Opinion
No. 1-1034 / 01-0764.
Filed July 3, 2002.
Appeal from the Iowa District Court for Cherokee County, DAVID A. LESTER, Judge.
Wilson Foods/Continental Deli appeals a ruling on judicial review which reversed an agency determination denying Thomas Keller workers' compensation benefits. REVERSED.
Thomas M. Plaza and Judith Higgs of Heidman, Redmond, Fredregill, Patterson, Plaza Dykstra, L.L.P., Sioux City, for appellant.
Ruth Carter and Roger Carter of the Carter Law Firm, P.C., Sioux City, for appellee.
Heard by VOGEL, P.J., and MILLER and VAITHESWARAN, JJ.
Wilson Foods/Continental Deli (Wilson) appeals from a ruling on judicial review which reversed an agency determination denying Thomas Keller's claim for workers' compensation benefits. We conclude the district court erred when it determined substantial evidence did not support the agency's conclusions. We therefore reverse the district court's ruling on judicial review.
Background facts and proceedings
Thomas Keller began working at Wilson in 1972. During his employment, Keller performed a variety of jobs, requiring different physical tasks, and usually changed departments approximately every four or five years. Keller worked for Wilson for almost twenty-six years, until April 25, 1997, when his deteriorating physical condition caused him to quit working.
After leaving Wilson, Keller brought four proceedings before the Iowa Division of Workers' Compensation against Wilson, seeking to recover benefits based on three traumatic back injuries that he alleged occurred on May 8, 1995, July 13, 1995, and February 20, 1996, and a cumulative injury allegedly sustained on April 25, 1997. The four actions were eventually consolidated and an arbitration hearing was held. Deputy Kent Enwright concluded Keller had not proven that his disability was work-related and therefore rejected the benefits claim. On appeal, Chief Deputy Workers' Compensation Commissioner Jon Heitland affirmed Deputy Enwright's decision. He also found Keller's disability was due to several long-standing non-work related problems.
On April 10, 2000, Keller filed a petition for judicial review of this decision. The district court concluded the agency had not given one of the medical opinions, that of Dr. O'Neil, proper weight. It reweighed the evidence and reversed the agency action, finding it was not supported by substantial evidence in the record. In particular, the court concluded instead there was substantial evidence to prove that Keller had sustained a cumulative injury to his back as of April 25, 1997, which was caused by the material aggravation and acceleration of an underlying degenerative condition, ankylosing spondylitis. It remanded to the Workers' Compensation Commissioner for a determination of Keller's entitlement to benefits. Wilson appealed this decision.
Scope of review .
Our review of this case is governed by Iowa Code chapter 17A, Iowa's administrative procedure act. See Second Injury Fund v. Nelson, 544 N.W.2d 258, 264 (Iowa 1995). "Our review of administrative agency decisions — like that of the district court — is limited to correcting legal error. The findings of the commissioner are akin to a jury verdict, and we broadly apply them to uphold the commissioner's decision." Second Injury Fund v. Shank, 516 N.W.2d 808, 812 (Iowa 1994).
We may reverse, modify, affirm, or remand the case to the commissioner for further proceedings if we conclude the agency's action is affected by an error at law or if it is not supported by substantial evidence. Iowa Code § 17A.19(8) (2001); Nelson, 544 N.W.2d at 264. Evidence is substantial if a reasonable mind would find it adequate to reach a conclusion. Shank, 516 N.W.2d at 812. The commissioner's decision does not lack substantial evidence because inconsistent conclusions may be drawn from the same evidence. Id. In such a case, we cannot interfere with the commissioner's conclusions. Id. The focus of the judicial inquiry is whether the evidence is sufficient to support the decision made, not whether it is sufficient to support the decision not made. Iowa Code§ 17A.19(10)(f) (2001); Riley v. Oscar Mayer Food Corp., 532 N.W.2d 489, 491 (Iowa Ct.App. 1995).
The District Court's scope of review .
The question presented in this appeal is whether the district court erred in concluding substantial evidence did not support the agency's determination Keller failed to prove by a preponderance of the evidence that he sustained a back injury arising out of and in the course of his employment with Wilson. We conclude the district court erred when it determined substantial evidence did not support the agency's decision. The district court appears to have looked beyond traditional standards of judicial review, and improperly substituted its judgment for that of the agency's. See Iowa Code § 17A.19(10) (2001).
In its appeal decision, the agency substantially adopted the deputy's arbitration decision, which found the majority of Keller's back problems were from non-work related incidents, and that if any aggravation of Keller's pre-existing condition occurred, it was only slight. The Commissioner's decision adds that there was little medical evidence to establish Keller's work aggravated his non-work related back condition. The decision concludes Keller's current back problem is more likely caused by his various long-standing, non-work ailments and inherited conditions such as ankylosing spondylitis, and is not caused by, or aggravated by, work activities, either on a cumulative basis or traumatically. It is our task to determine whether this conclusion is supported by substantial evidence. The district court concluded it was not. Indeed, the district court went further and concluded Keller proved he had sustained a cumulative injury which was caused by the material aggravation and acceleration of his underlying ankylosing spondylitis, due to his years of work at Wilson. See Barz v. Oler, 257 Iowa 508, 513, 133 N.W.2d 704, 707 (1965) (noting claimant is entitled to recovery if an underlying condition is accelerated, aggravated, worsened, or lighted up by the employment activity).
However, a genetic disease which is likely to progress so as to finally disable an employee does not become a "personal injury" under our workers' compensation scheme merely because it reaches a point of disablement while work for an employer is being pursued. Musselman v. Cent. Tel. Co., 261 Iowa 352, 359, 154 N.W.2d 128, 132 (1967). It is only when there is a direct causal connection between exertion of the employment and the injury that a compensation award can be made. Id. at 359-60, 154 N.W.2d at 132. The question is whether the diseased condition was the cause, or whether the employment was a proximate contributing cause. Id. at 360, 154 N.W.2d at 132.
We conclude the following evidence tends to support the agency's conclusion Keller did not prove a work related cumulative injury or specific traumatic injuries. First, it is undisputed that Keller suffers from ankylosing spondylitis, a hereditary condition in which the body is attacked by its own immune system and progressively destroys the joints. It often manifests itself in severe back pain, sacroiliac pain, and pain in most any joint in the body. Eventually, the joints fuse as the inflammation process eats away the lining of the joints. Moreover, it is undisputed this condition was pre-existing to any of the injury dates alleged by Keller. Keller suffered from back pain periodically throughout the 1980s and 1990s.
Keller offered a history of back pain. However, the majority of these complaints occurred during non-work situations such as a fall down some stairs, helping a friend move, bending over to clip his toenails, getting up after sitting for a long period of time, and arising from bed in the morning. Many of the remaining medical reports relating to these problems simply made no mention of work. In its appeal decision, the agency took note that Keller's "complaints commonly occur after non-work activity."
Dr. Leth, who performed an independent medical examination of Keller, described ankylosing spondylitis as a progressive condition. He therefore could not state whether Keller's condition would not have been as bad had it not been for the work. He also stated that he did not believe injuries or trauma could aggravate or accelerate ankylosing spondylitis. Further, Keller's history and x-rays appear consistent with the conclusion ankylosing spondylitis, progressed as he aged, causing his back pain and eventually forced him to leave his employment at Wilson. This evidence supports the agency's conclusion Keller's back problems would have worsened even if he had not been working at Wilson.
Conversely, the district court cited various evidence in support of its conclusion the evidence actually supported Keller's claim he sustained a compensable cumulative injury to his back as of April 25, 1997. For example, it noted there is no evidence Keller suffered any back pain prior to beginning employment with Wilson in 1972 at approximately age twenty. The court also found that medical records indicate that around 1980 Keller began complaining of back pain and sought treatment from Wilson's doctors. He routinely experienced back problems until 1995 when he began to miss work due to the pain. However, that same evidence could be read to support the agency's findings, see Holmes v. Bruce Motor Freight, Inc., 215 N.W.2d 296, 298 (Iowa 1974), that Keller's inherited, progressive condition surfaced and progressed totally unrelated to any work activities. In fact, Dr. Leth noted in a letter that it is common to see the onset of ankylosing spondylitis presenting as back pain in the second or third decade of life.
The district court also strongly relied on Dr. O'Neil's opinion, expressed in a March 2, 1998, questionnaire/letter to Keller's attorney, that Keller's employment with Wilson had aggravated his underlying medical condition. We believe the district court clearly second-guessed the agency with regard to Dr. O'Neil's conclusions. The agency had discounted Dr. O'Neil's credibility due to previous inconsistent diagnoses and other contradictions. For example, on April 7, 1997, Dr. O'Neil opined that Keller's problems were consistent with ankylosing spondylitis and restricted him from lifting above fifteen pounds. He further opined his condition was not work related and that the underlying condition had not changed. An August 7, 1997, report indicates again that Dr. O'Neil believed Keller had ankylosing spondylitis. The agency was the proper entity to make the judgment call regarding Dr. O'Neil's credibility and weigh any conflicting evidence. See Mercy Health Ctr. v. State Health Facilities Council, 360 N.W.2d 808, 809 (Iowa 1985) (noting judgment calls are the province of the agency). On judicial review, the court improperly invaded the domain of the agency in this regard.
In reversing the agency, the district court also noted that several doctors placed restrictions on Keller's work activities. It characterized these restrictions as additional evidence to support the conclusion Keller's work at Wilson materially aggravated his medical condition and it reasoned that the restrictions "lead to the logical conclusion that [the doctors] believed his work activities aggravated his underlying medical condition, and caused the pain he was experiencing." We find no support for this conclusion. The mere fact that a restriction is placed on an employee, without correlative evidence of causation between the employment and the injury, adds nothing to the question of whether work aggravated an underlying, progressive medical condition. See Musselman, 261 Iowa at 360, 154 N.W.2d at 132.
As noted, evidence is substantial when a reasonable mind would accept it as adequate to reach a conclusion. Grant v. Fritz, 201 N.W.2d 188, 197 (Iowa 1972). Nonetheless, the possibility of drawing two inconsistent conclusions from the evidence does not prevent an administrative agency's finding from being supported by substantial evidence. Reisner v. Bd. of Trs. of Fire Ret. Sys., 203 N.W.2d 812, 814 (Iowa 1973). Here, two inconsistent conclusions may be drawn based on the facts. The district court simply adopted its version of whether Keller suffered a cumulative injury over the agency's conclusion. In this regard, the court did not focus its judicial inquiry on whether the evidence is sufficient to support the decision made. Rather, it set aside the credibility findings of the agency and reweighed the evidence to come to a contrary conclusion. While the district court's findings may have some support in the record, its standard of review prevents the court from taking on the role of fact finder.
Conclusion .
We conclude the district court usurped the agency's prerogatives and exceeded its authority by substituting its judgment for that of the agency. The court appears to have taken on the role of fact finder and discounted the agency's own findings, which we conclude are supported by substantial evidence in the record. We therefore reverse the district court's ruling on judicial review.
REVERSED.