Opinion
No. 4-306 / 03-0861
Filed August 11, 2004
Appeal from the Iowa District Court for Polk County, Carla T. Schemmel, Judge.
Wal-Mart Stores, Inc. seeks further judicial review of a decision of the workers' compensation commissioner. AFFIRMED.
Chad M. Von Kampen of Simmons, Perrine, Albright Ellwood, P.L.C., Cedar Rapids, for appellants.
Jackie D. Armstrong of Brown, Kinsey Funkhouser, P.L.C., Mason City, for appellee.
Considered by Vogel, P.J., and Hecht and Vaitheswaran, JJ.
Mary Goeken injured her hands and wrists while working as a pharmacy technician at Wal-Mart. She was diagnosed with carpal tunnel syndrome, had surgery to ease the pain, and resigned her position. The surgery provided temporary relief but the pain resumed. Goeken began experiencing depression.
Goeken sought workers' compensation benefits. Following a hearing, a deputy workers' compensation commissioner awarded her permanent partial disability benefits for carpal tunnel syndrome in her right arm and ordered Wal-Mart to pay the reasonable medical expenses associated with her treatment for depression. The award was affirmed in an intra-agency appeal and on judicial review. On further judicial review, we also affirm.
I. Scope of Review
Wal-Mart essentially claims that the deputy commissioner's fact findings are not supported by substantial evidence. "Substantial evidence" is that which a reasonable and neutral person would find satisfactory to demonstrate the existence of a fact "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) (2001); Wal-Mart Stores, Inc. v. Caselman, 657 N.W.2d 493, 499 (Iowa 2003).
II. Carpal Tunnel Syndrome
Wal-Mart contends that the deputy commissioner's decision with respect to Goeken's right arm 1) discounts the opinions of treating physicians, 2) ignores Goeken's lack of credibility, and 3) affords too much weight to the opinion of an independent medical examiner.
A. Treating Physicians.
In determining whether an agency decision is supported by substantial evidence, a reviewing court must consider evidence detracting from an agency's findings, as well as evidence supporting the findings. Iowa Code § 17A.19(10)(f)(3); Caselman, 657 N.W.2d at 499. At issue here are the opinions of Drs. John Yankey and Delwin Quenzer.
In 1997, Dr. Yankey diagnosed Goeken with "probable carpal tunnel syndrome" and recommended "conservative treatment." In 2001, he again examined Goeken and concluded her complaints of wrist pain and numbness were a result of "wrist tendonitis" and not carpal tunnel syndrome.
Dr. Quenzer is the orthopedic surgeon who performed surgery on Goeken's hands. Shortly after the surgery in 1999, he opined that Goeken had "no impairment of either hand" and no work restrictions. In 2001, Wal-Mart asked Dr. Quenzer to reexamine Goeken. This time, Dr. Quenzer examined Goeken's hands and wrists but diagnosed her only with "right elbow pain." He opined that the condition was "not a continuation of the previous workers' compensation claim, but rather represents a new problem."
Contrary to Wal-Mart's assertion, the deputy commissioner considered the opinions of both these doctors. After summarizing Dr. Yankey's office notes in detail, the deputy determined that these notes could "not be given much weight." He based this determination on several factors including Dr. Yankey's failure to explain his findings of wrist pain and his decision to prescribe the same type of treatment in 2001 (when he found no carpal tunnel syndrome) as he did in 1997 (when he found probable carpal tunnel syndrome).
Wal-Mart takes issue with the fact that the deputy commissioner also relied on his own experience and knowledge of carpal tunnel syndrome and tendonitis. The company's argument ignores the maxim that an agency is free to use its "experience, technical competence, and specialized knowledge" to evaluate evidence. Iowa Code § 17A.14(8).
Wal-Mart next challenges the deputy commissioner's reliance on Goeken's recounting of more supportive statements Dr. Yankey made to her during an office visit, as well as Dr. Yankey's "employment relationship with defendants." These factors go to Dr. Yankey's credibility and are entitled to deference. Clark v. Iowa Dep't of Revenue Fin., 644 N.W.2d 310, 315 (Iowa 2002).
As for Dr. Quenzer's 2001 opinion, the deputy commissioner found it "a bit odd" that the opinion made no reference to Goeken's wrist pain despite the fact that this was the basis of all her complaints. The deputy elected to afford Dr. Quenzer's opinion little weight in light of Goeken's "very credible" testimony of "ongoing wrist symptoms" and her husband's "credible" testimony of "many hand problems." Again, we defer to the deputy's assignments of credibility. Id. B. Goeken's Credibility.
Wal-Mart next contends that the deputy commissioner should not have relied on Goeken's testimony because her credibility was severely impeached. In particular, Wal-Mart points to Goeken's insistence that she was fired in the face of concrete evidence that she resigned.
The deputy commissioner specifically addressed Goeken's testimony concerning the reason for her separation from Wal-Mart and determined that Goeken's belief that she was fired was "based upon speculation, not fact." This determination did not mandate that he reject all her testimony, including her subjective complaints of pain. Cf. McVay v. Carpe, 238 Iowa 1131, 1138, 29 N.W.2d 582, 585 (1947) ("The testimony of a witness is to be judged as a whole even if it is contradictory and conflicting."). Notably, the deputy commissioner made several positive credibility findings concerning Goeken's testimony about her impairments. We defer to those findings. Clark, 644 N.W.2d at 315.
C. Independent Medical Examiner.
Wal-Mart asserts that the deputy commissioner gave too much weight to the opinion of Dr. Ban, an independent medical examiner retained by Goeken to evaluate her complaints of wrist pain. We disagree. The deputy summarized Dr. Ban's report and explained why he was giving "the most weight" to his views. He stated:
Only Dr. Ban has demonstrated a greater knowledge of [the American Medical Association] guides in his detailed and extensive report on how the guides were utilized by him in arriving at his rating. Neither Dr. Quenzer nor Dr. Yankey explained how they arrived at their ratings. Also, Dr. Ban, given his specialty, has specialized knowledge in rating impairments. Finally, only the views of Dr. Ban are consistent with the credible testimony received from Mary and her husband
The deputy acted well within his authority in choosing Dr. Ban's opinion over those of the other physicians, as the weight to be given medical opinions is for the agency to decide. St. Luke's Hosp. v. Gray, 604 N.W.2d 646, 652 (Iowa 2000); Sanchez v. Blue Bird Midwest, 554 N.W.2d 283, 285 (Iowa Ct.App. 1996).
III. Depression
Approximately six to eight months before her workers' compensation hearing, Goeken sought treatment for depression from psychiatrist Dale Armstrong. The deputy commissioner found the depression causally related to her employment. Wal-Mart takes issue with this finding, asserting that Dr. Armstrong's opinion does not establish causation. We disagree.
In 2001, Dr. Armstrong diagnosed Goeken with "major depressive disorder — single episode of moderate intensity." He noted that this was her first mental health treatment and that she had no "prior history of depression." He opined, "[h]er situation is completely consistent with someone who's current mental distress is related to the bilateral wrists injury at Walmart and the consequences of not being able to move forward with her life as she had planned." This opinion, together with Goeken's testimony concerning the onset of her depression, amounts to substantial evidence of causation. See Giere v. Aase Haugen Homes, Inc., 259 Iowa 1065, 1072-73, 146 N.W.2d 911, 915-16 (1966).
IV. Disposition
On further judicial review, we affirm the commissioner's workers' compensation decision.