Court of Appeals Affirms Reduction of Industrial Disability by Commissioner's Designee

Claimant was originally found to have suffered a 40% industrial disability following the arbitration hearing.  On appeal, the commissioner's designee concluded that the appropriate level of disability was 25%.  The reviewing deputy also reversed an award of alternate medical care and penalty benefits by the hearing deputy.  In Harrod v. Advance Services Inc., No. 19-0169 (Iowa App. Jan. 23, 2020), the Court of Appeals affirms the appeal decision.

Claimant suffered shoulder and neck injuries at work.  The treating doctor provided treatment for the shoulder injury, but not the neck injury.  Claimant sought alternate medical care, which was denied by defendants.  The hearing deputy concluded claimant had suffered a 40% industrial disability and also found that alternative care was appropriate because claimant was still in pain and the treating doctor did not treat spinal injuries.  A penalty of $4500 was awarded for failure to pay benefits in a timely manner.  On appeal, the reviewing deputy reduced the award to 25% and denied alternate care and penalty.

With respect to the industrial award, the court concluded that an award would not be modified unless it was irrational, illogical or wholly unjustifiable.Claimant argued that the arbitration decision and appeal decision should be given equal weight since both claims were decided by a deputy.  The court noted that under section 86.3 of the code, a deputy had power to issue a final decision upon delegation by the commissioner. The court noted that it was the final decision being reviewed on appeal, not the arbitration decision, citing 17A.19(1).  The question before the court was whether the final agency action was supported by substantial evidence.

The court concluded that the final decision with respect to the 25% industrial award was supported by substantial evidence, and was not illogical, irrational or wholly unjustifiable.  The alternate medical care denial was found to be supported by substantial evidence.  The final decision had read the treating doctor's stoppage of treatment not as an abandonment of care, but as occurring during a period of symptom relief.  The court concluded this finding was supported by substantial evidence as there were no medical opinions demonstrating that reasonable medical care had not been provided.

The penalty award was reversed because the appeal deputy found that the record was devoid of evidence as to when benefits had been issued. No records or testimony concerning the dates of payment was provided at the hearing. The court finds the denial of penalty benefits was supported by substantial evidence.  On this question, the court does not grapple with the question of whether a delay in payments supports penalty, it finds only that claimant did not prove there had been a delay.