Ramirez-Trujillo v. Quality Egg, L.L.C.
| Decision Date | 11 February 2015 |
| Docket Number | No. 14-0640,14-0640 |
| Parties | DEANNA JO RAMIREZ-TRUJILLO, Plaintiff-Appellant, v. QUALITY EGG, L.L.C., WRIGHT COUNTY EGG DIVISION and SELECTIVE INSURANCE COMPANY OF AMERICA, Defendant-Appellees. |
| Court | Iowa Court of Appeals |
Appeal from the Iowa District Court for Polk County, Scott D. Rosenberg, Judge.
An employee appeals from a district court ruling upholding the Iowa Workers' Compensation Commissioner's award of benefits and reversing the commissioner's award of certain medical expenses. AFFIRMED IN PART AND REVERSED IN PART.
Mark S. Soldat of Soldat, Parrish-Sams & Gustafson, P.L.C., West Des Moines, for appellant.
Richard G. Book of Huber, Book, Cortese & Lanz, P.L.L.C., West Des Moines, for appellees.
Considered by Danilson, C.J., and Doyle and Tabor, JJ.
Deanna Ramirez-Trujillo appeals from an adverse ruling by the district court on her petition for judicial review of the Iowa Workers' Compensation Commissioner's decision, which determined her condition subsequent to September 30, 2009, was not the result of her August 1, 2009 work injury, thus denying her benefits after September 30, 2009. Ramirez-Trujillo also appeals from an adverse ruling by the district court reversing the commissioner's decision that ordered the employer and its insurance carrier to reimburse and hold Ramirez-Trujillo harmless from medical expenses she incurred after September 30, 2009. We affirm in part and reverse in part.
On August 1, 2009, Ramirez-Trujillo sustained an injury to her low back when she slipped and fell on some egg on the floor at the place of her employment. She was authorized by her employer to treat at the Wright Medical Center for her low-back work injury of August 1, 2009. She continued to treat at the Wright Medical Center for low-back problems after incidents occurring in December 2009 and May 2010. An L5-S1 surgical decompression was performed in August 2010. She was released to work in October 2010, but returned to Wright Medical Center in November 2010, complaining of low-back pain. She was seen again at the Wright Medical Center in November 2010, for recurring low-back pain. In January 2011, Ramirez-Trujillo's doctors placed work restrictions on her of no lifting greater than twenty pounds and no repetitive bending or twisting. Another L5-S1 surgical decompression was performed in March 2011.
Ramirez-Trujillo filed her contested case petition in October 2010. Hearing was held before a deputy workers' compensation commissioner in June 2011. The hearing deputy's arbitration decision was filed April 27, 2012. In pertinent part, the hearing deputy held: Ramirez-Trujillo's rehearing application was denied by the hearing deputy. Ramirez-Trujillo appealed to the commissioner.1 The commissioner issued an appeal decision on April 25, 2013, which affirmed in part and modified in part the arbitration decision. The commissioner agreed "with the decision and analysis by the hearing deputy that [Ramirez-Trujillo's] back condition after September 30, 2009 is not causally related to the work injury of August 1, 2009." But, the commissioner ordered the employer and its insurance carrier (collectively "employer") to reimburse Ramirez-Trujillo for out-of-pocket medical expenses she incurred after September 30, 2009, even though the expenses were not incurred as a result of the work injury, because the employer failed to notify Ramirez-Trujillo that the care was no longer authorized as required by Iowa Code section 85.27(4) (2009).
Ramirez-Trujillo filed an application for rehearing. The commissioner denied the rehearing but modified the arbitration decision in a respect notgermane to this appeal. Ramirez-Trujillo filed a petition for judicial review and the employer filed an answer and cross-petition.
In her petition for judicial review, Ramirez-Trujillo argued, among other things, that the commissioner's findings of fact and conclusions of law failed to comply with Iowa Code section 17A.16(1), and the deputy erred in misapplying and/or failing to apply the laws of proximate cause, sequelae, and probability/possibility with corroboration to the facts. In its cross-petition, the employer argued the commissioner erred by ordering it to reimburse and hold Ramirez-Trujillo harmless for the out-of-pocket medical expenses she incurred after September 30, 2009.
The district court affirmed in part and reversed in part the commissioner's decision. The court found "that the [commissioner] did not violate section 17A.16(1) because it is possible to deduce the agency's legal conclusions and findings of fact from its written decision." Further, the court found the commissioner's decision to be supported by substantial evidence considering the hearing deputy gave more weight to some expert testimony and less to others. Although the hearing deputy did not explicitly set out the basis for her rejection of the testimony of Ramirez-Trujillo's friends, the court found "it is apparent from the decision that she considered and rejected this testimony." The court found no error in the commissioner's application of the laws of proximate cause, sequelae, and probability/possibility with corroboration to the facts, and affirmed the commissioner's findings of fact and conclusions of law.
On the employer's cross-petition, the court concluded, "It is erroneous to interpret section 85.27(4) to require [the employer] to pay for medical treatmentwhen [it] reasonably believed that the work injury was resolved and [Ramirez-Trujillo] told [the employer] that the treatment was for a separate, non-work-related injury." The court reversed the commissioner's order regarding the section 85.27(4) issue. Ramirez-Trujillo's motion to enlarge, amend, modify and/or substitute was denied. She now appeals.
On appeal, Ramirez-Trujillo raises to us the same arguments she raised before the district court: the appeal deputy erred in failing to comply with Iowa Code section 17A.16(1), and the commissioner erred in misapplying and/or failing to apply the laws of proximate cause, sequelae, and probability/possibility with corroboration to the facts.
At the outset, we note our review of final agency action is "severely circumscribed." See Greenwood Manor v. Iowa Dep't of Pub. Health, 641 N.W.2d 823, 839 (Iowa 2002); Sellers v. Emp't Appeal Bd., 531 N.W.2d 645, 646 (Iowa Ct. App. 1995). Nearly all disputes are won or lost at the agency level; the cardinal rule of administrative law is that judgment calls are within the province of the administrative tribunal, not the courts. See id.
In the realm of workers' compensation proceedings, it is the workers' compensation commissioner, not the court, who weighs the evidence and measures the credibility of witnesses. Cedar Rapids Cmty. Sch. Dist. v. Pease, 807 N.W.2d 839, 845 (Iowa 2011). This includes the "determination of whether to accept or reject an expert opinion," as well as the weight to give the expert testimony. See id. Because these determinations remain within the agency'sexclusive domain and the "peculiar province" of the commissioner, we cannot reassess the weight of the evidence. See id.; see also Robbennolt v. Snap-On Tools Corp., 555 N.W.2d 229, 234 (Iowa 1996). In fact, "'we are obliged to apply those findings broadly and liberally to uphold rather than defeat the commissioner's decision.'" Pirelli-Armstrong Tire Co. v. Reynolds, 562 N.W.2d 433, 436 (Iowa 1997) (quoting Long v. Roberts Dairy Co., 528 N.W.2d 122, 123 (Iowa 1995).
"We are bound by the commissioner's factual determinations if they are supported by substantial evidence in the record before the court when that record is viewed as a whole." Mike Brooks, Inc. v. House, 843 N.W.2d 885, 889 (Iowa 2014) (citation and internal quotation marks omitted). "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." Iowa Code § 17A.19(10)(f)(1). When we conduct a substantial evidence review of an agency decision, it is not for us to make "a determination as to whether evidence 'trumps' other evidence or whether one piece of evidence is 'qualitatively weaker' than another piece of evidence." Arndt v. City of Le Claire, 728 N.W.2d 389, 394 (Iowa 2007). "On appeal, our task 'is not to determine whether the evidence supports a different finding; rather, our task is to determine whether substantial evidence . . . supports the findings actually made.'" House, 843 N.W.2d at 889 (quoting Pease, 807 N.W.2d at 845).
We have carefully reviewed the record, the briefs of the parties, and the district court's ruling. The district court's ruling identifies and considers all the issues presented. In applying the above precepts, and in giving the due deference we are statutorily obligated to afford the commissioner's findings of fact, we approve of the reasons and conclusions in the district court's ruling. Further discussion of the issues would be of no value. See Iowa Ct. R. 21.26(1)(b), (d), and (e). Accordingly, we affirm the district court's decision affirming the commissioner's decision as to Ramirez-Trujillo's petition.
In his appeal decision, the commissioner stated:
Although I agree with the hearing deputy that the medical expenses incurred after September 30, 2009 are not causally related to the work injury, I find that [the employer] failed to notify [Ramirez-Trujillo] pursuant to Iowa Code...
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