Court of Appeals Rejects Challenge to AMA Guides, Consideration of Chronic Pain, Affirms Decision Denying Claimant Benefits

 In Millanes-Ortiz v. Loyd Roling Construction, No. 19-2077 (Iowa App. Jan. 21, 2021), the agency and district court denied benefits to claimant, finding that claimant suffered no permanent impairment from a fall that occurred in the course of his employment.  On appeal, claimant argues that the commissioner erred as a matter of law in considering only the AMA Guides to determine permanency.  Claimant also alleges that the agency erred in applying law to fact by failing to consider chronic pain as sufficient evidence of a change in physiological capacity in a scheduled member case.  Finally, claimant argues that the decision to deny permanent disability is not supported by substantial evidence.

Claimant had a stipulated work injury and argued that he was entitled to permanency because of chronic pain and changes sustained in his left arm.  He argued that the commissioner erred by not considering any evidence beyond the AMA Guidelines when determining the extent of permanency.  Claimant argues that a finding of chronic pain in his arm was sufficient to award at a minimum 1% disability despite the absence of a rating under the AMA Guides.  The court acknowledges that for pre-7/1/17 cases, evidence outside the Guides is to be considered in determining permanency.  In this case, according to the court, the agency considered facts outside of the AMA guidelines in determining whether claimant had suffered a permanent injury.  Accordingly, the commissioner was affirmed on this point.  

The court disagreed that a finding of chronic pain was sufficient per se to show a change in physiological capacity.  Citing Robbenolt v.  Snap-On Tools, 555 N.W.2d 229, 234 (Iowa 1996), the court noted the commissioner is not required to award disability beyond the AMA Guides simply because of a complaint of pain or fatigue.  Furthermore, the question of claimant's pain level was disputed and defendants' doctor had opinion that there was no permanent disability.  In addition, an FCE demonstrating symptom magnification led to credibility questions concerning claimant's complaints of pain.  The court declined to find that the decision of the agency was irrational, illogical or wholly unjustifiable.  Having made this determination, the finding that the decision was supported by substantial evidence was also made by the court and the decision of the commissioner was affirmed in its entirety.