Michael Wooff v. Nine Park Lane, Inc., d/b/a Menefee Drywall and Western National Insurance Company

IN THE COURT OF APPEALS OF IOWA _______________ No. 25-1433 Filed October 21, 2026 _______________ Michael Wooff, Plaintiff–Appellant, v. Nine Park Lane, Inc., d/b/a Menefee Drywall and Western National Insurance Company, Defendants–Appellees. _______________ Appeal from the Iowa District Court for Linn County, The Honorable Chad Kepros, Judge. _______________ AFFIRMED IN PART, REVERSED IN PART, AND REMANDED _______________ Mindi M. Vervaecke (argued) and Thomas M. Wertz of Wertz Law Firm, Cedar Rapids, attorneys for appellant. Kent M. Smith (argued) of Smith Mills Law P.C., West Des Moines, attorney for appellees. _______________ Heard at oral argument by Tabor, C.J., and Schumacher and Buller, JJ. Opinion by Schumacher, J. 1 SCHUMACHER, Judge. Michael Wooff appeals a district court ruling on judicial review that affirmed the workers’ compensation commissioner’s decision. The commissioner limited Wooff’s recovery to functional impairment, rejected his psychiatrist’s mental-health impairment rating, and adopted a shoulder impairment rating that improperly applied a multiplier. Upon our review, we affirm in part and reverse in part the judgment of the district court, and we remand this case to the district court with instructions to remand this matter to the workers’ compensation commissioner for further proceedings consistent with this opinion. BACKGROUND FACTS AND PROCEEDINGS The material facts of this case are largely undisputed. In 1993, Wooff began working for Menefee Drywall, which provides commercial and residential drywalling and finishing services. On August 9, 2019, Wooff reported a workplace injury to Menefee.1 At the time of his injury, Wooff’s gross earnings were $864.90 weekly, or approximately $45,000 annually. Wooff received medical care for his right shoulder from a number of providers at various facilities,2 including orthopedic surgeon Dr. James Nepola. He also sought mental-health treatment through the Veterans’ Administration (VA). Wooff reported neck pain after his first shoulder surgery in October 2019, and he thereafter sought medical treatment for his 1 Wooff did not sustain an acute injury; rather, August 9 is the date he reported pain he was experiencing to his supervisor. Wooff related injuries to his right shoulder, neck, and mental health to that date. 2 The commissioner’s and district court’s decisions set forth Wooff’s medical history in detail. We do not reiterate that history here except as necessary to resolve the issues on appeal. 2 cervical spine. Over the next few years, Wooff visited the emergency room on several instances for neck pain, headaches, arm numbness, and ringing in his right ear. In total, Wooff underwent three surgeries to his right shoulder and two surgeries to his cervical spine. Wooff also continued to receive mental-health treatment for depression. By August 2021, Dr. Nepola had released Wooff with permanent work restrictions related to his shoulder, including no repetitive reaching away from the body or above-shoulder height. On August 25, 2021, Menefee offered Wooff a job as a superintendent, with a salary of “$60,000/year base” and a September 1 start date. Menefee president Mike Panoske had a conversation with Wooff to present the offer and sent Wooff a letter detailing the offer along with a copy of the job description, which was “within [Wooff’s] permanent work restrictions.” Wooff told Panoske that he did not want or accept a position as a superintendent. Panoske understood that communication to be a refusal of the job offer.3 In March 2022, Wooff obtained employment as a maintenance worker for Meth-Wick Manor. Wooff left that job after approximately six months due to increased pain, and he has not worked since. Wooff petitioned for workers’ compensation benefits against Nine Park Lane, Inc. (doing business as Menefee) and its insurer, Western National Insurance Company. The parties stipulated Wooff had sustained a work- related injury to his right shoulder but disputed whether Wooff’s alleged neck and mental-health injuries were compensable. 3 Panoske also discussed Menefee’s open position for an estimator. Wooff responded that he was not qualified for that position. 3  The matter came for hearing in October 2023, after which the deputy commissioner issued an arbitration decision concluding Wooff had work- related injuries to his right shoulder, cervical spine, and mental health. The deputy found that Wooff’s neck condition was compensable as a cumulative injury connected to his right shoulder injury that “arose out of and in the course” of Wooff’s employment and that Wooff’s mental-health condition was a sequela of the shoulder and neck injuries together.4 The deputy found Wooff sustained a 55% industrial disability, with compensation for permanent partial disability to begin at the termination of the healing period, which was June 24, 2023.5 Both parties appealed to the commissioner, who found the deputy’s industrial-disability analysis was “premature and failed to address defendants’ argument that [Wooff ]’s recovery is limited to a functional disability award pursuant to Iowa Code section 85.34(2)(v)” (2022). The commissioner concluded Wooff should be compensated pursuant to section 85.34(2)(v), with his permanent disability recovery limited to the “functional impairment resulting from the injury,” see Iowa Code § 85.34(2)(v), and Wooff should not be compensated for industrial disability. Turning to functional disability, the commissioner found the shoulder impairment rating offered by Dr. Joseph Chen more convincing than the rating offered by Dr. David Segal, a neurosurgeon who performed an independent medical examination (IME). The commissioner concluded Wooff had “proved six percent functional loss of the right upper extremity as However, the deputy found no credible evidence of permanent impairment due 4 to Wooff’s mental-health condition. 5 The deputy commissioner also ordered reimbursement for medical expenses, a penalty benefit, costs for an independent medical examination, and costs to Wooff. 4 a result of a loss of range of motion in the right shoulder,” and “an additional three percent permanent impairment of the right upper extremity for the distal clavicle excision performed in [his] right shoulder,” for a total “nine percent permanent impairment of his right upper extremity.” The commissioner further concluded, adopting Dr. Segal’s rating, that Wooff “proved 35 percent whole person permanent functional impairment related to the neck injury.” The commissioner affirmed the deputy’s rejection of permanent impairment ratings related to Wooff’s mental-health condition, finding weak support in the record for such determination. Specifically, the commissioner noted that psychiatrist Dr. Adam Woods “did not assign any permanent restrictions for the mental health injury,” and Wooff “returned to work for a different employer and did not identify mental health as a reason he had to quit that subsequent position.” Using the Combined Values Chart in the fifth edition of the American Medical Association’s Guides to the Evaluation of Permanent Impairment (AMA Guides), the commissioner determined Wooff had “established he sustained 41 percent permanent functional impairment,” entitling Wooff to 205 weeks of permanent partial disability benefits. Wooff petitioned and Menefee cross-petitioned for judicial review. On judicial review, the district court affirmed the commissioner’s decision except with regard to Menefee’s challenge to the commissioner’s calculation of functional disability. On that issue, the district court determined Wooff’s whole-body impairment should be 38% and not 41%, and the court modified the decision “to award 38% whole body impairment in accordance with the Combined Values Chart of the AMA Guides.” 5  Wooff appeals. Additional facts will be set forth below as relevant to his claims on appeal. STANDARD OF REVIEW We review the workers’ compensation commissioner’s interpretation of Iowa Code chapter 85 for errors at law. In recent years, we have repeatedly declined to give deference to the commissioner’s interpretations of various provisions in chapter 85. We do not believe the terms of the workers’ compensation statute at issue here are uniquely within the subject matter expertise of the agency. We accept the commissioner’s factual findings when supported by substantial evidence. Den Hartog Indus. v. Dungan, 26 N.W.3d 377, 381 (Iowa 2025) (cleaned up) (reviewing the commissioner’s interpretation of section 85.34(2)(v)); Koeller v. Cardinal Logistics Mgmt. Corp., 35 N.W.3d 335, 344 (Iowa 2026) (reviewing the commissioner’s interpretation of the AMA Guides). DISCUSSION I. Suitability of Offered Work under Section 85.34(2)(v) Wooff claims the commissioner erred in concluding that Menefee’s “offering Wooff a job that he was unqualified to do was sufficient to avoid an industrial disability award” and limit his recovery to functional impairment. This claim implicates section 85.34(2)(v), which provides: In all cases of permanent partial disability other than those described or referred to in paragraphs “a” through “u”, the compensation shall be paid during the number of weeks in relation to five hundred weeks as the reduction in the employee’s earning capacity caused by the disability bears in relation to the earning capacity that the employee possessed when the injury occurred. A determination of the reduction in the employee’s earning capacity caused by the disability shall take into account the permanent partial disability of the employee and the number of years in the future it was reasonably anticipated that the employee would work at the time of the injury. If an employee who is eligible for compensation 6  under this paragraph returns to work or is offered work for which the employee receives or would receive the same or greater salary, wages, or earnings than the employee received at the time of the injury, the employee shall be compensated based only upon the employee’s functional impairment resulting from the injury, and not in relation to the employee’s earning capacity. Notwithstanding section 85.26, subsection 2, if an employee who is eligible for compensation under this paragraph returns to work with the same employer and is compensated based only upon the employee’s functional impairment resulting from the injury as provided in this paragraph and is terminated from employment by that employer, the award or agreement for settlement for benefits under this chapter shall be reviewed upon commencement of reopening proceedings by the employee for a determination of any reduction in the employee’s earning capacity caused by the employee’s permanent partial disability. (Emphasis added). Since its amendment in 2017, the supreme court has applied section 85.34(2)(v) “in a straightforward manner.” Den Hartog, 26 N.W.3d at 382; see generally Loew v. Menard, Inc., 2 N.W.3d 880, 884 (Iowa 2024) (“Until 2017, all nonscheduled injuries were compensated using the industrial method.”). As applicable here, under sentences 1 and 2 of section 85.34(2)(v), Wooff’s injury would be compensated according to the industrial-disability method, based on “the reduction in [Wooff’s] earning capacity caused by the disability.” Iowa Code § 85.34(2)(v); accord Den Hartog, 26 N.W.3d at 382. However, Wooff was “offered work for which [he] . . . would receive the same or greater salary, wages, or earnings than [he] received at the time of the injury.” Iowa Code § 85.34(2)(v). “Therefore, under sentence 3, he should be compensated ʻbased only upon [his] functional impairment resulting from the injury, and not in relation to [his] earning capacity.’” Den Hartog, 26 N.W.3d at 382 (quoting Iowa Code § 85.34(2)(v)). “Finally, [Wooff ] was not ʻterminated from employment’ by [Menefee], so sentence 4 7 doesn’t apply, and there is no review-reopening.” Id. (quoting Iowa Code § 85.34(2)(v)). Accordingly, under the plain text of section 85.34(2)(v), Wooff “should be compensated based on functional impairment, as dictated by sentence 3, not loss of earning capacity.” Id. But Wooff maintains that we should read a suitability requirement into sentence 3—that an employer’s offer of work must be consistent with the employee’s training, experience, and qualifications. Wooff acknowledges section 85.34(2)(v) “does not use the terms ʻbona fide offer’ or ʻsuitable work,’” but he persists “certainly such is implied.” To support his claim, Wooff relies on Neal v. Annett Holdings, Inc., 814 N.W.2d 512, 519–21 (Iowa 2012), and Schutjer v. Algona Manor Care Center, 780 N.W.2d 549, 558–59 (Iowa 2010), both of which recognize a suitability requirement in the context of an employee’s refusal of work. However, Neal and Schutjer addressed an employee’s disqualification from temporary partial, temporary total, and healing period benefits under section 85.33(3),6 whereas the provision applicable here deals with permanent-disability 6 The relevant statute in those cases provided: If an employee is temporarily, partially disabled and the employer for whom the employee was working at the time of injury offers to the employee suitable work consistent with the employee’s disability the employee shall accept the suitable work, and be compensated with temporary partial benefits. If the employee refuses to accept the suitable work with the same employer, the employee shall not be compensated with temporary partial, temporary total, or healing period benefits during the period of the refusal. If suitable work is not offered by the employer for whom the employee was working at the time of the injury and the employee who is temporarily partially disabled elects to perform work with a different employer, the employee shall be compensated with temporary partial benefits. Iowa Code § 85.33(3) (2009). 8 benefits under section 85.34(2)(v) (2022). Moreover, the legislature added sentences 2, 3, and 4 of section 85.34(2) in 2017 as part of a series of amendments to the workers’ compensation law. With those amendments, the general assembly could have used language placing a suitability requirement on the employer’s offered work. Wooff points to no authority, and we are aware of none, extending such suitability analysis to section 85.34(2)(v)’s distinct text. “[W]e will not look beyond the express terms of the statute if the text of the statute is plain and its meaning clear.” Neal, 814 N.W.2d at 519. Specifically, Menefee offered Wooff a job as a superintendent, with a salary of “$60,000/year base,” approximately $15,000 more per year than Wooff had been earning. The offer letter from Menefee president Panoske stated in part: “After reviewing your extensive work experience, we would like to extend an offer as our new Superintendent. Your start date is September 1, 2021. Attached is a copy of the job description, which is within your permanent work restrictions.” The job description listed no physical requirements under “Essential Duties & Responsibilities.” As for “Experience,” the job description stated: “3–5 years of experience in construction (commercial preferred).” Wooff began working for Menefee in 1993. He explained his work as “doing the drywall hanging and finishing” of residential and commercial developments. Wooff described the work of Menefee’s superintendent as being “in charge of manning the jobs and then checking on the jobs, making sure you’re staying up-to-date and on schedule, plus answering questions from the contractors as well as the employees.” Wooff did not claim that his work restrictions prevented him from being able to perform the work of superintendent; rather, he testified he did not feel capable of performing that work due to “[j]ust the physical and mental demand of that job. . . . [P]lus I 9 just didn’t feel comfortable doing that job.” Wooff also stated he was easily fatigued, lacked knowledge of carpentry, and had few computer skills. The deputy found that Wooff “declined [the] position based upon his own subjective beliefs of his qualifications.” The commissioner agreed, observing in part: In this case, claimant was offered employment consistent with his restrictions by the employer. Claimant testified he did not believe he was qualified for the position but did not really dispute that he could physically perform the position. The employer apparently believed claimant was qualified because he was offered an increase in earnings if he accepted the position. . . . The district court concurred with the commissioner’s findings, explaining: The Court is not persuaded that [the commissioner] considered an improper factor or otherwise made an error of law in concluding that Menefee’s offer to [Wooff ] of a job for which he claims he was unqualified was sufficient to avoid an industrial disability award. [Wooff ] had a long history of working in the drywalling field and was familiar with drywalling processes. While [Wooff ] has argued that he did not have the mental abilities to perform the type of work offered to him by [Menefee], [Menefee] could have, as [the commissioner] found, provided training to [Wooff ] to perform this work, and it does not appear [Wooff ] even tried the new jobs to see if he could be trained into performing them. The Court agrees with [the commissioner] that the statute does not leave it to a claimant to determine whether he or she is suitable for the proposed position, nor does it preclude an employer from providing training to an employee to attempt to get them into a new area of employment that could be suitable for the employee. The Court finds merit in [the commissioner]’s conclusion that there is good policy that would encourage an employer to provide training in an effort to get an injured employee into a different and perhaps higher paying job so that the employment relationship can continue. The Court finds nothing in the record to suggest [Menefee] made the offer of employment in bad faith or an attempt to exclude [Wooff ] from employment, as opposed to making him an offer of 10  something the employer viewed him to be suitable for and then providing training to adjust [Wooff ] to the new position(s). The employer was in a position to assess [Wooff ]’s abilities with regard to what jobs he might be capable of performing, and the Court agrees with [the commissioner] that the offer was made in good faith. Wooff persists that “[w]ithout being able to read ʻsuitability’ into the offer of work, the results would allow for absurd offers to satisfy the statutory language in order to avoid fair compensation for injured workers.” The court considered and rejected a similar contention in Den Hartog. See 26 N.W.3d at 384. There, the court was unpersuaded by the employee’s “policy” argument that “[u]nscrupulous employers should not be incentivized to offer work at the same or greater wage for work which the injured worker cannot realistically perform.” Id. The court acknowledged the argument was “plausible” but nonetheless determined it could not “overcome clear statutory language.” Id. The court also noted several “counterarguments”: For example, one might argue that it is sound public policy to incentivize employers to keep workers who sustain workplace injuries on the payroll at their prior level of compensation. One might also argue that it is fairer to provide workers’ compensation benefits to such workers based on functional impairment rather than on a lost earning capacity that has not yet materialized in an actual loss of earnings. Id. In any event, the court reasoned that “[r]esolving these competing policy arguments is the legislature’s job; our duty is to interpret the text of the statute as written.” Id.; see also id. at 383 (noting that section 85.34(2)(v) “provides for specific consequences that flow from specific events”). Similarly, we are not persuaded by Wooff’s contention that Menefee’s offer was “premature” because he was not at maximum medical improvement (MMI) for his neck. Nothing in section 85.34(2)(v) ties the validity of an offer for work to the employee’s MMI status for every condition. We further observe that Wooff had reached MMI for his 11 shoulder—the condition precipitating Menefee’s offer—when such offer was extended. For these reasons, we conclude the commissioner did not err in determining that Wooff’s recovery is limited to functional impairment under section 85.34(2)(v). II. Impairment Rating for Mental-Health Condition Wooff next claims that “[s]ubstantial evidence supports that [his] mental health injury resulted in significant permanent impairment” and should have been “considered in the industrial disability analysis.” We have affirmed the commissioner’s conclusion that Wooff’s permanent-disability benefits should be calculated on a functional-disability basis. To that end, Wooff alternatively claims his mental-health injury “should also be considered” in the functional-impairment award. The parties do not dispute that Wooff’s mental-health condition is a work-related injury as a sequela of his shoulder and neck injuries,7 but they disagree about whether that condition resulted in compensable permanent impairment. Iowa Code section 85.34(2)(x), which governs functional-loss determinations, states as follows: In all cases of permanent partial disability described in paragraphs “a” through “u”, or paragraph “v” when determining functional disability and not loss of earning capacity, the extent of loss or percentage of permanent impairment shall be determined solely by utilizing the guides to the evaluation of permanent impairment, published by the American medical association, as adopted by the workers’ compensation commissioner by rule pursuant to chapter 17A. Lay testimony or agency expertise shall not be utilized in determining loss or percentage of permanent impairment pursuant to paragraphs “a” through “u”, or 7 The parties also agree Wooff has a history of depression and alcoholism. 12  paragraph “v” when determining functional disability and not loss of earning capacity. The commissioner has adopted the fifth edition of the AMA Guides “for determining the extent of loss or percentage of impairment for permanent partial disabilities and payment of weekly compensation for permanent partial scheduled injuries under Iowa Code section 85.34(2) not involving a determination of reduction in an employee’s earning capacity.” Iowa Admin. Code r. 876-2.4; accord Koeller, 35 N.W.3d at 342. “Chapter 14 of the AMA Guides addresses mental and behavioral disorders, and discusses the principles of assessment, diagnosis and impairment, and the method for evaluating psychiatric impairment.” Garcia v. Smithfield Foods, Inc., Iowa Workers’ Comp. Comm’n No. 1657969.01, 2022 WL 17170655, at *9 (Oct. 28, 2022). Unlike other parts of the body, which are discussed in surrounding chapters of the AMA Guides, chapter 14 directs the examiner not to assign percentages to estimate mental-health conditions. See id. at *10. Rather, [i]nstead of assigning a numeric permanent impairment rating, the AMA Guides direct the examiner to assess and record the extent of function in the areas of activities of daily living, social functioning, concentration, and adaptation. After assessing and recording the extent of function, the AMA Guides then direct the examiner to assign each area a class of impairment, from Class 1, no impairment, to Class 5, an extreme impairment precluding useful functioning. Id. at *9 (citation omitted). The commissioner has observed that strict application of the AMA Guide’s absence of a numeric percentage for quantifying mental-health conditions would lead to absurd results. See id. at *11; Clark v. Arconic, Inc., Iowa Workers’ Comp. Comm’n No. 5061553.01, 2022 WL 4595899, at *5 13 ( June 28, 2022); see generally Curette v. AAA Airporter Servs., Iowa Workers’ Comp. Comm’n No. 22003959.02, 2025 WL 2646369, at *15–16 (Sep. 5, 2025); Spading v. Pepsico, Iowa Workers’ Comp. Comm’n No. 23008655.01, 2026 WL 1291012, at *19 (Apr. 30, 2026). However, our review is “not bound by the legal conclusions in agency decisions.” Hayes v. Christian Ret. Homes, Inc., 36 N.W.3d 44, 51 (Iowa 2026). Rather, the workers’ compensation statutes and our supreme court’s opinions set out our “controlling legal standards.” Id. But we are to “liberally construe workers’ compensation statutes in favor of the worker, because the primary purpose of the workers’ compensation statute is to benefit the worker . . . insofar as statutory requirements permit.” Des Moines Area Reg’l Transit Auth. v. Young, 867 N.W.2d 839, 842 (Iowa 2015) (cleaned up). On the application of section 85.34(2)(x) to mental-health conditions, the commissioner has noted: Iowa Code section 85.34(2)(x) requires the extent of loss of permanent impairment for a “functional disability” to be determined “solely” by using the version of the AMA Guides adopted by the commissioner. The statute also prohibits the use of lay testimony or agency expertise in determining “functional disability.” The statute does not contain any express language providing the determination of extent of loss for a functional disability must be made by a physician or other medical provider. As discussed above, the AMA Guides allows an examiner to provide an impairment rating for all body parts other than for mental and behavioral disorders. There is no express wording in the statute that the legislature intended to treat mental and behavioral disorders differently from other parts of the body. Reading the statute to allow for the recovery of functional loss for an injury to a toe and not for a mental or behavioral disorder because the AMA Guides proscribe the assigning of a numeric impairment leads to an absurd, illogical, and unjust result. Clark, 2022 WL 4595899, at *5. 14  The general principle that the commissioner may review expert interpretations of the AMA Guides is supported by the supreme court’s recent holding in Koeller. Although Koeller did not specifically address mental-health impairment ratings, the court provided the following guidance on section 85.34(2)(x): Notably, section 85.34(2)(x) contains two distinct directives. First, it requires that the AMA Guides be used in determining the percentage of permanent impairment. In effect, those guides are given the force of law. Second, section 85.34(2)(x) prohibits the use of lay testimony or agency expertise in determining percentage of permanent impairment. This directive may have been clearer to those who wrote it than it is to us. However, at a minimum it seems apparent that lay testimony—such as that of an injured worker—cannot be used to boost a rating above the highest rating given by expert testimony (assuming the expert has followed the AMA Guides). Likewise, lay testimony—such as surveillance—cannot be used to lower a rating below the lowest rate given by expert testimony (again assuming the expert has followed the AMA Guides). What about the prohibition on using agency expertise? Presumably, the commissioner is supposed to be more than a cipher. After all, we often refer to the commissioner’s expertise in our opinions. Hence, we do not read section 85.34(2)(x) as prohibiting the commissioner from choosing among expert views on a specific point. Doing so is often necessary to decide a case. But the commissioner should not supplant the role of the experts. Also, and this is important for the present case, we do not read section 85.34(2)(x) as prohibiting the commissioner—or courts—from reviewing expert interpretations of the AMA Guides. After all, the AMA Guides have the force of law, and what the law requires is ultimately for the agency and the courts to decide. 35 N.W.3d at 342 (internal citations omitted). Here, as noted above, two physicians provided permanent impairment ratings for Wooff’s mental-health condition. Wooff attended an IME with Dr. 15 Segal, a neurosurgeon, on June 23, 2023. Dr. Segal opined that Wooff sustained an 18% whole-person impairment for his mental-health condition, reasoning “by analogy” to the AMA Guides because the fifth edition “does not give values for mental illness.” Dr. Segal opined that Wooff’s “psychiatric restrictions are complex” and listed various work restrictions due to Wooff’s cognitive impairments. Wooff also attended an IME with Dr. Woods, a psychiatrist, on August 8, 2023. Dr. Woods conducted a mental-status examination of Wooff and reviewed his medical records. Dr. Woods diagnosed Wooff with adjustment disorder with mixed anxiety and depressed mood. He opined that Wooff’s work injury was the identifiable stressor giving rise to that condition. Dr. Woods was asked to provide an impairment rating using the fifth edition of the AMA Guides. Dr. Woods considered chapter 14 and listed the four categories the Guides use to assess areas of function, including “(1) the ability to perform activities of daily living, (2) social functioning, (3) concentration, persistence, and pace, and (4) deterioration or decompensation in work or work-like settings.” Using those elements, Dr. Woods opined Wooff fell into “Class 3 or ʻModerate Impairment,’” which “means that the identified impairments are compatible with some, but not all, useful functioning.” Based on that analysis, in terms of a functional impairment rating, Dr. Woods assigned Wooff a 40% whole-person- impairment rating as a result of the work-related injury.8 With respect to permanent restrictions, Dr. Woods opined it was “highly doubtful that Mr. Wooff will be able to work a physical labor job ever 8 Dr. Woods also referenced the commissioner’s decision in Clark, 2022 WL 4595899, at *7–11, as well as Table 11–4 of the AMA Guides for “guidance for providing a numeric rating.” 16 again” and “[f ]or the sake of [Wooff’s] quality of life and peace of mind, we must proceed forward under the assumption he is not able to work at all at this point in time.” Dr. Woods stated he was “not comfortable, however, assigning permanent restrictions/limitations” and deferred to the VA mental-health staff and Wooff’s treating physicians “to make such decisions.” The deputy commissioner discounted Dr. Segal’s impairment rating, finding Dr. Segal’s “qualifications as they relate to evaluating mental health issues are flimsy, at best,” and “based upon a rotation that he performed during medical school several decades ago.”9 The deputy further found that Dr. Woods’s opinion that Wooff’s condition “may not be a permanent impairment” “casts doubt on the strength” of Dr. Woods’s impairment rating. As noted above, the commissioner affirmed the deputy’s “rejection of the permanent impairment rating offered by Dr. Segal.” The commissioner further concluded that Wooff “did not prove by a preponderance of the evidence that he is permanently and totally disabled.” The commissioner disregarded Dr. Woods’s impairment rating because “Dr. Woods did not assign any permanent restrictions for the mental health injury.” The commissioner further reasoned that Wooff “returned to work for a different employer and did not identify mental health as a reason he had to quit that 9 The deputy also discounted the opinion of Dr. Martin Carpenter, a psychiatrist who conducted an independent review of Wooff’s medical records in August 2023. Dr. Carpenter opined Wooff sustained no work-related “psychological or mental health injury,” and as such, that Wooff had no permanent impairment. The deputy gave Dr. Carpenter’s report “very little weight,” noting “[h]e did not examine or even interview” Wooff. Neither party appears to rely on Dr. Carpenter’s report on appeal. 17 subsequent position.” The district court affirmed the commissioner’s determination on judicial review. On appeal, Wooff does not challenge the commissioner’s lack of reliance on Dr. Segal’s opinion, and “we do not second-guess the commissioner’s determinations as to which expert testimony to credit.” Koeller, 35 N.W.3d at 343. Instead, Wooff claims “[s]ubstantial evidence supports that [his] mental health injury resulted in significant permanent impairment, as determined by Dr. Woods,” whose impairment rating the commissioner “completely disregarded.” In other words, according to Wooff, “[d]ue to the non-existence of a mechanism for rating mental impairment in the AMA Guides, the Commissioner took it upon himself to create an impairment rating for a mental health injury” wholly unsupported by the evidence. Here, Dr. Woods’s impairment opinion complied with the requirements of the AMA Guides, fifth edition. See Spading, 2026 WL 1291012, at *19, *23; Clark, 2022 WL 4595899, at *7–11. Even if restrictions due to Wooff’s mental-health condition were not yet “assigned,” there was no reliable evidence in the record countering Dr. Woods’s opinion that Woods’s mental-health symptoms were permanent. See Curette, 2025 WL 2646369, at *16. Accordingly, Wooff met his burden to prove permanent impairment from his work-related mental-health condition, and the commissioner erred in concluding otherwise. On remand, the commissioner shall review the expert interpretations of the AMA Guides to determine Wooff’s functional impairment as a result of his mental-health condition. See Koeller, 35 N.W.3d at 342 (noting the commissioner can “choos[e] among expert views on a specific point” but “should not supplant the role of the experts”). 18 III. Impairment Rating for Shoulder Injury Finally, Wooff claims the commissioner “erred as a matter of law when it improperly used agency expertise in determining [his] permanent impairment” to his shoulder, pointing to the commissioner’s rejection of Dr. Nepola’s and Dr. Segal’s 10% distal clavicle excision impairment ratings in favor of Dr. Chen’s 2.5% rating.10 Wooff claims “when the agency modifies an impairment rating rendered by a physician, this constitutes the use of agency expertise,” which is prohibited under section 85.34(2)(x). See Iowa Code § 85.34(2)(x) (stating “agency expertise shall not be utilized in determining loss or percentage of permanent impairment”). The supreme court recently resolved this issue in Koeller, determining that the commissioner erred in interpreting the AMA Guides as requiring the use of a table multiplier for a distal clavicle excision. See 35 N.W.3d at 345; see also Klein v. Whirlpool Corp., No. 25-0458, 2026 WL 1838660, at *2 (Iowa June 26, 2026) (same). The supreme court’s holding in Koeller controls here. Accordingly, the commissioner erred by accepting Dr. Chen’s opinion that Wooff’s 10% impairment for the distal-clavicle excision should be reduced to 2.5% using the multiplier. Koeller, 35 N.W.3d at 345; Klein, 2026 WL 1838660, at *2. 10 Specifically, Dr. Nepola and Dr. Segal assigned Wooff an additional 10% impairment of the upper extremity for the distal clavicle excision, as provided under the AMA Guides. Dr. Chen acknowledged the 10% rating for distal clavicle excision but opined the rating should be reduced to 2.5% “as has been recently recognized in local administrative rulings on the subject.” The commissioner rounded Dr. Chen’s rating up to 3%. 19  CONCLUSION We affirm in part and reverse in part the judgment of the district court, and we remand this case to the district court with instructions to remand this matter to the workers’ compensation commissioner for further proceedings consistent with this opinion. AFFIRMED IN PART, REVERSED IN PART, AND REMANDED. Tabor, C.J., concurs; Buller, J., specially concurs. 20 BULLER, Judge (specially concurring). I concur in the judgment. I write separately to address the frequent use by litigants and courts of agency decisions from unrelated cases as if they are persuasive authority—especially in areas where the General Assembly has not vested authority to interpret statutes with the agency. I appreciate that the majority opinion conducts its legal analysis with limited reliance on unrelated agency decisions, despite the prevalence of those cases in the briefing. “Iowa courts are not bound by the legal conclusions in agency decisions.” Hayes v. Christian Ret. Homes, Inc., 36 N.W.3d 44, 51 (Iowa 2026). When it comes to workers’ compensation cases, “the controlling legal standards are those set out in the workers compensation statutes and in [the appellate courts’] opinions, not in prior agency decisions.” Id. (cleaned up). This is not a choice the courts made—it was made by the legislative drafters of Iowa Code chapter 85 when they declined to grant the workers’ compensation commissioner interpretive authority over the law. See Ramirez- Trujillo v. Quality Egg, L.L.C., 878 N.W.2d 759, 769 (Iowa 2016). Yet, despite our supposed lack of deference, our courts and the litigants before us keep citing unvetted agency decisions as if they should control our resolution of legal questions. Agency decisions are not governed by stare decisis and are not akin to court decisions. They are intended to be fact-specific adjudications of matters before the agency and are typically the product of a single decisionmaker with limited review. I think it’s a mistake to treat agency decisions on the same level as decisions of another court owed respectful consideration for their persuasive value on the legal merits. I fear litigants and cour