Rukhsana Drahozal v. Envoy Air, Inc., d/b/a American Airlines Group and New Hampshire Insurance Company ( 2021 )


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  •                   IN THE COURT OF APPEALS OF IOWA
    No. 20-0027
    Filed April 28, 2021
    RUKHSANA DRAHOZAL,
    Petitioner-Appellant/Cross-Appellee,
    vs.
    ENVOY AIR, INC., d/b/a AMERICAN AIRLINES GROUP and NEW HAMPSHIRE
    INSURANCE COMPANY,
    Respondents-Appellees/Cross-Appellants.
    ________________________________________________________________
    Appeal from the Iowa District Court for Polk County, Scott D. Rosenberg,
    Judge.
    Rukhsana Drahozal and Envoy Air, Inc. appeal and cross-appeal the
    decision of the Iowa Workers’ Compensation Commissioner. AFFIRMED ON
    APPEAL; AFFIRMED IN PART, REVERSED IN PART, AND REMANDED ON
    CROSS-APPEAL.
    Thomas Wertz of Wertz Law Firm, Cedar Rapids, for appellant.
    Jean Z. Dickson and Lori N. Scardina Utsinger of Betty, Neuman &
    McMahon, P.L.C., Davenport, for appellees.
    Heard by Bower, C.J., and Doyle and Mullins, JJ.
    2
    BOWER, Chief Judge.
    Rukhsana Drahozal appeals the district court ruling on judicial review of a
    decision by the Iowa Workers’ Compensation Commissioner, seeking a finding of
    permanent total disability and additional penalty benefits. Envoy Air, Inc., doing
    business as American Airlines Group, and its insurer, New Hampshire Insurance
    Company, (collectively “AA”) cross-appeal the same ruling, claiming Drahozal only
    sustained scheduled injuries, did not establish an industrial disability, the court
    should not have awarded penalty benefits, and Drahozal was not entitled to
    healing-period benefits.     We affirm the commissioner’s rulings on industrial
    disability and healing-period benefits. We affirm in part and reverse in part the
    commissioner’s penalty-benefits ruling and remand to the district court with
    instructions.
    I. Background Facts & Proceedings
    The district court clearly identified the relevant facts:
    Drahozal was injured while employed by American Airlines
    working at the Eastern Iowa Airport in Cedar Rapids, Iowa. She had
    been employed by them for approximately sixteen years. As part of
    her duties, Drahozal was responsible for de-icing the planes in the
    winter. On January 4, 2015, while she was de-icing the planes,
    seepage from the de-icing solution soaked through her gloves onto
    her hands. Because her hands were already cold and thus partially
    numb, she did not realize the possible damage that had occurred.
    Over the next few days after the incident, Drahozal’s fingers began
    turning “reddish-brown” causing her to decide she needed to report
    the injury to her supervisor.
    On January 11, 2015, Drahozal went to the St. Luke’s
    Emergency Department for pain and swelling in her fingers. She was
    diagnosed with frostbite of eight fingers with a blister and necrosis by
    Dr. Nathan Harmon, M.D. Dr. Harmon referred Drahozal to the
    University of Iowa Hospitals and Clinics (UIHC) Burn Treatment
    Center.
    Drahozal was seen at the UIHC Burn Center on January 12,
    2015. She was seen by Robin Behr, Advanced Registered Nurse
    3
    Practitioner. Behr tended to Drahozal’s wounds and prescribed . . .
    a prescription pain medication.
    Drahozal visited the UIHC Burn Center again for pain in her
    fingertips on January 22, 2015 and was again seen by Behr. Behr
    noted Drahozal had “firm, black eschar on the end of digit 2 of the
    left hand. The distal ends of digit 2 of left hand and digit 3 of right
    hand are hardened to touch and fingertips with minimal sensation.”
    Behr prescribed [a different] prescription pain medication to treat the
    pain.
    Drahozal was seen again on January 29, 2015, at the UIHC
    Burn Center by Robert Lewis II, Physician Assistant. Lewis found
    Drahozal suffered frostbite to all of her fingers except to her fifth digit,
    or “pinky finger.” Lewis further found the deepest injury was to her
    middle finger tips as they were swollen and showed a loss of tissue.
    Lewis restricted Drahozal to temperatures between sixty and eighty
    degrees and told her to avoid harsh chemicals and blunt trauma.
    Lewis then recommended Drahozal wait one-year before having an
    impairment evaluation in order to monitor how her fingers recover
    over time.
    Drahozal continued treatment and, at one point, a brown tip
    fell off her finger. She remained in pain, her hands were stiff and she
    was mostly unable to use her hands for their regular functions.
    Gretchen Kass, Advanced Registered Nurse Practitioner, prescribed
    [another medication] for the pain, referred her to occupational
    therapy, and restricted Drahozal from working.
    On March 19, 2015, Drahozal was seen at the UIHC Burn
    Clinic for extreme pain in her fingers causing her anxiety. Lewis
    prescribed [medication] to help Drahozal sleep and referred her to
    the UIHC Pain Management Clinic and for counseling services.
    Drahozal began receiving treatment at the UIHC Pain
    Management Clinic in July 2015. She saw Dr. Shuchita Garg, M.D.
    who recommended pharmacologic treatment, use of a TENS unit, [1]
    desensitization exercises, occupational therapy, pain psychology,
    and counseling.
    Drahozal attended an appointment with Frank Gersh, Ph.D,
    as an authorized workers compensation psychological provider on
    October 27, 2015. Dr. Gersh diagnosed Drahozal with major
    depressive disorder, single episode, moderate. She continued to
    receive treatment from Dr. Gersh who restricted Drahozal from
    working on January 13, 2016.
    1“A transcutaneous electrical nerve stimulation (TENS) unit is a device that sends
    small electrical currents to targeted body parts. These currents are used to relieve
    pain. . . . These pulses control pain signals in the body, creating temporary or
    permanent relief from pain.” Transcutaneous Electrical Nerve Stimulation Unit,
    Healthline,     https://www.healthline.com/health/transcutaneous-electrical-nerve-
    stimulation-unit (last visited Apr. 2, 2021).
    4
    Dr. Joseph Chen, M.D. conducted an independent medical
    examination of Drahozal on January 25, 2016. He diagnosed her
    with chronic bilateral fingertip pain related to a work injury. He opined
    that no further treatments were likely to help and all treatments
    should be discontinued. Dr. Chen placed Drahozal on maximum
    medical improvement [(MMI)] and released Drahozal to return to
    work with no restrictions. Dr. Chen assigned a two percent body as
    a whole impairment rating.
    Dr. Gersh continued to treat Drahozal every two weeks for
    major depressive disorder which he confirmed was related to her
    work injury. He reported she needed additional treatment and
    referred Drahozal to psychiatrist, Dr. Mark Mittauer, M.D.
    On June 3, 2016, New Hampshire informed Drahozal that
    because Dr. Chen had placed her at [MMI], without restrictions, they
    would not pay [additional] healing period benefits.
    On June 24, 2016, Drahozal had a psychiatric evaluation with
    Dr. Mittauer. Dr. Mittauer diagnosed Drahozal with major depressive
    disorder, single episode, severe, without psychotic features,
    generalized anxiety disorder, other specified anxiety disorder
    including panic attacks and an insomnia disorder. Dr. Mittauer
    prescribed [medications] and discontinued the use of [the prior sleep
    medication].
    During this time, . . . an unrelated [family event occurred,]
    which New Hampshire claims caused Drahozal’s continued
    symptoms.
    [On June 27, 2016, Dr. Gersh informed New Hampshire that
    Drahozal was participating more in activities of daily life and no
    restrictions had been imposed on her ability to work. Dr. Gersh
    recommended Drahozal not return to work until employment could
    be found that she could perform despite her hand sensitivity and
    pain.]
    On July 20, 2016, Drahozal notified [AA] she was retiring.
    On September 1, 2016, Dr. Mittauer issued an opinion letter
    diagnosing Drahozal with major depressive disorder caused by her
    January 2015 work injury.
    New Hampshire retained two doctors to conduct independent
    psychiatric evaluations of Drahozal, Dr. Terrence Augspurger, M.D.,
    and Amy Mooney, Ph.D. They each reviewed the records and
    examined Drahozal. They both diagnosed Drahozal with major
    depressive disorder, recurrent, with prior depressive episodes
    following pregnancy and delivery, severe with anxious distress, and
    other specified personality disorder with borderline dependent
    features. They found no causation, claiming if a history of previous
    episodes were acknowledged, then any new episode is likely just a
    5
    manifestation of the pre-existing event based on the AMA Guide to
    the Evaluation of Disease and Causality and Injury Causation.[[2]
    On October 3, 2016, New Hampshire informed Drahozal that
    her injuries were due to stress caused by family events and not her
    work injury and additional treatment would not be authorized.
    [On February 10, 2017,] Dr. Mittauer responded to the report
    prepared by Drs. Augspurger and Mooney and said they provided no
    documentation of any symptoms Drahozal had at the time of
    postpartum depression that would lead to their diagnosis. Dr.
    Mittauer opined that Drahozal’s depression following the delivery of
    her children did not manifest severe enough symptoms to meet the
    criteria for major depressive disorder and that any symptoms from
    that event had resolved completely. He also opined she had
    sufficient symptoms to satisfy a separate diagnosis of generalized
    anxiety disorder. [Dr. Mittauer then placed her at MMI as to her
    psychiatric conditions and opined her mental health would “interfere
    with her ability to participate in full-time gainful employment.”]
    On March 22, 2017, New Hampshire sent Drahozal a letter
    informing her that because Dr. Augspurger did not find causation,
    they were disputing all liability as to further care and treatment
    including the mental health treatment.
    On April 17, 2017, Dr. Gersh opined he had diagnosed
    Drahozal with major depressive disorder and opined it was caused
    by her work injury. . . . Drahozal also retained Dr. Sunil Bansal, M.D.,
    an occupational medicine physician to conduct an independent
    medical examination. Dr. Bansal opined Drahozal suffered frostbite
    and assigned a nine percent body as a whole impairment for the
    dominant right hand injuries and a four percent body as a whole
    impairment for the left hand, with a thirteen percent total body as a
    whole impairment. Dr. Bansal recommended a five pound lifting
    restriction and no frequent squeezing, pinching or grasping.
    Dr. Bansal also diagnosed Drahozal with complex regional pain syndrome in her
    hands.
    On June 5, 2017, Dr. Mittauer prepared an opinion letter citing Drahozal’s
    work injury as “a substantial contributing factor” to her mental-health disorders.
    Dr. Mittauer opined Drahozal’s depression, anxiety, and insomnia disorders were
    2Drahozal’s youngest child had been born around twenty-five years earlier, and
    she had not previously been diagnosed with post-partum depression.
    6
    permanent conditions and would “more likely than not” continue as long as she
    had persistent pain and associated disability.
    When asked for his opinion, Dr. Chen disagreed with the complex-regional-
    pain-syndrome diagnosis, instead suggesting pain and fear-avoidance behaviors
    related to anxiety could explain the signs and symptoms.
    Drahozal filed a petition in arbitration with the workers’ compensation
    commissioner on July 18, 2016 (two days before her retirement). She listed as the
    part of the body affected or disabled “body as a whole.” AA admitted the finger
    injuries but denied any psychiatric sequelae.
    The arbitration hearing occurred on August 14, 2017. Drahozal was still
    seeing Dr. Gersh and Dr. Mittauer, but her appointments had decreased to one
    every six weeks.     She reported feeling much better in the past six months.
    Drahozal testified she had to modify how she performed activities with her hands
    due to numbness and sharp pain at times. With regard to her mental health, she
    reported a lack of confidence and motivation and poor energy. Drahozal had not
    applied for any jobs since retiring in July 2016, stating, “I don’t think I’m ready to
    do anything. Eventually I will be.” She later mentioned wanting to volunteer in a
    classroom in the school system.
    The arbitration decision was filed December 21, 2017.             The deputy
    commissioner found Dr. Chen’s and Dr. Mittauer’s expert opinions the most
    persuasive. The deputy found Drahozal “established she sustained mental-health
    sequelae as a result of her work injury, and thus has established she has sustained
    an industrial disability.” The deputy found Drahozal was “capable of retraining”
    and had failed to establish a permanent total disability under statute or under the
    7
    odd-lot doctrine. The deputy found Drahozal sustained an eighty-percent industrial
    disability as a result of the frostbite and mental-health injury and awarded her 400
    weeks of permanent partial disability benefits. The deputy adopted Dr. Mittauer’s
    MMI determination for Drahozal’s mental health and awarded healing benefits for
    the period from January 12, 2015, through February 10, 2017. The deputy also
    awarded penalty benefits for eleven delayed payments of Drahozal’s weekly
    benefits3 but denied penalty benefits related to the mental-health sequela injury,
    finding “at the time of the denial, the claim was fairly debatable.”
    Both parties appealed to the commissioner. On September 12, 2018, the
    commissioner affirmed and adopted the arbitration decision in its entirety.
    Drahozal filed a petition for judicial review of the commissioner’s decision,
    asserting all the grounds for reversal allowed under Iowa Code section 17A.19(10)
    (2017), without stating any specific facts or assertions relating to any particular
    ground. AA filed a counter-petition for judicial review, asserting many of the same
    legal grounds as Drahozal.
    On April 5, 2019, the district court held a hearing in the matter. The district
    court found substantial evidence supported the ruling of the commissioner and
    affirmed on all issues. Drahozal appeals, and AA cross-appeals.
    II. Scope and Standard of Review
    “Judicial review of workers’ compensation cases is governed by Iowa Code
    chapter 17A.    On our review, we determine whether we arrive at the same
    3The delayed payments were issued February 6, March 2, April 27, and June 22,
    2015, as well as February 2, 17, 22, and March 15, 2016.
    8
    conclusion as the district court.” Warren Props. v. Stewart, 
    864 N.W.2d 307
    , 311
    (Iowa 2015) (citation omitted).
    A district court decision rendered in an appellate capacity is
    examined for correction of errors at law. In making such a
    determination, we apply the standards of Iowa Code section
    17A.19[(10)], which provides an agency decision may be reversed
    where substantial rights of a party have been prejudiced and the
    action is unsupported by substantial evidence or affected by errors
    of law, to determine if our conclusion would be the same as that of
    the district court.
    Christensen v. Snap-On Tools Corp., 
    554 N.W.2d 254
    , 257 (Iowa 1996) (citation
    omitted); see also Puntenney v. Iowa Utils. Bd., 
    928 N.W.2d 829
    , 836 (Iowa 2019).
    “Just because the interpretation of the evidence is open to a fair difference
    of opinion does not mean the commissioner’s decision is not supported by
    substantial evidence.     An appellate court should not consider evidence
    insubstantial merely because the court may draw different conclusions from the
    record.” Arndt v. City of Le Claire, 
    728 N.W.2d 389
    , 393 (Iowa 2007) (citation
    omitted). “‘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.” Iowa Code
    § 17A.19(10)(f)(1). “It is the commissioner’s duty as the trier of fact to determine
    the credibility of the witnesses, weigh the evidence, and decide the facts in issue.
    The reviewing court only determines whether substantial evidence supports a
    finding ‘according to those witnesses whom the [commissioner] believed.’” Arndt,
    
    728 N.W.2d at
    394–95 (alteration in original) (citations omitted).
    9
    III. Drahozal’s Appeal
    Drahozal appeals (1) the commissioner’s determination her frostbite injuries
    did not result in permanent total disability and (2) the commissioner not awarding
    penalty benefits for the denied healing-period benefits related to the mental-health
    sequela injury between June 2016 and February 2017.
    A. Disability Rating. Drahozal’s first claim on appeal is the commissioner
    erred in not finding she was permanently and totally disabled under the statute or
    the odd-lot doctrine.   Drahozal argues the combination of her hand injuries,
    depression, age, and education level means there are no jobs in the community
    for which she can realistically compete. Drahozal claims,
    The only factor which weighed against a finding of permanent and
    total disability was Drahozal’s lack of motivation to find work and
    therefore, lack of work search. However, it was arbitrary and/or
    capricious for [the deputy], the commissioner, and the district court
    to use Drahozal’s alleged “lack of motivation” against her because
    her lack of motivation stemmed directly from her work injury.
    “Industrial disability measures an injured worker’s lost earning capacity.”
    Second Injury Fund v. Nelson, 
    544 N.W.2d 258
    , 265 (Iowa 1995). The focus of an
    industrial disability determination is the ability of the claimant to be gainfully
    employed; it is not merely an evaluation of what the claimant can or cannot do. Id.
    at 266. We inquire whether “there [are] jobs in the community that the employee
    can do for which the employee can realistically compete.” Second Injury Fund v.
    Shank, 
    516 N.W.2d 808
    , 815 (Iowa 1994). This requires consideration of those
    factors that bear on the claimant’s employability, including “age, intelligence,
    education, qualifications, experience, and the effect of the injury on the worker’s
    10
    ability to obtain suitable work.’” Guyton v. Irving Jensen Co., 
    373 N.W.2d 101
    , 103
    (Iowa 1985).
    Drahozal ignores the substantial evidence weighing in favor of the
    commissioner’s ruling. Dr. Chen released her to return to work with no medical
    restrictions in early 2016. Dr. Mittauer’s 2017 evaluation found Drahozal’s mental
    health would interfere with full-time gainful employment, but that allows space for
    Drahozal to work at a job with reduced hours. At the arbitration hearing, Drahozal
    reported feeling better and having less anxiety and stated she was taking up more
    tasks at home. After observing Drahozal’s testimony and reviewing the evidence,
    the deputy found “Drahozal is capable of retraining” but was not motivated to return
    to work. Substantial evidence supports the commissioner’s finding Drahozal’s
    earning capacity had been reduced by eighty percent as a result of her hand
    injuries and mental-health sequela, but she was capable of some level of
    employment.
    Odd-Lot Doctrine.    Drahozal asserts if she is not permanently totally
    disabled under the statute, then the court should apply the odd-lot doctrine to find
    her incapable of obtaining employment.
    “An odd-lot employee is one who is incapable of finding work in any
    established branch of the labor market.” Nelson, 544 N.W.2d at 267. The burden
    is on the employee to produce “substantial evidence that the worker is not
    employable in the competitive labor market.” Id. (emphasis omitted) (quoting
    Guyton, 
    373 N.W.2d at 106
    ). “[I]t is ‘normally’ incumbent on the claimant ‘to
    demonstrate a reasonable effort to secure employment’ in the worker’s area of
    11
    residence before the burden of producing evidence shifts to the employer.” 
    Id.
    (citations omitted).
    To make a prima facie case of odd-lot disability, Drahozal had the burden
    of producing substantial evidence she was not employable in any capacity in her
    labor market, not just that she could not perform her former job.            Drahozal
    produced no evidence to support her claim of being unable to work—she did not
    apply for any jobs, did not seek an evaluation from a vocational rehabilitation
    specialist, and did not produce evidence she was not employable in the Cedar
    Rapids labor market.
    The deputy commissioner found Drahozal failed to present a prima facie
    case of odd-lot unemployability. The commissioner agreed “claimant failed to carry
    her burden of proof that she is permanently and totally disabled under either the
    traditional industrial disability analysis or under the odd-lot analysis.” We affirm.
    B. Denied Penalty Benefits.        Drahozal claims the court erred in not
    awarding her penalty benefits for the period of June 6, 2016, through February 10,
    2017, when AA denied healing period benefits to cover her mental-health
    treatment.
    The Iowa Code specifies when the commissioner is to award penalty
    benefits:
    If a denial, a delay in payment, or a termination of benefits
    occurs without reasonable or probable cause or excuse known to the
    employer or insurance carrier at the time of the denial, delay in
    payment, or termination of benefits, the workers’ compensation
    commissioner shall award benefits in addition to those benefits . . .
    up to fifty percent of the amount of benefits that were denied,
    delayed, or terminated without reasonable or probable cause or
    excuse.
    12
    
    Iowa Code § 86.13
    (4)(a). A “reasonable or probable cause or excuse” must be
    preceded by a reasonable investigation and evaluation into whether benefits are
    owed; the results of the investigation were the basis upon which the employer
    relied for denial, delay, or termination; and the employer or insurance carrier
    informed the employee of that basis at the time of the denial, delay, or termination.
    
    Id.
     § 86.13(4)(c)(1)–(3).
    Healing period benefits “sustain[ ] the injured employee during
    convalescence and disability from work.” Waldinger Corp. v. Mettler, 
    817 N.W.2d 1
    , 7 (Iowa 2012). The employer owes the employee healing period compensation
    beginning on the first day of disability after the injury, and until the
    employee has returned to work or it is medically indicated that
    significant improvement from the injury is not anticipated or until the
    employee is medically capable of returning to employment
    substantially similar to the employment in which the employee was
    engaged at the time of injury, whichever occurs first.
    
    Iowa Code § 85.34
    (1).
    When evaluating whether penalty benefits were owed between June 2016
    and February 2017, the commissioner adopted the arbitration ruling:
    After receiving the opinion from Drs. Augspurger and Mooney
    of no causation, American and New Hampshire denied causation
    with respect to Drahozal’s alleged mental health sequela injury.
    American and New Hampshire notified Drahozal of the denial.
    Based on the opinions received at the time of the denial, the claim
    was fairly debatable. I decline to award penalty benefits on this
    ground.
    AA stopped paying healing-period benefits in March 2016, relying on
    Dr. Chen’s opinion Drahozal had reached MMI and could return to work without
    restrictions.   Dr. Chen’s report indicated he discussed Drahozal’s condition
    extensively with her and what activities she was medically able to do.
    13
    In April 2016, Dr. Gersh wrote to inform Drahozal’s counsel he had been
    notified treatment was no longer authorized and his treatment of her “was related
    to her frostbite injury.” Counsel for AA in May indicated Drahozal “is still at MMI so
    we would not be reinstating healing period.” Counsel again informed Drahozal’s
    counsel in June she would not be paid additional healing period benefits because
    Dr. Chen placed her at MMI and released her to full duty, so “there is no medical
    [reason] which keeps your client off work.”
    Causation and compensability of Drahozal’s mental health continued to be
    disputed by Drahozal and AA at the arbitration hearing and through all subsequent
    appeals. Drahozal reached MMI on her physical injury, which had paused her
    employment, and was released as medically capable to return to work. Under all
    the circumstances, we conclude substantial evidence supports the commissioner’s
    denial of penalty benefits between June 2016 and February 2017. We affirm.
    IV. AA’s Cross-Appeal
    AA asserts three claims in its cross-appeal relating to the mental-health
    sequela and the penalty benefits awarded by the commissioner.
    A. Mental-Health Sequela. First, AA asserts the commissioner erred in
    finding Drahozal’s depression was a result of her work injury and instead the
    commissioner should have found minimal industrial disability.          AA relies on
    Dr. Augspurger and Dr. Mooney’s evaluation of Drahozal’s mental health and
    14
    states substantial evidence only supports the scheduled-member injuries to
    Drahozal’s fingers.4
    On appeal, we do not re-weigh the evidence to come to a new finding.
    Arndt, 
    728 N.W.2d at 395
    . Rather, we merely determine if substantial evidence
    supports a finding according to the evidence believed by the commissioner. 
    Id.
    The reports from both Dr. Gersh and Dr. Mittauer support the commissioner’s
    finding Drahozal’s work-related physical injuries caused her to experience a “major
    depressive episode” affecting her ability to work.        The commissioner found
    Dr. Mittauer was more persuasive than Dr. Augspurger and Dr. Mooney regarding
    the question of Drahozal’s mental-health injury. See Cedar Rapids Cmty. Sch.
    Dist. v. Pease, 
    807 N.W.2d 839
    , 845 (Iowa 2011) (“Ultimately, however, the
    determination of whether to accept or reject an expert opinion is within the ‘peculiar
    province’ of the commissioner.” (citation omitted)). Substantial evidence thus
    supports the commissioner’s finding Drahozal experienced mental-health sequela
    as a result of her work injury.
    B. Awarded Penalty Benefits. Next, AA contests the penalty benefits
    awarded to Drahozal in the amount of $3611 relating to eleven late healing-period
    benefit payments.
    Iowa Code section 85.30 prescribes the time for investigation and requires
    “[c]ompensation payments shall be made each week beginning on the eleventh
    day after the injury, and each week thereafter during the period for which
    4 The workers’ compensation act establishes a predetermined permanent partial
    disability compensation for injuries or loss of specific body parts, including a set
    amount for the loss of each full or partial finger. 
    Iowa Code § 85.34
    (2)(a)–(f).
    15
    compensation is payable.” “[I]f Monday is the first day of the compensation week,
    full payment of the weekly compensation is due the following Monday.”
    Robbennolt v. Snap-On Tools Corp., 
    555 N.W.2d 229
    , 235 (Iowa 1996). “[W]eekly
    compensation payments are ‘made’ when they are mailed to the claimant, not
    when they are received.” 
    Id. at 236
    .
    Drahozal sustained her injury on January 4, 2015, though it is unclear if she
    reported it before January 11. The first payment was issued on February 6, 2015.
    AA states the initial check’s delay at the beginning of the injury was necessary time
    for investigation of the claim and obtaining medical opinions and records.
    However, even counting from when Drahozal ceased working on January 12,
    Drahozal was owed her first compensation payment two weeks before AA issued
    it. This delay was unreasonable, and the commissioner did not err in awarding
    penalty benefits.
    Five of the late payments—issued on March 2, March 15, April 27, June 22,
    2015, and February 22, 2016—were issued the Monday after the compensation
    week. The compensation week for each of the payments started the Monday
    before, and AA argues that under Robbennolt the payments were due on the days
    the checks issued. See 
    555 N.W.2d at 235
    ; see also Goodman v. Snap-On Tools
    Corp., No. 03-0414, 
    2004 WL 2066941
    , at *3 (Iowa Ct. App. Sept. 9, 2004) (“The
    . . . due dates fall on the day after the end of each compensation week . . . that is,
    the eighth day after the first day of each subsequent compensation week.”).
    Drahozal argues the payments were due at the end of the compensation week,
    and in any event AA did not prove the payments were mailed out on the date they
    were issued.
    16
    If the five checks were mailed the day they were issued, then they were
    timely under Robbennolt. See 
    555 N.W.2d at 235
    . If they were mailed on a later
    date, they were late.    Penalty benefits are not awarded under Iowa Code
    section 86.13(4) unless “[t]he employee has demonstrated a denial, delay in
    payment, or termination of benefits.” Therefore, Drahozal had the burden of
    demonstrating the checks were mailed late to be awarded penalty benefits. She
    did not do so.    Substantial evidence does not support this portion of the
    commissioner’s ruling.
    Four other payments—issued on February 2, February 10, February 17,
    and March 15, 2016—were issued two or three days late. AA did not provide an
    explanation for these late-paid benefits. On appeal, AA asserts—without citing
    any legal authority—the payments were “minimally late” so only a minimal penalty
    should be assessed. The application of the penalty provision does not turn on the
    length of the delay in making the correct compensation payment. “Any delay
    without reasonable excuse entitles the employee to benefits in some amount.”
    Robbennolt, 
    555 N.W.2d at 236
    . The commissioner correctly awarded penalty
    benefits for these unexplained late payments.
    The final late payment was a March 31, 2016 lump sum payment for
    permanent partial disability relating to Drahozal’s hands based on Dr. Chen’s MMI
    determination. AA claims they needed to conduct a reasonable investigation into
    the entitlement to permanent benefits. As Drahozal points out, Dr. Chen issued
    his report on January 25. AA stopped paying healing benefits as of March 14. Any
    reasonable investigation would have been completed before healing period
    17
    benefits were halted. The commissioner did not err in awarding penalty benefits
    for this late payment.
    The commissioner can award up to fifty percent of the amount of
    unreasonably delayed benefits as a penalty under Iowa Code section 86.13. See
    Schadendorf v. Snap-On Tools Corp., 
    757 N.W.2d 330
    , 336 (Iowa 2008). “The
    factors the commissioner should consider when awarding penalty benefits are ‘the
    length of the delay, the number of the delays, the information available to the
    employer regarding the employee’s injuries and wages, and the prior penalties
    imposed against the employer under section 86.13.’” 
    Id.
     (quoting Robbennolt, 
    555 N.W.2d at 238
    ). The penalty benefits awarded are within the statutory limits.
    Penalty benefits were wrongly awarded on five payments that Drahozal did
    not prove were late. Those five payments—each for $328.34—totaled $1641.70.
    The commissioner awarded a fifty-percent penalty benefit for the late payments—
    $820.85. Therefore, we reduce the penalty benefits award by $820.85. We affirm
    the awarded penalty benefits in the amount of $2790.15.
    C. Healing Period Benefits, Medical Expenses, and Costs. Finally, AA
    asserts because Drahozal is not entitled to benefits relating to her mental-health
    sequela, she is not entitled to the related healing-period benefits, medical
    expenses, or costs and those awards should be reversed. Because we have
    already confirmed benefits were properly awarded for her mental-health sequela,
    we affirm these rulings.
    V. Conclusion
    We conclude the district court erred in upholding a portion of the
    commissioner’s penalty-benefits award. We remand to the district court with
    18
    instruction to remand the matter to the workers’ compensation commissioner to
    amend the penalty-benefits award consistent with this opinion. On all of the
    remaining issues, we affirm.
    AFFIRMED ON APPEAL; AFFIRMED IN PART, REVERSED IN PART,
    AND REMANDED ON CROSS-APPEAL.