Opinion
No. 2-579 / 01-1450
Filed September 11, 2002
Appeal from the Iowa District Court for Pottawattamie County, James R. Richardson, Judge.
Glenwood State Hospital and State of Iowa appeal the district court's ruling that overruled the workers' compensation commissioner's decision denying compensation to claimant. REVERSED AND REMANDED.
Thomas J. Miller, Attorney General, Joanne Moeller, Special Assistant Attorney General, and Darrel Mullins, Assistant Attorney General, for appellant.
Robert Laubenthal and Thomp Pattermann of Smith Peterson Law Firm, L.L.P., Council Bluffs, for appellee.
Considered by Zimmer, P.J., and Hayden, and Habhab, S.J.
Senior judges assigned by order pursuant to Iowa Code section 602.9206 (2001).
In this workers' compensation action, the Workers' Compensation Commissioner denied compensation benefits to George Hunter, the surviving spouse of Sandra Hunter. On appeal to the district court, the trial judge overruled the Commissioner and held in favor of Mr. Hunter. Glenwood State Hospital and the State of Iowa appeal. We reverse the district court and remand.
George Hunter filed a workers' compensation claim alleging in substance that his wife Sandra's death arose out of and in the course of her employment at the Glenwood State Hospital. An initial hearing was held before a deputy workers' compensation commissioner, who ruled that Sandra's death arose out of and in the course of her employment and awarded benefits to her husband.
Glenwood and the State of Iowa (State) appealed to the Workers' Compensation Commissioner, who found for the State and, in doing so, held that although Sandra's death occurred during the course of her employment, it did not arise out of her employment. Thus George Hunter was not entitled to workers' compensation benefits.
George Hunter then appealed to the district court. That court, after hearing oral arguments, ruled in favor of Mr. Hunter. It overruled the Commissioner's decision, reinstated the deputy's finding and remanded for further determination of the weekly benefits to be paid George Hunter. For the reasons set forth below, we reverse the district court and affirm the decision of the Commissioner.
I. Sandra Hunter was employed as a resident treatment worker at Glenwood State Hospital School. On the evening of August 21, 1997, Sandra and her coworker, Joyce Westpfahl were working in House 239. A client named Billy was having behavior problems. Sandra was making entries in her daybook when Billy came over and grabbed the book. Sandra retrieved the book and after Billy swung at her, she restrained him with Joyce's help and asked him to calm down.
Sandra then returned to a work table and Billy again grabbed the daybook. He took a swing at Sandra. She again was able to restrain him. Sandra then attempted to retrieve her book. Billy resisted and began what is described as windmilling his arms. The entire sequence of events had taken no more than two or three minutes. It was at this point that Sandra pitched forward and collapsed.
II. As our supreme court stated in IBP, Inc. v. Harpole, 621 N.W.2d 410, 414 (Iowa 2001):
Statutory law dictates how we review appeals from administrative actions. Iowa Code § 17A.19(8) (1999). "On review of agency actions, this court functions solely in an appellate capacity to correct errors of law on the part of the agency."
The subsequent appeal of the district court's review of the agency decision "is limited to determining whether the district court correctly applied the law in exercising its section 17A.19(8) judicial review function." However, the district court, as well as this court, is "bound by the commissioner's factual findings if they are supported by substantial evidence in the record." The district court may reverse the agency finding if it is not supported by substantial evidence. Iowa Code§ 17A.19(10)(f). Upon our review of the district court's reversal, "we apply the standards of section 17A.19(8) to the agency action to determine whether our conclusions are the same as those of the district court." We will affirm if the district court satisfied its standard of review.
(Citations omitted.)
In this appeal, we are asked to determine whether the district court's decision was proper. In this respect, we must decide whether the Commissioner's decision was supported by substantial evidence such that the district court erred in reversing it. In looking at Iowa Code section 17A.19(10) (2001), we note that while an agency's legal determinations are entitled to only limited deference, its factual determinations are binding if supported by substantial evidence. As defined:
Since neither party raises an issue or argues subsequent amendments to Iowa Code section 17A.19 et al., we assume the parties agree that these proceedings are unaffected by the 1998 amendments to those sections.
"Substantial evidence" means the 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.
The district court determined that there was not substantial evidence to support the Commissioner's conclusion that death did not arise out of Sandra's employment. It concluded by holding that "substantial evidence supports the exact opposite conclusion."
III. Three expert witnesses testified by deposition: Dr. Roffman, the pathologist who performed the autopsy upon Sandra, Dr. Taylor, a neurologist at St. Joseph Hospital in Omaha, and Dr. Adams, a neurologist from the University of Iowa Hospitals and Clinics in Iowa City. Each doctor is truly an expert in his field of medicine. Dr. Roffman has experience and expertise in determining the cause of unexpected death, and Dr. Adams has expertise in the area of cerebrovascular disease. Dr. Taylor is board certified in neurological surgery and is an associate professor of surgery at Creighton University.
The Commissioner carefully and meticulously evaluated the testimony of each doctor. In her opinion, she states:
The doctors offering testimony in this case well qualified to give expert, medical opinion. They all had similar, accurate history on which to form their opinions. All agree that Sandra Hunter had a sudden, severe subarachnoid hemorrhage. They all agree that the brain hemorrhage caused her death.
The experts differed, however, over whether her death was related to the work. Drs. Roffman and Adams, after giving extensive medical testimony on the subject at hand, determined that neither the state of current medical knowledge nor the known facts of the case supported a conclusion that Sandra's work caused her fatal hemorrhage. Dr. Taylor also gave extensive testimony, concluding that Sandra's altercation with Billy was the significant cause of her hemorrhage and death.
IV. Counsel agree that Sandra's injury occurred in the course of her employment. The issue remaining then is whether her death arose out of her employment. "Arising out of" refers to the cause of the injury. The burden of proving causal connection between employment and injury rests with Hunter. Blacksmith v. All-American, Inc., 290 N.W.2d 348, 353 (Iowa 1980). The claimant must show by a preponderance of the evidence that Sandra's death was a "natural incidence of work. This means that it must be a rational consequence of a hazard connected with the employment." Miedema v. Dial Corp., 551 N.W.2d 309, 311 (Iowa 1996). The question is whether the diseased condition was the cause, or whether the employment is a proximate contributing cause. Littell v. Lagomarcino Grupe Co., 235 Iowa 523, 529, 17 N.W.2d 120, 124 (1945).
As the appellee points out in his brief, our review of an agency decision is not de novo. We are bound by the agency's findings of fact if they are supported by substantial evidence. Dico, Inc. v. Iowa Employment Appeal Bd., 576 N.W.2d 352, 354 (Iowa 1998). We, of course, are not bound by the agency's determination of the law. Madrid Home for the Aging v. Iowa Dep't of Human Servs., 557 N.W.2d 507, 510 (Iowa 1996). In this regard, we find no error.
The question of causal connection generally requires expert testimony. Bradshaw v. Iowa Methodist Hosp., 251 Iowa 375, 382-83, 101 N.W.2d 167, 171 (1960). The Commissioner, after carefully considering the testimony of each expert, accepted the medical testimony of Drs. Roffman and Adams over that of Dr. Taylor. It was within her province, as trier in fact, to determine which testimony was to be believed. Whether an injury is causally connected to employment is largely a factual, rather than a legal decision. Hemker v. Drobney, 253 Iowa 421, 429, 112 N.W.2d 672, 676 (1962).
Here, there is indeed conflicting testimony. But as our supreme court stated in Harpole, 621 N.W.2d at 418:
"An agency's decision does not lack substantial evidence because inconsistent conclusions may be drawn from the same evidence." Second Injury Fund v. Shank, 516 N.W.2d 808, 812 (Iowa 1994). This statement is the hallmark of this case. Regardless that there is contradictory medical evidence present, "[i]n such a case we cannot interfere with the commissioner's findings of fact." Id. If a reasonable person could have concluded the initial injury exacerbated the later problems and, thereby, amounted to proximate cause, the district court erred by reversing the commissioner's ruling. Stated another way, because
[t]he review is for correction of errors at law, not de novo, . . . the findings of the industrial commissioner have the effect of a jury verdict. . . . The possibility of drawing inconsistent conclusions from the same evidence does not mean an agency's decision lacks substantial support. In the case of conflict in the evidence we are not free to interfere with the commissioner's findings.Kostelac v. Feldman's, Inc., 497 N.W.2d 853, 856 (Iowa 1993) (citations omitted).
"Ultimately the question is not whether the evidence might support a different finding, but whether the evidence supports the finding actually made." Sherman v. Pella Corp., 576 N.W.2d 312, 320 (Iowa 1998). Even if "as fact finder, we might have found otherwise," we must affirm if there is enough testimony to support the finding. Id. We conclude the Commissioner's decision is supported by substantial evidence. The district court erred in not so finding.
V. In one part of his brief, Hunter asserts the district court "correctly determined that the Commissioner applied an improper burden of proof by requiring proof by certainty. . . ." We are unable to find from our examination of the trial court's ruling that it reversed the Commissioner's ruling on a burden of proof issue.
We have reviewed this issue and find the Commissioner applied the correct standard when determining whether Hunter proved Sandra's employment was a proximate cause of her death. In her ruling under Conclusions of Law, the Industrial Commissioner stated:
The party who would suffer loss if an issue were not established has the burden of proving that issue by a preponderance of the evidence.
The claimant has the burden of proving by a preponderance of the evidence that the alleged injury actually occurred and that it arose out of and in the course of employment. The words "arising out of" refer to the cause or source of the injury. The words "in the course of" refer to the time, place and circumstances of the injury.
The claimant has the burden of proving by a preponderance of the evidence that the injury is a proximate cause of the disability on which the claim is based. A cause is proximate if it is a substantial factor in bringing about the result; it need not be the only cause. A preponderance of the evidence exists when the causal connection is probable rather than merely possible.
The question of causal connection is essentially within the domain of expert testimony. The expert medical evidence must be considered with all other evidence introduced bearing on the causal connection between the injury and the disability. The weight to be given to any expert opinion is determined by the finder of fact and may be affected by the accuracy of the facts relied upon by the expert as well as other surrounding circumstances. The expert opinion may be accepted or rejected, in whole or in part.
(citations omitted.)
We find no error under this division.
In conclusion, we reverse the district court and remand for entry of judgment affirming the agency decision.
REVERSED AND REMANDED.