IN THE COURT OF APPEALS OF IOWA

No. 18-2182

Filed September 11, 2019

A-TEC RECYCLING, INC. and EMCASCO INSURANCE COMPANY,

Plaintiffs-Appellants,

vs.

CHARLES E. WOOD,

Defendant-Appellee.

________________________________________________________________

Appeal from the Iowa District Court for Polk County, Sarah Crane, Judge.

An employer and its workers’ compensation carrier appeal from the district 

court ruling on judicial review affirming the agency’s award of permanent partial 

disability benefits to an employee. AFFIRMED.

D. Brian Scieszinski of Bradshaw, Fowler, Proctor & Fairgrave, P.C., Des 

Moines, for appellant.

Nicholas G. Pothitakis of Pothitakis Law Firm, PC, Burlington, for appellee.

Considered by Mullins, P.J., Bower, J., and Carr, S.J.*

*Senior judge assigned by order pursuant to Iowa Code section 602.9206 (2019).
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CARR, Senior Judge.

A-Tec Recycling, Inc. (A-Tec) and its workers’ compensation carrier,

Emcasco Insurance Company (EMC), appeal from the judicial review ruling 

affirming the workers’ compensation commissioner’s award of permanent partial 

disability benefits to Charles Wood. Because this appeal involves agency action, 

we apply the standards in Iowa Code section 17A.19(10) (2018) to determine 

whether we reach the same result as the district court. See Lowe’s Home Ctrs., 

LLC v. Iowa Dep’t of Revenue, 921 N.W.2d 38, 45 (Iowa 2018). In doing so, we 

recognize the agency’s findings of fact

have the effect of a jury verdict. We may reverse the commissioner’s 

findings of fact only if they are unsupported by substantial evidence 

in the record made before the agency when the record is viewed as 

a whole. Evidence is substantial if a reasonable mind would find it 

adequate to reach the same conclusion. An agency’s decision does 

not lack substantial evidence because inconsistent conclusions may 

be drawn from the same evidence.

Evenson v. Winnebago Indus., Inc., 881 N.W.2d 360, 366 (Iowa 2016) (citation 

omitted). 

The record shows that Wood was working at A-Tec when he slipped and 

fell from the back of a truck and landed on his right side. First, Wood only 

experienced significant bruising on his right side, but his condition worsened over 

time. When he sought medical treatment eighteen days later, Wood was 

diagnosed with atrial fibrillation, pneumonia, and pleural effusion. 

The parties agree that Wood sustained a work injury. They disagree on the 

extent of the injury—namely, whether the work injury caused a permanent 

impairment. A deputy workers’ compensation commissioner determined that the 

work injury is a cause of permanent impairment to Wood’s cardiac system in the 
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form of atrial fibrillation and assigned Woods a ten-percent industrial disability. The 

workers’ compensation commissioner affirmed on appeal.

A-Tec and EMC petitioned for judicial review of the commissioner’s 

decision. The district court held that substantial evidence supported the 

commissioner’s determination that Woods sustained a ten-percent industrial 

disability because of his work injury. After also concluding that the determination 

was not arbitrary, unreasonable, irrational, or illogical, the court affirmed. On 

appeal, A-Tec and EMC challenge the commissioner’s determination that Wood’s 

work injury caused permanent impairment.

We may reverse the agency when it bases its action on “a determination of 

fact clearly vested by a provision of law in the discretion of the agency that is not 

supported by 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 “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.” Id. § 17A.19(10)(f)(1). That different 

conclusions may be drawn from the evidence does not render the evidence 

insubstantial. See Dunlap v. Action Warehouse, 824 N.W.2d 545, 555 (Iowa 

2012). We do not ask “whether the evidence would support a different finding than 

the finding made by the commissioner, but whether the evidence supports the 

findings actually made.” Schutjer v. Algona Manor Care Ctr., 780 N.W.2d 549, 

557-58 (Iowa 2010). We broadly construe the findings to uphold the 

commissioner’s decision. See id. We also give due regard to the commissioner’s 
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decision to accept or reject evidence based on the commissioner’s determination 

of witness credibility. See id. 

Does substantial record evidence support the determination of a causal 

connection between Wood’s heart condition and his work injury? Like the district 

court, we conclude that it does. Wood suffered an injury at work. He was 

diagnosed with atrial fibrillation two-and-one-half weeks later. A-Tec and EMC 

claim that Wood’s heart condition is unrelated to the work injury, citing the opinion 

of Dr. Joel Kline, who performed Wood’s independent medical examination. Dr. 

Kline stated it was not possible to determine the cause of the atrial fibrillation. But

Dr. Craig Stevens, the cardiologist who treated Wood’s atrial fibrillation, opined 

that the work injury was a substantial contributing factor. The deputy 

commissioner found Dr. Stevens’s opinion was entitled to the greatest weight, 

noting that Dr. Kline examined Wood on only one occasion while Dr. Stevens 

treated Wood’s condition. As trier of fact, the deputy commissioner was free to 

determine which expert opinions to accept or reject. See Cedar Rapids Cmty. Sch. 

Dist. v. Pease, 807 N.W.2d 839, 845 (Iowa 2011) (noting that the decision to accept 

or reject an expert opinion is within the “peculiar province” of the commissioner).

We next consider whether substantial record evidence supports the 

determination that Wood’s heart condition is a permanent impairment. A-Tec and 

EMC argue the record does not support such a finding because Dr. Stevens never 

opined that Wood would have any future episodes of atrial fibrillation or that future 

episodes of atrial fibrillation would relate to his work injury. Yet Dr. Stevens stated 

that Wood needed to take medication for the rest of his life to control his condition 

because a person who has had atrial fibrillation is at risk of it recurring. We agree 
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that substantial evidence supports a finding that Wood’s condition is a permanent 

impairment. See Bell Bros. Heating & Air Conditioning v. Gwinn, 779 N.W.2d 193, 

200 (Iowa 2010) (“[A] fundamental component of a permanent impairment is 

stabilization of the condition or at least a finding that the condition is ‘not likely to 

remit in the future despite medical treatment.’” (citation omitted)). 

A-Tec and EMC also argue the record cannot support a finding of a 

permanent impairment because Dr. Stevens released Wood to work without 

restrictions in November 2013. Although Dr. Stevens later imposed a lifting 

restriction, they claim Dr. Stevens never stated the restriction was permanent or 

related to Wood’s work injury. We disagree. The record shows that Wood 

experienced a second incident of atrial fibrillation in April 2014 and persistent 

palpitations after pushing barrels at work in September 2014. After the episode in 

September 2014, Dr. Stevens imposed the work restriction that prohibits Wood 

from pushing or lifting over one-hundred pounds without assistance. Wood 

testified that Dr. Stevens said the restriction was permanent. Wood also testified 

that he experienced atrial fibrillation episodes at work when lifting objects weighing 

over one-hundred pounds or repeatedly lifting objects weighing between fifty and 

seventy pounds. 

After reviewing the record, we conclude substantial evidence supports the 

agency’s determination that a work injury caused a permanent partial disability by 

impairing Wood’s cardiac system in the form of atrial fibrillation. Because we reach 

the same conclusion as the district court, we affirm. See Nance v. Iowa Dep’t of 

Revenue, 908 N.W.2d 261, 267 (Iowa 2018).

AFFIRMED.