Plenis v. North Dakota Workers Compensation Bureau

• Decision Date: 25 June 1991
• Docket Number: No. 910041,910041
• Citation: 472 N.W.2d 459
• Parties: Harlan PLEINIS, Appellee, v. NORTH DAKOTA WORKERS COMPENSATION BUREAU, Appellant. Civ.
• Court: North Dakota Supreme Court

Page 459

472 N.W.2d 459

Harlan PLEINIS, Appellee, v. NORTH DAKOTA WORKERS COMPENSATION BUREAU, Appellant.

Civ. No. 910041.

Supreme Court of North Dakota.

June 25, 1991.

Kenneth S. Rau, of Moench Law Firm, Bismarck, for appellee.

Dean J. Haas, Asst. Atty. Gen., N.D. Workers Compensation Bureau, Bismarck, for appellant.

VANDE WALLE, Justice.

The Workers Compensation Bureau appealed from a district court judgment reversing its order denying a claim by Harlan J. Pleinis for further benefits. We reverse the judgment and reinstate the Bureau's order.

Pleinis initially received medical benefits from the Bureau for a "[l]ocalized contusion and strain of the medial aspect of the right knee" which occurred on September 25, 1984, when he slipped and fell while getting into a pickup truck while at work. X-rays of Pleinis's knee taken at that time indicated that he had osteoarthritis. Pleinis returned to work and received no further medical treatment for his knee until he consulted Dr. Raymond S. Gruby on March 8, 1989. According to Pleinis, he had problems with his knee after the 1984 injury and those problems progressively worsened until he quit his job in 1989. On August 7, 1989, Pleinis filed a claim for further benefits. The Bureau denied his claim, and he requested a rehearing.

At the rehearing Dr. Gruby testified by deposition that the 1984 injury may have aggravated the osteoarthritis in Pleinis's knee; however, Gruby further explained that the x-rays in 1984 indicated that Pleinis had arthritis in his knee before the injury and that it did not cause the osteoarthritic changes. Dr. Gruby opined that Pleinis's arthritic changes were a natural progression of the osteoarthritic condition. Dr. Gruby testified:

"Q. [Mr. Haas] Now, the essence in this case, Doctor, is whether this injury of September 25, 1984, which has been diagnosed as a contusion and a strain of the right knee had a significant impact given this natural progression of the osteoarthritis. I want to make sure that you understand what I'm asking here. The question is: Do you think that if he had not had, for example, the September 25, 1984, injury, do you think the osteoarthritis would have progressed in the manner that it did, anyway?

"A. [Dr. Gruby] Yes, sir.

"Q. And I'll ask it another way just so that we are sure of your answer. Doctor, in your opinion, did the 9/25/84 injury significantly cause a progression of the underlying osteoarthritis that wouldn't have happened but for the injury or created a worsening of that injury that wouldn't have otherwise happened?

"A. I don't believe it did.

* * * * * *

"Q. [Mr. Rau] Now, I want to ask this last question one more time because I think that there has been some ambiguity in the record up to now. Is it fair to state your opinion that the fall in 1984 caused a significant aggravation of Mr. Pleinis's arthritic condition?

"A. To clarify the ambiguity, the way I view the fall is that the fall caused discomfort and swelling and began uncovering the arthritic process that was already there. I don't think that it accelerated the arthritic process. I don't think it knocked off a piece of bone or in that way caused a rapid acceleration of the osteoarthritis that was already there.

* * * * * *

"Q. (MR. HAAS CONTINUING) And that then in choosing between two theories one, that it's a natural progression and the second that the work injury of September 25, 1984, was a substantial accelerating factor, you would choose the former theory, that it was a natural progression; is that fair?

"A. Yes, sir."

Pleinis testified that he did not have any problems with his right knee before the 1984 injury. He also testified that when he returned to work after the injury, he had to wrap his knee to alleviate the pain and that he quit his job in 1989 because of his knee problems.

The Bureau denied Pleinis's claim for further benefits, finding that:

"VI.

"Following claimant's work injury of September 25, 1984, x-rays were taken. Those x-rays indicated that claimant had degenerative changes with bone spurs being formed. Dr. Gruby indicated that those x-rays showed that the claimant had osteoarthritis. The physician further testified that the osteoarthritic process was independent of the September 25, 1984, work injury.

"VII.

"Following claimant's September 25, 1984, work injury, claimant returned to work until approximately July of 1989. There is no evidence that claimant sought medical treatment in that interval. Claimant testified that his problems were getting progressively worse.

"VIII.

"Dr. Gruby testified at his deposition that claimant's underlying osteoarthritic changes were progressing over this period of time. The physician did not believe that the claimant's work injury of September 25, 1984, substantially contributed to the acceleration or progression of the arthritic condition. The physician indicated that a natural progression of the arthritic condition could likely explain claimant's condition and disability.

"IX.

"Dr. Gruby's opinion that the condition is primarily that of a natural progression of osteoarthritic changes is consistent with the history provided by the claimant.

* * * * * *

"II.

"Claimant has failed to prove a cause and effect relationship between his September 25, 1984, injury and his current osteoarthritic condition which is disabling."

Pleinis appealed to the district court which initially concluded that it was

"unable to understand the rationale for the agency order in this case. The agency's findings and conclusions are not in any manner related to the provisions of [Section] 65-01-02(8)(b)(6), and are mere generalities. Based on such generalities, I am unable to discern the reasoning of the agency and to conduct a review. The sole conclusion stated is lack of proof of cause and effect. In view of the detailed statutory structure in the above quoted statute, the agency is obligated under [Section] 28-32-13 to make findings and conclusions so that this court can understand the basis of the agency's decision."

The court remanded to the Bureau for additional findings of fact and conclusions. The Bureau made additional findings that Pleinis "failed to prove a cause and effect relationship between his current condition and his work injury"; that his "current condition [was] due to a pre-existing osteoarthritic condition which would have progressed similarly in the absence of his work injury"; and that his current condition was "due to a natural progression of his osteoarthritic condition."

The district court reversed the Bureau's decision, concluding that its findings of fact were not supported by a preponderance of the evidence and its decision was not in accordance with the law. The court reasoned:

"The decision of the Workers Compensation Bureau fails to give due consideration to the applicable law, and therefore does not contain appropriate findings and conclusions. The applicable law is [Section] 65-01-02(8)(b)(6) and the findings are incomplete so as to disqualify [Pleinis] under this statute."

In an appeal to this court from a district court judgment reviewing a decision of an administrative agency, we review the record before the administrative agency and its decision rather than the decision of the district court. Plante v. North Dakota Workers Compensation Bureau, 455 N.W.2d 195 (N.D.1990). Our review of administrative agency decisions is governed by Section 28-32-19, N.D.C.C., which requires a three-step process to determine (1) if the findings of fact are supported by a preponderance of the evidence; (2) if the conclusions of law are supported by the findings of fact; and (3) if the agency decision is supported by the conclusions of law. Schmalz v. North Dakota Workers Compensation Bureau, 449 N.W.2d 817 (N.D.1989). In determining whether an administrative agency's findings of fact are supported by a preponderance of the evidence, we do not make independent findings of fact or substitute our judgment for that of the agency; rather, we determine only whether a reasoning mind could have reasonably determined that its factual conclusions were supported by the evidence. Power Fuels, Inc. v. Elkin, 283 N.W.2d 214 (N.D.1979). An administrative agency's findings of fact must be adequate so that the reviewing court can understand the basis of the agency's decision. Walter v. North Dakota State Highway Commissioner, 391 N.W.2d 155 (N.D.1986); Matter of Boschee, 347 N.W.2d 331 (N.D.1984).

The Bureau asserts that its...