Care Initiatives D/B/A Heritage Nursing & Rehab v. Bonnie Hoffman

IN THE COURT OF APPEALS OF IOWA
No. 3-1119 / 13-0748
Filed February 19, 2014
CARE INITIATIVES d/b/a HERITAGE
NURSING & REHAB,
Petitioner-Appellant,
vs.
BONNIE HOFFMAN,
Respondent-Appellee.
________________________________________________________________
Appeal from the Iowa District Court for Polk County, Carla T. Schemmel,
Judge.
An employer appeals from a district court decision affirming the workers’
compensation commissioner’s ruling that the claimant is permanently and totally
disabled. AFFIRMED.
Joseph Thornton of Smith Peterson Law Firm, L.L.P., Council Bluffs, for
appellant.
Emily Anderson of Riccolo & Semelroth, P.C., Cedar Rapids, for appellee.
Considered by Vogel, P.J., and Mullins and McDonald, JJ.
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MULLINS, J.
An employer, Care Initiatives, appeals from a district court judicial review
decision affirming the ruling of the workers’ compensation commissioner
awarding the claimant, Bonnie Hoffman, permanent total disability benefits for an
injury she sustained while working. The employer asserts: 1) there is not
substantial evidence to support the commissioner’s finding; 2) the
commissioner’s decision was based upon an irrational, illogical, or wholly
unjustifiable application of the law to the facts; and 3) the commissioner’s
decision was an abuse of discretion.
I. Background Facts and Proceedings.
Hoffman was a registered nurse at the time she sustained an injury that is
the subject of this appeal. Hoffman graduated from high school and attended
one year of college. In 1968, she obtained a nursing diploma from St. Luke’s
Hospital and Coe College. After obtaining her nursing license, Hoffman worked
as a labor-and-delivery nurse, an office assistant, a nurse recruiter, an industrial
nurse in a factory, a nutrition- and weight-loss-class teacher, and finally a charge
nurse. At the time of the workers’ compensation hearing, Hoffman was sixty-five
years old and had been a nurse since 1968.
In August 2007, Hoffman was working at Heritage Nursing and
Rehabilitation (Heritage), one of several residential, senior-care facilities
operated by Care Initiatives. On August 27, Hoffman injured her right shoulder
and arm while repositioning a resident in his bed and lifting another resident from
the floor. Hoffman is right-hand dominant. Hoffman reported her injury to
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Heritage’s assistant director. Upon consulting a doctor, Heritage placed Hoffman
on light duty.
In November 2007, Hoffman underwent an MRI for her injury which
showed a torn rotator cuff, a sixty percent tear of the bicep tendon, and a
subluxation of the sternoclavicular joint. In January 2008, orthopedic surgeon Dr.
Fred Pilcher performed surgery on Hoffman’s shoulder and released her to work
four-hour days with no use of her right arm.1 Hoffman reported constant pain in
her shoulder that increased with a wider range of motion or repetitive movement.
Hoffman also attended physical therapy, but reported no improvement in her
pain. In July 2008, Dr. Pilcher reported Hoffman had achieved maximum medical
improvement and had a twelve percent whole-person impairment. On July 15,
2008, Heritage terminated Hoffman’s employment because of her physical
restrictions. Hoffman petitioned for workers’ compensation benefits, and the
parties stipulated Hoffman’s injury was work-related. Hoffman’s petition came on
for hearing before the deputy workers’ compensation commissioner in June
2011.
In September 2009, Hoffman underwent reverse right shoulder
replacement surgery under the care of Dr. Brian Adams. Dr. Adams released
Hoffman from his care in March 2010 after she achieved maximum medical
improvement. He assessed her to have twenty-percent impairment and
recommended a number of physical restrictions: Hoffman was able to lift, push,
or pull one to five pounds frequently with one or both hands or six to thirty
1
This work included washing handrails, filing papers, answering telephones, and other
clerical work.
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pounds occasionally with both hands; but never more than thirty pounds. Dr.
Adams also reported Hoffman was not able to climb. She was able to grasp,
push or pull, and reach out occasionally, but she should not reach above her
shoulder. Dr. Adams also reported Hoffman was fully able to do fine
manipulation. Although Hoffman reported discomfort and pain in her shoulder
and arm, Dr. Adams stated he found no structural reason for the discomfort. He
also stated, “Some patients do report mild discomfort in the shoulder following a
successful reverse total shoulder but it is not considered to be a limiting factor
within the activity restrictions listed[.]”
Between her termination in July 2008, and the hearing before the deputy
commissioner in June 2011, Hoffman never reentered employment. At the
hearing Hoffman offered into evidence a spreadsheet giving details of her job
applications since August 2008 and their outcomes. The spreadsheet showed
Hoffman applied to around 150 employers. For most positions Hoffman
submitted an online application or sent a resume. The spreadsheet contains
notations such as “sent resume,” “applied online,” “weight restrictions,” “must be
able to lift 50 lbs,” and other notes. Hoffman made in-person contact with the
prospective employer on only a few occasions. Hoffman had one interview, but
the prospective employer stated she was unable to perform the job due to lifting
restrictions. The positions she applied for include registered nurse, receptionist,
billing staff, pharmacy technician, clerical staff, retailer, and nurse recruiter.
There is a gap in the record from July 2009 to July 2010 during which Hoffman
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did not apply for any jobs. She testified she had shoulder surgery with follow-up
treatment and physical therapy during this time and was unable to drive.
Hoffman also sought assistance in regaining employment. In August
2010, she applied for assistance through Iowa Vocational Rehabilitation
Services, which classified her as “significantly disabled” and placed her on a
waiting list for services. She registered with the Iowa Reemployment Services
program for training on professional job application skills. She also obtained a
work certificate through Iowa Workforce Development designed to inform
prospective employers of her qualifications. At Worklife Resources, Inc., a
vocational rehabilitation counselor, Kent Jayne, administered a number of
employment-related tests and evaluated her employment prospects.
Pain continued to affect Hoffman’s ability to work. During a deposition on
December 16, 2010, Hoffman testified she was experiencing pain that day. Care
Initiatives’ counsel asked, “How would you describe the pain that you’re having
today.” Hoffman described it as “an aching in the shoulder and biceps, like a
nagging toothache, not one you really want to see a dentist about.” Hoffman also
testified the pain varied, feeling better and worse day-to-day. On that particular
day, she described the intensity of the pain as four or five out of ten, which was
unusually tolerable. She testified the pain intensity was nine out of ten roughly
half the time.
In June 2011, at the hearing before the deputy commissioner, Hoffman
testified she still had constant pain in her right shoulder, bicep, and the area
where the clavicle and sternum meet. The pain increased with daily activities.
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Hoffman testified the pain had changed how she did many activities such as
washing dishes and going grocery shopping. She also testified she experienced
pain while driving, and her daughter drove her to a destination half an hour or
forty-five minutes away. Although she took no medications, she did use a
transcutaneous electrical nerve stimulation (TENS) unit to treat the pain.
Kent Jayne, of Worklife Resources, Inc., testified as Hoffman’s vocational
expert and provided a written report of his conclusions. Jayne is a certified
rehabilitation counselor, has a master’s degree in rehabilitation counseling, is a
member of the American Academy of Pain Management, and has been a
vocational rehabilitation counselor for twenty-five years. Jayne testified he
administered a number of tests to Hoffman to determine whether she was
capable of employment and what kind of employment she would be capable of
based on her physical limitations, background, training, and experience. Jayne
administered tests in nonverbal and verbal reasoning, clerical perception, fine
motor and finger dexterity, and gross manual dexterity. The testing simulated a
sedentary office work environment where the subject can take breaks and work
at their own pace.
He also took into consideration the limitations outlined in Dr. Adams’
report. Jayne testified these restrictions on lifting, reaching, and handling were
very severe vocational limitations, not only in nursing but in the labor market
generally. Jayne testified Hoffman performed adequately in nonverbal and
verbal reasoning tests, but poorly in the physical tests. In the context of the
simulated office environment, Hoffman was unable to complete some testing
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because of poor endurance and pain in her right arm and shoulder. Because this
simulation took only three-and-a-half hours, Jayne believed Hoffman would be
unable to work a full day carrying out similar activities, which included
keyboarding, reaching, and handling items. Such activities, Jayne stated, are
required in almost all jobs.
In his written report, Jayne noted how the pain Hoffman reported affected
her daily activities such as lifting laundry or groceries, showering, dressing, and
doing housework. She required the help of family or friends to complete
everyday tasks inside and outside the home. When cross-examined, Jayne
agreed that no medical doctor had restricted Hoffman in any way due to pain.
Jayne also found Hoffman was very limited in some areas of fine motor
coordination, a finding Care Initiatives regards as inconsistent with Dr. Adams’
conclusion that Hoffman could perform fine manipulation without restriction.
Jayne testified he performed different testing than Dr. Adams and his finding was
in addition to Dr. Adams’ report, not inconsistent with it.
Jayne’s report, consistent with his hearing testimony, concluded,
Ms. Hoffman has been precluded as a consequence of her multiple
difficulties from performing work that her experience, training,
education, intelligence, and physical capacities would otherwise
have permitted her to perform but for injury. She is unable to
perform any services except those which are so limited in quantity,
dependability, and/or quality that there is no reasonably stable labor
market for them.
About two months before the hearing, Care Initiatives hired a rehabilitation
consultant, Shannon Ford, to evaluate Hoffman’s employability and assist her in
applying for jobs. Ford produced a written report of her evaluation and testified
as Care Initiative’s vocational expert. Ford is a medical case manager and
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rehabilitation consultant with Health Systems International. She is a certified
rehabilitation counselor with a master’s degree in rehabilitation counseling. She
has sixteen years of experience. Ford testified she reviewed Hoffman’s
application to the Iowa Department of Vocational Rehabilitation, documentation
from the Iowa Works program, medical records, and list of job applications. Ford
had one initial vocational interview with Hoffman. Ford testified she interpreted
Dr. Adams’ restrictions to mean there was no limitation on Hoffman doing office
work, including working at a computer. Based on these limitations and Hoffman’s
experience and training, Ford believed Hoffman would be able to obtain
alternative employment in a less physically demanding area of nursing, such as
office nursing, working in a lab, or as a medical assistant.
Ford testified she considered only objective factors in her assessment of
Hoffman, and did not consider any effect pain might have on Hoffman’s abilities.
Ford explained that to perform her analysis of Hoffman’s transferable skills, she
input information about Hoffman’s prior work history, functional capabilities, and
educational background into a computer program. The program then identified
categories of jobs in which Hoffman would be employable. Ford provided
Hoffman a number of job leads based on the results of this program. Ford
testified she did not look into whether any of the leads had any restrictions.
Both Ford and Jayne testified regarding the possibility of Hoffman
retraining for a different employment. Ford testified Hoffman was capable of
retraining and that some classes or workshops existed that would not involve a
lengthy training process. Ford did not perform any testing to determine
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Hoffman’s ability to retrain. Jayne testified he did not think Hoffman was capable
of retraining, given her physical limitations. Most important, her age was such
that retraining would not make employment more likely.
The deputy commissioner heard this testimony and issued its ruling on
July 28, 2011. The deputy commissioner found that Hoffman’s pain was most
accurately described during her deposition testimony as “a tolerable aching in the
shoulder and biceps that was similar to a toothache, for which one would not see
a dentist.” The deputy commissioner also found little to credit in Jayne’s
testimony and report. The deputy commissioner had encountered Jayne in
previous workers’ compensation cases and found his conclusions were “stock
language that the undersigned [deputy commissioner] regularly encounters in Mr.
Jayne’s reports.” Instead, the deputy commissioner regarded as most credible
Dr. Adams’ report and Hoffman’s deposition description of her pain, which she
found was “consistent with her having right shoulder and upper extremity
discomfort that is a reasonable residual from the work related condition and its
treatment.” The deputy commissioner also credited Ford’s testimony that
Hoffman was able to perform work with light physical demands. With respect to
her job search, the deputy commissioner also concluded Hoffman “made, at best,
a lackluster attempt to follow through on any job lead” and that Hoffman’s failure
to make personal contact with most potential employers signified a lack of
genuine motivation to find employment. On July 28, 2011, the deputy
commissioner filed a decision finding Hoffman’s loss of earning capacity was 75
10
percent and ordering Care Initiatives to pay Hoffman 375 weeks of permanent
partial disability benefits of $637.76.
Hoffman appealed the deputy’s commissioner’s decision to the workers’
compensation commissioner for de novo review. The commissioner issued a
ruling on July 27, 2012, concluding Hoffman had a total and permanent disability.
In so finding, the commissioner considered the fact that Care Initiatives
terminated Hoffman due to her work restrictions as evidence of her lack of
employability:
An employer knows the demands that are placed on its workforce.
Its determination that the worker is too disabled for it to employ is
entitled to considerable weight. If the employer in whose employ
the disability occurred is unwilling to accommodate the disability,
there is no reason to expect some other employer to have more
incentive to do so.
The commissioner noted the deputy’s dismissal of Jayne’s testimony but made
different credibility findings:
There is no showing that the findings of Mr. Jayne are not based
upon his in-person assessment of claimant’s current condition. The
report is quite specific and detailed to claimant’s impairment,
restrictions, vocational history, and her present vocational status.
The report does use concise language that mirrors the standards
considered by this agency in considering disability.
With regard to Hoffman’s claims of pain, the commissioner also came to a
different conclusion, stating that although the deputy found Hoffman’s deposition
testimony of her pain most credible, the description Hoffman provided during the
hearing was equally compelling and was entitled to consideration in the
assessment of a vocational expert. The commissioner noted particularly
Hoffman’s testimony of how the injury and pain have affected her ability to
function on a daily basis. Finally, the commissioner noted Hoffman’s age and the
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length of time she had been a nurse and found retraining efforts would be
unlikely to lead to future employment. The commissioner concluded, “[C]laimant
has sustained an injury which permanently disables her from performing work
within her experience, training, education, and physical capacities.” The
commissioner then ordered Care Initiatives to pay Hoffman permanent total
disability benefits at the rate of $637.76 per week for the period of Hoffman’s
disability commencing March 31, 2010. Care Initiatives petitioned for judicial
review and the district court affirmed the commissioner’s findings. Care
Initiatives appeals.
II. Scope and Standard of Review.
Our scope of review in judicial review cases is for correction of errors at
law. Iowa R. App. P. 6.907. Iowa Code section 17A.19 (2012) governs judicial
review of agency decisions. The district court acts in an appellate capacity when
it exercises its judicial review power. Neal v. Annett Holdings, Inc., 814 N.W.2d
512, 518 (Iowa 2012). We apply the same standards of section 17A.19(10) when
we review the district court’s decision to determine whether we reach the same
conclusions as the district court. Id. If our conclusions are the same, we affirm.
Id. Otherwise, we reverse. Id.Our standard of review depends on the issues raised on appeal.
Jacobson Transp. Co. v. Harris, 799 N.W.2d 192, 196 (Iowa 2010). In workers’
compensation cases, Iowa Code chapter 85 vests with the agency the
responsibility of determining an employee’s right to benefits. See Mycogen
Seeds v. Sands, 686 N.W.2d 457, 465 (Iowa 2004). “Because the agency is
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charged with such responsibility, the agency must necessarily make factual
findings to determine that right.” Id. We are bound by the agency’s
determinations of fact unless the agency’s fact determinations are “not supported
by substantial evidence in the record before the court when that record is viewed
as a whole.” Iowa Code § 17A.19(10)(f). Therefore, if what is alleged is an error
of fact, we must determine if the commissioner’s findings are supported by
substantial evidence. Id.; Meyer v. IBP, Inc., 710 N.W.2d 213, 219 (Iowa 2006).
“The determining factor is not whether the evidence supports a different finding
but whether the evidence supports the finding actually made.” I.B.P. v. Al-
Gharib, 604 N.W.2d 621, 632 (Iowa 2000). Courts should broadly and liberally
apply those findings to uphold rather than defeat the agency’s decision. Id. If the
alleged error is in the commissioner’s application of the law to the facts, we
disturb the decision if it is “[b]ased upon an irrational, illogical, or wholly
unjustifiable application of law to fact[.]” Iowa Code § 17A.19(10)(m); Meyer, 710
N.W.2d at 219.
The agency’s decision also cannot be unreasonable or involve an abuse
of discretion. Stephenson v. Furnas Elec. Co., 522 N.W.2d 828, 831 (Iowa
1994). Unreasonableness is “action in the face of evidence as to which there is
no room for difference of opinion among reasonable minds, or not based on
substantial evidence.” Id. Abuse of discretion “is synonymous with
unreasonableness, and involves lack of rationality, focusing on whether the
agency has made a decision clearly against reason and evidence.” Id.13
III. Analysis.
In this case, Care Initiatives contends the district court erred in finding
substantial evidence to support the commissioner’s decision and in ignoring the
factual findings of the deputy commissioner. Next, Care Initiatives contends the
district court erred in finding the commissioner’s decision was not based on an
irrational, illogical, or wholly unjustifiable application of the law to the facts.
Finally, Care Initiatives contends the commissioners’ finding that Hoffman is
permanently disabled was an abuse of discretion.
A. Findings of the Deputy Commissioner.
Our administrative code provides judicial review is available for “any final
agency action,” however, “the agency action shall not be final until all agency
remedies have been exhausted.” Iowa Code § 17A.19(1); see Myers v. F.C.A.
Servs., Inc., 592 N.W.2d 354, 358 (Iowa 1999) (“Only final agency action is
subject to judicial review.”). Here, administrative remedies were exhausted by
appeal to and de novo review by the commissioner. The commissioner’s
decision is the final action of the agency; therefore, it is this decision that is now
subject to review.
Care Initiatives agrees it is not the deputy’s decision but the
commissioner’s decision that is subject to judicial review. However, it argues the
district court should have considered and given weight to the deputy
commissioner’s findings because the deputy commissioner presided over the
hearing and is better able to assess the credibility of the witnesses than the
commissioner. Care Initiatives cites to the requirement that the district court
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examine the record “as a whole,” as set out in Iowa Code section
17A.19(10)(f)(3):
[T]he adequacy of the evidence in the record before the court to
support a particular finding of fact must be judged in light of all the
relevant evidence in the record cited by any party that detracts from
that finding as well as all of the relevant evidence in the record cited
by any party that supports it, including any determinations of
veracity by the presiding officer who personally observed the
demeanor of the witnesses and the agency's explanation of why the
relevant evidence in the record supports its material findings of fact.
Our supreme court has also stated,
When the agency decision is attacked on the substantial evidence
ground in section [17A.19(10)(f)(3)], the district court must examine
the entire record. This includes the hearing officer’s decision. The
hearing officer’s decision is not evidence, but his findings may
affect its weight when credibility issues are involved.
Iowa State Fairgrounds Sec. v. Iowa Civil Rights Com’n, 322 N.W.2d 293, 295
(Iowa 1982). This is because “evidence supporting a conclusion may be less
substantial when an impartial, experienced examiner [the deputy commissioner]
who has observed the witnesses and lived with the case has drawn conclusions
different from the [commissioner].” Id. (quoting Universal Camera Corp. v.
National Labor Relations Board, 340 U.S. 474, 496 (1982)).
In this case, the district court found, “[A] deputy’s decision is not to be
considered in an appeal, which must be based solely upon the final agency
decision . . . . The Deputy’s opinion concerning Mr. Jayne’s testimony cannot be
used as a basis for overruling the Commissioner who did not agree with the
Deputy.” Because section 17A.19(10)(f)(3) requires the court to examine the
entire record, including any evidence that detracts from or supports any finding,
and because of the foregoing authority, the deputy’s credibility findings are
15
entitled to consideration upon judicial review. See Iowa State Fairgrounds Sec.,
322 N.W.2d at 295. However, the deputy’s findings are not controlling and we
give no particular deference to them. Furthermore, our consideration of them
does not change the standard we apply when the claimant attacks the final
agency decision on substantial evidence grounds.
B. Substantial Evidence.
The district court may disturb the final decision of the agency only under
circumstances set out in Iowa Code section 17A.19(10). One such circumstance
is when it determines “that substantial rights of the person seeking judicial relief
have been prejudiced” and the agency decision is “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 record before the court when that
record is viewed as a whole.” Iowa Code § 17A.19(10)(f). “Substantial evidence”
means “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.” Id. § 17A.19(10)(f)(1). Care Initiatives
contends there was not substantial evidence to support the commissioner’s
findings of fact.
An industrial disability is a “loss of earning capacity, and not a mere
‘functional disability’ to be computed in terms of percentages of the total physical
and mental ability of a normal [person].” Diederich v. Tri-City Ry. Co. of Iowa,
258 N.W. 899, 902 (Iowa 1935). The criteria considered include the claimant’s
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age, education, qualifications, experience, and ability to engage in the
employment previously held. McSpadden v. Big Ben Coal Co., 288 N.W.2d 181,
192 (Iowa 1980). Total disability does not mean a state of absolute
helplessness. I.B.P., Inc. v. Al-Gharib, 604 N.W.2d at 633 (Iowa 2000). Rather,
total disability occurs “when the injury wholly disables the employee from
performing work that the employee’s experience, training, intelligence, and
physical capacities would otherwise permit the employee to perform.” Id.The commissioner found Hoffman had “sustained an injury which
permanently disable[d] her from performing work within her experience, training,
education, and physical capacities.” In coming to this decision, the commissioner
credited Jayne’s testimony, particularly with regard to his assessment of
Hoffman’s restrictions and the effect of pain on her physical capacities. The
commissioner relied upon Jayne’s testimony that, because of Dr. Adams’
restrictions, Hoffman would be unable to do the kinds of activities required by any
job she might otherwise be qualified to perform.
The commissioner also gave greater credit to the description of Hoffman’s
pain she gave during the hearing. The deputy commissioner found Hoffman’s
deposition description, “an aching . . . like a toothache, not one you [ ] see a
dentist about,” most credible and, as stated above, this is entitled to some
consideration. However, the deputy commissioner was not present for the
deposition testimony, thereby diminishing the rationale for general deference to
the credibility determinations of the hearing officer. Moreover, the description
Hoffman gave during the deposition was specifically limited to the pain she was
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experiencing on that particular day. She testified the pain varied day-by-day and
the day of the deposition the pain was unusually tolerable, rating four or five out
of ten. At the deposition, Hoffman further testified she experienced pain she
rated at nine out of ten about every other day. This part of Hoffman’s deposition
testimony was consistent with her testimony at the hearing in which she
described the pain she experienced and how it impaired her ability to carry out
daily activities.
Jayne also testified on the same subject. Care Initiatives complains Jayne
is unqualified to testify about Hoffman’s pain because he is not a medical doctor.
Jayne is, however, a rehabilitation expert and a member of the American
Academy of Pain Management. He was not asked or required to provide an
explanation for Hoffman’s pain; his testimony is limited to how the pain has
affected Hoffman’s physical capacities. He took Hoffman’s medical records into
account, including Dr. Adams’ restrictions, in his assessment of Hoffman. He
also conducted his own testing of Hoffman’s abilities as part of his assessment.
Care Initiatives also argues we should consider the deputy
commissioner’s findings that Jayne was not a credible expert witness because he
used similar language in multiple reports before that deputy commissioner. The
deputy commissioner’s statement is not evidence in this case; nothing else in the
record indicates Jayne’s report is not credible. The commissioner found the
report to be specific, detailed, credible, and a result of Jayne’s in-person
assessment of Hoffman’s condition. The commissioner found the language
Jayne used simply “mirror[ed] the standards considered by this agency in
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considering permanent disability.” Our review of Jayne’s report and testimony
discloses the commissioner’s findings with regard to Jayne’s credibility are
supported by substantial evidence. Although the commissioner did not state
explicitly that he gave more weight to Jayne’s testimony than Ford’s, Ford
conducted no independent testing; selected jobs for Hoffman from a computer
program; and failed to look into whether the job leads she provided had
restrictions that would disqualify Hoffman. Ford also ignored any effect that
constant pain had on Hoffman’s physical capacities. The record supports the
commissioner’s view of Jayne’s credibility.
The commissioner concluded Hoffman had a total and permanent
industrial disability that prevented her from performing work within her
experience, training, education, and physical capacities. Dr. Adams placed
restrictions on Hoffman with regard to lifting that mean she is no longer able to
perform the duties of a nurse. She is only occasionally able to grasp, push, pull
or reach out, motions that are required in almost all jobs. Dr. Adams reported
she was able to do fine manipulation, however, Jayne concluded from his testing
she would be unable to carry out most clerical-type work for a full work day due
to her restrictions and the pain remaining in her arm and shoulder. Hoffman
herself testified that the pain interferes with her ability to carry out daily activities.
She requires help from family members for many tasks, including driving longer
distances.
The commissioner also found Hoffman’s job search was extensive, yet
unsuccessful. Care Initiatives insists Hoffman’s tendency to apply for jobs
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through online applications or emailed resumes shows a lack of commitment to
reemployment. Hoffman’s record of job applications shows over 150 job
applications submitted, and numerous notations indicating lifting restrictions,
responses from employers, and other follow-up work. Hoffman had been
applying for jobs since she was terminated with no success, around three years.
Even Heritage, where she had worked without incident for seventeen years, was
unable or unwilling to accommodate her restrictions. The commissioner also
considered that Hoffman is an older worker who is close to retirement; has been
a registered nurse most of her life; has limited training, education, or experience
in any other field; and whose job prospects are unlikely to improve with more
retraining. Upon our review of the record as a whole, we conclude substantial
evidence supports the commissioner’s factual findings. Bound by these facts, we
agree with the commissioner and the district court that Hoffman has suffered an
injury that wholly disables her from performing the work that her experience,
training, and intelligence would otherwise permit her to perform. Therefore, we
come to the same conclusion as the district court, that Hoffman has a permanent
and total disability. Nothing in the record supports Care Initiatives’ contention
that the commissioner’s decision in this case was based on an irrational, illogical,
or wholly unjustifiable application of law to fact. Nor is there any evidence in the
record supporting the contention that the commissioner’s decision constitutes an
abuse of discretion.
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IV. Conclusion.
We find substantial evidence supports the commissioner’s findings of fact.
Bound to these facts, we find the injured claimant is wholly disabled from
performing work that her experience, training, intelligence, and physical
capacities would otherwise permit her to perform. Therefore, we come to the
same conclusion as the district court, that the claimant has a permanent and total
disability. Consequently, we affirm.
AFFIRMED.