Opinion
No. 2-237 / 01-0560
Filed October 30, 2002
Appeal from the Iowa District Court for Polk County, George W. Bergeson, Judge.
Mike Saylor appeals the district court's judgment on judicial review affirming the workers' compensation commissioner's denial of workers' compensation benefits for work-related shoulder and mental health injuries. Manpower, Inc. cross-appeals from the district court's judgment affirming the commissioner's award of benefits for Saylor's work-related permanent knee injury. The Second Injury Fund cross-appeals from the district court's reversal of the commissioner's decision denying Saylor Second Injury Fund benefits. AFFIRMED IN PART, REVERSED IN PART, AND REMANDED.
Richard R. Schmidt of Berg, Rouse, Spaulding Schmidt, P.L.C., Des Moines, for appellant.
Michael L. Mock of Bradshaw, Fowler, Proctor Fairgrave, P.C., Des Moines, for appellees Manpower, Inc. and EMC Insurance Companies.
Thomas J. Miller, Attorney General, and Shirley A. Steffe, Assistant Attorney General, for appellee Second Injury Fund.
Heard by Sackett, C.J., and Huitink and Hecht, JJ.
I. Background Facts and Proceedings.
Mike Saylor's claim for workers' compensation benefits stems from injuries he sustained when the pneumatic staple gun he was using discharged a staple into his left knee on December 7, 1995. Saylor also fell during this incident, striking his right elbow on a worktable and the floor. As a result, Saylor sought benefits for his knee, right elbow, right shoulder, and mental health injuries. Saylor also sought Second Injury Fund benefits based on a first injury to his left knee in 1979 and the right elbow injury sustained in this incident.
The commissioner summarily rejected Saylor's mental health claim, citing the absence of evidence establishing a causal connection between the December 7 incident and his mental health. After determining Saylor suffered an injury to a scheduled member (right arm), the commissioner found Saylor sustained a "twelve percent functional loss impairment to his right upper extremity or arm."
Whether the puncture wound to Saylor's left knee necessitated a total knee replacement or otherwise caused permanent partial disability were issues vigorously disputed before the commissioner. After noting conflicting medical opinions on this issue, the commissioner determined Saylor's work-related injury required a total knee replacement. The commissioner then determined Saylor suffered a twenty-five percent functional loss to his left knee with a resulting entitlement to weekly compensation for fifty-five weeks as a scheduled injury to the left leg. The commissioner additionally found that Saylor had shoulder problems dating back to 1991 and that his right shoulder had not significantly changed as the result of his December 7 injury. Saylor's claims for permanent partial disability and healing period benefits for his shoulder were accordingly denied.
The commissioner found Saylor was entitled to temporary total healing period benefits for the injuries to his right elbow and left knee that resulted in permanent impairment. Citing expert testimony indicating Saylor reached maximum medical improvement on August 31, 1998, the commissioner awarded healing period benefits from December 7, 1995, through that date.
The commissioner rejected Saylor's Second Injury Fund claim. The commissioner's appeal decision states:
In the case before us, claimant sustained two scheduled member injuries in the same scheduled member (left knee), and the second claimed injury resulted in injury to the body as a whole. Since compensation is only available from the Second Injury Fund where two injuries were to specific scheduled members, claimant's assertion against the Second Injury Fund fails on this record as a matter of law.
Saylor sought judicial review challenging the commissioner's denial of Second Injury Fund benefits as well as the denial of benefits for his shoulder and mental health injuries. Manpower also sought judicial review, challenging the commissioner's award of excessive healing period and permanent partial disability benefits for Saylor's knee and right elbow injuries. The district court affirmed the commissioner's decision in all respects except the commissioner's denial of Second Injury Fund benefits. The court reversed on that issue and remanded to the commissioner for an award of Second Injury Fund benefits.
On appeal Saylor challenges the district court's decision citing insufficient evidentiary support for the commissioner's denial of benefits for his shoulder and mental health injuries. He also argues the district court correctly affirmed the commissioner's award of healing period and permanent partial disability benefits for his knee and elbow injuries. Saylor further argues the district court's remand for an award of Second Injury Fund benefits should be affirmed.
Manpower cross-appeals, challenging the sufficiency of the evidence supporting an award of benefits for Saylor's knee injury. Manpower also argues the district court erroneously affirmed the commissioner's award of healing period and permanent disability benefits for Saylor's knee and elbow injuries. Manpower further argues the district court's decision correctly affirmed the commissioner on all issues concerning Saylor's shoulder and mental health injuries.
The Second Injury Fund contends the district court should have affirmed the commissioner's denial of Second Injury Fund benefits. The Fund alternatively argues that even if the commissioner wrongfully decided this issue, the district court's remand order requiring entry of an award of fund benefits exceeded the court's judicial review jurisdiction.
II. Standard of Review.
Our review is for errors of law. Squealer Feeds v. Pickering, 530 N.W.2d 678, 681 (Iowa 1995). We may reverse, modify, affirm or remand for further agency proceedings if the action is affected by error of law or if it is not supported by substantial evidence. Iowa Code § 17A.19(8) (1995). We give deference to the agency's findings of facts. Meads v. Iowa Dep't of Social Servs., 366 N.W.2d 555, 561 (Iowa 1985).
III. The Merits. A. Mental Health Injury.
As noted earlier, Saylor's claim for mental health benefits was denied because he failed to establish a causal connection between his mental condition and any work-related injury. Our review of the record discloses abundant evidentiary support for the commissioner's factual findings on this issue, including expert testimony indicating that there was no relationship between Saylor's mental condition and work history. The commissioner, as the finder of fact, was free to accept this testimony and reject other evidence to the contrary. See Sondag v. Ferris Hardware, 220 N.W.2d 903, 907 (Iowa 1974). We accordingly affirm on this issue.
B. Shoulder Injury.
The gist of the commissioner's ruling was that Saylor did not sustain a permanent injury to his right shoulder. The record includes conflicting expert testimony on this issue. Manpower's expert testified that Saylor's shoulder complaints were of "unproven etiology and not causally related to the December 1995 injury." The commissioner was free to accept this testimony and reject Saylor's evidence to the contrary. See id. We also affirm on this issue.
C. Knee Injury.
Manpower argues that the record conclusively establishes that Saylor sustained no more than a puncture wound to his knee and that this injury did not cause or otherwise necessitate total replacement of his knee. Manpower cites Saylor's extensive history of knee problems including preexisting degenerative joint disease. Manpower also cites expert testimony that "the puncture wound . . . did not cause or aggravate Saylor's significant, severe pre-existing degenerative arthritis caused by numerous traumatic injuries and surgeries from 1970 through 1995." Both the deputy commissioner and the commissioner ultimately resolved this issue against Manpower by assigning greater credibility to the physician who performed Saylor's total knee replacement. The operating physician testified that Saylor's puncture wound exacerbated his preexisting arthritic condition. He also testified that Saylor's injury was more debilitating than first thought because the staple punctured Saylor's patella tendon. The disposition of this issue, like the foregoing, is controlled by our standard of review. The commissioner, as the finder of fact, was free to accept or reject any or all of the expert testimony on this issue, and we are required to defer to those findings based on the commissioner's credibility assessments. Id. We affirm on this issue.
D. Healing Period Permanent Partial Disability Benefits.
Iowa Code section 85.34(1) provides that healing period benefits are payable to an injured worker who has suffered permanent partial disability until (1) the worker has returned to work, (2) the worker is medically capable of returning to substantially similar employment, or (3) the worker has achieved maximum medical recovery. In awarding healing period benefits the commissioner expressly referred to medical evidence indicating Saylor reached maximum medical improvement for his injuries (right elbow and right knee) August 3, 1998. It is sufficient to note that Manpower's contrary interpretation of the same evidence affords no basis for our interference. See Second Injury Fund v. Shank, 516 N.W.2d 808, 812 (Iowa 1994).
Manpower's challenge to the commissioner's award of permanent partial disability benefits for Saylor's left knee fails for the same reason. The commissioner's award was premised on expert testimony assigning a fifty-percent total disability to the left leg, and equal apportionment of that disability between Saylor's preexisting arthritic condition and December 7, 1995, injury. Because Manpower's arguments are nothing more than a rehash of its earlier rejected causation argument, it has no merit. We also affirm on this issue.
E. Second Injury Fund.
The Iowa Second Injury Fund compensates an injured worker for a permanent industrial disability resulting from the combined effect of two separate injuries to a scheduled member. Iowa Code §§ 85.63-85.69. There are three requirements under the statute to invoke Second Injury Fund liability. Shank, 516 N.W.2d at 812. First, there must be a permanent loss or loss of use of one hand, arm, foot, leg, or eye. Id. Secondly, there must be a permanent loss of use of another such member or organ through a compensable subsequent injury. Id. Third, there must be permanent industrial disability to the body as a whole arising from both the first and second injuries, which is greater in terms of relative weeks of compensation than the sum of the scheduled allowances for those injuries. Id. If there is greater industrial disability due to the combined effects of the prior loss and the secondary loss than equals the value of the prior and secondary losses combined, then the Fund will be charged with the difference. Second Injury Fund v. Nelson, 544 N.W.2d 258, 269 (Iowa 1995); Anderson v. Second Injury Fund, 262 N.W.2d 789, 790 (Iowa 1978).
Second Injury Fund liability requires both the first and second injuries be scheduled member injuries. Nelson, 544 N.W.2d at 269. Scheduled member injuries are those parts of the body specifically listed in Iowa Code section 85.34(2)(a)-(t).
Saylor sought Second Injury Funds benefits based on a first injury to his left knee predating December 7, 1995, and a second injury to his left elbow on that date. As noted earlier, the commissioner denied fund benefits citing the absence of a second injury to a scheduled member. We are unable to reconcile this conclusion with the commissioner's conflicting determinations that Saylor's upper extremity injuries were limited to his right elbow and that he did not sustain a compensable injury to his right shoulder. Moreover, the fact that Saylor's first scheduled member injury (arthritic left knee) was affected by a second injury (puncture wound to the left knee) was of no consequence to Saylor's entitlement to Fund benefits. See Durham v. Second Injury Fund, File No. 1151170, 11167674 (Feb. 7, 2000); Putzier v. Wilson Forms Corp., File No. 835165 (May 24, 1991) (decisions by commissioner holding the fact that the first member injury is again affected by a second injury does not defeat Fund liability as long as the second injury results in loss to another scheduled member).
The undisputed record establishes that Saylor sustained a permanent first injury to a scheduled member (left knee or leg) and a permanent second injury to a scheduled member (right elbow or arm). Saylor has accordingly met the requirements triggering Second Injury Fund liability under sections 85.63-85.69. The commissioner's contrary decision is not supported by the evidence and was correctly reversed by the district court.
The remaining determination is whether Saylor suffered a resulting industrial disability to the body as a whole that is greater in terms of relative weeks of compensation than the term of the scheduled allowance for the first and second injuries. Because that determination requires additional fact finding by the agency, a remand to the agency for that purpose is therefore required. To the extent the district court's remand order provided for an award of benefits prior to an agency determination of Saylor's industrial disability, the order exceeded the district court's jurisdiction on judicial review. See Armstrong v. State of Iowa Bldgs. Grounds, 382 N.W.2d 161, 165 (Iowa 1986). The offending provisions of the district court's remand order are accordingly reversed. The judgment of the district court is affirmed in part, reversed in part, and the matter is remanded to the workers' compensation commissioner for further proceedings in conformity with our opinion.