Keystone Nursing Care Center v. Craddock

705 N.W.2d 299, 2005 Iowa Sup. LEXIS 131, 2005 WL 2398527
CourtSupreme Court of Iowa
DecidedSeptember 30, 2005
Docket04-0526
StatusPublished
Cited by30 cases

This text of 705 N.W.2d 299 (Keystone Nursing Care Center v. Craddock) is published on Counsel Stack Legal Research, covering Supreme Court of Iowa primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Keystone Nursing Care Center v. Craddock, 705 N.W.2d 299, 2005 Iowa Sup. LEXIS 131, 2005 WL 2398527 (iowa 2005).

Opinions

TERNUS, Justice.

In this appeal, an employer and its workers’ compensation insurance carrier [302]*302seek reversal of a district court judgment affirming an award of permanent partial disability benefits and penalty benefits to a former employee. We affirm the district court’s decision upholding the award of disability benefits, but we reverse on the issue of penalty benefits.

I. Background Facts and Proceedings.

On March 26, 1998, appellee, Billi Crad-dock, was employed as a certified nursing assistant (CNA) at a nursing home operated by the appellant, Keystone Nursing Care Center. Craddock testified she injured her back on that date when helping a resident into a wheelchair. A co-employee working with Craddock at the time recalled the lifting incident, but did not remember Craddock complaining of an injury or pain. Five days later Craddock completed a formal report of injury for her employer.

Upon being notified of the injury, Keystone referred Craddock to Rita Taylor, a physician assistant, for medical care. After conservative treatment was unsuccessful, Craddock saw Dr. Chad Abernathey, who eventually performed surgery on her lower back. On June 15, 1998, Dr. Aber-nathey released Craddock to return to work. The written release form states, “No restriction.” Craddock testified, however, that Dr. Abernathey told her orally that she should not help residents with showers or whirlpools. She also said Keystone accommodated her request that she not be assigned such duties. On October 9, 1998, Dr. Abernathey gave Craddock a seven percent whole body impairment rating.

Keystone paid all of Craddock’s medical expenses.1 In addition, Keystone paid healing period benefits until Craddock returned to work on June 15,1998, but made no voluntary permanent partial disability payments. The employer did not notify Craddock of the reason for its refusal to pay additional benefits until Craddock’s counsel inquired on November 5, 1999. In its response ten days later, the employer explained that it believed Craddock had not sustained an industrial disability because she was released to full duty without restrictions.

Craddock left her employment with Keystone in September 1998, and began working for another nursing home located closer to her residence. She did not have to give baths in her new job because her new employer had an employee who bathed all residents. Nonetheless, in March 1999, Craddock sustained another on-the-job injury to her lower back. Dr. Abernathey again performed surgery, and upon releasing Craddock to return to work, imposed a thirty-pound lifting restriction.

After the second injury, Craddock obtained an independent medical examination from Dr. Ray Miller. Dr. Miller reported his opinion that Craddock had a ten percent permanent impairment for the whole person following the second surgery. He also suggested that the claimant would have benefited from a 30-pound lifting restriction after her first surgery.

At the time of the hearing, Craddock was employed as a cashier at a convenience store at an hourly wage of $9.15. (She earned $7.40 per hour when working for Keystone.) The claimant was able to do most of the required work except her back condition and restrictions prevented her from taking out the garbage.

[303]*303Craddock filed a petition seeking workers’ compensation benefits and penalty benefits on February 14, 2001. After a hearing, a deputy workers’ compensation commissioner issued a decision holding the claimant had sustained a compensable injury that had resulted in a fifteen percent industrial disability. The deputy also ruled that Craddock was entitled to penalty benefits because the employer had not advised her of the reason for its decision not to pay permanent partial disability benefits at the time it stopped paying healing period benefits. The deputy rejected Craddock’s argument that she was entitled to penalty benefits because there was no reasonable basis for Keystone’s position that she had sustained no industrial disability.

On the employer’s appeal, the commissioner affirmed the deputy’s decision and adopted it as the final agency action with one exception. The commissioner held the denial of benefits was itself unreasonable because Craddock was restricted from bathing duties upon her return to work. Therefore, the commissioner stated, “it was not reasonable [for Keystone] to conclude that the injury had not caused any permanent disability.”

Keystone sought judicial review in the district court. That court held there was substantial evidence to support the agency’s decision that Craddock sustained an injury arising out of and in the course of her employment with Keystone, and that she suffered a fifteen percent industrial disability as a result of the injury. Relying on this court’s decision in Meyers v. Holiday Express Corp., 557 N.W.2d 502 (Iowa 1996), the district court also concluded the agency properly awarded penalty benefits based on Keystone’s failure to advise Craddock, contemporaneously with, its denial, of the reason it denied permanent disability benefits. The district court held, however, that there was not substantial evidence to support the commissioner’s alternate basis for penalty benefits: the absence of a reasonable basis to deny benefits. The court stated, “Given the fact Dr. Abernathey wrote ‘no restriction’ on his release form when he released [Craddocjf] to return to work, the issue of industrial disability was fairly debatable.”

The case now comes to us on the employer’s appeal. The employer challenges the commissioner’s decision in four respects: (1) that Craddock sustained a com-pensable injury; (2) that Craddock sustained any industrial disability; (8) that Craddock was entitled to penalty benefits; and (4) the extent of penalty benefits. Because we hold the claimant is not entitled to penalty benefits, we will not address the parties’ dispute over the amount of those benefits. We turn our attention instead to the other three issues.

II. Scope of Review.

Our review is controlled by Iowa’s Administrative Procedure Act, Iowa Code chapter 17A. Griffin Pipe Prods. Co. v. Guarino, 663 N.W.2d 862, 864 (Iowa 2003). Under the provisions of that statute, we may grant relief from the commissioner’s decision if a party’s substantial rights' have been prejudiced by agency action that falls within one of several enumerated grounds. Iowa Code § 17A.19(10) (2003). The grounds implicated in the present appeal include the following agency action:

c. Based upon an erroneous interpretation of a provision of law whose interpretation has not clearly been vested by a provision of law in the discretion of the agency.
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f. Based upon a determination of fact clearly vested by a provision of law in the discretion of the agency that is not supported by substantial evidence in the [304]*304record before the court when that record is viewed as a whole....

Id. § 17A.19(10)(c), (f).2

Because “factual findings regarding [an] award of benefits are within the agency’s discretion, ...

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Bluebook (online)
705 N.W.2d 299, 2005 Iowa Sup. LEXIS 131, 2005 WL 2398527, Counsel Stack Legal Research, https://law.counselstack.com/opinion/keystone-nursing-care-center-v-craddock-iowa-2005.