Opinion
No. 3-635 / 03-0004
Filed November 17, 2003
Appeal from the Iowa District Court for Polk County, Douglas F. Staskal, Judge.
Mark Hawkins appeals the decision of the district court denying workers' compensation benefits. REVERSED AND REMANDED.
N. Richard Willia of Willia, Stahle Andreasen, L.L.P., Sioux City, for appellant.
William H. Grell of Huber, Book, Cortese, Happe Lanz, P.L.C., Des Moines, for appellees.
Heard by Mahan, P.J., and Eisenhauer, J. and Hendrickson, S.J.
Senior judge assigned by order pursuant to Iowa Code section 602.9206 (2003).
The petitioner-appellant, Mark Hawkins (Hawkins), appeals the order of the district court in a judicial review proceeding. The district court affirmed the decision of Iowa Workers' Compensation Commissioner denying benefits because of untimely notice of an alleged work-related injury. We reverse.
Background
The appellant, Mark Hawkins, was employed by TMC Transportation (TMC) as an over-the-road truck driver. He claims that on March 15, 1999, he wrenched his back pulling a truck tarp. The next day he called the fleet manager for TMC and reported he had injured his back. Hawkins indicated he would seek chiropractic care on his own. The fleet manager acknowledges that Hawkins reported he had injured his back but denies being told the injury occurred while pulling on the truck tarp.
TMC claims it learned that Hawkins's injury was work-related in July 1999 after Hawkins was sent to a physician by TMC for an evaluation to determine his fitness to continue at TMC. Upon learning that the injury was work-related more than ninety days from the date of the incident, TMC paid for surgery and post-surgical expenses, as well as partial and temporary total disability from July 2, 1999, to October 17, 1999, and permanent partial disability from October 18, 1999, to October 30, 1999. Thereafter, Hawkins filed an arbitration petition seeking additional compensation benefits. TMC asserted it had not received timely notice and denied further liability.
The deputy workers' compensation commissioner who heard the evidence concluded that Hawkins had given timely notice and further that TMC, by virtue of having paid benefits, was precluded from raising the affirmative defense of lack of timely notice. The commissioner reversed the deputy commissioner, and the district court affirmed the commissioner.
Issues
The issues raised on appeal are:
1. Did the commissioner improperly place the burden of proving timely notice on Hawkins?
2. Is there substantial evidence to support the commissioner's finding that Hawkins failed to give timely notice of a work-related injury?
3. Because some benefits were paid, does Iowa Code section 86.13 (2001) preclude TMC from raising a notice defense?
Scope of Review
In Wal-Mart Stores, Inc. v. Caselman, 657 N.W.2d 493, 498-99 (Iowa 2003), the court set forth principles to apply to judicial review of administrative decisions. Our review under Iowa Code chapter 17A is for correction of errors at law, not de novo. Locate.Plus.Com, Inc. v. Iowa Dep't of Transp., 650 N.W.2d 609, 612 (Iowa 2002). Chapter 17A was amended in 1998, with amendments effective for agency actions commenced after July 1, 1999, however, the court in Wal-Mart Stores, Inc. concluded that the amendments did not change the substantive law but reaffirmed long-established principles of administrative review. Wal-Mart Stores, 657 N.W.2d at 499. The "courts are not to simply rubberstamp the agency fact finding but engage in a fairly intensive review of the record to ensure that the fact finding is itself reasonable." Id.
Discussion
I. Timely Notice — Burden of Proof. In DeLong v. Iowa State Highway Comm'n, 229 Iowa 700, 703, 295 N.W. 91, 92 (1940), the court held the claim of lack of notice is an affirmative defense and the burden of proof would be on the party asserting it. In this case, TMC is asserting the affirmative defense of lack of timely notice. The commissioner stated in his ruling:
It is found that Mark [Hawkins] has failed to carry his burden of proof to show that he gave notice of work injury on March 15, 1999, to his employer within 90 days as required by Iowa Code § 85.23.
Clearly, the commissioner was in error in making this statement. The commissioner, however, did also accurately state in his conclusions that the defendant has the burden to prove by the preponderance of the evidence an affirmative defense. The district court found that despite the misstatement of the law, the commissioner properly placed the burden on TMC to show it had not received notice of Hawkins's injury within the required time.
We agree with the reasoning of the district court on this issue.
II. Is there substantial evidence in the record to conclude Hawkins failed to give timely notice?
Hawkins claims this court should give "very little, if any deference" to the commissioner's decision. He provides no authority for this claim, which runs contrary to the statutory provision that findings are binding on this court unless unsupported by substantial evidence. SeeIowa Code § 17A.19(10)(f) (2001). Assessing the credibility of witnesses is the province of the agency, not the reviewing court. See E.N.T. Assocs. v. Collentine, 525 N.W.2d 827, 830 (Iowa 1994). Although Hawkins claims the commissioner's findings are limited and tainted, our review is circumscribed by statute. Hawkins basically tries to retry the case on appeal. An agency decision is supported by substantial evidence when a reasonable person could reach the same conclusions after considering the record in its entirety. Al-Khattat v. Engineering Land Surveying Examining Bd., 644 N.W.2d 18, 23 (Iowa 2002). Even if the evidence is capable of supporting a conclusion different from the agency's, we affirm if we can find substantial evidence in the record to support the agency's determination. S.E. Iowa Coop. Elec. Ass'n v. Iowa Utils. Bd., 633 N.W.2d 814, 818 (Iowa 2001).
Hawkins claims he told Lillie he injured his back pulling on a tarp. Lillie admits receiving the call, but denies Hawkins told her the cause of his injury. Hawkins requested and received a change in schedule so he could be home on weekends to receive treatment. TMC does not pay for chiropractic treatments. Hawkins did not submit the chiropractic bills to TMC for payment, but instead submitted them to his own insurance carrier. After Hawkins's medical evaluation in July and subsequent surgery, TMC paid for the surgery and some permanency benefits. TMC claims the first notice it had that Hawkins's injury was work related was when he told the examining doctor in July-after which TMC paid the benefits. There is substantial evidence in the record to support the commissioner's decision.
III. Is TMC precluded from raising a notice defense?
While we have found there is substantial evidence in the record to support the conclusion Hawkins did not give a timely notice of a work-related injury as required by Iowa Code section 85.23, the question becomes whether the employer waived the lack of timely notice defense by subsequently paying benefits.
Iowa Code section 85.23 provides:
Unless the employer or the employer's representative shall have actual knowledge of the occurrence of an injury received within ninety days from the date of the occurrence of the injury, or unless the employee or someone on the employee's behalf or a dependent or someone on the dependent's behalf shall give notice thereof to the employer within ninety days from the date of the occurrence . . . no compensation shall be allowed.
Iowa Code section 86.13 provides, in part:
If an employer or insurance carrier pays weekly compensation benefits to an employee,. . . . The payments establish conclusively that the employer and insurance carrier have notice of the injury for which benefits are claimed but the payments do not constitute an admission of liability under this chapter or chapter 85, 85A, or 85B.
The commissioner and the district court concluded Iowa Code section 86.13 should be read to mean that voluntary payments by the employer or insurance carrier establish notice of the injury as of the date the payments are made and do not imply notice at some earlier date, nor do they result in the waiver of a defense under section 85.23.
There are well-established principles to be applied in resolving seemingly conflicting statutes. See IBP, Inc. v. Harker, 633 N.W.2d 322, 325 (Iowa 2001). A few of the principles applicable here are:
In reviewing the Commissioner's interpretation of the statute governing the agency, we defer to the expertise of the agency, but reserve for ourselves the final interpretation of the law.
Second Injury Fund v. Bergeson, 526 N.W.2d 543, 546 (Iowa 1995).
A statute should be accorded a logical, sensible construction which gives harmonious meaning to related sections and accomplishes the legislative purpose.
McSpadden v. Big Ben Coal Co., 288 N.W.2d 181, 188 (Iowa 1980).
The primary purpose of the workers' compensation statute is to benefit the worker and his or her dependents, insofar as statutory requirements permit. . . . Thus, the court "liberally construe[s] workers compensation statutes in favor of the worker."
IBP, 633 N.W.2d at 325 (quoting Ewing v. Allied Constr. Servs., 592 N.W.2d 689, 691 (Iowa 1999)) (citation omitted).
A statute is ambiguous if reasonable persons could disagree as to its meaning. . . . Ambiguity may arise in two ways: (1) from the meaning of particular words; or (2) from the general scope and meaning of a statute when all its provisions are examined.
William C. Mitchell, Ltd. v. Brown, 576 N.W.2d 342, 347 (Iowa 1998) (citations omitted).
Prior to 1982, when Iowa Code section 86.13 was amended (see 1982 Iowa Acts ch. 1161,§ 23), any payments of benefits pursuant to a memorandum of agreement conclusively established liability for a particular injury. See Trenhaile v. Quaker Oats Co., 228 Iowa 711, 715, 292 N.W. 799, 800-01 (1940); Fickbohm v. Ryal Miller Chevrolet Co., 228 Iowa 919, 925, 292 N.W. 801, 803 (1940).
The court in Tussing v. George A. Hormel Co., 461 N.W.2d 450, 452 (Iowa 1990), discussed the change to section 86.13 which added that voluntary payments "establish conclusively that the employer and insurance carrier have notice of the injury for which benefits are claimed but the payments do not constitute an admission of liability under this chapter." The court concluded that the amendment was intended to reverse prior law which viewed voluntary payments as being conclusive that the injury arose out of and in the course of employment.
We believe that the construction given to Iowa Code section 86.13 by the commissioner and the district court that voluntary payments mean the employer has notice only from the date of the payments are made to be illogical. We believe the clear intent of the legislature is that voluntary payments waive any objection to notice, but preserve other defenses regarding liability. The distinction between notice and other defenses in the wording of the statute clearly indicates that the legislature intended to retain the prior law that payments establish notice and preclude a defense based on the lack of timely notice while giving the employer the right to raise other defenses.
Because we conclude that payment of benefits waived any defense regarding timely notice, we reverse the decision of the district court affirming the commissioner's ruling and remand for further proceedings.