IN THE SUPREME COURT OF IOWA 

No. 77 / 07–0468 

Filed September 5, 2008 

HOLSTEIN ELECTRIC and INTEGRITY 

MUTUAL INSURANCE COMPANY, 

 Appellants, 

vs. 

JAY BREYFOGLE, 

 Appellee. 

 Appeal from the Iowa District Court for Polk County, Robert J. 

Blink, Judge. 

 An employer and its insurance carrier appeal from the district 

court’s ruling affirming an adverse decision of the workers’ compensation 

commissioner. AFFIRMED. 

 D. Brian Scieszinski of Bradshaw, Fowler, Proctor & Fairgrave, 

P.C., Des Moines, for appellants. 

Steven D. Hamilton of Hamilton Law Firm, P.C., Storm Lake, for 

appellee. 
2

WIGGINS, Justice. 

 In this appeal we hold an injury to the wrist is to be compensated 

as an injury to the arm under Iowa Code section 85.34(2)(m) (2003). 

Additionally, because substantial evidence supports the commissioner’s 

decision, we affirm the judgment of the district court. 

I. Background Facts and Proceedings. 

Holstein Electric employed Jay Breyfogle as an electrician from 

1998 until 2004. His employment required heavy lifting, running power 

tools, swinging sledgehammers, and various other manual tasks. On 

July 16, 2002, as Breyfogle grabbed some conduit, he heard his wrist 

pop. Shortly after he heard the noise, his wrist swelled. A physician 

diagnosed Breyfogle with Kienbock’s disease, which is avascular necrosis 

of the carpal lunate. The carpal lunate is a bone located in the wrist. 

Breyfogle was referred to a hand specialist, Dr. Tiedeman. 

Breyfogle had seen Dr. Tiedeman on three separate occasions at the time 

of his compensation hearing. During the first visit Dr. Tiedeman agreed 

with the prior diagnosis of Kienbock’s disease after taking x-rays of 

Breyfogle’s wrist. During that visit Breyfogle reported he had 

intermittent discomfort in his wrist, particularly with activity, and he 

wore a brace at work and periodically at night. Dr. Tiedeman explained 

several treatment options, one being surgery, but noted surgery was only 

a salvage procedure and that Breyfogle’s wrist would never be normal or 

fully functional again. Dr. Tiedeman released Breyfogle to work without 

restrictions. 

On Breyfogle’s second visit to Dr. Tiedeman, Breyfogle reported he 

was still experiencing occasional discomfort in his wrist with activity, and 

he still wore the splint intermittently. Repeat x-rays of Breyfogle’s wrist 

were taken and did not show any further progression or change from his 
3

February x-rays. Dr. Tiedeman again opined Breyfogle’s symptoms did 

not warrant surgical intervention at that time because surgery would not 

produce a normal wrist. Dr. Tiedeman allowed Breyfogle to return to 

work without restrictions but advised him to avoid heavy lifting, forceful 

use, and the extremes of motion. 

Breyfogle returned to Dr. Tiedeman for a third visit in September 

2003. Breyfogle reported his symptoms remained unchanged and he had 

occasional discomfort in his wrist with more vigorous use. Dr. Tiedeman 

took range-of-motion measurements and opined Breyfogle’s condition 

was unchanged and fairly stable, but that the damage to his wrist was 

irreversible. Dr. Tiedeman opined Breyfogle had reached maximum 

medical improvement. He further opined Breyfogle suffered a nineteen 

percent impairment to his right wrist based on the AMA Guides to the 

Evaluation of Permanent Impairment and due to the residual loss of 

motion in his wrist as well as the loss of carpal height and strength. Dr. 

Tiedeman recommended continued conservative treatment. 

Breyfogle saw Dr. Herrera, a neurologist, in November at the 

request of his employer. Breyfogle reported he was about fifty percent 

improved and had been stable for the previous six months. On a pain 

scale of zero to ten, Breyfogle indicated his wrist pain would vary from a 

zero to a ten and that when he had severe pain it would go away in three 

to four minutes. Dr. Herrera performed range-of-motion tests and 

opined Breyfogle suffered eight percent impairment to his right upper 

extremity. He broke that down into a one percent impairment of the 

upper extremity, three percent for wrist flexion, one percent for ulnar 

deviation, and three percent for radial deviation. Dr. Herrera also based 

his opinion on the AMA Guides. 
4

Next Breyfogle saw Dr. O’Neil, an orthopedic surgeon, in June 

2004. Dr. O’Neil agreed with the impairment rating Dr. Tiedeman 

assigned. In his testimony, Dr. O’Neil admitted he did not know how 

Dr. Tiedeman arrived at his opinion, but that even if the AMA Guides did 

not provide a nineteen percent impairment rating, the rating was 

reasonable based on Breyfogle’s stage four Kienbock’s disease. 

Because section 85.34(2) does not specify whether a wrist injury 

should be compensated as a scheduled injury to the arm or hand, the 

workers’ compensation deputy commissioner concluded Breyfogle’s wrist 

injury should be compensated as an injury to the arm. The deputy gave 

more weight to Dr. Tiedeman’s testimony. The deputy went on to 

conclude Breyfogle suffered a nineteen percent impairment to his right 

arm. 

The employer and its insurance carrier appealed to the 

commissioner. The commissioner agreed that an injury to the wrist 

should be compensated as an injury to the arm. The commissioner also 

upheld the impairment rating. 

The employer and its insurance carrier filed a petition for judicial 

review. The district court made a legal conclusion that an injury to the 

wrist should be compensated as an arm injury, not a hand injury. The 

district court also upheld the agency’s impairment rating. 

The employer and insurance carrier appeal. 

II. Issues. 

The employer and the insurance carrier raise two issues on appeal: 

first, whether an injury to the wrist should be compensated as an injury 

to the hand under section 85.34(2)(l) or as an injury to the arm under 

section 85.34(2)(m) and second, whether substantial evidence supports 

the commissioner’s finding of impairment. 
5

 III. Scope of Review. 

The standard upon which we review a decision of the 

commissioner is governed by section 17A.19(10). It is well settled that 

“ ‘[t]he interpretation of workers’ compensation statutes and related case 

law has not been clearly vested by a provision of law in the discretion of 

the agency.’ ” Lakeside Casino v. Blue, 743 N.W.2d 169, 173 (Iowa 2007) 

(citation omitted). Accordingly, we will not give the commissioner’s 

interpretation of the law deference and are free to substitute our own 

judgment. Id.; see also Iowa Code § 17A.19(10)(c). 

As to the agency’s factual determinations, we determine whether 

the findings are based on “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). Factual determinations in workers’ 

compensation cases are “ ‘clearly vested by a provision of law in the 

discretion of the agency,’ ” and so is the application of the law to those 

facts. Mycogen Seeds v. Sands, 686 N.W.2d 457, 465 (Iowa 2004) 

(citation omitted). By applying the “substantial evidence” standard to the 

agency’s fact finding, we are giving the agency appropriate discretion. Id. 

When reviewing an agency’s application of the law to the facts, we reverse 

only when the agency’s application is “irrational, illogical, or wholly 

unjustifiable.” Id. This standard of review affords appropriate deference 

to the agency. Id. 
6

IV. Whether a Wrist Injury is Compensated as an Injury to the 

Hand or to the Arm.

 The scheduled injuries contained in the Code applicable to this 

appeal are as follows: 

l. For the loss of a hand, weekly compensation during one 

hundred ninety weeks. 

m. The loss of two-thirds of that part of an arm between the 

shoulder joint and the elbow joint shall equal the loss of an 

arm and the compensation therefor shall be weekly 

compensation during two hundred fifty weeks. 

Iowa Code § 85.34(2)(l), (m). The Code is silent as to whether a wrist is 

part of the hand or the arm for purposes of a scheduled injury. 

Therefore, we must determine whether the Code compensates a wrist 

injury as an injury to the hand or an injury to the arm. This requires us 

to construe sections 85.34(2)(l) and 85.34(2)(m). 

We must determine whether the language of the statute is 

ambiguous before engaging in statutory construction. State v. Spencer, 

737 N.W.2d 124, 129 (Iowa 2007). If reasonable persons could disagree 

on a statute’s meaning, it is ambiguous. Id. “ ‘Ambiguity may arise in 

two ways: (1) from the meaning of particular words; or (2) from the 

general scope and meaning of a statute when all its provisions are 

examined.’ ” Id. (quoting IBP, Inc. v. Harker, 633 N.W.2d 322, 325 (Iowa 

2001)). Under the statutory scheme of section 85.34(2), reasonable 

persons could disagree as to whether the legislature considered a wrist 

injury as an injury to the hand or to the arm. 

We look to the intent of the legislature to resolve this ambiguity. 

See State v. Wiederien, 709 N.W.2d 538, 541 (Iowa 2006). In interpreting 

a statute, we look for “an interpretation that is reasonable, best achieves 

the statute’s purpose, and avoids absurd results.” State v. Bower, 725 

N.W.2d 435, 442 (Iowa 2006). 
7

The legislature enacted the workers’ compensation statute 

primarily for the benefit of the worker and the worker’s dependents. 

Cedar Rapids Cmty. Sch. v. Cady, 278 N.W.2d 298, 299 (Iowa 1979). 

Therefore, we apply the statute broadly and liberally in keeping with the 

humanitarian objective of the statute. Id. We will not defeat the 

statute’s beneficent purpose by reading something into it that is not 

there, or by a narrow and strained construction. Id. 

The wrist is the joint located between the hand and the arm. The 

distal point of the wrist is the point between the wrist bones and the 

hand bones. The proximal point of the wrist is the point between the 

wrist bones and the arm bones. In the past when faced with analogous 

situations, this court has looked to the proximal point of the joint to 

classify an injury under the workers’ compensation statutes. Lauhoff 

Grain Co. v. McIntosh, 395 N.W.2d 834, 839–40 (Iowa 1986) (holding an 

injury to the hip joint is compensated as an injury to the body as a 

whole); Second Injury Fund v. Nelson, 544 N.W.2d 258, 269–70 (Iowa

1995) (holding an injury to the shoulder joint is compensated as an 

injury to the body as a whole). One rationale for reaching this 

conclusion is that the workers’ compensation statute is to be construed 

in favor of the worker. Lauhoff Grain Co., 395 N.W.2d at 839. By 

choosing the proximal point of a joint to classify an injury, the worker’s 

impairment rating is applied to a higher number of maximum weeks of 

compensation than if we classify the injury using the distal point of the 

joint. 

To be consistent with our prior cases, we look at the proximal side 

of the wrist joint and hold an injury to the wrist is to be compensated as 

an injury to the arm. By construing an injury to the wrist as an injury to 

the arm, a worker’s compensation is based on a 250-week maximum, 
8

rather than a 190-week maximum for an injury to the hand. Compare

Iowa Code § 85.34(2)(m), with id. § 85.34(2)(l). This construction of the 

statute is consistent with our prior decisions finding the legislative intent 

behind the workers’ compensation statute is to apply this law broadly 

and liberally in favor of a worker when an ambiguity exists. Accordingly, 

as a matter of law a wrist injury is compensated as an injury to the arm 

under section 85.34(2)(m). 

V. Whether Substantial Evidence Supports the 

Commissioner’s Finding of Impairment. 

The employer and its insurance carrier claim the commissioner 

should have rendered an award to Breyfogle consistent with Dr. Herrera’s 

rating rather than the ratings of doctors Tiedeman and O’Neil. As the 

trier of the facts, it is the commissioner’s duty to determine the 

credibility of the witnesses, weigh the evidence, and decide the facts in 

issue. Arndt v. City of Le Claire, 728 N.W.2d 389, 395 (Iowa 2007). 

Doctors Tiedeman and O’Neil rated Breyfogle’s injury as a nineteen 

percent impairment, a rating well within the range of impairment 

contained in the Guides. Although the commissioner could have chosen 

to adopt Dr. Herrera’s opinion, the commissioner decided the ratings by 

doctors Tiedeman and O’Neil were entitled to the greater weight of the 

evidence. Therefore, substantial evidence supported the commissioner’s 

decision. 

VI. Disposition. 

Having found that an injury to the wrist should be compensated as 

an injury to the arm under section 85.34(2)(m) and that substantial 

evidence supports the commissioner’s rating, we affirm the judgment of 

the district court. 

AFFIRMED.