Court of Appeals Affirms Award of Workers' Compensation Benefits and Alternate Medical Care
In yet another decision demonstrating that if the question presented is one of substantial evidence, the party seeking to overturn the agency's decision is not going to prevail at the appellate level, the court in Talton v. Fleur Delis Motors Inns, Inc., No. 12-0999 (Iowa App. Feb. 27, 2013) affirmed the decision of the commissioner finding that claimant's injuries did not arise out of and in the course of employment, denying healing period benefits, and denying alternate medical care.
Claimant suffered a stipulated work injury when a can of tomatoes fell on her foot. She developed arthritis, which the treating doctor did not believe was work related, but which Dr. Mandracchia opined was work related. Dr. Simon indicated that claimant developed an antalgic gait as a result of the foot injury. The deputy found the injuries had arisen out of claimant's employment, but concluded that claimant had not reached maximum medial improvement and still in an healing period. The commissioner found that claimant's injuries had healed, and also found that the low back, left foot and right knee injuries alleged by claimant were not work related. Alternate medical care and penalty benefits were denied.
The commissioner relied on testimony from Dr. Barp to establish that the left foot, right knee and lower back problems were unrelated to the work injury. The court found that the commissioner was responsible for determining the weight given to expert testimony, and concluded that there was substantial evidence to support the conclusion of the agency. Claimant argued that the decision that the left foot, right knee and lower back problems did not arise out of employment was based on an irrational, illogical or wholly unjustifiable application of the law to the facts. The court found that because medical causation was within the domain of expert testimony, the weight to be given these opinions was for the commissioner.
The court also concluded that the decision denying alternate medical care was supported by substantial evidence, as the alternate medical care related to the left foot, right knee and lower back, which were found not to be work related. Finally, the court found substantial evidence supported the conclusion that claimant reached MMI on the date specified by the commissioner and no further benefits were payable.
As with numerous other appellate court decisions in recent years, if a claim is premised on substantial evidence, it is unlikely to be reversed in district court, the court of appeals or the supreme court. Both claimants and defendants have moved to arguing that the decision of the agency was "illogical, irrational or wholly unjustifiable," but this rationale has not been found persuasive by the courts because, as a general matter, if the decision of the agency is supported by substantial evidence, it is unlikely to be found illogical.
Claimant suffered a stipulated work injury when a can of tomatoes fell on her foot. She developed arthritis, which the treating doctor did not believe was work related, but which Dr. Mandracchia opined was work related. Dr. Simon indicated that claimant developed an antalgic gait as a result of the foot injury. The deputy found the injuries had arisen out of claimant's employment, but concluded that claimant had not reached maximum medial improvement and still in an healing period. The commissioner found that claimant's injuries had healed, and also found that the low back, left foot and right knee injuries alleged by claimant were not work related. Alternate medical care and penalty benefits were denied.
The commissioner relied on testimony from Dr. Barp to establish that the left foot, right knee and lower back problems were unrelated to the work injury. The court found that the commissioner was responsible for determining the weight given to expert testimony, and concluded that there was substantial evidence to support the conclusion of the agency. Claimant argued that the decision that the left foot, right knee and lower back problems did not arise out of employment was based on an irrational, illogical or wholly unjustifiable application of the law to the facts. The court found that because medical causation was within the domain of expert testimony, the weight to be given these opinions was for the commissioner.
The court also concluded that the decision denying alternate medical care was supported by substantial evidence, as the alternate medical care related to the left foot, right knee and lower back, which were found not to be work related. Finally, the court found substantial evidence supported the conclusion that claimant reached MMI on the date specified by the commissioner and no further benefits were payable.
As with numerous other appellate court decisions in recent years, if a claim is premised on substantial evidence, it is unlikely to be reversed in district court, the court of appeals or the supreme court. Both claimants and defendants have moved to arguing that the decision of the agency was "illogical, irrational or wholly unjustifiable," but this rationale has not been found persuasive by the courts because, as a general matter, if the decision of the agency is supported by substantial evidence, it is unlikely to be found illogical.
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