Cedar Rapids Cmty. Sch. Dist. v. Pease, No. 09–0724.

• Court: United States State Supreme Court of Iowa
• Writing for the Court: APPEL
• Citation: 275 Ed. Law Rep. 989,807 N.W.2d 839
• Parties: CEDAR RAPIDS COMMUNITY SCHOOL DISTRICT and EMC Insurance Companies, Appellants, v. Christine PEASE, Appellee.
• Decision Date: 16 December 2011
• Docket Number: No. 09–0724.

275 Ed. Law Rep. 989
807 N.W.2d 839

CEDAR RAPIDS COMMUNITY SCHOOL DISTRICT and EMC Insurance Companies, Appellants,
v.
Christine PEASE, Appellee.

No. 09–0724.

Supreme Court of Iowa.

Dec. 16, 2011.

[807 N.W.2d 842]

Tina M. Eick and Wendy D. Boka of Hopkins & Huebner, P.C., Des Moines, for appellants.

Thomas M. Wertz and Daniel J. Anderson of Wertz & Dake, Cedar Rapids, for appellee.

APPEL, Justice.

In this workers' compensation case, we consider whether the court of appeals properly applied the “substantial evidence” test under Iowa Code section 17A.19(10)( f ) (2009) when it reversed an award of benefits in an appeal of a decision of the workers' compensation commission. Based on our review of the record, we conclude substantial evidence supports the commissioner's findings. As a result, we vacate the decision of the court of appeals and affirm the judgment of the district court.

I. Factual and Procedural Background.

Christine Pease injured her right ankle when she slipped on ice and fell in the course of her employment with the Cedar Rapids Community School District (District) as a “job coach.” The position of job coach involved working with disabled children, transporting them to various locations in the community in the school van.

Pease filed a claim with the workers' compensation commission seeking benefits as a result of her alleged injuries. While the parties stipulated that Pease suffered a right ankle injury as a result of the slip and fall and that the injury arose within the scope of employment, the District disputed “the nature, scope and effect of the injury.”

Pease's ankle injury required her to undergo two surgeries related to the placement and removal of a screw. In addition, Pease claimed that her fall caused her to have an altered gait, which in turn caused her to sustain an injury to her left ankle and back. Pease further maintained that her injuries increased her preexisting state of depression.

At the hearing, Pease offered evidence in support of her claim that her right ankle injury caused a change in gait which subsequently caused injuries to her left ankle and back. With respect to her right ankle, Pease offered the testimony of a physician that she suffered “a rather significant ligamentous injury to her right ankle involving both the deltoid and syndesmotic ligament.” She then reported to another physician that she began experiencing low back pain due to her altered gait. Although Pease sought treatment for lower back pain before, her physician noted that her back pain had become more difficult to control after her fall. In addition, Pease reported that she began to experience pain in her left ankle due to her altered gait. Pease, however, had a history of problems with her left ankle, which included a

[807 N.W.2d 843]

chronic tear of ligaments and two arthroscopic surgeries prior to her slip and fall involved in this case.

According to Pease, after she had reached maximum medical improvement she was asked to undergo a functional capacity evaluation. The results of the functional capacity evaluation indicated that Pease could stand or walk no more than fifty percent of her work shift and for limited durations; could lift twenty pounds rarely, fifteen pounds occasionally, and seven to eight pounds frequently; could tolerate a maximum of ten to twelve stairs up and down once a day using handrails for support; and should avoid ladder or step climbing greater than an eight inch height. Her physician characterized these work restrictions as “permanent.”

More than four months later, the District terminated Pease's employment. The District stated that Pease had been unable to return to work since her injury and, in light of the permanent restrictions, she was unable to perform the essential functions of the position of job coach or any other job with the District in her pay range.

After her termination from employment, Pease became increasingly depressed and sought medical help for this condition. Pease had a history of depression prior to her work injury, but testified her depression became much worse following the injury. She testified that her constant pain, inability to walk, loss of her job, and her increased stress levels all contributed to her depression and that the depression interfered with her concentration, her sleep, and her social life.

Pease offered expert medical testimony in support of her claim that she suffered deeper depression as a result of her work injury. Dr. William Stutts, a psychiatrist, concluded that Pease's work injury was a “substantial contributing factor[ ] in bringing about her current level of depression.” Dr. Stutts asserted it was more likely than not that the chronic pain resulting from her injuries was permanent and that the pain would continue to contribute to Pease's depression. Another physician, Dr. John Brownell, characterized Pease as suffering from a “pretty clear case of post-surgical depression” and further stated that the depression was a result of both the stress of the surgery and her decreased mobility.

Pease offered the opinion of Barbara Laughlin, a vocational expert, in support of her claim that she was no longer employable. Laughlin asserted that Pease suffered a ninety to one hundred percent loss of access to the labor market as a result of her injuries. Laughlin stated that Pease would have great difficulty finding and maintaining employment in light of her inability to interact appropriately with peers, the general public, and supervisors.

The District countered by offering evidence that tended to characterize Pease's injuries as less substantial. After performing an independent medical examination, Dr. Ray Miller opined that Pease had an eight percent of the whole person impairment due to the right ankle injury and the subsequent sequelae to the back and left ankle.

With respect to the claim of depression, the District offered evidence from Dr. Raymond Crowe indicating that Pease's depressive episode was not causally connected to the injury. Dr. Crowe later asserted that Pease was malingering.

The District offered a vocational report prepared by Dr. Elizabeth Mease and Dr. Janeen Montgomery. They opined that Pease was employable at the sedentary physical level and was not psychiatrically foreclosed from employment.

[807 N.W.2d 844]

The deputy commissioner ruled in favor of Pease. The deputy concluded that Pease suffered “an injury to the body as a whole.” Additionally, the deputy found that Pease's work injury was a “substantial contributory factor in [Pease's] current state of depression.” Further, the deputy held that as a result of her physical and psychological injuries, Pease was “unable to return to any job she ha[d] previously held.” As a result, the deputy awarded Pease permanent total disability, accrued benefits, and reimbursement for medical expenses.

The commissioner affirmed the decision of the deputy, but modified and expanded on the deputy's ruling. The commissioner noted that the deputy had erroneously stated that Dr. Miller had assigned an eight percent permanent disability rating to the injuries to the right ankle, neck, lower back, and left ankle when, in fact, Dr. Miller assigned the disability rating based only on the injuries to Pease's lower back and left ankle. The commissioner concluded that this error had no impact on the case.

The commissioner further considered whether the deputy erred in failing to apportion Pease's alleged preexisting disability. The commissioner noted that this issue was not raised before the deputy and was not preserved for appeal.

The district court affirmed in part and reversed in part. The district court first concluded that the commissioner applied the appropriate standard of review and correctly held the District failed to preserve error on the apportionment issue. The district court also upheld the commissioner's findings of fact with respect to the causation of Pease's mental and physical injuries. The court observed that the commissioner favored the findings of Dr. Miller and Dr. Stutts and concluded that, on the whole, substantial evidence supported the commissioner's findings. Further, the district court held that substantial evidence supported the commissioner's findings regarding disability. The court reversed, however, the commissioner's award of medical expenses for Pease's neck injuries because there were no findings to establish that the neck injuries were caused by the January 26 accident. The District appealed, and the court of appeals reversed and remanded.

The court of appeals held substantial evidence did not support the commissioner's findings on causation. The court questioned the reliability of Dr. Miller's conclusions, observing that Dr. Miller's reliance on the history provided by Pease was misplaced because other evidence, including video surveillance, undermined Pease's credibility. Additionally, the court noted that Dr. Miller incorrectly believed Dr. Kline opined that Pease's back pain was caused by the January 26 accident when, in fact, Dr. Kline concluded the opposite. Further, the court questioned the conclusions of Dr. Stutts, explaining that Dr. Stutts' opinion rested, in part, on an inaccurate and incomplete history of depression provided by Pease. Finally, the court discussed the conflicting evidence and Pease's “lengthy history of symptoms” relating to the injuries and concluded medical causation was lacking between the January 26 accident and the injuries to Pease's left ankle, lower back, and postaccident level of depression. Pease applied for further review, which we granted.

II. Standard of Review.

Our decision is controlled in large part by the deference we afford to decisions of administrative agencies. Medical causation presents a question of fact that is vested in the discretion of the workers' compensation commission. See

[807 N.W.2d 845]

Dunlavey v. Econ. Fire & Cas. Co., 526 N.W.2d 845, 853 (Iowa 1995). We will therefore only...