construction Company. In 1994, while working for a previous employer, Clark was diagnosed with heat exposure syndrome. He was given fluids at a hospital and released the same day.
On August 9, 1999, Clark was flagging traffic in a rural area. It was overcast that day, with temperatures at fifty-five degrees at 7:00 a.m. and seventy-one degrees at 2:00 p.m. Clark became increasing distraught that morning, and told his supervisor, Michael Fall, he believed there was a conspiracy to set him up to take a fall for something. There was evidence that Clark had not been eating or drinking for several days due to his paranoia. Fall called the labor supervisor, who came out to the job site and picked up Clark. Clark reported that he felt unable to drive, and he was taken to his parents' home.
Clark's mother took him to the hospital, where he had symptoms of confusion, dizziness, light-headedness, headache, and nausea. He was diagnosed with "1) mild-moderate dehydr. 2)? Heat prostration." Clark was given fluids and sent home with the understanding that he would continue to drink fluids. The next day, however, he refused to drink fluids, and he continued to be confused, and so his mother returned with him to the hospital.
Clark had a neurological examination by Dr. Brian Sires, who did not find any physical cause for his symptoms. Dr. Sires diagnosed Clark with a psychotic disorder with paranoid personality disorder. Clark was also seen by Dr. Raja Junaid, who diagnosed him with schizo-affective disorder. Clark was given medication and Dr. Sires found his "symptoms of acute confusion and disorientation responded well to psychiatric treatment." Clark returned to work for a short period of time, but then again exhibited signs of confusion, and he voluntarily quit his employment. He committed suicide in April 2000.
Teresa Poland, Clark's sister, and Roger Clark, Clark's father, as co-administrators of Clark's estate, filed a workers' compensation claim alleging that Clark suffered heat stroke on August 9, 1999, and this caused his psychological problems which resulted in his death. In a deposition, Dr. Junaid gave the opinion that Clark "had some insidious premorbid predisposition towards a schizo-affective disorder, and then heat or other stresses at work kind of aggravated that situation, where he had a mental breakdown and had to come to the emergency room." Clark's medical records were examined by Dr. Kenneth McMains and Dr. Loren Olson. These doctors gave the opinion that Clark's mental condition was not caused by a heat-related disorder caused by his work.
A deputy workers' compensation commissioner concluded Clark suffered from a mental condition unrelated to his work. The deputy determined:
There is no evidence or opinion in the record that the accepted diagnosis, schizo-affective disorder, was directly related or substantially caused by Jerry's work. The only way the schizo-affective disorder could be work related is if Jerry had suffered a heat-related condition and that heat-related condition caused the schizo-affective disorder. Having found that claimants failed to prove Jerry suffered a heat-related condition, it cannot be found that the heat-related condition caused the schizo-affective disorder. Even if claimants had proved Jerry suffered a heat-related condition, they have not proved it caused the schizo-affective disorder.
The workers' compensation commissioner adopted the deputy's decision. On judicial review, the district court affirmed the commissioner, finding there was substantial evidence to support the conclusion that Clark's psychiatric disorder was not attributable to a heat-related illness caused by his employer. Petitioners appeal.
II. Standard of Review
Our review is governed by the Iowa Administrative Procedure Act. Iowa Code § 17A.20 (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 Hosp. Clinics v. Waters, 674 N.W.2d 92, 95 (Iowa 2004).
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 Rests., Inc., 696 N.W.2d 596, 603 (Iowa 2005).
III. Merits
Petitioners contend there is insufficient evidence in the record to support the commissioner's finding that Clark did not sustain an injury on August 9, 1999, which arose out of and in the course of his employment. In particular, they claim the evidence shows that Clark suffered heat prostration on that day. Also, in taking Clark's medical history, Dr. Sires wrote "He has been out in the heat a lot recently and has a remote history of what is felt to be heat stroke." Poland and Roger Clark testified Clark did not exhibit signs of psychological problems prior to August 9, 1999.
The record shows that when Clark was initially seen in the emergency room on August 9, 1999, the treating physician felt that Clark could have been suffering from heat prostration. When Clark returned the next day, however, the notes of Dr. Sires state, "Dr. Brunkhorst evaluated the patient and felt that possibly there was something more than dehydration going on." The medical history taken by Dr. Sires is not the same as a diagnosis. After performing a series of tests, Dr. Sires gave a diagnosis of psychotic disorder with paranoid personality traits. He noted that Clark responded well to psychiatric treatment.
Dr. McMains stated that Clark had signs of dehydration on August 9, 1999, shown by an increased concentration of urine, but he did not have signs of a heat-related disorder because there were no changes in his sodium levels or in his skin condition. Dr. McMains found, "Clark's last admission to Allen Hospital was in August 1999, which was initially thought to be related to heat problems but later it was found that he was suffering from an acute schizo-affective disorder that responded to psychiatric treatment." Dr. McMains concluded "Clark's diagnosis and treatment eventually centered on a psychiatric diagnosis with an acute manifestation that responded very nicely to medication for that specific problem."
Dr. Olson noted that it was possible that heat exposure might cause a change in mental status. He felt, however, that Clark's delusional thinking was "much more characteristic of a psychiatric disorder." Dr. Olson also stated that Clark's problems with dehydration might have been the result of the paranoia, rather than the cause of it. He stated that if Clark's problems had been caused merely by dehydration, once he received fluids his condition would have improved. Dr. Olson gave the opinion that Clark's condition was not related to his work environment.
We determine that there is substantial evidence in the record to support the commissioner's conclusion that Clark suffered from a mental condition unrelated to his work. The commissioner's decision is supported by the medical opinions of Drs. Sires, McMains, and Olson. It is the commissioner's role as the finder of fact to determine the weight to be afforded expert testimony. Terwilliger v. Snap-on Tools Corp., 529 N.W.2d 267, 272 (Iowa 1995).
We affirm the decision of the workers' compensation commissioner and the district court.