Opinion ID: 1955561
Heading Depth: 1
Heading Rank: 4

Heading: Psychological Condition Caused or Aggravated by Work-Related Injury.

Text: The deputy commissioner in his findings of fact found Honeywell's work experience at the time of his injury was as a roughneck for a drilling company. Following his injury Honeywell returned to college and completed a four-year college degree. While hospitalized for the injury, Honeywell was administered morphine, codeine and demerol for pain. He testified that he became addicted to morphine as a result of the medical treatment following the severance of his arm. The deputy commissioner found Honeywell's testimony credible. The record shows that Honeywell had a preexisting personality disorder and substance abuse disorder. The deputy commissioner found: It is found that claimant's preexisting personality disorder and substance abuse disorder were materially aggravated by the accident of February 5, 1983. The aggravations are compensable. Only one period of lost time can be linked to the aggravation. That being the inpatient treatment for opiate addiction starting on May 13, 1986 and ending June 12, 1986. Claimant's inpatient treatment was a direct result of his addiction to morphine. .... Claimant's entitlement to permanent partial disability is at issue. Claimant alleges an entitlement to industrial disability due to psychological impairment. The treating doctors failed to issue an impairment rating which apportioned the impairment allegedly caused by the aggravation of the preexisting substance abuse disorder and personality disorder. Therefore, claimant has failed to prove by a preponderance of the evidence that the aggravation of the preexisting disorders resulted in permanent partial disability. Claimant's demand for industrial disability also fails as a matter of law in that the claimant is compensated for any reduction in earning capacity through the schedule. The record reflects that Dr. Reagan rated the impairment to Honeywell's right upper extremity at seventy-one percent, Dr. Clendenin at seventy-five percent, and Dr. Sauer rated the impairment at ninety-one percent. The deputy commissioner stated in his findings that he accepted Dr. Sauer's opinion because Dr. Sauer was the primary treating physician, his rating was related to the AMA guidelines and most accurately reflected the severity of the impairment, and he had followed claimant continuously over a longer period of time. In his conclusions of law, the deputy commissioner stated: Claimant has met his burden in proving that the February 5, 1983, amputation injury aggravated his preexisting substance abuse disorder and personality disorder. .... A claimant may not recover benefits for industrial disability if the injury is to a scheduled member and not to the body as a whole even when psychological problems affect earning capacity. A claimant is compensated for any reduction in earning capacity through the schedule. The scheduled loss system created by the legislature is presumed to include compensation for reduced capacity to labor and to earn. Schell v. Central Engineering Co., 232 Iowa 421, 4 N.W.2d 399 (1942) (citations to commissioner decisions omitted). Claimant has requested an award of industrial disability. Claimant's injury and impairment are limited to the right upper extremity. Psychological impairment and loss of earning capacity attributable to the aggravation have not been demonstrated. The undersigned is without jurisdiction to award industrial disability in a scheduled member case. As a matter of law, the claimant is not entitled to industrial disability. The commissioner found the deputy commissioner's findings of fact adequate and that they accurately reflected the pertinent evidence. The commissioner adopted all of the conclusions of law stated in the arbitrator's decision relating to the claim for industrial disability benefits. In Schell, the court did say [t]he schedule or standard fixed by the legislature for the loss of this member [foot] provides for weekly compensation for 125 weeks, which includes compensation for resulting reduced capacity to labor, and earning power. Schell, 232 Iowa at 424-25, 4 N.W.2d at 401. The commissioner's reliance on this language is misplaced. We have not cited the quoted language in subsequent opinions. Our subsequent cases make clear that compensation payable for a scheduled injury is not related to industrial disability; the amount paid for scheduled injuries is made regardless of the employee's ability or inability to engage in employment. Graves v. Eagle Iron Works, 331 N.W.2d 116, 118 (Iowa 1983). As stated in the special concurrence, no necessary correlation exists in fact between functional loss and industrial disability. Id. at 120. The commissioner's decision suggests a psychological condition resulting from a scheduled injury is not compensable under Iowa workers' compensation law. We disagree. In Mortimer, decided after this case was appealed, we held that a psychological condition caused or aggravated by a scheduled injury is to be compensated together as an unscheduled injury. Mortimer, 502 N.W.2d at 17. Whether the spill over effects are physical or mental, the result is the same: disability. Id.
The commissioner found psychological impairment and loss of earning capacity attributable to the aggravation had not been demonstrated. In determining if there is substantial evidence to support the commissioner's finding, the question is not whether the evidence might support a different finding, but whether under this record there is substantial evidence to support the finding actually made by the commissioner. See Freeland v. Employment Appeal Bd., 492 N.W.2d 193, 197 (Iowa 1992). If the evidence is in conflict or reasonable minds might disagree about the conclusions to be drawn from the evidence, we are bound to accept the commissioner's findings. Id. After reviewing the entire record, we find no evidence to support the commissioner's findings and conclusion. When the relevant evidence is uncontroverted and reasonable minds could not draw different inferences from the evidence, we may determine the facts as a matter of law. Bearce v. FMC Corp., 465 N.W.2d 531, 534 (Iowa 1991). The record clearly reflects that the work-related aggravation of Honeywell's psychological disorder caused psychological impairment. There was no contrary evidence. All three medical experts expressed opinions as to the resulting industrial disability. Dr. Sauer was asked, What is the percentage of impairment of the body as a whole as a result of his [Honeywell's] injury on February 5, 1983? Dr. Sauer stated there would be a fifty-five percent impairment to the whole body. Dr. Bost, who had evaluated Honeywell on three separate occasions in 1989 and 1990, found Honeywell appears to be having serious anxiety symptoms. Test results and Honeywell's medical history pointed strongly to the presence of a personality disorder. His medical history also supported a diagnosis of a substance abuse disorder. In the doctor's opinion, the trauma on May 5, 1983, may have precipitated an acute worsening of his preexisting personality disorder and substance abuse disorder. In his view, the collective impairment was moderate to severe, fifty-five percent to seventy-five percent. Dr. Bost stated in his report that Honeywell's personality disorder almost certainly impairs his ability to relate successfully to co-workers, and that this personality disorder is a major factor in Honeywell's underemployment. Dr. Graham, a psychologist employed by the insurer and employer, testified that he had examined Honeywell and reviewed his extensive medical records. He concluded the work-related accident does appear to have played an aggravating role in terms of his drug use and antisocial behavior, but quantitatively, the aggravation does not appear great. He testified that the degree of Honeywell's disabilityhis psychological impairmentwas something in the twenty-to-thirty percent range; this being in addition to any physical impairment resulting from the amputation.