Court of Appeals Finds There Was No Substantial Evidence to Support Denial of Benefits
Numerous cases on this blog have discussed situations in which the decision of the agency was affirmed on substantial evidence grounds. In Estate of Herman v. Overhead Door Co. of Des Moines, No. 12-0892 (Iowa App. May 15, 2013), the court concludes that because there was no substantial evidence to support the agency's decision that claimant's injury did not arise out of and in the course of employment, claimant (or claimant's estate, since claimant died before this decision) was entitled to benefits. The court concluded that: "because we find the commissioner’s outright rejection of uncontroverted medical opinions is not supported by substantial evidence when the record is viewed as a whole, and we find Herman’s injury arose out of
and in the course of his employment as a matter of law, we reverse and remand."
Claimant worked in an unheated warehouse, and there was really little dispute that claimant worked in subfreezing temperatures in the winter of 2009, when he suffered his injury. On January 21, 2009, claimant noted blisters on his foot, and the following day, his foot was wet when the blisters broke open. On January 23, claimant reported the injury to his employer, and he was sent to the emergency room. This visit resulted in a finding that claimant had suffered frostbite and a secondary injection in the right foot. The frostbite was treated and claimant had skin grafts and an infection before finally losing his right toe.
Both treating physicians found that Mr. Herman's injury was more likely than not related to his work at Overhead Door and specifically his exposure to cold. There were apparently no opinions finding that the injury was not related to work, but despite this fact the deputy and commissioner concluded that the injury did not arise out of and in the course of employment.
The arbitration decision in Mr. Herman's case was very brief and focused not on the doctor's opinions, but on how cold it was in the warehouse and outside. That decision ignored the doctor's opinions by simply stating that they were not of much assistance, despite the fact that those opinions had linked the injury to claimant's work exposures.
On review, the court of appeals noted that this was not a classic "battle of the experts," since there were no experts indicating that the injury was not related to work. The court commented on the decision of the deputy, finding that the deputy had "inexplicably" found that the doctors were not helpful in determining whether the injury was work related. The court found that both the deputy and commissioner had failed to explain why the comments of the doctors were rejected in determining causation. The court found that the outright rejection of the doctor's opinions was not supported by substantial evidence. The court also found that the injury arose out of claimant's employment, and remanded the case to the agency.
Although the result in Herman is not something that occurs with frequency, the case serves as an example that there are still situations where there is no evidence to support a particular proposition, and thus no substantial evidence to support that proposition.
and in the course of his employment as a matter of law, we reverse and remand."
Claimant worked in an unheated warehouse, and there was really little dispute that claimant worked in subfreezing temperatures in the winter of 2009, when he suffered his injury. On January 21, 2009, claimant noted blisters on his foot, and the following day, his foot was wet when the blisters broke open. On January 23, claimant reported the injury to his employer, and he was sent to the emergency room. This visit resulted in a finding that claimant had suffered frostbite and a secondary injection in the right foot. The frostbite was treated and claimant had skin grafts and an infection before finally losing his right toe.
Both treating physicians found that Mr. Herman's injury was more likely than not related to his work at Overhead Door and specifically his exposure to cold. There were apparently no opinions finding that the injury was not related to work, but despite this fact the deputy and commissioner concluded that the injury did not arise out of and in the course of employment.
The arbitration decision in Mr. Herman's case was very brief and focused not on the doctor's opinions, but on how cold it was in the warehouse and outside. That decision ignored the doctor's opinions by simply stating that they were not of much assistance, despite the fact that those opinions had linked the injury to claimant's work exposures.
On review, the court of appeals noted that this was not a classic "battle of the experts," since there were no experts indicating that the injury was not related to work. The court commented on the decision of the deputy, finding that the deputy had "inexplicably" found that the doctors were not helpful in determining whether the injury was work related. The court found that both the deputy and commissioner had failed to explain why the comments of the doctors were rejected in determining causation. The court found that the outright rejection of the doctor's opinions was not supported by substantial evidence. The court also found that the injury arose out of claimant's employment, and remanded the case to the agency.
Although the result in Herman is not something that occurs with frequency, the case serves as an example that there are still situations where there is no evidence to support a particular proposition, and thus no substantial evidence to support that proposition.
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