Court of Appeals Affirms Denial of Death Benefits
In Moad v. Gary Jensen Trucking, No. 14-0164 (Iowa App. March 11, 2015), the Court of Appeals affirmed the agency's decision finding that claimant was not entitled to death benefits. Claimant died three months following a head on collision that occurred while he was driving for the employer. Claimant had been hospitalized with serious injuries following the collision. When he was released he complained of constant pain, swollen legs and poor appetite. He continued smoking despite doctor's instructions, and continued to be in pain, including pain when he attempted to take a deep breath. He was readmitted to the hospital, but discharged about a week later. Pain in the chest continued, and he ultimately had to be admitted to the hospital again with cardiac problems. While being airlifted to another hospital, claimant died, with the death certificate noting a massive pulmonary embolus.
Claimant's treating physician indicated that he had died from either a pulmonary embolism or from a massive heart attack, either of which would have been caused by the injury and its sequella. The employer's doctor indicated there was no evidence of a pulmonary embolism and that his preexisting heart disease was the cause of death. Claimant's IME doctor disagreed with both of the other doctors, concluding that the emotional and physical stress associated with the accident, plus his painful convalescence, had caused the rupture of unstable coronary plaque, causing his death.
The deputy concluded that claimant had not met his burden of proving that his death was the sequella of his work related accident and denied benefits. The commissioner found that the deputy's failure to discuss important evidence was troubling, but ultimately agreed with the result. The district court, noting its limited standard of review, affirmed on substantial evidence grounds, despite noting that it would have reached a different result had it decided the case ab initio.
The Court of Appeals noted that medical causation presented a question of fact that was vested in the discretion of the workers' compensation commissioner. The court noted that although some states have a presumption that when death follows soon after an injury, the death is due to the injury, Iowa does not follow such a rule. The court noted that is review was "extremely limited" and affirmed the decision of the agency.
Moad is an example of the extremely limited scope of review given by the courts on issues of substantial evidence. As a practical matter, unless there is some legal question presented, or perhaps an application of law to fact, it is unlikely that the courts will reverse a decision of the agency on factual grounds.
Claimant's treating physician indicated that he had died from either a pulmonary embolism or from a massive heart attack, either of which would have been caused by the injury and its sequella. The employer's doctor indicated there was no evidence of a pulmonary embolism and that his preexisting heart disease was the cause of death. Claimant's IME doctor disagreed with both of the other doctors, concluding that the emotional and physical stress associated with the accident, plus his painful convalescence, had caused the rupture of unstable coronary plaque, causing his death.
The deputy concluded that claimant had not met his burden of proving that his death was the sequella of his work related accident and denied benefits. The commissioner found that the deputy's failure to discuss important evidence was troubling, but ultimately agreed with the result. The district court, noting its limited standard of review, affirmed on substantial evidence grounds, despite noting that it would have reached a different result had it decided the case ab initio.
The Court of Appeals noted that medical causation presented a question of fact that was vested in the discretion of the workers' compensation commissioner. The court noted that although some states have a presumption that when death follows soon after an injury, the death is due to the injury, Iowa does not follow such a rule. The court noted that is review was "extremely limited" and affirmed the decision of the agency.
Moad is an example of the extremely limited scope of review given by the courts on issues of substantial evidence. As a practical matter, unless there is some legal question presented, or perhaps an application of law to fact, it is unlikely that the courts will reverse a decision of the agency on factual grounds.
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