Court Reverses Agency Decision Denying Benefits

Bensley v. Dee Zee, No. 1-638 (Iowa App. Sept. 8, 2011) is a case in which benefits were initially denied to claimant's at the arbitration level, a conclusion that was affirmed on appeal.   Claimant alleged elbow and shoulder problems, and in the arbitration decision, the finding was made that claimant had not established how her shoulder injury had occurred, and dismissed that claim.  The district court (Judge Rosenberg) reversed, finding that the evidence was "overwhelmingly" in favor of causation.

On appeal to the court of appeals, the decision of the agency is reversed, and the decision of the district court adopted.  The employer argued that claimant's injury was preexisting and not caused by claimant's work activities.  The court concludes that the issue of causation is largely a determination based on the medical evidence.  The court finds it "clear" that the evidence did not support the conclusions made by the commissioner.  The court notes that the medical experts reported, "ad nauseam", that the work at Dee Zee was repetitive in nature and resulted in the shoulder problems claimant described.  The court found that under Catalfo, the agency failed to explain its rejection of the three medical opinions that supported claimant's contention that her shoulder injury was related to work.  The court noted that the employer takes the claimant as they are found, subject to any infirmities that they may have.  The decision of the agency was reversed and the claim remanded to the commissioner.

A special concurrence by Judge Vogel notes her concern that the agency provided no specific credibility findings, which may have influenced the decision on appeal.  She noted that it was not clear in the decision why the decisions of the doctors, specifically Dr. Neff, were rejected by the commissioner.  Had there been a credibility finding and the agency's decision more clearly explained, the result may have been different on appeal.