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Des Moines Area Regional Transit Authority v. Young

Supreme Court of Iowa

June 5, 2015


On review from the Iowa Court of Appeals. Appeal from the Iowa District Court for Polk County, Eliza J. Ovrom, Judge. An injured worker awarded workers' compensation benefits following a hearing seeks further review of a decision by the court of appeals denying the assessment of expenses of a medical examination as costs of the hearing taxed to the employer.


David L. Jenkins of Bradshaw, Fowler, Proctor & Fairgrave, P.C., Des Moines, for appellant.

Robert E. Tucker of Tucker Law Office, Des Moines, for appellee.

CADY, Chief Justice. All justices concur except Hecht, J., who dissents and is joined by Appel and Zager, JJ., and Appel, J., who dissents and is joined by Hecht and Zager, JJ.


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CADY, Chief Justice.

In this workers' compensation appeal, we must decide whether Iowa Code section 85.39 (2009) provides the exclusive method for reimbursement of an independent medical examination obtained by a claimant or if the workers' compensation commissioner may tax the expense of the examination as costs incurred in the hearing under an administrative rule authorizing the taxation of costs of obtaining reports by doctors. In this case, the deputy workers' compensation commissioner taxed as costs to the employer a medical examination obtained by the worker outside of the provisions of section 85.39. The workers' compensation commissioner and the district court affirmed the taxation of the cost. On appeal, the court of appeals reversed, holding the reimbursement would be inconsistent with Iowa Code section 85.39. On our review, we affirm the decision of the court of appeals and remand the case to the district court to further remand to the commissioner for further proceedings consistent with this opinion.

Page 841

I. Factual Background & Proceedings.

The Des Moines Area Regional Transit Authority (DART) employed Arbreina Young as a bus driver. On June 2, 2009, the bus she was driving collided with an empty vehicle on DART premises. She sought medical treatment for a back injury and returned to work on June 8, 2009. She was reassigned to perform light work.

Young received physical therapy for her injury and was sent by DART to an orthopedic surgeon, Dr. Daniel McGuire. He determined surgery would not aid in Young's healing. Dr. McGuire referred Young to Dr. Donna Bahls for pain management. Dr. Bahls treated Young from August 2009 to November 2011. Young regularly attended physical therapy from June 2009 through March 2010.

On March 18, 2010, Young went to Dr. Jacqueline Stoken for a medical examination. The examination was not authorized by DART, but arranged independently by Young. Dr. Stoken examined Young, reviewed her medical records, and drafted a report. In the report, Dr. Stoken concluded Young reached maximum medical improvement (MMI) on March 11, 2010, and suffered a permanent disability to her back. She assigned Young a fifteen percent body-as-a-whole impairment rating. Dr. Stoken also imposed work restrictions.

On April 16, Young underwent a functional capacity evaluation. The evaluation found she should be limited to light to medium categories of work. On May 18, Dr. Bahls determined Young had reached MMI, suffering a permanent disability to her back, and assigned her a five percent body-as-a-whole impairment rating. She also adopted the restrictions recommended by the functional capacity evaluation.

Young filed a workers' compensation claim on December 29, 2010, and the case proceeded to a hearing before a deputy workers' compensation commissioner. At the hearing, Young submitted the report from Dr. Stoken as evidence. Following the hearing, the deputy commissioner found Young suffered a permanent partial disability to her back resulting in a twenty-five percent reduction in earning capacity. The deputy commissioner also taxed as a cost against DART the expense of Dr. Stoken's examination and report under the administrative rule governing the assessment of costs in a hearing. The fee for the examination and report was $2800.

The commissioner affirmed the decision of the deputy commissioner. DART filed for judicial review. The district court affirmed the decision of the commissioner. The district court held that the reimbursement was proper under Iowa Code section 86.40 and Iowa Administrative Code rule 876-4.33, as the " statute and corresponding rule give the Workers Compensation Commissioner discretion to award costs related to hearings before the agency."

DART appealed, and we transferred the case to the court of appeals. The sole issue raised concerned the award as a cost of the examination and report by Dr. Stoken. The court of appeals reversed the district court's ruling. It found the practice of assigning the expense of an examination as a cost under the rule would defeat the statutory requirements governing the reimbursement of an independent medical examination. Further, the court of appeals determined that Dr. Stoken's bill was a charge for the examination, not a report, as required by the language of Iowa Administrative Code rule 876-4.33. Young sought and we granted further review.

II. Scope of Review.

Our review of this workers' compensation appeal is governed by the Iowa

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Administrative Procedure Act, Iowa Code chapter 17A. Mycogen Seeds v. Sands, 686 N.W.2d 457, 463 (Iowa 2004). Iowa Code section 17A.19(1) entitles parties who are " aggrieved or adversely affected by any final agency action" to judicial review. Iowa Code § 17A.19(1). " We apply the standards of section 17A.19(10) to the Commissioner's decision and decide whether the district court correctly applied the law in exercising its [section 17A.19(1)] judicial review function." Lakeside Casino v. Blue, 743 N.W.2d 169, 172-73 (Iowa 2007). If we reach the same conclusions as the district court, " 'we affirm; otherwise, we reverse.'" Neal v. Annett Holdings, Inc., 814 N.W.2d 512, 518 (Iowa 2012) (quoting Mycogen Seeds, 686 N.W.2d at 464).

" [W]e give an agency substantial deference when it interprets its own regulations," so long as such interpretation is not in violation of the rule's plain language and clear meaning. Boehme v. Fareway Stores, Inc., 762 N.W.2d 142, 146 (Iowa 2009) (" 'When the language of a statute is plain and its meaning clear, the rules of statutory construction do not permit us to search for meaning beyond the statute's express terms.'" (quoting Rock v. Warhank, 757 N.W.2d 670, 673 (Iowa 2008))). When discretion has been vested in the commissioner, " we reverse only if the commissioner's application was 'irrational, illogical, or wholly unjustifiable.'" Larson Mfg. Co. v. Thorson, 763 N.W.2d 842, 850 (Iowa 2009) (quoting Iowa Code § 17A.19(10)(l)). On the other hand, if discretion has not been clearly vested, " then the court must disregard any interpretation by the agency that it finds erroneous." Evercom Sys., Inc. v. Iowa Utils. Bd., 805 N.W.2d 758, 762 (Iowa 2011). We " are not bound by the agency's interpretation [of law] and may substitute our own to correct a misapplication of law." SZ Enters., LLC v. Iowa Utils. Bd., 850 N.W.2d 441, 449 (Iowa 2014); accord Iowa Code § 17A.19(10)(c).

When interpreting statutes, we look to the intent of the legislature based on the words used and what interpretation will best effect the purpose of the statute. IBP, Inc. v. Harker, 633 N.W.2d 322, 325 (Iowa 2001). It is well established that " [w]e liberally construe workers' compensation statutes in favor of the worker," Ewing v. Allied Constr. Servs., 592 N.W.2d 689, 691 (Iowa 1999), because " [t]he primary purpose of the workers' compensation statute is to benefit the worker and his or her dependents, insofar as statutory requirements permit," McSpadden v. Big Ben Coal Co., 288 N.W.2d 181, 188 (Iowa 1980).

III. The Positions of the Parties.

DART argues that Iowa Code section 85.39 occupies the entire field for the reimbursement of what has become known as an independent medical examination (IME), and therefore, the commissioner cannot provide for the reimbursement of an IME outside the framework of section 85.39. Young argues the process works to the disadvantage of the employee. She claims it is unfair and impractical to wait to obtain an IME until after the employer has had the employee examined by a physician of the employer's choice. For example, Young asserts that an employee, who must wait under section 85.39 to obtain a reimbursable examination with the employee's choice of physician until after the employer's choice of physician has performed an examination, may be unable to file a timely claim because the employer could refuse to establish an impairment rating and, in effect, prevent the employee from filing a claim. As to the question of precisely what costs may be taxed, Young argues the physical examination is part of

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the cost of obtaining the doctor's report and so can be taxed at the commissioner's discretion as hearing costs.

The deputy commissioner found that Dr. Stoken's IME report did not qualify for reimbursement under Iowa Code section 85.39 because it was premature. However, the deputy noted that an IME is " routinely awarded as costs" under the rule because section 85.39 limits reimbursement to a single examination. Further, the deputy commissioner found the rule was not limited to an assessment of the costs of the report but could include the underlying examination. The commissioner affirmed, finding the fee was properly assessed under the rule and that the cost of the report included the time spent examining the claimant and reviewing the records.

The district court held that section 85.39 did not control the awarding as a cost of Dr. Stoken's IME because it was at a time not contemplated in the statute. However, the court combined the discretion vested in the commissioner to award costs under section 86.40 with our general principle of construing workers' compensation statutes liberally in favor of the worker to give deference to the ...

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