IN THE COURT OF APPEALS OF IOWA

No. 14-0336

Filed October 15, 2014

EMCO and OLD REPUBLIC INSURANCE COMPANY,

Plaintiffs-Appellants,

vs.

AVDULAH SEHIC,

Defendant-Appellee.

________________________________________________________________

Appeal from the Iowa District Court for Polk County, Michael D. Huppert, 

Judge.

EMCO appeals from the district court’s order affirming the Iowa Workers’

Compensation Commissioner’s award of thirty-five percent industrial disability to 

Avdulah Sehic. AFFIRMED.

Timothy W. Wegman and Joseph M. Barron of Peddicord, Wharton, 

Spencer, Hook, Barron & Wegman, L.L.P., West Des Moines, for appellants.

Adnan Mahmutagic of Beecher, Field, Walker, Morris, Hoffman 

& Johnson, P.C., Waterloo, for appellee.

Considered by Danilson, C.J., and Vogel and Bower, JJ.
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VOGEL, J.

EMCO appeals from the district court’s order affirming the Iowa Workers’

Compensation Commissioner’s award of thirty-five percent industrial disability to 

Avdulah Sehic, claiming the award is not supported by substantial evidence. 

Because we conclude there is some evidence in the record showing Sehic

sustained a work injury that caused a disability, we affirm the decision of the 

district court.

I. Factual and Procedural Background

Sehic was born in Bosnia and came to the United States in 1999. He was 

sixty-three at the time of the hearing, and had worked at EMCO making door and 

window frames since June 7, 1999. He did not complete any education in the 

United States and speaks only limited English. On August 17, 2010, Sehic 

sustained an injury to his neck and lower back after falling while carrying a door 

frame from one machine to another. He stated he did not remember how he fell 

or what happened but that he did lose consciousness. 

The record contains several reports from a number of different examining 

and treating doctors regarding Sehic’s injury and subsequent disability. On 

August 18, 2010, Sehic was examined by Anandeep Kumar, M.D., whose report 

stated Sehic had lower back pain. The second report, dated August 24, noted 

Sehic also reported pain in his mid-back and cervical spine, and he had shooting 

pain radiating upwards that made him dizzy, as well as numbness and tingling in 

both upper and lower extremities. Dr. Kumar’s report also stated: “In addition to 

physical impairments, [Sehic] does demonstrate psychological barriers to 

recovery including anxiety and depression, and these are provocative of 
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subjective pain perceptions. He may benefit from ongoing counseling sessions.” 

On several occasions Sehic informed Dr. Kumar he wanted to be taken off work 

completely, to take advantage of earned sick days. In his subsequent 

examinations, Dr. Kumar noted Sehic was not always compliant with taking his 

medications or consistently attending physical therapy.

On October 27, 2010, Sehic was examined by M.S. Iqbal, M.D., with the 

aid of an interpreter. Dr. Iqbal diagnosed Sehic with myofascial pain syndrome 

lumbar, thoracic and cervical spine; lumbar radicular pain; and dizziness, etiology 

unknown. He performed various trigger point injections at that time as well as on 

December 16. On February 28, 2011, Dr. Iqbal reported: “I could not find any 

objective evidence to support any need for permanent work restrictions or 

permanent functional impairment pursuant to AMA Guidelines, 5th Edition. I do 

not see any objective reason for further medical treatment for the alleged work 

related injury of August 17, 2010.” 

Steven Adelman, D.O., a neurologist, examined Sehic on November 1, 

2010. Dr. Adelman’s report stated:

Mr. Sehic presents as a 61-year-old gentleman who suffered a 

work-related injury in mid August when he fell and subsequently 

has had low back pain, neck pain, headache, and dizziness. His 

neurologic examination is normal as are the MRIs of his cervical 

and lumbar spine. Clinically, I suspect we are dealing with 

musculoskeletal lumbar and cervical pain along with tension-type 

headaches. His vertigo is fairly nonspecific in nature. Certainly, I 

do not believe that he has suffered an intracranial lesion. I suspect 

he may have some degree of vestibular dysfunction . . . . 

Obviously, his symptoms are subjective in nature. I see nothing 

that would suggest that he will have any permanent impairment 

from his work-related accident. 
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David Boarini, D.O., performed an independent medical examination (IME) 

on February 2, 2011, and in his report dated February 15, asserted Sehic’s:

[M]ain difficulty at the present time is back pain, although he 

has some neck pain. He has an extremely positive review of 

symptoms, which would be consistent with no possible physical 

finding and is strongly suggestive of psychological difficulties or 

symptom exaggeration.

. . . .

I reviewed the patient’s MRI scans of the entire spine. They 

show some minimal degenerative changes in the neck and back 

consistent with his age but no sign of anything unusual, significant, 

or traumatically related. This patient has simple myofascial pain 

from a rather nonspecific injury. He has signs of symptom 

exaggeration, as noted above. I don’t find any physical basis for 

the patient’s ongoing difficulties. I don’t see anything that should 

keep him from returning to normal activities and do not find 

anything upon which to base an impairment rating. 

Arnold Delbridge, D.O., performed another IME on April 28, 2011, and 

found no evidence of impairment regarding Sehic’s neck. His report opined:

In summary, Mr. Sehic had a fall at work. He was examined shortly 

thereafter by the nurse and by Dr. Kumar and was found to have 

specific findings related to the fall which are reasonably consistent 

with the history. Mr. Sehic was noted by different examiners to 

have limited range of motion and has continued to have limitation of 

motion in the cervical and lumbar spine in particular. He did not 

respond well to medications, trigger point injections, or physical 

therapy. 

Dr. Delbridge further noted: 

There does appear to be some effort on [Sehic’s] part to convince 

me that he was injured; however, he has had physical findings with 

a fall as he describes immediately after the injury which persist to 

the present time; most particularly of limited motion of the cervical 

and lumbar spine.

Consequently, Dr. Delbridge assigned a five percent whole-body impairment 

rating and placed restrictions on lifting heavy objects from the floor, repeated 

twisting of the head or body, and a lift-restriction of no more than forty pounds.
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On August 24, 2012, Sunil Bansal, M.D., performed another IME and 

found Sehic’s lumbar back and cervical neck symptoms were caused by his work 

injury. In the examination Sehic reported a six out of ten on a pain scale, with the 

pain increasing to seven or eight after activity or when the medication wore off. 

Dr. Bansal’s report stated: 

It is implausible that [Sehic] would have been able to perform the 

above duties on a sustained basis with his current lumbar back and 

cervical neck pathological state. Thus, from both a chronological 

and mechanistic standpoint it is clear that his back pathology is 

related to his work injury on 8/17/2010.

Dr. Bansal assigned Sehic a twelve-percent whole body impairment rating, 

advising that Sehic not lift more than twenty pounds frequently and forty pounds 

occasionally. Dr. Bansal placed Sehic at MMI as of August 24, 2012.

Scott Neff, D.O., performed another IME on October 22, 2012. He noted 

Sehic’s x-rays only showed degeneration consistent with Sehic’s age as well as 

an exaggerated pain response. He found no evidence demonstrating an injury to 

Sehic’s lower back. He did not have any recommendations for further treatment. 

Sehic was also seen at Broadlawns Medical Center on several different 

occasions with complaints of pain in his back and neck.

Sehic continued to work at EMCO after his injury in a position designed to 

accommodate his medical restrictions. However, EMCO terminated Sehic on 

June 9, 2011, based on Sehic’s refusal to perform his work duties. Sehic 

claimed the type of work was not properly within his medical restrictions, despite 

EMCO’s assessment that the new work activities accommodated Sehic’s 

disability. Sehic applied for unemployment benefits but was ultimately denied. 
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On November 23, 2011, Sehic filed a petition with the Iowa Workers’ 

Compensation Commissioner. A hearing was held and Sehic was awarded 175 

weeks of permanent partial disability benefits, with a finding he suffered a thirtyfive percent industrial disability. The commissioner affirmed the decision without 

additional analysis. The district court, after aptly noting it was not in a position to 

reweigh the competing medical testimony, issued a decision on February 12, 

2014, affirming the commissioner. EMCO appeals. 

II. Standard of Review

Under Iowa Code section 17A.19 (2013), our review of agency action is to 

determine whether our conclusions are the same as those of the district court. 

Stephenson v. Furnas Elec. Co., 522 N.W.2d 828, 831 (Iowa 1994). “The district 

court may grant relief if the agency action has prejudiced the substantial rights of 

the petitioner, and the agency action meets one of the enumerated criteria 

contained in section 17A.19(10)(a) through (n).” Renda v. Iowa Civil Rights 

Comm’n, 784 N.W.2d 8, 10 (Iowa 2010). Reviewing the record as a whole, we 

may reverse, modify, affirm, or remand to the agency for further proceedings if 

the agency’s factual findings are not supported by substantial evidence, or its 

application of law to the facts is irrational, illogical, or wholly unjustifiable. 

Westling v. Hormel Foods Corp., 810 N.W.2d 247, 251 (Iowa 2012); Second 

Injury Fund v. Nelson, 544 N.W.2d 258, 264 (Iowa 1995).

Evidence is substantial if a reasonable mind would accept it as adequate 

to reach the conclusion at issue. Suluki v. Emp’t. Appeal Bd., 503 N.W.2d 402, 

404 (Iowa 1993). The mere fact that we could draw different conclusions from 

the same evidence does not mean substantial evidence does not support the 
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commissioner’s findings. Kostelac v. Feldman’s, Inc., 497 N.W.2d 853, 856 

(Iowa 1993). Thus, the ultimate question is not whether the evidence supports a 

different finding, but whether it supports the findings the commissioner actually 

made. Reed v. Iowa Dep’t of Transp., 478 N.W.2d 844, 846 (Iowa 1991).

III. Industrial Disability Award

EMCO claims because there were numerous medical opinions stating 

Sehic did not suffer a disability, and the deputy commissioner found Sehic’s 

testimony unreliable, substantial evidence does not support the commissioner’s 

award of thirty-five percent industrial disability.

The decision awarding benefits stated:

Since his fall at work, claimant has consistently complained 

of significant symptoms in his neck, back and dizziness. The 

medical evidence is consistent that MRIs and x-rays do not show 

any significant findings which would account for the level of 

claimant’s pain.

. . . .

The record shows claimant has symptoms, which appear to 

be exaggerated when he has been examined. There have been a 

number of suggestions that claimant may have psychological 

difficulties. There is no evidence that any psychological evaluation 

took place. The claimant has exhibited symptoms out of proportion 

to the objective medical evidence. However, as noted by Dr. 

Delbridge in his April 28, 2011 IME:

“In summary, Mr. Sehic had a fall at work. He was examined 

shortly thereafter by the nurse and by Dr. Kumar and was found to 

have specific findings related to the fall which are reasonably 

consistent with the history. Mr. Sehic was noted by different 

examiners to have limited range of motion and has continued to 

have limitation of motion in the cervical and lumbar spine in 

particular.”

I find Dr. Delbridge’s opinions to be the most convincing of 

the IMEs and medical opinions in this case. Dr. Iqbal found 

claimant had myofascial pain syndrome lumbar, thoracic and 

cervical spine, Dr. Boarini found claimant had simple myofascial 

pain. Dr. Simon noted evidence of myofascial pain or spasms. 

Broadlawns noted claimant had chronic neck and back pain. Dr. 

Bansal found the claimant had back pathology related to his work.
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. . . .

Dr. Neff did not find claimant had any work injury. He 

attributed claimant’s condition to degenerative disease of the 

cervical, thoracic and lumbar spine. Dr. Neff’s opinion is not 

convincing. It does not adequately explain the fact that claimant 

was essentially symptom free before his fall at work in August 2010 

and has had chronic back pain since that date. It is true no MRI 

has shown significant results. It is also true the claimant 

consistently sought treatment for back and neck symptoms since 

his fall.

The deputy then found, due to Sehic’s limited education and ability to speak 

English, that he had suffered a thirty-five percent industrial disability as a result of

his work injury.

Our court is bound by the rule that “[o]ur analysis is shaped largely by the 

deference we are statutorily obligated to afford the commissioner’s findings of 

fact.” Mike Brooks, Inc. v. House, 843 N.W.2d 885, 889 (Iowa 2014). However 

attenuated from the weight of the evidence the commissioner’s decision may be, 

as long as there is some evidence supporting the conclusion, we must affirm the 

commissioner. See id. at 889–90; Arndt v. City of Le Claire, 728 N.W.2d 389, 

394 (Iowa 2007) (“Making a determination as to whether evidence ‘trumps’ other 

evidence or whether one piece of evidence is ‘qualitatively weaker’ than another 

piece of evidence is not an assessment for the district court or the court of 

appeals to make . . . .”). Due to the opinion of Dr. Delbridge, who was found to 

“be the most convincing” among the medical opinions, there is some evidence 

supporting the causal connection between Sehic’s injury and his reported 

disability. Consequently, despite the deputy’s own finding that Sehic was not 

credible, as well as the majority of the doctors who concluded Sehic was not 

suffering from a permanent disability, we must conclude substantial evidence 
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supports the commissioner’s decision. See Kostelac v. Feldman’s, Inc., 497

N.W.2d 853, 856 (Iowa 1993) (“In the case of conflict in the evidence we are not 

free to interfere with the commissioner's findings.”). We therefore affirm the 

decision of the district court, which affirmed the commissioner.

AFFIRMED.