Iowa Court of Appeals Affirms Award of Benefits Where Causation Finding Based on Lay Evidence
Martinez Construction v. Ceballos, No. 12-1514 (Iowa App. June 12, 2013), involved a situation in which the evidence used to support a finding of causation was primarily lay testimony. The court found that in the circumstances in the case, medical testimony was not required to establish causation.
The accident that led to the injury occurred when claimant lost his footing on a roof, attempted to jump into a forklift basket, and hit his face and right shoulder and twisted his left knee. Claimant was knocked unconscious as a result of the injury. Hospital records demonstrated that claimant had four broken ribs and a perforated lung. X-rays showed that there was a dislocation of the shoulder and fluid on the knee. Claimant was deported shortly after this and did not attend a followup appointment.
At hearing, claimant appeared by telephone, to which defendants objected. The deputy allowed claimant to testify by telephone. Claimant testified he had continuing problems with his shoulder and left knee. Defendants called a co-worker to testify, and he claimed he saw claimant carry a heavy television and a bed, as well as performing work on a car. These activities were said to have occurred after the accident. No medical reports were placed in evidence to demonstrate the extent of claimant's impairments or restrictions on his activities. The decision found that claimant was entitled to TTD benefits and assessed the costs of the hearing, including the costs of the telephone call, to defendants. The deputy concluded that a portion of the lack of medical evidence was because defendants had denied medical care. The deputy credited claimant's testimony and discounted the testimony of the co-worker. The decision was affirmed on appeal.
On review, defendants argued there was no substantial evidence to support the conclusions of the agency. Defendants also alleged that the costs of the telephone call for the hearing should not be assessed to them. Defendants argued that because there was no medical testimony to support the claim, there could be no finding of causation. The court found that under Sondag v. Ferris Hardware, 220 N.W.2d 903, 907 (Iowa 1974), the general rule was that expert testimony, even if uncontroverted, could be accepted or rejected by the trier of fact. Lay witness testimony is also relevant and material to the causation determination. Terwilliger v. Snap-On Tools Corp., 529 N.W.2d 267, 273 (Iowa 1995).
Although medical testimony is ordinarily necessary to establish causation, according to the court, it is not necessary in every instance. In this case, the court found that the agency was within its power in finding claimant credible and using his testimony as the sole basis of causation. On the costs of the hearing phone call, defendants argued there was nothing in the commissioner's rules to support the payment of costs. Citing section 86.40 of the Code, the court concluded that costs are to be taxed in the discretion of the commissioner and that the key was whether the commissioner had abused his discretion. The court then found that there was nothing in 876 IAC 4.33 to allow these costs. Because of this, the costs of the telephone call were not to be taxed against the employer.
Although the result in this case is that lay testimony can be used to support a conclusion of causation, the ruling is narrowly tailored to the facts. Claimant suffered clear injuries as a result of the traumatic events, and it was not a leap to find that the shoulder and knee problems were sufficient to support a finding of TTD. Defendants did not seem to put on any medical evidence that the injuries were not sufficient to allow a finding of temporary total disability. Thus, the case became one in which credibility determined the outcome. Because of the unique situation involved in the case, including the fact that only temporary benefits and not permanency were in issue, Martinez could well be sui generis.
The accident that led to the injury occurred when claimant lost his footing on a roof, attempted to jump into a forklift basket, and hit his face and right shoulder and twisted his left knee. Claimant was knocked unconscious as a result of the injury. Hospital records demonstrated that claimant had four broken ribs and a perforated lung. X-rays showed that there was a dislocation of the shoulder and fluid on the knee. Claimant was deported shortly after this and did not attend a followup appointment.
At hearing, claimant appeared by telephone, to which defendants objected. The deputy allowed claimant to testify by telephone. Claimant testified he had continuing problems with his shoulder and left knee. Defendants called a co-worker to testify, and he claimed he saw claimant carry a heavy television and a bed, as well as performing work on a car. These activities were said to have occurred after the accident. No medical reports were placed in evidence to demonstrate the extent of claimant's impairments or restrictions on his activities. The decision found that claimant was entitled to TTD benefits and assessed the costs of the hearing, including the costs of the telephone call, to defendants. The deputy concluded that a portion of the lack of medical evidence was because defendants had denied medical care. The deputy credited claimant's testimony and discounted the testimony of the co-worker. The decision was affirmed on appeal.
On review, defendants argued there was no substantial evidence to support the conclusions of the agency. Defendants also alleged that the costs of the telephone call for the hearing should not be assessed to them. Defendants argued that because there was no medical testimony to support the claim, there could be no finding of causation. The court found that under Sondag v. Ferris Hardware, 220 N.W.2d 903, 907 (Iowa 1974), the general rule was that expert testimony, even if uncontroverted, could be accepted or rejected by the trier of fact. Lay witness testimony is also relevant and material to the causation determination. Terwilliger v. Snap-On Tools Corp., 529 N.W.2d 267, 273 (Iowa 1995).
Although medical testimony is ordinarily necessary to establish causation, according to the court, it is not necessary in every instance. In this case, the court found that the agency was within its power in finding claimant credible and using his testimony as the sole basis of causation. On the costs of the hearing phone call, defendants argued there was nothing in the commissioner's rules to support the payment of costs. Citing section 86.40 of the Code, the court concluded that costs are to be taxed in the discretion of the commissioner and that the key was whether the commissioner had abused his discretion. The court then found that there was nothing in 876 IAC 4.33 to allow these costs. Because of this, the costs of the telephone call were not to be taxed against the employer.
Although the result in this case is that lay testimony can be used to support a conclusion of causation, the ruling is narrowly tailored to the facts. Claimant suffered clear injuries as a result of the traumatic events, and it was not a leap to find that the shoulder and knee problems were sufficient to support a finding of TTD. Defendants did not seem to put on any medical evidence that the injuries were not sufficient to allow a finding of temporary total disability. Thus, the case became one in which credibility determined the outcome. Because of the unique situation involved in the case, including the fact that only temporary benefits and not permanency were in issue, Martinez could well be sui generis.
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