Nordstrom, Inc. v. Pamela Carmer f/k/a Pamela Hyde

IN THE COURT OF APPEALS OF IOWA

No. 23-1423
Filed May 8, 2024

NORDSTROM, INC.,
Plaintiff-Appellant,

vs.

PAMELA CARMER f/k/a PAMELA HYDE,
Defendant-Appellee.
________________________________________________________________

Appeal from the Iowa District Court for Polk County, Heather L. Lauber,

Judge.

An employer appeals a district court order affirming a decision of the

workers’ compensation commissioner. AFFIRMED IN PART, REVERSED IN

PART, AND REMANDED WITH INSTRUCTIONS.

James M. Peters of Simmons Perrine Moyer Bergman PLC, Cedar Rapids,

for appellant.

Benjamin R. Roth of Ball, Kirk & Holm, P.C., Waterloo, for appellee.

Considered by Bower, C.J., and Badding and Langholz, JJ.
2

BOWER, Chief Judge.

Nordstrom, Inc. appeals the district court’s order affirming the decision of

the workers’ compensation commissioner awarding industrial disability benefits to

Pamela Carmer for injuries to Carmer’s shoulders. Upon review, we affirm in part,

reverse in part, and remand with instructions.

I. Background Facts and Proceedings

The parties agree Carmer sustained a work-related injury to her right

shoulder in August 2018. In December, Dr. Brendan Patterson performed a “right

shoulder arthroscopy rotator cuff repair, open subpectoral biceps tenodesis,

‘[e]xtensive debridement,’ and subacromial decompression” on Carmer. She

engaged in physical therapy following her surgery. Dr. Patterson examined

Carmer in May 2019 and noted she “was doing well overall, her pain was minimal,

her shoulder felt very comfortable, and she had improved with physical therapy.”

Dr. Patterson released Carmer without restrictions with use of her shoulder “as

tolerated.”

In fall 2020, Carmer requested medical care from Nordstrom for pain in her

left shoulder “due to compensating for her work injury with her other arm.”

Nordstrom referred Carmer to Dr. James Milani, a family practitioner, who

conducted an independent medical examination in January 2021. Dr. Milani noted

Carmer “has had no specific injury or event to the left shoulder.” He diagnosed

Carmer with “[l]eft shoulder pain–etiology uncertain. Most likely contributor to pain

is underlying degenerative changes and/or progressive underlying systemic

inflammatory arthritis/rheumatologic disorder that has not been diagnosed yet. It

appears she has an advancing destructive joint disease/rheumatologic etiology
3

that is affecting more than just her left shoulder.” Dr. Milani opined Carmer’s left-

shoulder injury was not causally related to her August 2018 work injury.

Dr. David Segal, a neurosurgeon, conducted an independent medical

examination of Carmer later that month. Dr. Segal noted following Carmer’s work-

related injury in August 2018, she “has now developed symptoms on the left side

that are caused by favoring her right arm and corresponding with the overuse of

her left arm . . . .” Specifically, Dr. Segal opined Carmer’s left-shoulder symptoms

“began when [she] became more active after the surgery, and the right shoulder

symptoms increased at that time, requiring her to rely on her left arm for most

activity.” He noted, “Because of the pain and limitation in range of motion of her

right arm since this injury, [Carmer] uses her non-dominant left arm for most of life

activities where she would normally use her right arm. [She] also uses her left arm

alone for most activities where should have used both arms.”

Dr. Segal disagreed with Dr. Milani’s discussion of rheumatoid arthritis as a

possible cause for Carmer’s symptoms, and he further opined the possibility

Carmer has osteoarthritis “does not preclude one material factor in the causation

of her left shoulder symptoms, being overuse and compensation due to the limited

function of her right shoulder.” Dr. Segal acknowledged when Carmer reported to

Dr. Patterson in May 2019, “she was doing well,” but he pointed out Dr. Patterson’s

last examination of Carmer was at the time of her “peak improvement after surgery

and physical therapy.” Dr. Segal noted, “It is common for regression to occur after

physical therapy has ended and a patient resumes normal life activities.” Dr. Segal

observed Dr. Mark Taylor’s examination of Carmer in October 2019, “showed

worse symptoms . . . than Dr. Patterson’s exam, and . . . did not indicate
4

inflammatory arthritis as the cause.” Dr. Segal opined “one material factor in the

causation of [Carmer’s] left shoulder symptoms is the compensation and overuse

needed of her left shoulder due to the work injury.”

Carmer petitioned for workers’ compensation benefits for both injuries.

Nordstrom admitted Carmer sustained a work-related injury to her right shoulder

in August 2018 but denied she sustained a sequela injury to her left shoulder.

Specifically, Nordstrom argued Carmer’s “underlying rheumatoid arthritis or joint

problems . . . are the cause of her left upper extremity symptoms.” A deputy

workers’ compensation commissioner agreed with Carmer, determining the

greater weight of evidence supported a finding Carmer sustained a sequela to her

left shoulder caused by the work injury to her right shoulder. In reaching this

conclusion, the deputy noted it “f[ound] Dr. Segal’s opinion on causation more

persuasive than Dr. Milani’s opinion.” The deputy further stated:

Contrary to Dr. Milani’s opinion, there is no evidence Carmer has
rheumatoid arthritis or that an autoimmune or systemic
rheumatological disease or process is the cause of her left-sided
symptoms. lt is undisputed Carmer has swelling and deformity in her
hands. Carmer testified she underwent testing to determine if she
had rheumatologic disease, which was negative. Even if Carmer has
underlying arthritis in her left shoulder, which is not supported by her
medical records, I do not find Nordstrom has proven underlying
preexisting arthritis is the sole cause of Carmer’s left shoulder
symptoms.
The evidence supports that after her right shoulder surgery
and physical therapy, Carmer’s condition improved at the time
Dr. Patterson released her from care. Carmer testified at hearing her
symptoms later increased in her right upper extremity and she
started relying more on her left upper extremity following surgery and
that she did not recognize the seriousness of the problems with her
Ieft upper extremity at first. While Carmer struggled to recall dates
during the hearing, I found her generally to be a credible witness,
given she maintained appropriate eye contact and did not engage in
furtive movements during the hearing. Objective testing performed
by Dr. Taylor six months after Dr. Patterson released her from care
5

shows a decline in her right upper extremity, consistent with
Dr. Segal’s opinion and her testimony. Dr. Segal cited to authority
supporting his contention overuse of the opposite limb following an
injury can cause pathology. This finding is consistent with Carmer’s
credible testimony in this case. I find Carmer has established she
sustained a sequela to her left upper extremity caused by the work
injury.

Upon concluding Carmer had suffered compensable permanent injuries to

her right and left shoulders, the deputy also concluded Carmer’s injuries should be

treated as unscheduled injuries under Iowa Code section 85.34(2)(v) (2022). The

deputy therefore calculated Carmer’s compensation based on her loss of future

earning capacity, which the deputy found to be seventy percent, and awarded

compensation on that basis.

Nordstrom appealed to the commissioner. The commissioner affirmed the

deputy’s arbitration decision, with a slight modification to decrease the deputy’s

industrial disability rating. The district court affirmed the commissioner’s appeal

decision on judicial review. Nordstrom appeals.

II. Standard of Review

“Iowa Code section 17A.19(10) ‘governs judicial review of administrative

agency decisions.’” P.M. Lattner Mfg. Co. v. Rife, 2 N.W.3d 859, 865 (Iowa 2024)

(citation omitted). Because “the legislature has not vested the workers’

compensation commissioner with interpretive authority regarding Iowa Code

chapter 85,” we “review the commissioner’s interpretation of Iowa Code chapter

85 for correction of errors at law instead of deferring to the agency’s interpretation.”

Id. (citation omitted). We review factual determinations made by the commissioner

for substantial evidence. Larson Mfg. Co. v. Thorson, 763 N.W.2d 842, 850 (Iowa

2009). We will only reverse the commissioner’s application of law to facts if it was
6

“irrational, illogical, or wholly unjustifiable.” Id. (quoting Iowa Code §

17A.19(10)(l)). “This standard requires us to allocate some deference to the

commissioner’s determinations, but less than we give to the agency’s findings of

fact.” Id.

III. Causal Relationship

Nordstrom challenges whether substantial evidence supports the

commission’s finding Carmer’s left shoulder injury was “causally related to her

workplace injury to her right shoulder.” Under our workers’ compensation statute,

employers must pay compensation to employees for “personal injuries . . . arising

out of and in the course of the employment.” Iowa Code § 85.3(1). Because

“[m]edical causation is a question of fact vested in the commissioner’s discretion,”

Mike Brooks, Inc. v. House, 843 N.W.2d 885, 889 (Iowa 2014), Nordstrom is

entitled to judicial relief only if the commissioner’s finding “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 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.” Id. § 17A.19(10)(f)(1). “Evidence is not insubstantial merely because

different conclusions may be drawn from the evidence.” Brooks, 843 N.W.2d at

889 (citation omitted). So the question before us is not whether the evidence

supports a different finding; it is whether it supports the finding the commission

made. Id.
7

Nordstrom claims Carmer’s left shoulder injury is “highly speculative” and

“lacks any indicia of reliability” because Carmer “failed to report any symptoms

involving her left shoulder for over two years.” Indeed, Carmer testified she started

noticing pain on her left side in spring or summer 2019. At first the pain felt like

“post-workout soreness,” but it had “gotten worse,” like “a burning sensation.”

Dr. Segal’s report explained why injuries like Carmer’s were slow to progress.

According to Dr. Segal, “the symptoms in the left shoulder developed at the time

[she] was overusing and compensating for the limited use of her right shoulder.”

As the commissioner noted:

I understand defendant’s frustration with this outcome.
Claimant’s left shoulder complaints did not manifest until long after
her initial right shoulder injury. As a result, mentions of claimant’s
left shoulder are scant in the evidentiary record. However, as
explained by Dr. Segal, “There was no mention of the left shoulder
symptoms in the records because the records predated the time that
[claimant] realized the left shoulder was substantial and not
transient.”

Nordstrom also claims Dr. Segal’s report is “unreliable” because Carmer

provided “inconsistent” descriptions with respect to when her symptoms started.

However, the commissioner stated:

Like the deputy commissioner, I find Dr. Segal’s opinions to
be more persuasive than those of Dr. Milani. While it is undisputed
that claimant has swelling in her fingers and hands, there is no
objective evidence of rheumatoid/inflammatory/autoimmune
arthritis—only Dr. Milani’s speculation. Furthermore, even if claimant
has underlying arthritis, such a pre-existing condition does not
preclude the possibility that overuse caused or materially aggravated
that condition.

“Medical causation ‘is essentially within the domain of expert testimony.’”

Cedar Rapids Cmty. Sch. Dist. v. Pease, 807 N.W.2d 839, 845 (Iowa 2011)

(citation omitted). “[T]he determination of whether to accept or reject an expert
8

opinion is within the ‘peculiar province’ of the commissioner.” Bridgestone

Americas, Inc. v. Anderson, ___ N.W.2d ___, ___, 2024 WL 1334165, at *3 (Iowa

2024) (citation omitted). “[H]ere, . . . we see no grounds to second guess the

commissioner’s reliance on the expert opinion[]” of Dr. Segal. Id. Substantial

evidence supports the commissioner’s findings in this case.

IV. Scheduled or Unscheduled

Nordstrom next claims the commissioner erred in concluding Carmer’s

injuries should be compensated as unscheduled injuries rather than scheduled

injuries. Nordstrom argues the legislature “clearly intended to make shoulder

injuries into scheduled member injuries when it amended the schedule in 2017 to

include shoulders.” According to Nordstrom, the commissioner should have found

Carmer’s injuries to be scheduled injuries under Iowa Code section 85.34(2)(n),

rather than unscheduled injuries under section 85.34(2)(v).

Our supreme court recently addressed this issue. In Bridgestone Americas,

Inc., 2024 WL 1334165, at *2, an employee sought compensation for an injury to

his right shoulder and an injury to his right arm. The commissioner found the

injuries were compensable and “should be treated as unscheduled injuries under

Iowa Code section 85.34(2)(v).” The employer appealed, challenging in part the

commissioner’s finding the injuries should be compensated as unscheduled

injuries under section 85.34(2)(v), rather than scheduled injuries under section

85.34(2), paragraphs (m) and (n). Id. In addressing the employer’s claim, the

court observed it was “essentially a question of statutory interpretation.” Id., 2024

WL 1334165, at *4. The court determined:
9

Following our study of the plain language of section 85.34, we
conclude that the commissioner erred by concluding that [employee]
Anderson suffered an unscheduled injury. As mentioned, an injury
can be unscheduled only if it fits in paragraph (v). Iowa Code
§ 85.34(2)(v). And by its plain terms, paragraph (v) can only apply
to injuries “other than those . . . described or referred to in
paragraphs ‘a’ through ‘a.’” Id. (emphasis added). But Anderson’s
injuries are not “other than those . . . described or referred to in
paragraphs ‘a’ through ‘u.’” Id. (emphasis added). Anderson’s
injuries are to his shoulder and arm. Both are “described or referred
to” in the schedule composed of “paragraphs ‘a’ through ‘u.’” Id.
§ 85.34(2). Specifically, Anderson’s shoulder injury is “described or
referred to” in paragraph (n), which states: “n. For the loss of a
shoulder, weekly compensation during [a percentage of] four
hundred weeks.” Id. § 85.34(2)(n). And Anderson’s arm injury is
“described or referred to” in paragraph (m), which states: “m. The
loss of two-thirds of that part of an arm between the shoulder joint
and the elbow joint shall equal the loss of an arm and the
compensation therefor shall be weekly compensation during [a
percentage of] two hundred fifty weeks.” Id. § 85.34(2)(m). Because
Anderson’s injuries are “described or referred to” in scheduled
paragraphs (m) and (n), paragraph (v) does not apply. Id. § 85.34(2).
The injuries are scheduled, not unscheduled.

Id.

Following this reasoning, we likewise conclude because Carmer’s shoulder

injuries are “described or referred to” in scheduled paragraph (n), paragraph (v)

does not apply. See also id., 2024 WL 1334165, at *6 (noting “paragraph (v)

generally doesn’t apply to injuries to . . . shoulders”). We also note in reaching its

decision, the supreme court considered—and rejected—the employee’s

counterargument relating to the statute’s use of the singular rather than the plural

to describe compensation for injuries. Id., 2024 WL 1334165, at *5. Similarly,

here, Carmer maintains because section 85.34(2)(n) provides compensation for

“a” shoulder, “meaning only one,” her injuries to both shoulders are not addressed

by section 85.34(2)(n), and therefore fall under “the catchall provision of section

85.34(2)(v).” On this question, the supreme court stated:
10

Anderson notes that paragraph (n) describes compensation
for “a shoulder”—singular—and paragraph (m) describes
compensation for “an arm”—also singular. Id. § 85.34(2)(m), (n).
From this, Anderson infers that the schedule cannot apply to him
because his injuries include both “a shoulder” and “an arm.”
We disagree. To begin with, when we interpret statutes, we
usually don’t put too much weight on the use of “a” or “an” or to other
uses of the singular or plural. Id. § 4.1(17) (“Unless otherwise
specifically provided by law the singular includes the plural, and the
plural includes the singular.”); see Little v. Davis, 974 N.W.2d 70, 75–
76 (Iowa 2022) (applying Iowa Code section 4.1(17)); Porter v.
Harden, 891 N.W.2d 420, 426 (Iowa 2017) (observing that Iowa
Code section 4.1(17) “should caution us against reading too much
into the presence of the words ‘a’ or ‘an’ in a statute depending on
the context”); Sexton v. Lauman, 244 Iowa 570, 57 N.W.2d 200, 202
(1953) (construing a singular term in a statute to extend to the plural).
Moreover, the singular/plural distinction is not especially
relevant here. This is not a case of plural shoulder injuries or plural
arm injuries. Rather, Anderson suffered injuries to “a shoulder” and
“an arm.” Iowa Code § 85.34(2)(m), (n). So it makes sense to
compensate Anderson under the scheduled provisions for “a
shoulder” and “an arm.” Id.
This view is supported by the narrow scope of paragraph (v),
the provision for unscheduled injuries. Paragraph (v) does not say
that it applies unless a patient’s injuries fit into only one of the
paragraphs identified as (a), (b), (c), etc. Id. § 85.34(2)(v). Rather,
according to its plain text, paragraph (v) only applies to injuries “other
than those . . . described or referred to in paragraphs ‘a’ through ‘u.’”
Id. And, as explained, Anderson’s injuries are “described or referred
to in paragraphs ‘a’ through ‘u.’” Id. (emphasis added). They are
“described or referred to” in paragraphs (n) and (m), both of which
are part of the schedule composed of “paragraphs ‘a’ through ‘u.’”
Id. § 85.34(2). So paragraph (v) does not apply.

Id.

We acknowledge this is a case of “plural shoulder injuries.” But we are not

convinced we should interpret the Bridgestone court’s statement “[t]his is not a

case of plural shoulder injuries” to insinuate injuries to both shoulders should be

treated any differently than two scheduled injuries. Indeed, we believe the court’s

subsequent example sheds light on this very question:
11

For example, paragraph (e) makes the loss of the fourth finger—the
“little finger”—a scheduled injury that requires twenty weeks of
compensation. Id. § 85.34(2)(e). If an employee lost both little
fingers—in a single accident or otherwise[1]—the employee would be
compensated for each little finger under paragraph (e). Id. In other
words, there would be two scheduled injuries. There would not be
an unscheduled injury. Because little fingers are “described or
referred to” in the schedule composed of “paragraphs ‘a’ through ‘u,’”
the worker who lost both little fingers would not fall into paragraph (v).
Id. § 85.34(2).

Id., 2024 WL 1334165, at *5. In other words, “[b]ecause [shoulders] are described

or referred to in the schedule composed of paragraphs a through u, [Carmer,] who

lost both [shoulders,] would not fall into paragraph (v).” Id. (cleaned up). Carmer’s

injuries “are scheduled, not unscheduled.”2 Id., 2024 WL 1334165, at *4.

V. Disposition

The district court was correct to affirm the commissioner’s finding Carmer’s

left shoulder injury is compensable. We affirm that ruling of the district court.

The district court erred in affirming the commissioner’s finding Carmer’s

shoulder injuries should be compensated as unscheduled injuries. We reverse

that ruling of the district court.

“Because we conclude that the commissioner erred in treating [Carmer]’s

injuries as unscheduled, we also conclude that the commissioner erred in awarding

compensation based on [Carmer]’s loss of earning capacity. Likewise, the district

court erred in affirming the award of compensation.” Id., 2024 WL 1334165, at *7.

1 Similarly, here, Carmer’s injuries were not “caused by a single accident,” but the

exclusion of “both shoulders” from paragraph (t) is irrelevant. Iowa Code
§ 85.34(2)(t).
2 On appeal, Nordstrom also claims the commissioner erred in “using Dr. Segal’s

[impairment] rating for the shoulders.” In light of our conclusion above, we need
not reach this claim.
12

We therefore reverse that ruling of the district court. We remand to the district

court for entry of an order remanding to the commissioner for further proceedings

to determine compensation for Carmer’s scheduled injuries. Id.

AFFIRMED IN PART, REVERSED IN PART, AND REMANDED WITH

INSTRUCTIONS.