Court of Appeals Addresses Issues Concerning Commencement of Permanent Total Disability Benefits, Interest
In Searle Petroleum, Inc. v. Mlady, No. 12-2008 (Iowa App. December 5, 2013), the Court of Appeals addressed issues concerning substantial evidence and the appropriate commencement date for permanent total disability benefits and interest in a review-reopening proceeding. The agency had concluded that claimant had demonstrated that he was entitled to additional benefits on review-reopening, and awarded permanent total disability. The agency had indicated that benefits commenced on the date of the injury.
In the initial decision, the commissioner had concluded that claimant had an industrial disability of 80%. On review reopening, the agency found that given claimant's physical condition, he had been unable to secure employment and also noted that there had been no improvement in the claimant's employability. The commissioner affirmed, finding that there had been a deterioration of claimant's condition. The agency found that benefits commenced as of the date of the injury, with credit for amounts previously paid.
The court initially addressed an issue that had not been presented to the district or appellate courts - whether claimant had committed fraud and perjury at the hearing. The court found that the remedy for this allegation was to file a petition with the agency within one year of the decision under IRCP 1.1013. Since the employer had not done so, the court could not consider the newly discovered evidence. On another tangential issue, the court indicated that the district court had accepted verbatim the judicial review decision authored by claimant's counsel. The court indicated that although this practice was not encouraged, it did not apply a separate standard of review when the the district court issued such an opinion.
The court first found that substantial evidence supported the commissioner's findings that claimant's condition had deteriorated. The court noted that the agency had based this on claimant's testimony, and that the only piece of medical evidence addressing this issue had indicated that there was no worsening of claimant's condition. The court noted that there was no requirement that medical evidence is necessary to demonstrate a worsening of claimant's condition, citing ENT Assocs. v. Collentine, 525 N.W.2d 827, 830 (Iowa 1994). The court also found that the change in claimant's condition was related to his work injury. The court noted that the injuries complained of were the same injuries found to be work related at the initial hearing, and further stated that there was no evidence of a subsequent injury that could have caused the increased symptomatology. Finally, the court found that the finding that there had been a change in claimant's economic condition was not "irrational, illogical or wholly unjustifiable."
As noted above, the agency had concluded that claimant's benefits commenced as of the date of injury, with the employer receiving credit for the benefits it had paid. The court, citing Verizon Bus. Network Servs. v. McKenzie, No. 11-1845, 2012 WL 4899244 (Iowa App. Oct. 17, 2012), concluded that the date of commencement for a review-reopening case is the date on which the review-reopening petition was filed. Note that in this case, this did not make a difference because claimant was still receiving the 80% industrial disability award at the time the review-reopening petition was filed. In may cases, however, that will not be the situation. The court noted that in McKenzie, the court had noted that in Dickenson v. John Deere Products Engineering, 395 N.W.2d 644, 646 (Iowa App. 1986), the court had concluded that interest payments were to commence on the date of the filing of the petition. The court concluded that since interest payments commenced on this date, benefits should also commence on this date, finding that it was implicit in the holding in Dickenson that weekly benefits cannot be due before a review-reopening petition is filed. Note that this is inconsistent with the commissioner's general rule that in a review-reopening petition, benefits commence as of the end of the earlier award. See Pena v. Tyson Fresh Meats, Inc., No. 5008361 (App. Nov. 20, 2006).
The court also addressed a cost issue, finding that an IME was not appropriate because defendants had not obtained a medical opinion. The court, on another cost issue, found that vocational costs were appropriately awarded under 876 IAC 4.33.
In the initial decision, the commissioner had concluded that claimant had an industrial disability of 80%. On review reopening, the agency found that given claimant's physical condition, he had been unable to secure employment and also noted that there had been no improvement in the claimant's employability. The commissioner affirmed, finding that there had been a deterioration of claimant's condition. The agency found that benefits commenced as of the date of the injury, with credit for amounts previously paid.
The court initially addressed an issue that had not been presented to the district or appellate courts - whether claimant had committed fraud and perjury at the hearing. The court found that the remedy for this allegation was to file a petition with the agency within one year of the decision under IRCP 1.1013. Since the employer had not done so, the court could not consider the newly discovered evidence. On another tangential issue, the court indicated that the district court had accepted verbatim the judicial review decision authored by claimant's counsel. The court indicated that although this practice was not encouraged, it did not apply a separate standard of review when the the district court issued such an opinion.
The court first found that substantial evidence supported the commissioner's findings that claimant's condition had deteriorated. The court noted that the agency had based this on claimant's testimony, and that the only piece of medical evidence addressing this issue had indicated that there was no worsening of claimant's condition. The court noted that there was no requirement that medical evidence is necessary to demonstrate a worsening of claimant's condition, citing ENT Assocs. v. Collentine, 525 N.W.2d 827, 830 (Iowa 1994). The court also found that the change in claimant's condition was related to his work injury. The court noted that the injuries complained of were the same injuries found to be work related at the initial hearing, and further stated that there was no evidence of a subsequent injury that could have caused the increased symptomatology. Finally, the court found that the finding that there had been a change in claimant's economic condition was not "irrational, illogical or wholly unjustifiable."
As noted above, the agency had concluded that claimant's benefits commenced as of the date of injury, with the employer receiving credit for the benefits it had paid. The court, citing Verizon Bus. Network Servs. v. McKenzie, No. 11-1845, 2012 WL 4899244 (Iowa App. Oct. 17, 2012), concluded that the date of commencement for a review-reopening case is the date on which the review-reopening petition was filed. Note that in this case, this did not make a difference because claimant was still receiving the 80% industrial disability award at the time the review-reopening petition was filed. In may cases, however, that will not be the situation. The court noted that in McKenzie, the court had noted that in Dickenson v. John Deere Products Engineering, 395 N.W.2d 644, 646 (Iowa App. 1986), the court had concluded that interest payments were to commence on the date of the filing of the petition. The court concluded that since interest payments commenced on this date, benefits should also commence on this date, finding that it was implicit in the holding in Dickenson that weekly benefits cannot be due before a review-reopening petition is filed. Note that this is inconsistent with the commissioner's general rule that in a review-reopening petition, benefits commence as of the end of the earlier award. See Pena v. Tyson Fresh Meats, Inc., No. 5008361 (App. Nov. 20, 2006).
The court also addressed a cost issue, finding that an IME was not appropriate because defendants had not obtained a medical opinion. The court, on another cost issue, found that vocational costs were appropriately awarded under 876 IAC 4.33.
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