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Jones v. Tie Yard of Omaha8/17/2005
Greg Jones seeks further review of a workers' compensation decision denying his claim for payment of medical expenses. AFFIRMED.
Considered by Sackett, C.J. and Huitink and Vaitheswaran, JJ.
Greg Jones seeks further judicial review of a workers' compensation decision denying his claim for payment of medical expenses. We affirm.
I. Background Facts and Proceedings
In 1990, Jones injured his back while working for Tie Yard of Omaha. He applied for workers' compensation benefits. In 1992, Jones underwent back surgery, performed by Dr. James LaMorgese. A deputy workers' compensation commissioner concluded that Jones showed "a causal relationship between injury and permanent partial disability as manifested on June 21, 1990," but did not show a causal relationship between his injury and the 1992 surgery. The agency awarded permanent partial disability benefits and denied medical benefits for the 1992 surgery.
In 1999, Jones underwent a second back surgery, performed by Dr. Michael Chapman. He sought reimbursement for the medical expenses associated with that surgery. A deputy workers' compensation commissioner concluded the 1990 work injury "was at least a substantial factor in the need for the 1999 surgery and subsequent treatment and medications." The deputy ordered Tie Yard to pay Jones's medical expenses.
On intra-agency appeal, the workers' compensation commissioner reversed, concluding Jones failed to establish that the work injury was a proximate cause of the 1999 surgery.
Jones sought judicial review. The district court concluded the commissioner applied the correct legal standard and his findings were supported by substantial evidence. This appeal followed.
II. Further Judicial Review
The parties agree the sole issue before the agency was whether the 1999 surgery was proximately caused by the 1990 work injury. They also agree that the commissioner cited the correct causation standard, as follows:
The claimant has the burden of proving by a preponderance of the evidence that 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. . . .
They part ways on whether the commissioner correctly applied the law to the facts, with Jones contending he did not. This contention triggers review under Iowa Code section 17A.19(10)(m) (2005) (reviewing agency action based upon "irrational, illogical, or wholly unjustifiable application of law to fact that has clearly been vested by a provision of law in the discretion of the agency"); P.D.S.I. v. Peterson, 685 N.W.2d 627, 633 (Iowa 2004) (stating application of law to fact in workers' compensation cases is "vested by a provision of law in the discretion of the agency," permitting reversal only if application was "irrational, illogical, or wholly unjustifiable").
The commissioner's application of law to fact was as follows. He first noted that the evidence supported several causes for Jones's 1999 surgery. He stated:
First, the work injury itself may have contributed to his present condition. Second, scarring from the 1992 surgery was observed by Dr. Chapman in the 1999 surgery and may be causing part of the problem. Third, the claimant had a slip and fall on ice prior to the 1999 surgery that may have precipitated the surgery. Fourth, the claimant has degenerative changes that may also be a factor producing his present condition.
The commissioner then summarized the medical causation opinions of Drs. LaMorgese and Chapman. He noted that Dr. LaMorg
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