Opinion ID: 1938906
Heading Depth: 1
Heading Rank: 2

Heading: Adequacy of Administrative Findings.

Text: Several of the particular acts or omissions of the agency that claimant attacks involve the findings of fact and conclusions of law made by the deputy and later adopted by the commissioner. Consequently, a brief summary of the contents of the deputy's ruling is necessary. First, the deputy summarized claimant's work history and physical complaints from his testimony given at the hearing. Specifically, the deputy noted that claimant had worked underground in coal mines in various capacities from ages thirteen to sixty-seven and that he now claimed to be unable to breathe with any exertion or to perform the duties of his former job. The deputy then quoted parts of the medical evidence. Included was a report of W. K. C. Morgan, M.D., Chief of the Appalachian Laboratory for Occupational Respiratory Diseases, stating that claimant's 1971 x-ray revealed evidence of some early dust retention in the lungs, category 1 simple pneumoconiosis. . . .  The ruling also contained a report by Ralph E. Hines, M.D., a radiologist, which said that there was no evidence of pneumoconiosis in claimant's x-ray of 1975. A report by D. A. Mater, M.D., who has been claimant's family physician for many years, was quoted as well: [X]-ray and Ventilatory Studies, show that the pulmonary disease has progressed to the point where he can no longer perform physical exertion or tolerate the fatigue involved in his job at the mine. Skeletal damage from prior injuries had stabilized prior to 1977. The lung condition worsened during the past seven years. This in turn, tends to overtax his heart, which requires that he avoid conditions of stress or lifting, and that he take frequent rest periods. I regard this condition as chronic and irreversible. The deputy observed that Dr. Mater related his findings to claimant's exposure to coal dust and gases. Finally, the ruling reiterated excerpts from a deposition of Randall R. Hanson, M.D., a specialist in internal medicine and pulmonary disease: It appears that Mr. McSpadden has mild to moderate obstructive airways disease, which is primarily a combination of chronic bronchitis and intrinsic asthma, with a significant amount of reversibility, as demonstrated by the pulmonary function tests. Mr. McSpadden has a history of significant coal dust exposure, but my interpretation was not radiographically evidence that he had coal worker's pneumoconiosis and that his functional capacity would fall into that of mild disability as far as his total cardiopulmonary function is concerned, depending on what one defined as disability for a sixty-seven year old male. The ruling also quoted Dr. Hanson's description of claimant's ability to work: How much strenuous work are you asking? Are you asking that: Is this man able to do the physical work that a twenty-five [ sic ] year old man should do or can do? My answer to that is no. Is this gentleman able to do the same amount of work that an average sixty-seven year old man should do? I would say yes. Next, the deputy set out applicable principles of law with case authority. He stated that claimant had the burden of proving by a preponderance of the evidence that his health impairment resulted from an incident or activity of employment. Determining causal connection is essentially within the domain of expert medical testimony, he explained, citing Bradshaw v. Iowa Methodist Hospital, 251 Iowa 375, 101 N.W.2d 167 (1960). Finally, he set forth the broad definition of personal injury under chapter 85, articulated in Almquist v. Shenandoah Nurseries, Inc., 218 Iowa 724, 732, 254 N.W. 35, 39 (1934) (something, whether an accident or not, that acts extraneously to the natural processes of nature, and thereby impairs the health). The deputy's ruling continued as follows: ANALYSIS Claimant failed to sustain his burden of proof of an occupational disease under Chapter 85A which arose out of and in the course of his employment for defendant employer. The opinion of Dr. Hanson that claimant did not have coal worker's pneumoconiosis was given greater weight than the opinion of Dr. Mater due to the expertise of Dr. Hanson. Dr. Hanson's opinion that a part of claimant's chronic bronchitis and asthma was probably related to the inhalation of coal dust by claimant could be construed to be an injury within the definition stated in Almquist, supra. However, claimant failed to prove that he was disabled from work as a result of this injury. Dr. Hanson described claimant's disability to be . . . a mild degree of disability. He believed claimant could perform the same amount of work as an average sixty-seven year old and could perform the work of an underground supervisor. Additionally, the medical evidence failed to specifically relate the chronic bronchitis and asthma of claimant or an aggravation of these conditions to the exposure of claimant to coal dust while working for defendant employer immediately preceding the injury date of April 26, 1977. FINDINGS WHEREFORE, it is found that claimant failed to sustain his burden of proof of an injury or occupational disease arising out of and in the course of his employment for defendant employer. THEREFORE, the relief requested in claimant's petition for arbitration is denied. Claimant argues that the deputy's findings of fact and conclusions of law were deficient for lack of specificity and comprehensiveness and for the application of erroneous principles of law. It is well established that the application of erroneous legal principles mandates reversal. See, e. g., Langford v. Kellar Excavating & Grading, Inc., 191 N.W.2d 667, 668, 670 (Iowa 1971); cf. Nelson v. Cities Service Oil Co., 259 Iowa 1209, 1214, 146 N.W.2d 261, 264 (1967) (reversal not required if commissioner misstates rule of law but actually determines case under correct rule). Remand is also necessitated in order to permit the agency to re-evaluate the evidence, applying the correct rule of law, unless the reviewing court can make the necessary factual findings as a matter of law because the relevant evidence is both uncontradicted and reasonable minds could not draw different inferences from it. Compare Flint v. City of Eldon, 191 Iowa 845, 849-50, 183 N.W. 344, 346 (1921), with Langford. The rationale for this principle is that if the reviewing court proceeded to re-evaluate the contradictory evidence, applying what it deemed to be the correct rule of law, it would be usurping the agency's function of making factual findings. Flint, 191 Iowa at 850, 183 N.W. at 346; see SEC v. Chenery Corp., 318 U.S. 80, 94, 63 S.Ct. 454, 462, 87 L.Ed. 626, 636 (1943); 2 K. Davis, Administrative Law Treatise § 16.05, at 445-46, § 16.12, at 480-83 (1958). Remand is also required if the commissioner has rejected or disregarded material evidence without any stated reasons. McDowell v. Town of Clarksville, 241 N.W.2d 904, 908-09 (Iowa 1976); Catalfo v. Firestone Tire & Rubber Co., 213 N.W.2d 506, 510 (Iowa 1973). According to Catalfo, the deputy has the duty to state the evidence he relies upon and specify in detail the reasons for his conclusions. Id. at 510; see § 17A.16, The Code. A principal reason for this requirement of specificity in agency findings is to facilitate judicial review. To be able to review an agency decision, a court must know what it means. Id. ; 2 K. Davis, supra § 16.12, at 477-83. Finally, if the ruling reveals that the commissioner rejected uncontroverted evidence either for reasons unassigned or through the application of an erroneous principle of law, this court has decided that both reversal and remand are necessary. See Sondag v. Ferris Hardware, 220 N.W.2d 903, 908 (Iowa 1974). It is this precise situation which exists in this case. A. Finding that Claimant Failed to Prove Pneumoconiosis. Claimant asserts that the deputy's ruling was inadequate because it failed to make findings and conclusions rejecting or discounting claimant's proof of pneumoconiosis. As previously indicated, the deputy did include summaries of the medical evidence which was both favorable and unfavorable to claimant's claim. He also stated his reason for rejecting possibly the most favorable evidence, that of Dr. Mater, when he admitted according greater credence to the diagnosis of Dr. Hanson because of his expertise. As it appears that Dr. Hanson was the only board certified pulmonary medicine specialist whose report or testimony was received into evidence, it is reasonable to assume that the same reason explained the deputy's rejecting other evidence favorable to claimant and contradictory to Dr. Hanson's opinion. This case is clearly distinguishable from McDowell v. Town of Clarksville, 241 N.W.2d 904, 908-09 (Iowa 1976), and Catalfo v. Firestone Tire & Rubber Co., 213 N.W.2d 506 (Iowa 1973), in which no reasons for rejecting certain evidence were stated in the agency ruling. We find no merit in this contention of claimant. Nor do we agree with his argument that the deputy erred in giving controlling weight to Dr. Hanson's diagnosis of claimant's disease. We defer to the trier of fact in determining the weight to be given conflicting opinion testimony. E. g., Farmers Elevator Co. v. Manning, 286 N.W.2d 175, 176 (Iowa 1979); Barz v. Oler, 257 Iowa 508, 512, 133 N.W.2d 704, 706 (1965). Additionally, claimant asserts that Dr. Hanson's testimony should not have even been admitted into evidence because it lacked proper foundation. The foundation objection was not raised, however, in a timely fashion. At the time Dr. Hanson's deposition was taken, claimant's counsel refused to make the common stipulation reserving certain types of objections until after the deposition has been completed. Nonetheless, counsel failed to make any objections whatsoever during Dr. Hanson's examination, as was necessary when he failed to stipulate. See generally Iowa R.Civ.P. 148(a) (made applicable to workers' compensation proceedings by 500 I.A.C. 4.35). Nor did he make any objection grounded upon lack of proper foundation before the deposition was offered into evidence to the deputy. As such, he afforded no opportunity to his adversary to remedy the alleged defect, and his argument concerning the admission of the testimony was not preserved. See Webb v. Iowa-Nebraska Coal Co., 198 Iowa 776, 779-83, 200 N.W. 225, 226-28 (1924); 500 I.A.C. 4.28 (The record is closed as of the time it is submitted to the deputy commissioner, except in unusual circumstances.). Because we uphold the deputy's finding that claimant does not have pneumoconiosis, we also reject claimant's argument that the deputy's ruling is erroneous for failing to apply the statutory provisions regarding pneumoconiosis, given in section 85A.13 of The Code. That section provides, in part: 1. Pneumoconiosis defined. Whenever used in this chapter, pneumoconiosis shall mean the characteristic fibrotic condition of the lungs caused by the inhalation of dust particles. 2. Presumptions. In the absence of conclusive evidence in favor of the claim, disability or death from pneumoconiosis shall be presumed not to be due to the nature of any occupation within the provisions of this chapter unless during the ten years immediately preceding the disablement of the employee who has been exposed to the inhalation of dust particles over a period of not less than five years, two years of which shall have been in employment in this state. Specifically, claimant's argument appears to be that because even Dr. Hanson found some fibrosis in the area of claimant's lungs and related claimant's respiratory problems to the inhalation of coal dust and the deputy adopted Dr. Hanson's findings, section 85A.13(1) mandates that claimant be found to be suffering from pneumoconiosis. However, these findings alone do not match the statutory definition of pneumoconiosis. First, the statute requires a fibrotic condition of the lungs that is characteristic of pneumoconiosis, not merely any type of fibrosis in the lung area. As Dr. Hanson explained, numerous diseases can result in fibrosis in the lung area. Unfortunately, our statute fails to delineate the characteristics indicative of pneumoconiosis. [1] Consequently, it is left to the deputy industrial commissioner or industrial commissioner reviewing the medical evidence presented to determine the particular characteristics of pneumoconiosis which must be present to justify a finding of the disease. [2] Here, the deputy adopted the opinion of Dr. Hanson, including his views regarding the essential characteristics of pneumoconiosis. The observable criteria he gave for coal worker's pneumoconiosis were radiographic evidence not attributable to other disease that's compatible with what's felt to be coal worker's pneumoconiosis, be it small irregular densities progressing to what we call progressive massive fibrosis, which are large conglomerate masses seen on the chest x-ray, which result in pulmonary disability.. . . In interpreting claimant's chest x-rays dated from 1969 to 1977, Dr. Hanson stated that he found no specific evidence for the presence of pneumoconiosis. Although he did observe fibrosis located in the pleura, or lining between the lung and chest wall, he also noted that pleural fibrosis is not a particular major component to the process and the radiographic appearance [of coal worker's pneumoconiosis]. Moreover, the statutory definition imposes another requirement which was not met here: the fibrotic lung condition must be caused by the inhalation of dust particles. Dr. Hanson specifically denied that claimant's pleural fibrosis was in any way due to or related to the inhalation of dust particles. Instead, he attributed claimant's pleural fibrosis to chest trauma which claimant sustained in 1969. Claimant also asserts that the deputy's ruling incorrectly ignored the presumption stated in section 85A.13(2). According to his argument, a presumption of compensable pneumoconiosis applies whenever the claimant has been exposed to dust particles for the length of time specified in that provision. Because claimant was exposed to the inhalation of dust particles for at least five of the ten years preceding his alleged disablement and at least two of those years of exposure were spent in employment in this state, he contends that a presumption should apply to his case. Again, claimant misinterprets the statutory provision. The propose of the presumption in section 85A.13(2) is to establish a causal link between the disease and the employment, not to establish the disease in the first place. Moreover, this particular presumption can only serve to aid defendants' cases, not claimants' cases. This construction of section 85A.13(2) is supported by the application of various rules of statutory construction. One of those rules is that a statute should be accorded a logical, sensible construction which gives harmonious meaning to related sections and accomplishes the legislative purpose. See In re Estate of Bliven, 236 N.W.2d 366, 367 (Iowa 1975); Olson v. District Court, 243 Iowa 1211, 1214, 55 N.W.2d 339, 340 (1952). The primary purpose of the workers' compensation statute is to benefit the worker and his or her dependents, insofar as statutory requirements permit. Cedar Rapids Community School v. Cady, 278 N.W.2d 298, 299 (Iowa 1979); see Wetzel v. Wilson, 276 N.W.2d 410, 411-12 (Iowa 1979); Hoenig v. Mason & Hanger, Inc., 162 N.W.2d 188, 190 (Iowa 1968). One of the requirements for qualifying for workers' compensation benefits under chapter 85 is that the claimant must prove that his injury occurred in the course of employment and also arose out of employment. See, e. g., McClure v. Union, et al., Counties, 188 N.W.2d 283, 287 (Iowa 1971); Musselman v. Central Telephone Co., 261 Iowa 352, 356, 154 N.W.2d 128, 130 (1967); §§ 85.3(1), .20, The Code. To occur in the course of employment, the injury must occur within the period of employment. E. g., McClure, 188 N.W.2d at 287; Golay v. Keister Lumber Co., 175 N.W.2d 385, 386 (Iowa 1970). Isolating and proving the particular period of employment that caused a claimant's occupational disease may be extremely difficult if the claimant was exposed to the same hazardous conditions while employed with various employers. The reason for this is that clinical manifestations of occupational diseases are typically caused by prolonged exposure to hazardous substances. See 3 A. Larson, The Law of Workmen's Compensation § 95.21, at 508.136-.137 (1976). To overcome this problem of proving causation in the occupational disease context, chapter 85A identifies the employer who shall be held accountable. Section 85A.10 imposes liability upon the last employer in whose employment the claimant was injuriously exposed to the hazardous condition of employment. It does not require that the claimant prove that his disease was actually caused by that exposure. Rather, we believe it is sufficient that he show that the hazardous employment condition which at some time caused his disease existed to the extent necessary to possibly cause the disease at his last employer's place of employment. Accord, Climax Uranium Co. v. Claimants, 33 Colo.App. 337, 522 P.2d 134 (1974); W. M. Coal Co. v. Campbell, 344 S.W.2d 794 (Ky.1961) (also interpreting statutes imposing liability on employer in whose employment the claimant was last injuriously exposed to the hazards of the disease); see 3 A. Larson, supra § 95.21, at 508.140 ([B]efore the last-injurious-exposure rule can be applied, there must have been some exposure of a kind contributing to the condition.); Note, The Iowa Occupational Disease Law, 34 Iowa L.Rev. 510, 515-16 (1949). Thus, once the claimant has proved that he has a disease caused by the hazards of his occupation, a narrow presumption of causation by a particular period of employment is, in effect, created by section 85A.10 to aid claimants in meeting their burden of proof. However, it appears that the legislature believed that causation is so speculative in cases of pneumoconiosis [3] that special provisions were necessary to assure the probability of its employment causation. Accordingly, section 85A.10 also provides that only the employer in whose employment the claimant was last injuriously exposed to the hazards of his disease for at least sixty days may be held liable. It is in this context that section 85A.13(2) must be construed. Like the sixty day limitation in section 85A.10, section 85A.13(2) was designed to assure the employment relatedness of the claimant's disease. Accord, Notch v. Victory Granite Co., 306 Minn. 495, 506-07, 238 N.W.2d 426, 433 (1976) (interpreting the essentially identical presumption in Minn. Stat. § 176.662 (1971)). It does this by requiring the claimant who lacks conclusive evidence of occupational causation to show that he has suffered a specified length of exposure to dust inhalation. In the absence of such a showing, section 85A.13 creates a presumption of the nonexistence of occupational causation. As such, it serves only defendants by heightening the proof requirements of occupational causation in pneumoconiosis cases. Its only relationship to the presumption serving claimants, given in section 85A.10, is that of establishing a length of exposure to dust inhalation which must be met, if the claimant cannot otherwise conclusively prove occupational causation, as a prerequisite to invoking the section 85A.10 presumption. Another rule which supports our construction is that [w]ords and phrases shall be construed according to the context and the approved usage of the language; but technical words and phrases, and such others as may have acquired a peculiar and appropriate meaning in law, shall be construed according to such meaning. § 4.1(2), The Code; see City of Des Moines v. Elliott, 267 N.W.2d 44, 45-46 (Iowa 1978). Both the words disability and pneumoconiosis are statutorily defined, see §§ 85A.4, .13(1), The Code, and thus have acquired a peculiar and appropriate meaning in law. Claimant's construction of section 85A.13(2) ignores the criteria stated in those definitions and substitutes a criterion of dust exposure for a particular length of time. We are convinced that both the existence of pneumoconiosis and disability resulting from it must be proved in accordance with the statutory criteria before the presumption in section 85A.10 and the exception to the presumption in section 85A.13(2) apply. Cf. Ciaravella v. Richardson, 377 F.Supp. 201, 203 (W.D.Pa.1974) (refusing to apply statutory presumption of death due to pneumoconiosis because claimant presented no evidence of pneumoconiosis, as required by statute); Robinson v. Crider Mining Co., 533 S.W.2d 530, 532 (Ky. 1976) (refusing to apply statute presuming that all disability resulting from pneumoconiosis complicated with other disease is work related and compensable because workmen's compensation board found claimant did not have pneumoconiosis). B. Finding that Claimant Failed to Prove an Occupational Disease. In his ruling, the deputy concluded that claimant failed to sustain his burden of proof of an occupational disease under chapter 85A. The only apparent stated reason for that conclusion was his determination that claimant did not have pneumoconiosis. Nonetheless, the deputy apparently accepted as true Dr. Hanson's opinion that claimant did suffer from chronic bronchitis and asthma which were probably induced by his inhalation of coal dust. The deputy's reasons for rejecting the conclusion that those diseases constituted occupational diseases under chapter 85A are either erroneous or unstated. Consequently, under Sondag v. Ferris Hardware, 220 N.W.2d 903, 908 (Iowa 1974), we must reverse and remand so that the commissioner may either set forth its unstated adequate reasons or re-examine the evidence, applying the correct legal principles. If the deputy's sole reason for concluding that claimant's chronic bronchitis and asthma do not constitute occupational disease was that only diseases mentioned by name in chapter 85A qualify as occupational diseases, he erroneously decided the issue of whether claimant has an occupational disease. In 1973, the legislature broadened the definition of occupational diseases in section 85A.8 by omitting the restriction that the disease in question be one of those listed in a schedule of specific diseases. 1973 Session, 65th G.A., ch. 144, § 24. In fact, it eliminated from chapter 85A that schedule of diseases. Id. § 30 (repealing § 85A.9, The Code 1973). Hence, the fact that claimant was not found to have pneumoconiosis or any other previously scheduled disease did not altogether preclude his chances for recovery under chapter 85A. Additionally, we are unwilling to conclude as a matter of law that the deputy's finding that claimant failed to prove an injury under chapter 85 dictates a finding that he also failed to prove an occupational disease. By the same session law that broadened the definition of occupational disease, the legislature narrowed the definition of injury to exclude occupational diseases as defined in section 85A.8. 1973 Session, 65th G.A., ch. 144, § 21. Consequently, the concepts of injury and occupational disease cannot be used interchangeably. Moreover, the criteria for establishing the employment causation of an injury under chapter 85 are not the same as those for establishing employment causation of an occupational disease under chapter 85A. As previously stated, to qualify for benefits under chapter 85, the claimant must prove that his injury arose out of and in the course of his employment with the defendant employer. On the other hand, to prove causation of an occupational disease, the claimant need only meet the two basic requirements imposed by the statutory definition of occupational disease, given in section 85A.8. [4] First, the disease must be causally related to the exposure to harmful conditions of the field of employment. All but the last sentence of the definition pertains to that requirement. Dahl, The Iowa Workmen's Compensation Law and Federal Recommendations, 24 Drake L.Rev. 336, 343 (1975). Secondly, those harmful conditions must be more prevalent in the employment concerned than in everyday life or in other occupations. The latter requirement is based on the last sentence of the definition. [5] See generally 1B A. Larson, The Law of Workmen's Compensation § 41.32-33 (1978). The fact that other employment experiences which the claimant had prior to working for the defendant employer may have also caused his disease will not defeat his claim because of the presumption of causation from employment with the last employer provided in section 85A.10. In his ruling, the deputy stated that claimant failed to sustain his burden of proof of employment causation of injury because the medical evidence failed to specifically relate claimant's disease to his exposure to coal dust while working for defendant employer immediately preceding the injury date of April 26, 1977. It is not entirely clear what that statement meant. If it meant that claimant failed to prove that his exposure to coal dust while working for the defendant employer was in fact the cause of his disease, claimant could still prevail under chapter 85A. If, on the other hand, it meant that claimant failed to prove that coal dust which could have caused his disease was present in defendant employer's mines, section 85A.10 will not aid claimant in sustaining his burden of proof. The evidence regarding the existence of dangerous quantities of coal dust in Big Ben's mines was not fully developed. Thus, we leave this determination for the industrial commissioner on remand if employment causation under chapter 85A remains an issue which must be resolved. Because section 85A.10 had not been previously construed by this court, we believe opportunity should be afforded claimant to present further evidence concerning the existence of quantities of coal dust in Big Ben's mines which could have caused his disease. C. Finding that Claimant Is Not Disabled. The deputy ruled that claimant failed to prove he was disabled from his afflictions. Ordinarily, compensation is awarded for disability, not for injury as such. Deaver v. Armstrong Rubber Co., 170 N.W.2d 455, 466 (Iowa 1969). From the statements made concerning disability, it appears that the deputy may have applied erroneous legal principles in determining whether claimant is disabled. Apparently, the only evidence bearing on claimant's disability which he considered was the testimony of Dr. Hanson. Dr. Hanson found that claimant did suffer a certain degree of disability. He additionally found that claimant could perform the same amount of work as an average person his age and that he could perform the work of an underground supervisor. Contrary to the deputy's ruling, those two additional findings do not necessarily negate the initial finding that claimant is disabled. First, the fact that the normal aging process may produce the ailment from which a claimant suffers as an actual result from his employment experience does not operate to bar a finding of disability. See, e. g., M. D. Thompson & Son Co. v. McCuan, 255 Ark. 762, 502 S.W.2d 93 (1973); Furlong v. Northwestern Casket Co., 190 Minn. 552, 554-55, 252 N.W. 656, 657-58 (1934); 2 A. Larson, The Law of Workmen's Compensation § 59.20, at 10-281 (1976). Secondly, Dr. Hanson's evaluation of claimant's functional ability to perform his work does not necessarily dispose of the issue of his disability within the contemplation of workers' compensation law. Disability from injuries covered by chapter 85 has been defined by case law as industrial disability, or a reduction in earning capacity. E. g., Olson v. Goodyear Service Stores, 255 Iowa 1112, 1120, 125 N.W.2d 251, 256 (1963). Among the criteria considered in determining industrial disability are the claimant's age, education, qualifications, experience and his inability, because of the injury, to engage in employment for which he is fitted. Id. at 1121, 125 N.W.2d at 257. Functional disability, while a consideration, has not been the final criterion. Id. at 1120, 125 N.W.2d at 256. This was exemplified in Diederich v. Tri-City Railway, 219 Iowa 587, 594, 258 N.W. 899, 902 (1935), which concluded, His [functional] disability may be only a twenty-five or thirty per cent disability compared with the one hundred per cent perfect man, but, from the standpoint of his ability to go back to work to earn a living for himself and his family, his disability is a total disability . . . . Importat factors in the decision were that claimant was fifty-nine years of age, that he had little or no education and that his injury kept him from performing all kinds of physical work. Similar factors supported a finding of permanent total disability in Dailey v. Pooley Lumber Co., 233 Iowa 758, 765-66, 10 N.W.2d 569, 573-74 (1943) (considering claimant's functional disability of seventy-five to one hundred per cent, his age of sixty-five, his limited education and training and his nonperformance of physical labor since date of injury). See also Martin v. Skelly Oil Co., 252 Iowa 128, 133-35, 106 N.W.2d 95, 98-99 (1960) (considering claimant's employment history and earnings since date of accident). There is no reason to believe that these criteria should not also be applicable in determining the claimant's capacity to perform his work or to earn equal wages in other suitable employment, the standards for determining disability under section 85A.4, at least in cases where claimant proves that he has been unable to continue working for reasons related to his disease. [6] See § 85A.17, The Code. These reasons may not always be directly related to functional impairment. For example, a defendant-employer's refusal to give any sort of work to a claimant after he suffers his affliction may justify an award of disability. See, e. g., Wood v. Industrial Commissioner, 13 Ariz.App. 449, 452-53, 477 P.2d 568, 571-72 (1970); Rosenau Bros. v. Workmen's Compensation Appeal Board, 10 Pa. Cmwlth.Ct. 462, 464-66, 311 A.2d 160, 161-62 (1973). Similarly, a claimant's inability to find other suitable work after making bona fide efforts to find such work may indicate that relief should be granted. See, e. g., Dean v. Industrial Commission, 113 Ariz. 285, 551 P.2d 554 (1976); Franklin Fabricators v. Irwin, 306 A.2d 734 (Del.1973). See generally 2 A. Larson, supra § 57.61. According to McSpadden's undisputed testimony, he has been unable to secure employment since he worked for the defendant Big Ben. However, we cannot say that the evidence is such that reasonable minds could not draw different inferences from it regarding whether his inability to secure employment has been caused by reasons related to his disease. Hence, remand is necessary so that this and other evidence relevant to determining claimant's industrial disability may be reconsidered in light of the proper standards for determining disability or for a supplemental decision showing the reasons why all evidence bearing on claimant's industrial disability, other than Dr. Hanson's testimony, was rejected. D. Failing to Require Defendants to Support Their Pleaded Affirmative Defense. Claimant also assails the deputy's ruling for omitting to make conclusions regarding defendants' alleged failure to prove the assertion in their pleadings that claimant's condition arose out of causes other than those connected with his employment. He cites McDowell v. Town of Clarksville, 241 N.W.2d 904, 907-08 (Iowa 1976). That case states that the defendant has a burden of going forward with proof of his affirmative defense if the claimant establishes a prima facie case. Because the deputy found that plaintiff failed to prove a prima facie case, his legal reasoning was not incorrect for failing to consider the extent of defendants' proof of their affirmative defense. By his thinking, the burden of going forward with evidence never shifted. Moreover, we reaffirm the principle reiterated in McDowell that the burden of persuasion regarding causation never shifts from the claimant to the defendant. In other words, even if the defendants did fail to prove their affirmative defense, that would not mandate a finding against them. Rather, it would only subject them to the risk that the fact finder would find that claimant had sustained his burden of proving causation. 241 N.W.2d at 908.