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IN THE COURT OF APPEALS OF IOWA No. 2-441 / 11-1781 Filed June 27, 2012 BENITO VILLAFANA, Petitioner-Appellant, vs. BLACKHAWK FOUNDRY and TRAVELERS, Respondent-Appellees. ________________________________________________________________ Appeal from the Iowa District Court for Polk County, Scott D. Rosenberg, Judge.

Benito Villafana appeals a district court's ruling affirming a finding by the workers' compensation commissioner that Villafana's injuries were not caused by his employment. AFFIRMED.

William J. Bribriesco of William J. Bribriesco & Associates, Bettendorf, for appellant. Tonya A. Oetken of Law Offices of Daniel P. Hanson, West Des Moines, for appellees.

Considered by Vogel, P.J., and Tabor and Bower, JJ.

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TABOR, J. Benito Villafana challenges the conclusion of the workers' compensation commissioner that his carpal tunnel and neck injuries were not caused by his work as a scale operator at Blackhawk Foundry & Machine Company. argues the agency findings are not supported by substantial evidence. He The

deputy commissioner found the views of the employer's medical expert to be more convincing than the opinion of the neurosurgeon who evaluated Villafana. The district court deferred to the agency's fact finding, as do we. Because the denial of benefits is supported by substantial evidence, we affirm. I. Background Facts and Proceedings Benito Villafana was born in Mexico and immigrated to the United States in 1976 after completing the sixth grade. Once in America, he worked as a farm laborer until 1988, when he began his employment at Blackhawk Foundry & Machine Company (Blackhawk). The foundry produces iron castings used for agriculture, manufacturing, and construction. Villafana started as a grinder,

performing that job for about ten years until he suffered a carpal tunnel injury related to his repetitive work. To accommodate the permanent work restrictions resulting from the injury, including a lifting limit of fifty pounds, the company moved him to the position of scale operator, where he picked up castings, weighed them, recorded their weights, and returned them to a box. Because some castings weighed up to 100 pounds, the company instructed Villafana to request help from his supervisor or

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the forklift operator who delivered and retrieved the boxes of castings for those that were in excess of his lifting restrictions. In 1999, Villafana suffered a shoulder injury while working as a scale operator. To compensate for his right shoulder impingement and biceps tear, in 2004 the agency awarded Villafana benefits, finding he sustained a thirty-five percent permanent partial industrial disability. Villafana was unrestricted in lifting objects weighing up to twenty pounds, but limited to occasional lifting of objects weighing twenty-one to fifty pounds, and prohibited from lifting anything over fifty pounds. Villafana's present claim is based on neck and hand pain beginning in 2006. He attributes the pain to his repetitive lifting of castings in his job as scale operator. He continued to work at Blackhawk until June 2009, when he lost his job in a plant-wide layoff. At the hearing before the deputy commissioner--in addition to his earlier carpal tunnel injury--Villafana admitted to experiencing ongoing neck problems before his listed injury dates. In 1997, he reported neck pain in conjunction with finger pain. He also received treatment for neck pain in 1998. In 2002, he again complained to a physician that he was experiencing neck pain in conjunction with the pain from his shoulder injury, and in 2003 a neurosurgeon evaluated Villafana for neck pain and ultimately recommended neck surgery. Villafana lists his first injury date as April 28, 2006, when he went to orthopedic surgeon Peter Pardubsky regarding his neck pain. Dr. Pardubsky believed Villafana's neck pain was caused by his earlier shoulder injury; the

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surgeon's report is silent as to whether the symptoms could have been caused by work activities. Dr. Pardubsky provided Villafana with scapular stabilization and strengthening exercises. In a subsequent visit, Dr. Pardubsky told Villafana he could offer nothing further for his shoulder pain and referred him to a neurologist and oral surgeon for help with his neck and facial pain. Villafana did not follow up with either specialist. Villafana's second alleged injury date is January 2, 2007, when Blackhawk referred him to Dr. Camilla Frederick. The doctor's notes show that during an office visit, Villafana complained of chronic right trapezium and cervical pain, as well as numbness and tingling in his right fourth and fifth fingers. Dr. Frederick noted the right trapezium and cervical pain had been well documented since his injury in 1999. She offered stretching exercises, and prescribed a trial use of a transcutaneous electrical nerve stimulation (TENS) unit to aid in any recurrent carpal tunnel syndrome. In a follow-up visit, Dr. Frederick noted that Villafana's electromyogram (EMG) was "positive for moderate to severe right carpal tunnel." She believed the condition was work-related based on the history provided by Villfana that he was performing "highly repetitive grasping tasks" in his job. But Dr. Frederick also explained that the employer told her Villafana's new position did not require as much gripping as his old job. Blackhawk did not offer further treatment for Villafana's carpal tunnel or other chronic problems related to the prior work injury, nor did Villafana seek treatment for his ailments, aside from some chiropractic care. His chiropractor conducted an MRI, which did not reveal cervical disc involvement. The

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chiropractor told Villafana that ultimately surgery may be necessary to mitigate his neck pain. At Blackhawk's request, Dr. Frederick revisited her opinion as to whether Villafana's recurrent carpal tunnel was work-related and whether he suffered a new neck injury. While she did not re-examine Villafana, the doctor conducted an extensive review of his past medical records. In a December 20, 2007 report, Dr. Frederick described conflicting information that she received regarding the nature of Villafana's most recent work. A job description provided by Blackhawk detailed lifting tasks that appeared to be repetitive in nature. But a physical therapist who performed a jobsite evaluation did not find Villafana's work to be repetitive. Dr. Frederick concluded that Villafana "[d]efinitely has had a worsening of the median nerve," but expressed an opinion "with a reasonable degree of medical certainty" that she could not "relate this recurrent right carpal tunnel to his job at Blackhawk Foundry." She also determined that Villafana did not suffer a new neck injury as of 2006, and that his pain was likely caused by "an ongoing cervical spondylosis from 1998 that has never resolve d." She based her view in part on the fact that Villafana did not report an injury during subsequent medical appointments with her and two other physicians. Villafana visited neurosurgeon Robert Milas on June 30, 2009, about one month before the deputy commissioner heard his compensation claim. Dr. Milas obtained an oral history from Villafana, but reported that the facts of the case were "somewhat confusing" because the patient was "such a poor historian."

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The neurosurgeon noted Villafana experienced a significant change in cervical pain as well as loss of strength in his right hand in 2007. He opined the 2007 injury was linked to his recurrent carpal tunnel syndrome and cervical radiculopathy, and that the injuries caused Villafana to be permanently impaired. The deputy commissioner held an evidentiary hearing on August 4, 2009. On September 14, 2009, the deputy ruled that Villafana failed to show he suffered an injury of and in the course of his employment at Blackhawk Foundry, and denied his claim. The deputy explained why he was more persuaded by the conclusions of Dr. Frederick than the opinion of Dr. Milas: While Dr. Milas may have superior qualifications as a specialist in neurosurgery than those of Dr. Frederick, the record does not indicate what prior medical records, if any, were reviewed by Dr. Milas before making his opinion. This is a critical flaw in claimant's case given Benito's past medical history involving not only cervical and right extremity pain, but facial numbness dating back four years prior to the claimed neck injury. Also, it is not clear if Dr. Milas had any understanding of what claimant's job at Blackhawk involved. In addition, the deputy was troubled by the doctor's reference to a January 2, 2007 injury without explaining its cause or whether Dr. Milas agreed it was a cumulative injury arising from repetitive work. Accordingly, the deputy found "Dr. Milas's views simply are not more convincing than those of Dr. Frederick." On appeal, the workers' compensation commissioner found the deputy's findings to be "well-reasoned and supported by a preponderance of the evidence contained within the record." The commissioner issued its one-page decision on November 24, 2010, affirming the deputy's holding "without further comment." The district court considered Villafana's petition for judicial review on July 15, 2011. In its October 5 decision, the district court affirmed the agency

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determination. Villafana appeals this ruling, alleging "the district court erred as a matter of law" in finding he failed to carry his burden to prove he suffered a new carpal tunnel injury, and not finding he suffered a permanent aggravation of a previous cervical spine injury. II. Scope and Standard of Review We review final agency action for correction of legal error. Eyecare v. Dep't of Human Servs., 770 N.W.2d 832, 835 (Iowa 2009). If we reach the same conclusions as the district court, we affirm; otherwise, we reverse. Seeds v. Sands, 686 N.W.2d 457, 463 (Iowa 2004). To the extent the agency's decision reflects factual determinations that are "clearly vested by a provision of law in the discretion of the agency," we are bound by the commissioner's findings of fact if they are supported by substantial evidence. Schutjer v. Algona Manor Care Ctr., 780 N.W.2d 549, 557 (Iowa Mycogen

2010). "Substantial evidence" is "the quantity and quality of evidence that would be deemed sufficient by a neutral, detached, and reasonable person, to establish the fact at issue when the consequences resulting from the establishment of that fact are understood to be serious and of great importance." Iowa Code

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