Opinion
No. 5-367 / 04-1911
Filed July 13, 2005
Appeal from the Iowa District Court for Black Hawk County, Bruce B. Zager, Judge.
IBP, Inc., appeals the district court's reversal of the agency decision. REVERSED.
James Drury, Dakota Dunes, South Dakota, for appellant.
Robert Rush of Rush Nicholson, P.LC., Cedar Rapids, for appellee.
Heard by Sackett, C.J., and Huitink and Vaitheswaran, JJ.
Jerry Meyer claimed he sustained a compensable injury in the form of carpal and cubital tunnel syndromes on December 22, 2000, during the course of his employment with IBP, Inc. The agency denied his claim, finding there was no medical evidence to support a finding that Meyer's work incident of that date either caused or materially aggravated his syndromes. On judicial review the district court rejected the agency's findings, determining there was not substantial evidence to support the conclusions reached by the agency. The district court then proceeded to find that substantial evidence existed to support the conclusion Meyer established an injury occurring on December 22, 2000, in the course of Meyer's employment and that the record established Meyer's injury manifested itself on December 22, 2000. The court also found there was no evidence to support any other finding. We reverse the district court and affirm the agency decision.
I. BACKGROUND FACTS AND PROCEEDINGS.
At the time of alleged injury, Meyer had been employed by IBP for only two days. Meyer had worked at the plant the prior two months, but as an employee of Advance Services, Inc. While working for both employers Meyer was assigned the job of "popping tongues/mark snout." This job required repetitive bilateral upper extremity grasping, pulling, pushing, and cutting. Meyer was hired as a permanent IBP employee on December 18, 2000, after a pre-employment physical.
Meyer's claim originally was filed against both IBP and Advance Services. The claim against Advance Services was dismissed for reasons not apparent from the record.
On December 22, 2000, Meyer reported he experienced a sharp, sudden pain in his finger on his left hand after he felt a popping and snapping sensation in his left wrist while he was working. He said the pain traveled up his arm and he experienced numbness and tingling in his fingers. Meyer went to the IBP health center about the pain. He was told to ice his hand and was kept off work for the remainder of his shift. Meyer returned to light duty work, but on December 26, 2000, he returned to the IBP health center due to pain and swelling in his left hand. IBP sent Meyer to an outside health care provider. Meyer reported that while popping tongues he had pain in this fingers, wrist, and arm. Also, he reported numbness and tingling in his first three fingers. To treat the injury, Meyer was fitted for a brace and prescribed medication.
On January 25, 2001 Dr. Brian Sires conducted electrodiagnostic testing on Meyer, which revealed moderate left carpal tunnel syndrome with median nerve entrapment at the wrist and moderate left ulnar neuropathy at the elbow. Meyer was referred to Dr. Thomas Gorsche, an orthopedic specialist, for a surgery consultation. Dr. Gorsche recommended carpal tunnel release and ulnar nerve transposition procedures. IBP sent a letter to Dr. Gorsche on February 26, 2001 stating that Meyer had worked at IBP since October 10, 2000 as an employee of Advance Services, and then had recently been hired by IBP as a permanent employee. The ultimate question IBP sought to have Dr. Gorsche answer was, "Are you able to state within a reasonable degree of medical certainty that the left CTS and ulnar neuropathy was causally related to 1 day of work activities for IBP?" The question was followed with a space to check either "No" or "Yes." A couple of months later, on April 13, 2001, IBP sent another letter to Dr. Gorsche. IBP wrote to correct the first letter, informing Dr. Gorsche that Meyer had worked for IBP for two days. Specifically, IBP asked Dr. Gorsche, "Are you able to state within a reasonable degree of medical certainty that the left CTS and ulnar neuropathy was causally related to 2 days of work activities for IBP?" In response to the second letter, Dr. Gorsche circled "No," signed the letter, and returned it to IBP. IBP then refused to authorize the surgery.
Meyer subsequently sought treatment from his family physician, who referred him to Dr. Gary Knudson, another orthopedic specialist. After evaluating Meyer in May 2001, Dr. Knudson concluded Meyer had left ulnar neuropathy and carpal tunnel syndrome. Dr. Knudson also recommended carpal tunnel release and ulnar nerve transposition surgical procedures. Dr. Knudson concluded:
I believe [Meyer] is suffering from an overuse injury to his left upper extremity precipitated by his work at IBP this past fall and early winter. . . .
Certainly he was only on the job a few months before beginning significant symptomology, but he may have had a predisposition to develop symptomology which became manifested after significant repetitive use of his arms at IBP . . . and was likely the specific action he was performing at IBP that caused his symptoms to manifest themselves.
After a follow-up visit, at which point Meyer decided to proceed with the surgery, Dr. Knudson concluded, "I do feel that this is partially related to his work at IBP." (Emphasis added).
In a letter sent to Dr. Knudson on January 14, 2002, after summarizing the work history and treatment history of Meyer, IBP asked, "Given the above facts, within a reasonable decree of medical certainty, do you agree with Dr. Gorsche that the left CTS and ulnar neuropathy was not causally related to 2 days of work activities for IBP?" Dr. Knudson responded to the letter by marking the answer "Yes."
Meyer also received an independent medical examination by Dr. Farid Manshadi. Dr. Manshadi concluded Meyer suffered a cumulative work injury that did arise out of and in the course of his work at IBP and produced left ulnar neuropathy at the cubital tunnel, as well as left carpal tunnel syndrome. Dr. Manshadi's evaluation of Meyer does not specifically state whether the two workdays Meyer spent as an employee of IBP caused the cumulative injury to develop or either substantially contributed to development or materially aggravated the injury.
Dr. Knudson performed the ulnar nerve transposition procedure on June 21, 2001, and carpal tunnel release on September 10, 2001. Following successful surgery, Meyer was released by Dr. Knudson to return to work on October 15, 2001, at Meyer's request.
Meyer filed his petition with the Workers' Compensation Commissioner in June 2001. The petition indicated an injury date of December 22, 2000. Meyer claimed an injury to his left/right upper extremities and that the injury occurred from repetitive motion. Five issues were raised before the agency: (1) whether Meyer received an injury that arose out of and in the course of his employment with IBP, (2) whether a causal relationship existed between the claimed injury and the claimed temporary and permanent disability, (3) the extent of Meyer's entitlement to temporary or permanent disability or both, if any, (4) whether Meyer was entitled to certain medical costs as causally connected to the alleged injury, and (5) whether Meyer was entitled to payment of the costs of an independent medical evaluation.
On June 10, 2003, the deputy commissioner entered a decision. The deputy concluded Meyer had not established an injury on December 22, 2000, that arose out of and in the course of Meyer's employment at IBP and stated:
All physicians who have rendered opinions in this matter agree that claimant does have a cumulative trauma injury that developed as a result of his performing the job of popping tongues at the IBP facility. Doctors Gorsche and Knu[d]son, both of whom are orthopedic surgeons and both of whom actually treated claimant, have expressed their belief that the two days claimant performed work as an IBP employee prior to December 22, 2000 would not, of itself, have produced his left upper extremity hand and elbow conditions. Claimant's evaluating physician expresses no opinion as regards to that question. Likewise, no physician addresses the issue of whether claimant's work incident of December 22, 2000 could, of itself, have either caused or materially aggravated claimant's carpal and cubital tunnel syndromes. Hence, the record as it exists is insufficient to support a factual finding that claimant's ulnar and median nerve neuropathies arose out of his limited tenure as an actual IBP employee.
Meyer appealed the decision to the commissioner. The commissioner affirmed and adopted the decision of the deputy as the final agency action.
Meyer petitioned for judicial review in March 2004. After a hearing on the matter, the district court reversed and remanded to the agency on November 3, 2004. The district court determined there was not substantial evidence in the record to support the conclusion of the agency and that the agency committed errors of law.
The district court asserted that the record clearly established Meyer's injury manifested itself on December 22, 2000, while he was working as an employee of IBP. The district court cited the established facts that (1) Meyer had only experienced minor pain before becoming a permanent employee and that after consulting with the IBP health center he returned to work without substantive medical treatment, (2) Meyer underwent a physical examination before becoming a permanent IBP employee and only minor deficiencies were noted, (3) Meyer experienced a sharp, shooting pain during his shift after which he sought treatment at IBP's health center, (4) after the sudden pain, Meyer missed work due to injury for the first time, (5) after the sudden pain, Meyer was assigned to light duty work for the first time, (6) after the sudden pain Meyer was referred to numerous health care providers for the first time, and (7) after the sudden pain, Meyer underwent surgeries to alleviate his symptoms.
The district court determined the commissioner committed legal error in concluding that the medical evidence presented was insufficient to show the injury arose out of or was materially aggravated by Meyer's work at IBP. The district court noted that all evidence in the record indicated Meyer's injury was suffered while working for IBP on December 22, 2000. Additionally, there was no evidence in the record that Meyer suffered from carpal and cubital tunnel syndromes before December 22, 2000. The district court concluded that the only rational explanation as to why Meyer suffered from carpal and cubital tunnel syndromes after December 22, 2000 was his work as an employee of IBP.
IBP appeals the ruling of the district court, arguing there was substantial evidence to support the agency decision.
II. SCOPE OF REVIEW.
Our scope of review is governed by the judicial review provisions of Iowa Code chapter 17A (2003). Wal-Mart Stores, Inc. v. Caselman, 657 N.W.2d 493, 498 (Iowa 2003). Our review under Iowa Code chapter 17A is for correction of errors at law, not de novo. Id. "If we conclude the agency has committed a legal error, it is our obligation to correct it." Van Meter Indus. v. Mason City Human Rights Com'n, 675 N.W.2d 503, 506 (Iowa 2004).
Iowa Code section 17A.19(10) provides specificity as to the principles of law applicable to judicial review. Locate.Plus.Com., Inc. v. Iowa Dep't of Transp., 650 N.W.2d 609, 612 (Iowa 2002). The provision "reaffirms the notion that courts must not `simply rubber stamp the agency fact finding without engaging in a fairly intensive review of the record to ensure that the fact finding is itself reasonable.'" Caselman, 657 N.W.2d at 499 (quoting Arthur E. Bonfield, Amendments to Iowa Administrative Procedure Act (1998) at 68)). An agency's fact findings are binding on us if supported by substantial evidence in the record before the court when that record is viewed as a whole. Iowa Code § 17A.19(10)(f). Substantial evidence is
the quantity and quality of evidence that would be deemed sufficient by a neutral, detached, and reasonable person, to establish the fact at issue when the consequences resulting from the establishment of that fact are understood to be serious and of great importance.
Id. § 17A.19(10)(f)(1); University of Iowa Hospitals Clinics v. Waters , 674 N.W.2d 92, 95 (Iowa 2004).
Evidence is not insubstantial merely because it would have supported contrary inferences. Nor is evidence insubstantial because of the possibility of drawing two inconsistent conclusions from it. The ultimate question is not whether the evidence supports a different finding but whether the evidence supports the findings actually made.
Missman v. Iowa Dept. of Transp. , 653 N.W.2d 363, 367 (Iowa 2002). "The burden of demonstrating the required prejudice and the invalidity of agency action is on the party asserting invalidity." Iowa Code § 17A.19(8)(a).
III. ANALYSIS.
A. Substantial Evidence.
The district court held that there was not substantial evidence in the record to support the agency decision. IBP argues, pointing out our court's and the district court's limited scope of review, the district court erred in its holding and we should reverse the district court.
IBP points to the following facts, among others, as demonstrating there was substantial evidence to support the agency's decision that Meyer failed to establish his burden of proof: (1) Meyer was only an IBP employee for two days prior to reporting the injury, and (2) in response to IBP's letters, two orthopedic surgeons opined that, within a reasonable degree of medical certainty, the left carpal tunnel syndrome and ulnar neuropathy exhibited by Meyer were not causally related to two days of work activities for IBP.
Meyer argues the agency made incorrect or incomplete factual findings. The agency found, "No physician has specifically opined that [Meyer's] experience of pain in the left third finger on December 22, 2000 either produced or materially aggravated [Meyer's] left hand and arm problems." The agency relied on this finding in its determination that Meyer did not establish his burden of proof. Meyer argues this finding was flawed. Furthermore, Meyer argues the agency ignored evidence in the record that indicated the incident of pain Meyer felt on December 22, 2000 did produce or materially aggravate Meyer's left hand and arm problems. In making this argument, Meyer contends we should consider the following evidence: (1) the report of the physician assistant that IBP referred him to, which indicated that after experiencing a sharp pain in his left third finger and a popping and snapping sensation in his wrist, he experienced pain traveling up his arm and numbness and tingling in his fingers; (2) Dr. Sires's tests after the December 22, 2000 incident that revealed left carpal tunnel syndrome and moderate left ulnar neuropathy; (3) the physical examination that IBP conducted before permanently hiring him, which revealed some problems, but did not reveal significant problems; and (4) the fact that Dr. Knudson, after examining Meyer, concluded it was his belief Meyer was "suffering from an overuse injury to his left upper extremity precipitated by his work at IBP this past fall and early winter."
We agree with the agency that this evidence does not support a finding that Meyer's work for IBP caused the syndromes. While Meyer said he had pain on December 22, 2000, there is no medical evidence that the pain he felt caused the syndromes. We agree that Dr. Knudson said his injury was from the overuse of his left upper extremity precipitated by work at IBP during the fall and winter. However, Meyer was employed by Advance Services for all but two days of this period and Dr. Knudson, as well as Dr. Gorsche, gave the specific opinion that the syndromes were not causally related to two days of work for IBP.
B. Legal Error.
Meyer also asserts he is not required to prove the two days of work caused the injury. While Meyer must prove the injury is a proximate cause of the disability on which the claim is based, a cause is proximate if it is a substantial factor in bringing about the result; it need not be the only cause. Blacksmith v. All-American, Inc., 290 N.W.2d 348, 354 (Iowa 1980).
Meyer correctly argues there is evidence that he suffered a cumulative injury. Dr. Knudson and Dr. Manshadi indicated Meyer's injury was a cumulative injury, but nevertheless neither attributed its cause to the two days Meyer worked for IBP. The date of injury in cases of cumulative injury is fixed when the disability manifests itself, or "the date on which both the fact of the injury and the causal relationship of the injury to the claimant's employment would have become plainly apparent to a reasonable person." Oscar Mayer Foods Corp. v. Tasler, 483 N.W.2d 824, 829 (Iowa 1992). Meyer argues the date his injury manifested itself was December 22, 2000. The agency found there was no medical evidence that what happened on December 22, 2000 was a manifestation of the syndromes. Meyer has pointed to no evidence, medical or otherwise, that it was. We reverse the district court and affirm the agency decision.
REVERSED.
Huitink, J., concurs; Vaitheswaran, J., dissents.
I respectfully dissent. The majority states "there is no medical evidence that the pain [Meyer] felt caused the syndromes." The majority concludes "Meyer has pointed to no evidence, medical or otherwise" that "what happened on December 22, 2000 was a manifestation of the syndromes." I disagree with this statement and conclusion.
IBP concedes Meyer suffered from left carpal tunnel syndrome and cubital tunnel syndrome. IBP also concedes this was a cumulative injury, defined as a gradual injury which results in the development of a disability over time. McKeever Custom Cabinets v. Smith, 379 N.W.2d 368, 373 (Iowa 1985). The only dispute concerns when this cumulative injury "manifested" itself. "`Manifestation' is best characterized as `the date on which both the fact of the injury and the causal relationship of the injury to the claimant's employment would have become plainly apparent to a reasonable person.'" Oscar Mayer Foods Corp. v. Tasler, 483 N.W.2d 824, 829 (Iowa 1992) (citation omitted). Although the deputy commissioner acknowledged Meyer sustained a cumulative injury, she side-stepped the manifestation question and focused instead on whether Meyer's injuries arose out of his two days of work as an IBP employee. I would conclude that, in doing so, she misapplied the cumulative injury rule. See Iowa Code § 17A.19(10)(m).
As the Iowa Supreme Court stated, the manifestation rule "does not require any significant causal occurrence on the date of injury thus established." Ellingson v. Fleetguard, Inc., 599 N.W.2d 440, 444 (Iowa 1999). Application of the rule simply requires a determination of when Meyer knew he suffered from a work-related condition or injury. Herrera v. IBP, Inc., 633 N.W.2d 284, 288 (Iowa 2001). An employee may gain this knowledge when an injury prevents the employee from working. Excel Corp. v. Smithart, 654 N.W.2d 891, 896 (Iowa 2002).
Applying these legal precepts to the record before us, I concur with the district court that the only possible manifestation date was December 22, 2000. This was the first date on which Meyer was referred for medical treatment, the first date on which IBP's health department kept him from returning to his shift, the first time he was given a light duty work restriction, and the first time he was referred for medical treatment. Although Meyer complained of swelling in his fingers and soreness in his wrist before that date, he was not removed from his shift, was not prescribed any medications, was not referred to a physician, and was told by IBP's health department that he was experiencing "break-in pain." Under these circumstances, a reasonable person would not have expected him to have known that his pre-December 22 symptoms reflected a work-related injury.
In reaching this conclusion, I have considered the fact that a pre-employment physical revealed some abnormalities in Meyer's hand. These abnormalities did not prevent Meyer from being hired by IBP as a permanent employee. See Smithart, 654 N.W.2d at 896. In my view, the physical exam, therefore, would not have made it "plainly apparent" to a reasonable person that Meyer sustained an injury that was work-related. Tasler, 483 N.W.2d at 829.
I have also considered the two medical responses to questions posed by IBP's workers' compensation examiner. In both instances, the physicians stated Meyer's injuries were "not causally related to 2 days of work activities at IBP." Because the cumulative injury rule does not require a showing of a causal relationship between the injury and a specified number of days at work, those opinions are irrelevant. To the extent the agency relied on these opinions, it misapplied law to fact.
Finally, I recognize that a determination of the manifestation date is an "inherently fact-based determination." Id. I also recognize that we will affirm "a determination of fact clearly vested by a provision of law in the discretion of the agency" if is "supported by substantial evidence in the record before the court when that record is viewed as a whole." Iowa Code § 17A.19(10)(f). Assuming the deputy commissioner properly applied the cumulative injury rule and the law on manifestation of an injury, I agree with the district court that her determination of the injury date was nevertheless unsupported by substantial evidence. The agency relied on medical answers to irrelevant questions. Those answers could not constitute substantial evidence in support of the decision. See Clark v. Iowa Dep't of Revenue Fin., 644 N.W.2d 310, 320 (Iowa 2002) (stating agency decision may not be based on irrelevant evidence); cf. Taylor v. Chater, 118 F.3d 1274, 1278-79 (8th Cir. 1997) (stating an expert witness's answer to inaccurate hypothetical question is not substantial evidence).
I would affirm the district court decision which reversed the agency decision and remanded for proceedings consistent with the opinion.