*1 COMPANY, Appellant, LITHCOTE BALLENGER, Appellee.
Chet
No. 90-46. Iowa. Appeals of
Court *2 Lithcote,
working for he had worked in a variety jobs, including bartending, of com- fishing, clamming, mercial carpentry, paint- work, ing, masonry plumbing, and electri- jobs required cal work. Most of these hard physical exertion. Dahl, Moines, appel- Des Harry W. 16, 1984, On Ballenger date
lant. back, injured his working as a Russo, City, appel- Nicholas Iowa “helper.” J. This inspecting, involved clean- lee. ing, painting Ballenger railroad cars. using grinder was inside a railroad car DONIELSON, P.J.,
Considered
and when the scaffold on which he was stand-
SACKETT,
HAYDEN and
JJ.
ing
Ballenger
shifted.
fell. At the time of
injury,
only
leg.
he noticed
a skinned
DONIELSON,
Judge.
Presiding
However,
couple
days Ballenger
after a
of
Compa-
employer-appellant,
The
Lithcote
began to notice
numbness
his feet. He
(Lithcote),
ny
findings
seeks review of the
sought professional
then
medical attention.
fact,
law,
judgment
of
conclusions of
13, 1989, affirming
ap-
filed December
lengthy
To summarize a rather
medical
peal decision of the industrial commissioner history, Ballenger
saw several
filed
In the appeal
on December
received different and sometimes conflict-
decision, the commissioner affirmed with
ing
advice,
medical
and underwent several
modification an arbitration decision filed
treatment,
types
different
including
of
sur-
deputy
industrial commissioner who con- gery.
following
His overall condition
claimant-appellee
inju-
cluded:
sustained an
completely
fall was never
the same. His
16, 1984,
ry
to his back on
result-
treating physician placed lifting restrictions
damage
to the L4-5 intervertebral
on him.
lumbar disc and L5-S1 intervertebral
lum-
Following
injury Ballenger
felt he
disc;
healing
bar
claimant was entitled to
medically incapable
performing
19, 1984,
period
benefits from
un-
type
previously per-
same
of work he had
August
five-day
til
for a
exception
five-day
formed. With the
of a
period;
thirty
and claimant had sustained a
period when he made an unsuccessful at-
percent
disability.
deputy
industrial
The
tempt, Ballenger did not return to work
commissioner also ordered the
until
then
pay the costs of the action. The commis-
painting
worked
stencils on the sides of
sioner modified the decision to disallow the
railroad ears.
production
claimant reimbursement for
evidence,
duplicative
but affirmed the bal-
By
hearing,
the time of the
before the
appealed
ance of
decision. Lithcote
commissioner, Ballenger’s inju-
industrial
and the district
affirmed.
court
damage
ries
to his
included
L4-5 interver-
appeals.
Lithcote
It maintains the dis-
tebral lumbar disc and also to the L5-S1
1) finding
erred in:
trict court
bulging
intervertebral lumbar disc.
employee
two lumbar discs
upon
these discs encroached
nerve roots
injury;
than one
on the date of his
spine.
developed degenerative
his
He had
2) determining
length
healing
experiencing pain
arthritis. He was still
3)
period;
affirming
the excessive
taking prescription
and was
medication.
disability.
of industrial
af-
award
now
dispute
before the commissioner cen-
firm.
the fall had caused
tered around whether
injuries
to both discs or to
one of
claimant,
Ballenger,
Chet
was twen-
conflicting
considering
them. After
ty-seven years old at the time of the hear-
testimony,
the commissioner con-
ing.
family
He had a
and had left school
eighth grade
injuries
caused
after the
to work. Prior to
cluded all of the back
were
85.20;
Iowa Code
employment. See
§
court
fall. The district
by the work-related
cf.
Fischer, Inc., 257 Iowa
Bodish
the commissioner.
affirmed
(1965).
question
scope
Review. Our
Scope
I.
“essentially within
of causal connection
to deter
review
limited. We
review is
*3
expert testimony.” Id.
the domain
sup
decision
mine
whether
521,
(quoting Bradshaw
limited education chemonucleolysis per- Intradiscal thirty found a history, February 21, at the on formed L4-5 level percent permanent impairment earning complications. There were no On The district affirmed. capacity. court reported Dr. that the June Naden find no reason to disturb the deci- diagnosed fragment which had free been the commissioner and the district sions of present surgery still that further regard. court in this Dr. indicated. On Na- AFFIRMED. reported respondent that did not want den surgery improving. to have the and he was HAYDEN, J., concurs. long respondent said Dr. Naden as as felt improving Dr. Naden he was would SACKETT, J., dissents. respondent surgery not recommend SACKETT, Judge (dissenting). get along would as well without sur- I dissent. he would it. gery as with thought Respondent reported the fall and respondent again saw on June Dr. Jersild leg. he had skinned his Two apparently agreed He with Dr. began to in his later he notice numbness that if felt he was im- Naden Monday, feet. He was unable to work on proving he should continue under his 19th, January 1984. On the he consult- present program of rehabilitation exercises O’Dell, complaining of back ed Dr. Mark surgery. than have pain and numbness his calf and left foot. 26, 1984, respondent rest for three was ex- Dr. O’Dell recommended bed On October Respondent by Dr. A. Lehman and days. returned to see O’Dell amined James Dr. University Hospitals. and on Tozzi at of Iowa radiographic referred to Dr. The doctors reviewed O’Dell studies Naden, orthope- myelographic certified and determined there was a David C. board interspace bilaterally surgeon. dic defect at L4-5 bilat- lem amputation of the L5 nerve root was related to his with work. Dr. Naden erally, large with a extradural defect did not feel that there awas causal connec- left, ventrally, body of L5. behind tion between the herniation of the L5-S1 Dr. agreed Dr. Lehman and Dr. Tozzi with level injury. and the work Dr. Naden re- Naden, respon- Dr. Kundel and Dr. Jersild ported during laminectomy surgery fragment had a free from the L4-5 dent observed a difference in appearance be- which could of his com- disc cause tween the disc at the L4-5 and the level plaints. Dr. Lehman Dr. also Tozzi L5-S1 level. This indicated to him the L4- as Naden and Jersild preceded had the L5-S1 herniation. long respondent expressed gradual im- Dr. Naden said the existence of fibrosis provement forego surgery. They he could and scarring found at the time of his sur- reported respondent’s healing period had gery degradation was the result of They assigned twenty percent ended. fragment free mye- he observed in the 1984 permanent impairment rating. logram. reported respondent Dr. Naden Young, Dr. Donald C. a board certified improvement reached maximum medical on radiologist specializes who also in nuclear although he there stated medicine, respondent’s radio- evaluated nonsignificant improve- be minimal graphic studies and also gave respondent per- ment. He a fifteen myelogram showing a bilateral L4- permanent impairment cent of the whole protrusion 5 disc awith ov- body. erlying the L5 intervertebral disc on the Respondent examined Dr. Raul displaced left which the SI nerve root. Espinosa E. and Dr. Steven Stein at the Kundel, findings This verified the of Dr. Mayo Clinic on 1985. The doc- Dr. Lehman and Dr. Tozzi. Dr. *6 reported respondent’s neurological tors ex- Young interpreted subsequent the 1985 amination subjective was normal myelogram showing a defect at the L4-5 complaints percussion of diffuse tender- pronounced level which was less than the back, difficulty ness in the low in lumbar myelographic study. Young 1984 Dr. indi- pain straight leg raising flexion and at asymmetry cated there was at the left side seventy percent right fifty per- on the and level, possi- of the which he felt was L5-S1 interpreted cent on the left. The doctors bly fragment. reported due to a free He respondent’s radiographic studies as show- no indication of a herniated disc but felt ing large protrusion a lumbosacral disc and protruding a there could be disc. protrusion a midline disc at the L4 level. Respondent’s attorney arranged to have Respondent returned to work on Beck, respondent evaluated Dr. David 26, 28, May Dr. 1985. He saw Naden on 20, neurosurgeon, May on 1986. Dr. Beck myelogram performed and a was on respondent evaluated and determined re- 1985. Dr. Kundel the June spondent injured had the L4-5 and both showing probable results as on 1984. This L5-S1 discs disc herniation on the left side at the L4-5 diag- not with the consistent and L5-S1 level. physicians of the who had examined nosis Respondent hospitalized and a lami- respondent diagnosis of earlier or with the nectomy performed at L4-5 and Naden, physician operated who on L5-S1 levels with extraction of the herniat- respondent and observed the discs. and claim- ed disc intradiseal material. The examining disagreed Beck also with the recovery ant’s was uneventful. Dr. Naden physicians and Dr. Naden there was respondent released for work on fragment resulting from the to respondent returned to work Beck later L4-5 intervertebral disc. Dr. day. fragments he did not know if disc testified exclude the reported disappear and he would not
Dr. Naden the L5-S1 level was fragment. possibility of a free He also myelogram. normal at the time of the 1984 treating respondent’s prob- physician, He indicated L4-5 disc 70 to give respect respon- position to observe in a better they must be agency’s findings, set diagnosis. make a
dent’s condition clearly record shows the aside thirty per- gave respondent a Dr. Beck justified. not agency decision was interpretation on his impairment based cent Evidence to an L4-5 and injured both the respondent person agency if a reasonable decision January 16, in the 1984 fall. levels L5-S1 given adequate find to reach attorney Rich- also had Dr. Respondent’s v. State Mercy conclusion. Health Center respondent. Dr. Neiman evaluate ard F. Facilities, 360 N.W.2d Health felt sus- testified he Neiman 1985). (Iowa finding is in agency ac- damage the L4-5 discs to and L5-S1 tained opinion cord with of two doctors who injury. the time only finding evaluated claimant. respon- further testified he felt Dr. Neiman contrary of all of claimant’s twenty-five percent per- dent sustained a treating including surgeon impairment. rating His was based manent operated visibly on claimant injured respondent having two discs on I find under this viewed discs. record the decision of the commissioner should be employer first contends it was error modified find that claimant suf- sustained an find fered a herniated disc at L4-5. and L5-S1 both the L4-5 disc levels I would to reevalu- remand 1984. The industrial commis- healing pe- ate the industrial respon- sioner assessment of found finding. riod in accord with this case as Doc- dent’s medical determined correct, op- Beck and Neiman as tors
posed phy- to the assessments the other this
sicians. No reasons were substantially The trial court made
finding. finding, same also without reasons. acknowledges the doctors respondent had discs in
found two *7 contends, 1984 fall. It In re Elizabeth the MARRIAGE OF however, accept it was erroneous to its Joseph SMITH and Smith. contrary because it was assessment Upon diagnosis of all the doctors who had treat- of Elizabeth the Petition time, Smith, period Appellant, ed the over contrary and it was also Smith, Appellee. Concerning Joseph And surgeon operated was, therefore, superior position 90-153. No. observe the conditions. Appeals Court of of Iowa. review to determine whether supported decision is viewing the evidence when record as a Chauffeurs,
whole. See Teamsters and
Helpers, Local Union No. 238 v. Iowa Commission, Rights
Civil N.W.2d requirement that we
take all record evidence account re-
viewing administrative findings does not duty grant appropriate
detract from our agency’s expertise.
deference to Cerro County Facility
Gordo Care v. Iowa Civil Commission,
Rights 195-