Opinion ID: 1721256
Heading Depth: 2
Heading Rank: 1

Heading: Disability Determination

Text: Robbennolt claims error in the commissioner's decision in not assigning more than a disability of twenty percent scheduled member impairment of his right hand. He asserts he has at least an uncontroverted forty percent hand loss and forty percent arm loss. He argues that the decision is not sufficiently detailed to show the path taken through conflicting evidence. He believes the commissioner secretly adopted the AMA Guides to evaluation of permanent impairment rating without considering other evidence. The other evidence is Robbennolt's testimony of pain and numbness in the thumb, web, palm, graft site, and forearm. He states that the guides also offer no measurement of loss of hand grip and pinch strength or of arm-lifting strength. In the absence of countering evidence to negate, he believes a higher disability rating than twenty percent is mandated. He says this is because otherwise uncontroverted lay and subjective evidence of functional impairment is disregarded. Snap-On argues that there is a great deal of evidence that Robbennolt has sustained very little impairment of his activities either at work or elsewhere. Snap-On points to the recitation by the commissioner of Robbennolt's problems both as recited by the examining doctor, by Robbennolt himself, and by a counselor who helped him on unresolved grief as a result of the loss of his finger. We note that the deputy detailed the loss of pinch strength, pain, functional use of his hand, and other decreased use experienced by Robbennolt. The deputy then stated: It is expressly found that claimant has a decreased ability to lift with the right upper extremity as well as decreased grip and pinch strength in the right hand. These factors are sufficient to demonstrate that claimant's overall impairment is an impairment to the hand and not an impairment to the right third finger only. Regarding the emotional trauma the deputy said: It is expressly found that claimant's emotional concerns and reactions as presented in this record were part of the normal sequela of recovery from the significant injury. It is further expressly found that these conditions did not rise to the level of an independent debilitating psychological condition such that claimant's impairment is to the body as a whole and not to the hand. Robbennolt complains that there is virtually no rationale for how the commissioner deduced that he had sustained only a twenty percent loss of permanent function in the right hand. He says the commissioner noted, but did not analyze, the findings of functional capacity evaluations. He says the commissioner also noted, but did not analyze, the medical knowledge that a ray resection significantly lessened grip strength in the hand. He questioned that the twenty percent disability just happened to be the same percentage as the only medical rating percentage in evidence. Snap-On points out accurately that there is no medical opinion in this case that Robbennolt has a permanent functional impairment beyond the twenty percent. The AMA guides, relied on by the examining doctor, have been specifically adopted as a guideline for determining PPD. Snap-On also argues that there is no rule of law that requires an award greater than the impairment rating determined by the AMA guidelines where a claimant makes complaints of pain or fatigue. We believe that Snap-On's argument on this point is sound. Where the commissioner has recognized and written about Robbennolt's condition and deficiencies, as was done here, the evidence is sufficient to support a reasonable conclusion reached. Here, the conclusion of the deputy, commissioner, district court, and court of appeals was that a twenty percent award was appropriate, viewing the record as a whole. See ALCOA v. Employment Appeal Bd., 449 N.W.2d 391, 394 (Iowa 1989). Robbennolt's argument is actually that the commissioner did not properly assess the evidence. On judicial review of agency action, the court's review is not de novo. The court must not reassess the weight of the evidence because the weight of the evidence remains within the agency's exclusive domain. Burns v. Board of Nursing, 495 N.W.2d 698, 699 (Iowa 1993). Robbennolt insists that the commissioner should be directed to consider and weigh any impairment beyond that which is measurable under the AMA guidelines, and if rejected, to detail the reasons for rejecting each of the various facts and evidence advanced by Robbennolt in favor of the advanced percentages. He quotes the examining doctor's opinion that the AMA guidelines do not attempt to measure the medically immeasurable. Pain is not a feature that is utilized in determining impairment because medical impairment is only dealing with the medically measurable loss of function. For this reason, Robbennolt insists that the medically immeasurable must be quantified by the commissioner in much the same way a jury quantifies pain and suffering and other intangible losses. There is no requirement in the statutes or our case law commanding the commissioner to validate the agency's decisions with precise detail and specificity. If this was required, the agency's efficiency and capacity to expedite decisions for the benefit of the injured worker would collapse under the dead weight of detail. Robbennolt's argument ignores our well-recognized rule that the agency's decision is final if supported by substantial evidence and if correct in its conclusions of law. Heatherly, 397 N.W.2d at 670. It is also contra to the purpose of our review as set out by the legislature in section 17A.19(8). We affirm the district court decision on this issue.