Opinion ID: 1615368
Heading Depth: 1
Heading Rank: 4

Heading: The Appeal: Whether Substantial Evidence Supports the Finding of Permanent and Total Disability.

Text: IBP contends there was not substantial evidence to support the commissioner's finding that Raad was permanently and totally disabled as a result of the November 1993 injury. In support of this contention, IBP argues that, in making this finding, the commissioner relied on medical conditions (headaches and depression) that the commissioner specifically found were not work-related. The district court resolved IBP's petition for judicial review under Iowa Code section 17A.19(8)(f), which provides that a court may grant appropriate relief from agency action when that action is, in a contested case, unsupported by substantial evidence in the record made before the agency when that record is viewed as a whole. Iowa Code § 17A.19(8)(f). An agency's findings of fact are binding on the courts when they are supported by substantial evidence. Norland v. Iowa Dep't of Job Serv., 412 N.W.2d 904, 913 (Iowa 1987). And the courts should broadly and liberally apply those findings to uphold rather than to defeat the agency's decision. Ward v. Iowa Dep't of Transp., 304 N.W.2d 236, 237 (Iowa 1981). `Evidence is not insubstantial merely because it would have supported contrary inferences. It is substantial when a reasonable mind could accept it as adequate to reach the same findings.' Norland, 412 N.W.2d at 913 (quoting New Homestead v. Iowa Dep't of Job Serv., 322 N.W.2d 269, 270 (Iowa 1982)). The determining factor is not whether the evidence supports a different finding but whether the evidence supports the finding actually made. City of Hampton v. Iowa Civil Rights Comm'n, 554 N.W.2d 532, 536 (Iowa 1996). In her ruling, the commissioner found that the greater weight of the medical evidence establishes that [Raad's] impairment as a result of his work injury extends beyond the arm and into the body as a whole. Consequently, the commissioner concluded that Raad's disability would be analyzed industrially. The commissioner arrives at industrial disability by determining the loss to the employee's earning capacity. Sherman, 576 N.W.2d at 321. In determining Raad's industrial disability, the commissioner relied on the following factors taken from McSpadden v. Big Ben Coal Co., 288 N.W.2d 181, 192 (Iowa 1980): the employee's medical condition prior to the injury, immediately after the injury, and presently; the situs of the injury, its severity and the length of the healing period; the work experience of the employee prior to the injury and after the injury and the potential for rehabilitation; the employee's qualifications intellectually, emotionally, and physically; earnings prior and subsequent to the injury; age; education; motivation; functional impairment as a result of the injury; inability, because of the injury, to engage in employment for which the employee is fitted; loss of earnings caused by a job transfer for reasons related to the injury; and the employer's refusal to give any sort of work to an impaired employee. As the commissioner noted, [t]otal disability does not mean a state of absolute helplessness. Such disability occurs when the injury wholly disables the employee from performing work that the employee's experience, training, intelligence, and physical capacities would otherwise permit the employee to perform. Diederich v. Tri-City Ry., 219 Iowa 587, 593-94, 258 N.W. 899, 902 (1935). The commissioner made several findings that are at the root of IBP's complaint that she relied on medical conditions which she specifically found were not work-related and for which she awarded no benefits. One such finding related to headaches: In March of 1995, [Raad] also sought treatment at the University of Iowa Hospitals for sinus and allergy complaints. Dr. Barcellos determined that [Raad's] headaches were histamine headaches. The headaches prompted [Raad] to quit going to his college classes. Later, the commissioner found that there is no medical opinion that any of this pain [from the headaches] was caused by [Raad's] work injury to his arm. As mentioned, the commissioner did not admit Harding's opinion testimony on the causal connection between Raad's depression and his work injury. The commissioner concluded that, because there was no other medical testimony on the causal connection, Raad had failed to carry his burden of proof to show that his depression is causally related to his work injury. Immediately following this finding, the commissioner noted: [E]ven if [Raad] had carried his burden of proof, his depression is described by all physicians who noted it as mild. [Raad's] present disability appears to be more due to his right arm and shoulder pain, and his headaches, than his depression. (Emphasis added.) Later, in her ruling, the commissioner concluded: [Raad] relies on the opinion of Dr. Harding that he is unable to work, and on the opinion of vocational rehabilitation counselor Russo, who also stated that [Raad] was presently unemployable. Dr. McMains on July 12, 1994 said that until [Raad's] arm heals, or until he starts using it, he is virtually unemployable. On May 26, 1995 a Goodwill Industries Vocational Evaluation concluded that [Raad] was not employable. Based on these and all other factors of industrial disability, it is found that [Raad] is permanently and totally disabled. (Emphasis added.) IBP points out that the opinions from Russo and Goodwill Industries were based in part on (1) Harding's diagnosis that Raad was suffering from depression and (2) Raad's headachesconditions that the commissioner found were not work-related. Therefore, IBP argues, the commissioner erred by basing her opinion of permanent and total disability in part on medical conditions she earlier determined were not work-related. It is true that the commissioner has a duty to state the evidence she relies on and to detail the reasons for her conclusions. See Catalfo, 213 N.W.2d at 510. In addition, she must sufficiently detail her decision to show the path she has taken through conflicting evidence. See id. But, we have held that an agency's decision is sufficient if `it is possible to work backward [from the agency's written decision] and to deduce what must have been [the agency's] legal conclusions and [its] findings.' Norland, 412 N.W.2d at 909 (quoting Ward, 304 N.W.2d at 239). To do so is to recognize our duty to broadly and liberally apply the commissioner's findings to uphold rather than to defeat the commissioner's decision. That is the framework of analysis that the district court used and the one we use too. In working backwards, we must first assume the commissioner relied substantially on the physical injury in reaching her conclusion that Raad was permanently and totally disabled and that the injury was work-related. We find support for that assumption in the commissioner's action denying Raad benefits for the medical conditions she found were not work-related. As the district court noted, however, the crucial question is whether there was substantial record evidence to support the finding that Raad was permanently and totally disabled because of the physical injury. We begin with Harding's deposition testimony. Although the commissioner would not consider Harding's testimony that Raad's mental condition was work-related, she did not similarly reject other parts of his testimony on Raad's physical injury the right-side impairment. Harding testified he would not recommend that Raad seek full-time employment because of Raad's depressive disorder and his physical condition. A fair reading of that deposition, however, leads us to conclude that Harding believed the pain and discomfort from the right-side impairment was a substantial cause why Raad was unemployable: [From my contact with Raad, I think he generally wants to be able to work and be productive.] If we could make that pain fifty percent less I think we would see him out there working. .... ... [T]he amount of pain and distress I see in an hour's interview with him sitting here, that if he has to move that much to remain comfortable that means most any job, even if it's taking tickets at a parking place, it is going to be something of a problem. It was my observation of the distress and what to do with his arm and shoulder and so on that I wouldn't have recommended [full-time employment]. .... ... What I am observing is the degree to which he protects that part. He has to move it to not be in pain, sometimes [he] has to get up and walk around or shift his position about every two to three minutes usually. Russo testified that, because of Raad's physical and psychological condition, Raad was unable to work. A fair reading of Russo's testimony, however, supports a finding that Raad's right-side impairment was a substantial cause, which she believed, made him unemployable: Q. How much impairment do you require to be found or reflected in the medical records [to make Raad eligible for rehabilitative services]? A. There are different levels of impairment. Some people we consider most severely disabled. Others we consider severely disabled. And some we consider just disabled. So Raad is considered severely disabled, based on functional limitation in terms of work tolerance, meaning that he can't stand or sit for prolonged periods; he's limited in his range of motion, his dexterity, the work environments that he can be subjected to. And the functional area that limits him is called work tolerance. .... Q. Has [Raad] at any time since you have been working with [him], has he been able to function physically, in your opinion, which would have allowed him to obtain employment in the competitive employment market on an ongoing basis? A. No. The Goodwill Industries evaluator wrote in a report that Raad could only work part time because he starts having pain in his neck and getting headaches. The evaluator, however, stated that Raad's primary disability is listed as a right side impairment. In addition, the evaluator stated before any further services could be provided to Raad, he would have to get his pain issue under control. As a fact finder the commissioner could certainly consider this evidence as proof that the right-side impairment was a substantial cause for Raad's disability. The commissioner noted that Raad's prior work experience and training involved welding and physical labor. The commissioner found that Raad cannot now, nor could he in the future, perform this kind work, or return to the type of work he performed for IBP. There is substantial evidence to support a finding that Raad's right-side impairment and limitations due to such impairment were substantially the reasons for his inability to obtain the type of employment for which he was fitted. The commissioner also found that Raad functions at roughly a ninth-grade level, limiting his ability to obtain other types of employment. In addition, the commissioner relied on Dr. Kenneth McMains' testimony that, until Raad's arm heals, or until he starts using it, he is virtually unemployable. McMains was one of the doctors who saw Raad at Allen Memorial Hospital. McMains' opinion mentioned neither Raad's mental condition nor his headaches. The opinion was additional supporting evidence for the conclusion that the right-side impairment was substantially the reason for Raad's disability. Although she noted that doctors had given Raad a minimal rating of impairment of the right upper extremity (four and six percent), the commissioner appropriately concluded that functional impairment is only one of many factors in determining industrial disability. See Olson v. Goodyear Serv. Stores, 255 Iowa 1112, 1120, 125 N.W.2d 251, 256 (1963). Obviously, the commissioner gave that factor little weight. As a fact finder it was her function to determine the weight of the evidence. Given the substantial evidence of Raad's disability, we cannot and should not disturb the commissioner's finding giving limited weight to Raad's functional impairment. For all these reasons, we conclude that the evidence supports a finding that Raad's disability is substantially the result of his physical, work-related injury. Although a fact finder might have reached a different and inconsistent conclusion from this record, our rules mandate we are nevertheless bound by the conclusion the commissioner reached.