NWCDN Members regularly post articles and summary judgements in workers’ compensations law in your state.
Select a state from the dropdown menu below to scroll through the state specific archives for updates and opinions on various workers’ compensation laws in your state.
Contact information for NWCDN members is also located on the state specific links in the event you have additional questions or your company is seeking a workers’ compensation lawyer in your state.
Legal Update by Attorneys Alison Stewart and Jordan Gehlhaar and Law Clerk Darbi Spellman
The issues in Bryan Barry v. John Deere Dubuque Works of Deere & Company were (1) whether the Commissioner abused his discretion when he rejected an expert opinion for lack of credibility, and (2) whether the Commissioner could determine the AMA Guides were misapplied. The Claimant, Bryan Barry, suffered from bilateral carpal tunnel syndrome that arose out of and in the course of his employment with John Deere Dubuque Works. In the arbitration decision in 2017, the Deputy Commissioner determined that Barry sustained permanent partial disability of 11% to the body as a whole due to bilateral arm injuries. In 2019, Barry filed a review-reopening petition, claiming that his carpal tunnel syndrome had worsened since the arbitration decision. His petition was denied, and he appealed.
Following the arbitration award, Barry received medical care for shoulder pain he began to experience and reported some hand numbness. To support his review-reopening, Claimant had an IME with Dr. Stanley Matthew. He used Table 16-18 of the AMA Guides to evaluate Barry’s injuries and concluded that Barry had permanent impairment at “a 10% upper extremity rating to each of his elbows, a 15% upper extremity impairment of his wrists, and a 15% impairment rating as a result of loss of function of his finger joints.” Dr. Matthew further determined that Barry’s shoulder pain was separate from his other diagnoses, and he added further permanent restrictions.
Barry’s review-reopening petition was denied for failure to meet the burden of proof. The Deputy Commissioner specifically found that Dr. Matthew was not credible because he used “incorrect” sections of the AMA Guides to determine Barry’s impairment. On appeal, Barry argued the Commissioner abused his discretion by rejecting Dr. Matthew’s opinion.
Claimant first argued that the opinion should not have been rejected because it was the only opinion in the record. The Court of Appeals disagreed, stating that expert testimony may be rejected in whole or in part—even if the only opinion in the record—and the Commissioner as trier of fact is tasked with credibility determinations. However, it was found that the opinion of Dr. Sassman from the Arbitration Hearing was considered part of the record.
Barry also relied on Iowa Code Section 85.35(2)(x), which provides:
[W]hen 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 [AMA Guides], 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 paragraph “a” through “u”, or paragraph “v” when determining functional disability and loss of earning capacity.
Claimant Barry argued this section prevents the Commissioner from finding a physician misapplied the AMA Guides. The Court of Appeals again disagreed. Dr. Matthews provided no explanation of how he reached his figures or why he relied on the portion of the AMA Guides he did. The Commissioner comparing this to Dr. Sassman’s detailed explanation, and weighing credibility, did not “run afoul of the statutory prohibition on determining ‘the extent of loss or percentage of permanent impairment’” in 85.34(2)(x).
Finally, it was found that Barry’s shoulder injury is new, and under Iowa Code § 86.14(2) for reopening an award, new injuries cannot increase the original impairment rating. New injuries are not to be deemed as a worsening of old injuries and are to be pursued in a separate proceeding.
Peddicord Wharton will continue to monitor case law on this issue.
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NOTICE TO THE PUBLIC
The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. This disclosure is required by rule of the Supreme Court of Iowa.
Peddicord Wharton Legal Updates are intended to provide information on current developments in legislation impacting our clients. Readers should not rely solely upon this information as legal advice. Peddicord Wharton attorneys would be pleased to answer any questions you may have about this update. ©2023 Peddicord Wharton. All Rights Reserved.
The Iowa Division of Workers’ Compensation has released updated rate information that will be in effect from July 1, 2023 through June 30, 2024. Peddicord Wharton has updated its rate and interest calculators which can be found on our website under the Resources page. We hope you will take advantage of these resources we have there for you, including our legal blog.
The Iowa Division of Workers’ Compensation releases annual rate information for mileage reimbursement and the following types of weekly workers’ compensation benefits: temporary total disability (TTD), healing period (HP), permanent partial disability (PPD), permanent total disability (PTD), and death.
Legal Update by Attorney Alison Stewart
Once the Iowa Workers’ Compensation Commissioner makes an arbitration award, instead of receiving permanent disability or death benefits on a weekly basis, the Claimant can opt to receive payment in a lump sum. In some cases, both parties elect this option as a way to resolve a particular claim. The legislative changes in 2017 impacted these provisions in that commutations of any type could only be obtained with the consent of both parties and upon approval by the Commissioner. In cases where both parties are in agreement that a commutation is appropriate, these new changes will remove the barriers to this type of resolution that had previously been in place. Prior to the rule change, all commutations required (1) the Claimant to establish financial need to receive an award in a lump sum, and (2) a prescribed period of remaining benefits (10 consecutive, un-accrued weeks of indemnity benefits). Previously, in order to make use of the Full Commutation option for resolution, the parties were required to establish that a minimum of ten un-accrued indemnity benefits remained outstanding.
6.2(6): Statement of Need: "If all parties are represented by an attorney, the parties may waive the statement of need, unless the case involves a dependent who is a minor."
6.2(9): Best Interests of Claimant: "If all parties are represented by an attorney, a commutation of benefits is presumed to be in the best interests of the claimant."
6.2(10) Definitely Determined Period of Time: "If all parties are represented by an attorney, the parties may stipulate to the definitely determined period of compensation."
Going forward, where both parties are represented and are in agreement that a commutation is appropriate, a commutation will be presumed to be in the best interest of the Claimant. Practically speaking, this means Claimants will no longer be required to identify on the Full Commutation documents why they are in need of a lump sum settlement or how they intend to spend their settlement proceeds, unless they are a minor. In addition, where all parties are represented, the parties may stipulate to the period of commutation involved in commuting the award or settlement. Parties attempting to settle via Full Commutation will no longer be required to establish consecutive weeks of indemnity paid in the past or that there are at least ten remaining weeks owed in the future to satisfy the prior Full Commutation requirements. Parties now merely need to agree on the period of compensation. Note, pursuant to Iowa Administrative Code section 876-6.3(2), unless the discount is waived by the insurance carrier, the future benefits that are commuted are discounted to their present value at the rate of interest on judgments and decrees.
These rules went into effect March 25, 2023 for Full Commutations going forward.
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NOTICE TO THE PUBLIC
The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. This disclosure is required by rule of the Supreme Court of Iowa.
Peddicord Wharton Legal Updates are intended to provide information on current developments in legislation impacting our clients. Readers should not rely solely upon this information as legal advice. Peddicord Wharton attorneys would be pleased to answer any questions you may have about this update. ©2023 Peddicord Wharton. All Rights Reserved.
Legal Update by Attorney Alison Stewart and Law Clerk Morgan Todd Borron
When a worker falls at work, and the fall cannot be
attributed to an acute event caused by the work (e.g., tripping over an object,
slipping on ice or water, losing balance while carrying an object, etc.), the
fall will likely fall into one of two categories: idiopathic or unexplained.
These types of falls require additional analysis into compensability. An idiopathic
fall is one that originates from a purely personal condition to the
claimant. See Koehler Elec. v. Wills, 608 N.W.2d 1, 4 (Iowa 2000)
(citing Arthur Larson, Workmen’s Compensation Law, sec. 12.11, at 3-356
(1994)); Bluml v. Dee Jay’s, Inc., 920 N.W.2d 82, 84 (Iowa 2018). An unexplained
fall is where a claimant trips, slips, or falls for no specifically
identifiable reason. Bartle v. Sidney Care, Inc., 672 N.W.2d 333, 2003
WL 22346956 at *2. (Iowa Ct. App. Oct. 15, 2003).
There are different standards that apply to these different
types of falls. In Bluml, the worker sustained an idiopathic fall.
The Iowa Supreme Court determined that “the claimant should have both the
burden and the opportunity to meet the increased-risk test[,]” and “may recover
if he or she proves that ‘a condition of his [or her] employment increased the
risk of injury.’” Bluml, 920 N.W.2d at 91 (quoting Koehler Elec.,
608 N.W.2d at 5). The Court noted that for unexplained falls, the
actual-risk rule is the appropriate standard. Bluml, 920 N.W.2d at fn.1.
Under the actual-risk doctrine, an injury is compensable “as long as the employment subjected [the] claimant to the actual risk that caused the injury.” Lakeside Casino v. Blue, 743 N.W.2d 169, 176 (Iowa 2007) (quoting Arthur Larson & Lex K. Larson, Larson’s Workers’ Compensation Law, sec. 3.04, at 3-5 (2007)). “[U]nder the actual-risk doctrine, the injury must result from a condition, risk, or hazard of employment.” Murray as Conservator of Meyers v. Lazer Spot, Inc., No. 21004833.01, 2022 WL 16826433 at *11 (Iowa Workers’ Comp. Comm’n Arb. Dec. July 28, 2022) (citing Lakeside Casino, 743 N.W.2d at 178; Hanson v. Reichelt, 452 N.W.2d 164, 168 (Iowa 1990)).
In Lakeside Casino, the worker was injured after she
stumbled while walking down stairs at work. The Iowa Supreme Court stated, “it
is a matter of common knowledge that stairs pose an actual risk of stumbling or
falling when traversing them, similar to the risk posed by going up and down
ladders. Although Blue did not stumble due to any particular defect in or
condition of the stairs, it is not necessary under Iowa case law that that the
stairs in Blue’s workplace be more dangerous than a typical set of steps. In
addition, it matters not that she stumbled through her own inattention. Blue’s
misstep was causally related to the fact that she was walking on stairs, and
therefore, the Commissioner rationally concluded her injury arose out of her
employment.” 743 N.W.2d at 177. The Court found that “Blue stumbled on the
stairs, the Commissioner finding that ‘the injury occurred from the
hazard of traversing stairs.’ It is this causal relationship between a
condition of Blue’s employment—the stairs—and her injury that distinguishes the
present case from those in which we have determined the employee’s injury was
not compensable” (referring to earlier discussion distinguishing McIlravy,
where EE injured knee walking across level floor; Gilbert, where EE
arguably injured neck straightening up from signing a document; Miedema,
where EE injured back turning to flush toilet; and Musselman, where EE
injured back leaning against wall for balance). Lakeside Casino, 743
N.W.2d at 177-178.
In Lapcheske v. Polk Cty., No. 5055505, 2019 WL 7559785 (Iowa Workers’ Comp. Comm’n App. Dec. Nov. 6, 2019), the worker suffered an unexplained fall on a hard floor (described as concrete, marble, or terrazzo throughout the record) resulting in an arm injury. The treating physician opined that claimant’s landing on a hard surface resulted in a “higher-energy fracture than if she would have fallen on carpet” and “elevated the severity” of the fracture; Dr. Bansal opined similarly. Lapcheske, at *3. The Commissioner stated, “Simply put, claimant’s arm was not fractured until it struck defendant’s floor. This factor distinguishes the injury from one that coincidentally occurs at work.” Id. at *4. The Commissioner held that “the hard floor in this case did present an actual risk of injury; in fact, the hard floor even went so far as to increase the risk of injury. Thus, applying the actual-risk doctrine to this case, I find the hard floor was a condition and ultimately a hazard of claimant’s employment.” Id.
In McClain v. Lennox, No. 1664566.01, 2021 WL 2624684
(Iowa Workers’ Comp. Arb. Dec. Apr. 22, 2021), affirmed 2021 WL 4447174
(Iowa Workers’ Comp. App. Dec. Sept. 22, 2021), the worker tripped and fell
landing on his right side. He thought he caught his toe on an uneven portion of
the cement floor or a corner of a pallet but was not sure. Defendants argued
that claimant’s fall was idiopathic or unexplained. The evidence presented at
hearing showed that claimant had caught his toe on some kind of crack or
obstruction, causing the fall and subsequent injury. McClain, 2021 WL
2624684 at *6. This was affirmed on appeal, with the Commissioner noting “I
therefore affirm the deputy commissioner’s finding that claimant’s fall was
explained, meaning the resulting injury arose out of and in the course of
claimant’s employment.” McClain, 2021 WL 4447174 at *1.
In 2019, there was amendment to Iowa Code section 85.61, adding that “Personal injuries due to idiopathic or unexplained falls from a level surface onto the same level surface do not arise out of or in the course of employment and are not compensable under this chapter.” Iowa Code 85.61(7)(c). In light of the subsequent case law, however, we think application of this amendment is limited to cases where the worker does not hit another object (like a wall, or a desk or shelf) on the way to the ground.
Peddicord Wharton will continue to monitor this evolving area of the law and provide relevant updates.
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NOTICE TO THE PUBLIC
The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. This disclosure is required by rule of the Supreme Court of Iowa.
Peddicord Wharton Legal Updates are intended to provide information on current developments in legislation impacting our clients. Readers should not rely solely upon this information as legal advice. Peddicord Wharton attorneys would be pleased to answer any questions you may have about this update. ©2023 Peddicord Wharton. All Rights Reserved.
Legal Update by Attorney Alison Stewart and Law Clerk Morgan Borron
In Tripp v. Scott County Emergency Communication Center, 977 N.W.2d 459 (Iowa 2022), the Iowa Supreme Court addressed whether Iowa law holds emergency workers to a separate, higher standard to be eligible to receive workers’ compensation benefits for trauma-induced mental injuries, than other workers who sustain identical injuries, but work in other roles. In this case, Claimant was diagnosed with PTSD after receiving a disturbing call from a mother who was screaming about the death of an infant. Claimant had worked in that role for approximately 16 years prior, but testified the screams in this call were “beyond ‘normal’ sounds: ‘guttural, awful.’” In the days that followed, Claimant became withdrawn, unable to process emotions, wanting to sleep, and tearful. The employer approved Claimant’s treatment with a licensed mental health counselor and psychologist, both of whom diagnosed Claimant as having suffered from PTSD as the result of the September 30, 2018 call.
Claimant’s treating psychologist testified her PTSD constituted a chronic episodic condition that resulted in a permanent disability. The Deputy Commissioner denied Plaintiff’s petition for workers’ compensation benefits because 911 dispatchers “’routinely’ take calls involving death and traumatic injuries” and that Plaintiff had failed to establish that the call was “unusual” or “unexpected” as required under the court’s prior mental injury cases. The Commissioner affirmed the Deputy’s Arbitration Decision, as did the District Court. Claimant appealed, which was retained by the Iowa Supreme Court.
Psychological injuries meet the definition of personal injuries for purposes of determining workers’ compensation benefit entitlement in Iowa, but employees claiming mental injuries must prove both medical and legal causation. See Brown v. Quik Trip Corp., 641 N.W.2d 725, 727-29 (Iowa 2002). The legal causation requirement could be satisfied where an “unusual strain” led to the mental injury. The Court held that based on the evidence, Plaintiff Tripp’s PTSD arose directly from her handling of the September 30, 2018, 911 call in the course of her work as an emergency dispatcher. The Court held that focusing on an employee’s job to determine an “unexpected strain” placed emergency workers in a disfavored position when compared to other workers. It held there should be no “heightened evidentiary hurdle” for these types of employees. Rather, because Claimant was able to prove her purely mental injury (PTSD) was traceable to a readily identifiable work event (the September 30, 2018, phone call) she had proven legal causation. The likely impact of this case is that this expands the compensability of mental injuries in Iowa.
The Commissioner awarded industrial disability in two cases involving the shoulder.
Both Carmer and Anderson are on appeal; however, they are the current law of the Agency and should be considered when evaluating shoulder cases.
In Martinez-Rivera v. Signet Builders, Inc., File No.: 5064517.01 (Arb. Dec. Sept. 16, 2021), the deputy commissioner held that the Claimant did not qualify for Second Injury Fund benefits because section 85.64(1) does not list the shoulder as an enumerated body part which may trigger Fund liability.
The question of whether a claimant was entitled to industrial disability pursuant to 85.34(2)(v) due to her voluntary choice to transfer to a lower-paying position with Defendant/Employer was addressed in Kish v. University of Dubuque, File No.: 5066482 (Arb. Dec. July 29, 2021), affirmed on appeal, (App. Dec. Nov. 30, 2021). In Kish, claimant injured her back on May 30, 2018, while working as a lead custodian for the University (making $1.00 more per hour than regular custodians). She was released to return to work without restrictions and placed at MMI on June 19, 2019 and returned to work that same day as a lead custodian, at the same rate of pay and working the same number of hours. Claimant did not think she would be able to handle the lead custodian position when students returned to campus, and so she bid into a regular custodial position in August 2019, which reduced her pay by $1.00/hour.
The deputy held that Claimant made a voluntary choice to transfer, that the University did not request/require Claimant to change positions, and no physician had imposed permanent restrictions that would prevent her from continuing to work as a lead custodian. In light of the above, the Deputy found that the employer had offered Claimant ongoing work in a position that paid the same or more than she earned on the date of injury, limiting her recovery to the functional impairment pursuant to 85.34(2)(v). Kish is currently being appealed.
The agency addressed employer responsibility for an alleged work related COVID-19 death in Bolton v. Marcus Lumber, File No. 20015335.01, 2022 WL 1787479 (Arb. Dec. Mar. 24, 2022).
To establish a compensable injury in Iowa, an employee must establish
that the injury has a causal connection to the employment. The question
of medical causation is “essentially within the domain of expert
testimony.” Cedar Rapids Cmty. Sch. Dist. v. Pease, 807 N.W.2d
839. 844-45 (Iowa 2011). Here, both parties presented expert witnesses
to opine when Bolton may have contracted COVID-19, which ultimately led
to his death. The employer provided evidence they followed all CDC
guidelines and precautions for their employees, including requiring
masks, social distancing, temperature checks, and negative COVID tests
for employees before return to work after exhibiting symptoms. In this
case, multiple employees had tested positive for COVID in the weeks
leading up to Bolton’s diagnosis, however, the employer was not found
liable. The Claimant did not meet the burden of proof where evidence was
introduced indicating Claimant was not following the CDC guidelines in
his personal life where he was gathering with family outside of his
household, going out to lunch, and working for the fire department all
while not wearing a mask.
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NOTICE TO THE PUBLIC
The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. This disclosure is required by rule of the Supreme Court of Iowa.
Peddicord Wharton Legal Updates are intended to provide information on current developments in legislation impacting our clients. Readers should not rely solely upon this information as legal advice. Peddicord Wharton attorneys would be pleased to answer any questions you may have about this update. ©2022 Peddicord Wharton. All Rights Reserved.
Read More
Legal Update by Attorneys Alison Stewart and Jordan Gehlhaar
The Iowa Division of Workers’ Compensation recently released a decision assessing how settlement with the Second Injury Fund (SIF) affects an injured employee’s claim against their employer and its insurance carrier in Milbrandt v. R.R. Donnelly.
The SIF compensates injured employees who have proven a previous qualifying injury, a second compensable work injury, and permanent disability resulting from each. In effect, the current employer is responsible only for the portion of disability attributable to the injury occurring during their employ; SIF assumes responsibility for the remainder of total disability.
Claimant Nancy Milbrandt filed a petition alleging a work related cumulative injury to her left and right arms and hands as of November 26, 2019. In addition to the employer and insurance carrier, the petition stated a claim against the Second Injury Fund of Iowa. Prior to the arbitration hearing, the claimant entered into a compromise settlement agreement with SIF, which was approved by the Workers’ Compensation Commissioner.
The subject of the settlement included the November 26, 2019 injury occurring with the defendant employer. As such, the employer argued that once the settlement was approved, the Commissioner lacked jurisdiction over the case. Claimant argued that the settlement was a contract binding only the parties—her and the SIF—and the case against her employer should still proceed to hearing.
The Deputy Commissioner focused on the language of Iowa Code Section 85.35(9): “an approved compromise settlement shall constitute a final bar to any further rights arising under this chapter . . . regarding the subject matter of the compromise . . . .” The Iowa Supreme Court had previously interpreted this language broadly. Accordingly, a previous decision by the Commissioner found that as a matter of law, a settlement with the SIF operated to deprive the agency of jurisdiction, meaning a claimant cannot re-litigate the same injury against the employer that was the subject of the settlement. This is true even when the parties include language attempting to preserve further claims against other defendants.
Since the date of injury against the employer was part of the subject matter of the approved settlement with the SIF, Claimant Milbrandt had no further rights under the workers’ compensation code. Employers and their insurance carriers should be aware their liability may be affected if the SIF is a co-defendant. However, this holding may affect claimants’ willingness to enter into settlement negotiations.
Peddicord Wharton will continue to monitor case law on this issue.
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NOTICE TO THE PUBLIC
The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. This disclosure is required by rule of the Supreme Court of Iowa.
Peddicord Wharton Legal Updates are intended to provide information on current developments in legislation impacting our clients. Readers should not rely solely upon this information as legal advice. Peddicord Wharton attorneys would be pleased to answer any questions you may have about this update. ©2022 Peddicord Wharton. All Rights Reserved.
Attorney Alison Stewart has been appointed to serve a second
term on the Workers’ Compensation Section Council of the Iowa State Bar
Association (ISBA) for 2022-2023. The ISBA is a vibrant organization due in
large part to its volunteers. This will be Alison’s second term of service on the Council.
The purpose of this ISBA Section is to provide an organization in which members who have an interest in workers' compensation can meet for discussion and exchange of ideas; to provide an opportunity for discussion and exchange of ideas leading to improvement of the abilities of its members to practice in this field; and to assist the Worker's Compensation Commissioner in establishing rules and procedures for the more certain and expeditious disposition of matters coming before the Commissioner.
Legal Update by Attorney Alison Stewart and Law Clerk Tori Biggerstaff
Governor Reynolds signed a bill relating to injured workers’ entitlement to prosthetic device needs as a result of work-related injuries. (H.F.2411). An Act Relating to Replacements of Permanent Prosthetic Devices for Injured Workers, was signed into law on June 15, 2022. This bill changes the prosthetic allotment for workers injured on the job. Prior to this bill, injured workers were allowed one permanent prosthetic over their lifetime. When a worker is injured in a compensable injury while employed, the employer is now responsible for replacement prosthetics. Now, injured workers are eligible for a replacement permanent prosthetic if theirs is damaged or made unusable by circumstance arising out of and in the course of employment. They are eligible for this replacement whether or not the artificial member was previously provided by the employer. The replacement of the prosthetic device is now included in an employer’s obligation to provide reasonable medical care for employees injured at work as required by Iowa Code section 85.27.
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NOTICE TO THE PUBLIC
The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. This disclosure is required by rule of the Supreme Court of Iowa.
Peddicord Wharton Legal Updates are intended to provide information on current developments in legislation impacting our clients. Readers should not rely solely upon this information as legal advice. Peddicord Wharton attorneys would be pleased to answer any questions you may have about this update. ©2022 Peddicord Wharton. All Rights Reserved.
Legal Update by Attorneys Alison Stewart and Tyler Smith, and Law Clerk Jordan Gehlhaar
Significant debate has stemmed from the legislature’s addition of the “shoulder” to Iowa Code Section 85.34(2). The Iowa Supreme Court settled this debate, in part, in their recent decisions, Chavez v. M.S. Technology and Deng v. Farmland Foods.
Prior to the 2017 amendment, shoulder injuries were considered a “whole person” or “body as a whole” injury, which result in industrial disability analysis. In contrast, for scheduled injuries, claimants receive a rating of their functional impairment to the body part; this is multiplied by the number of weeks provided by the legislature (400 weeks for the shoulder) to ascertain the number of weeks in which compensation is due. However, since the amendments, claimants have consistently argued industrial disability analysis is still appropriate for shoulder injuries despite the legislative change—focusing on the anatomy of the shoulder. This created an issue of statutory interpretation for the Agency and courts because the legislature did not define what constituted the “shoulder.”
Originally, the Agency determined “shoulder” was limited to the ball and socket joint, and did not include other connected anatomical parts. See Smidt v. JKB Restaurant, LC, File No. 5067766 (May 6, 2020, Arb. Dec.). Slowly, through various opinions, the definition of “shoulder” has expanded to include anatomical parts that are essential to the functioning of the shoulder joint, such as the rotator cuff muscles, labrum, and acromion.
Claimants Chavez and Deng both sustained tears of their rotator cuff muscles. The lower courts determined these were scheduled shoulder injuries, and both claimants appealed. Each claimant argued that the shoulder was limited to the ball and socket joint, whereas the employers and insurers argued a broader interpretation including “the tendons, ligaments, muscles, and articular surfaces connected to the glenohumeral joint.”
The Iowa Supreme Court first determined that “shoulder” is ambiguous, and that statutes should be interpreted reasonably in accordance with the legislature’s intent. Accordingly, the Court held:
These rules of statutory construction guide our conclusion that “shoulder” under section 85.34(2)(n) must be defined in the functional sense to include the glenohumeral joint as well as all of the muscles, tendons, and ligaments that are essential for the shoulder to function. . . Viewing section 85.34(2) in its entirety, it is apparent that the legislature did not intend to limit the definition of “shoulder” solely to the glenohumeral joint.
Under this functional analysis, the Court determined rotator cuff injuries are injuries to the shoulder because those muscles are essential for the shoulder to remain stable and work properly. The Court also looked to the language contained in medical records, the AMA Guides, and the treating physicians’ interpretation of the injury.
The Court recognized that more litigation “may be needed in the short term to develop the exact parameters of a scheduled shoulder injury.” Although these opinions provide some clarity, we can expect some additional litigation regarding specific parts in the shoulder area. Ultimately, absent legislative change, this determination will likely be based upon medical opinions regarding what is essential to the functioning of the shoulder.
Peddicord Wharton will continue to monitor this issue and provide updates.
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NOTICE TO THE PUBLIC
The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. This disclosure is required by rule of the Supreme Court of Iowa.
Peddicord Wharton Legal Updates are intended to provide information on current developments in legislation impacting our clients. Readers should not rely solely upon this information as legal advice. Peddicord Wharton attorneys would be pleased to answer any questions you may have about this update. ©2022 Peddicord Wharton. All Rights Reserved.
Legal Update by Attorney Marshall Tuttle and Law Clerk Jordan Gehlhaar
Iowa Uniform Jury Instruction 200.34 is titled “Previous Infirm Condition” and reads:
If plaintiff had [a] condition making [them] more susceptible to injury than a person in normal health, then the defendant is responsible for all injuries and damages which are experienced by plaintiff that are caused by defendant's actions, even though the injuries claimed produce a greater injury than those which might have been experienced by a normal person under the same circumstances.
This is known as the “Eggshell Plaintiff Rule.” It originates from the idea that some victims have an “eggshell-thin” skull which results in abnormally excessive damage. The rule requires the person causing the injury to be liable for all damage, even though most people would not experience the same effects or require the same treatment. It applies in personal injury cases where the victim is more susceptible to injury because of their pre-existing condition. For example, if you’re involved in a minor car accident and the other driver has osteoporosis or heart disease, you are still liable for their substantial medical care even if a “healthier” person would not have required care. Therefore, this rule can make damages—such past and future medical expenses—much higher.
The Iowa Supreme Court recently discussed this instruction in Mengwasser v. Comito and Capital Fruit Company. The plaintiff in that case was rear-ended by a vehicle traveling approximately five miles per hour; the airbags did not deploy. She requested an eggshell plaintiff instruction under the theory that degenerative disk disease in her neck made her more susceptible to injury. The trial court denied this instruction and she appealed. The appellate court affirmed, finding the plaintiff had only proven she aggravated a previous injury, which is not the same as proof of a greater susceptibility to injury.
For this instruction to apply, the plaintiff must request it prior to
trial. Additionally, there must be evidence showing that prior to the
injury, a condition made them more vulnerable or prone to injury than a
person of average health. This can be determined through medical
records, discovery responses, and correspondence with opposing counsel.
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NOTICE TO THE PUBLIC
The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. This disclosure is required by rule of the Supreme Court of Iowa.
Peddicord Wharton Legal Updates are intended to provide information on current developments in legislation impacting our clients. Readers should not rely solely upon this information as legal advice. Peddicord Wharton attorneys would be pleased to answer any questions you may have about this update. ©2022 Peddicord Wharton. All Rights Reserved.