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Significant debate and litigation have continued to stem
from the Iowa legislature’s 2017 amendment to Iowa Code section 85.34(2)(v) and
its impact on an injured worker’s entitlement to a traditional industrial
disability analysis. Attorneys Lee Hook, Michael Roling, Christopher Spencer,
and Morgan Todd Borron of Peddicord Lillis recently had the opportunity to
bring a case before the Iowa Supreme Court to clarify just that.
An injury is unscheduled if it is an injury “other than
those . . . described or referred to in paragraphs ‘a’ through ‘u’” of §
85.34(2). See Iowa Code § 85.34(2)(v). Prior to the 2017 amendment, all
unscheduled injuries were considered a “whole person” or “body as a whole”
injury, which result in industrial disability analysis.
When the legislature amended § 85.34(2)(v) in 2017, it
retained the only existing sentence and added three new sentences to the end of
the subsection; the statute is now comprised of a total of four sentences. The
first two sentences of § 85.34(2)(v) provide a default rule for compensating
nonscheduled injuries—that is, such injuries are to be compensated based on the
reduction in the employee’s earning capacity (i.e., industrial disability).
Iowa Code § 85.34(2)(v). This was the default rule prior to the 2017 amendment
of this statute. Central to the ongoing debate and litigation were the
legislature’s addition of the third and fourth sentences to Iowa Code §
85.34(2)(v) as a part of the 2017 amendments. Together, the third and fourth
sentences provide:
[3] If an employee who is eligible for compensation
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. [4] 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.
Iowa Code § 85.34(2)(v) (numerical designations identified
in bolded brackets added).
In Den Hartog Industries v. Dungan, the Iowa
Supreme Court reversed the Commissioner’s finding (which was affirmed by the
District Court and Iowa Court of Appeals in a 2-1 split decision) that Claimant
Dungan was entitled to an award of industrial disability under Iowa Code §
85.34(2)(v), based on earning capacity rather than functional impairment. In
applying section 85.34(2)(v) in a straightforward manner, the Court stated:
Under sentences 1 and 2, Dungan’s back injury would
ordinarily be compensated according to the industrial method, based on “the
reduction in the employee’s earning capacity caused by the disability.” Iowa
Code § 85.34(2)(v). However, Dungan “return[ed] to work . . . for which [he]
receive[d] or would receive the same or greater salary, wages, or earnings than
[he] received at the time of the injury.” Id. Therefore, under sentence
3, he should be compensated “based only upon [his] functional impairment resulting
from the injury, and not in relation to [his] earning capacity.” Id. Finally,
Dungan was not “terminated from employment” by Den Hartog, so sentence 4
doesn’t apply, and there is no review-reopening. Id. In other words,
when all is said and done, Dungan should be compensated based on his functional
impairment, as dictated by sentence 3, not loss of earning capacity.
Den Hartog Industries v. Dungan, No. 23-1402 at *8, __ N.W.3d __ (Iowa 2025). The Supreme Court then vacated the Court of Appeals Decision, District Court Decision, and remanded the case to the Commissioner with instructions to calculate Claimant Dungan’s entitlement to benefits based on his functional impairment. Dungan, No. 23-1402 at *12, __ N.W.3d __ (Iowa 2025).
Legal Update by Attorney Sandra Kromminga
The issues in Tweeten d/b/a Tweeten Farms v. Tweeten were: (1) Does the statutory bar under Iowa Code section 85.35(9) preclude further benefits following a compromise settlement between a claimant and the Second Injury Fund of Iowa (“SIF”); (2) Does the discovery rule toll the statute of limitations following amendments to Iowa Code section 85.26(1); and (3) How do amendments to Iowa Code section 85.39(2) affect reimbursement for independent medical examinations? This case was argued by Attorney Christopher S. Spencer.
The Claimant, Corey Tweeten, worked for his father on the family farm, Tweeten Farms. While Claimant and his father were vacuuming grain out of a bin on July 25, 2017, the Claimant injured his right arm. The Claimant sought treatment on August 14 and was diagnosed with right lateral epicondylitis or ‘tennis elbow.’ The Claimant eventually underwent an MRI in May of 2018 that showed a “significant deltoid insertional tear.” Surgery to repair the deltoid was done on June 18. At a follow-up appointment in October, Dr. Warme opined that Corey had likely overcompensated for the tennis elbow which had caused the deltoid tear. Dr. Warme believed that both injuries were related to the July 2017 grain bin incident.
In January of 2020, the Claimant filed an arbitration petition seeking benefits from Tweeten Farms and Grinnell Mutual for an upper right extremity injury, asserting his injury date was February 1, 2018. The Petition also included a claim against the Second Injury Fund of Iowa, premised on a prior right ankle injury in 2008. The Claimant also sought reimbursement for an independent medical evaluation (“IME”) with Dr. Robin Sassman at hearing. The cost of the IME was $4,650.00.
An arbitration hearing was set for March of 2021. The Second Injury Fund of Iowa filed a notice that they had reached a settlement with the Claimant and would not be at the upcoming hearing pending approval of the settlement. The case proceeded to hearing. In Defendants’ April 13 Post-Hearing Brief, they argued that the Compromise Settlement with the Second Injury Fund of Iowa extinguished Claimant’s claims for benefits under section 85.35(9). This divested the workers’ compensation Commissioner of jurisdiction to award him additional benefits. The settlement was approved in April. The deputy found that the Claimant did not learn of the seriousness of his injury until April 2018, meaning that his January 21, 2020, Petition was not barred by the two-year statute of limitations in section 85.26.
The Iowa Supreme Court held that the Commissioner’s decision in Millbrandt v. R.R. Donnelly recognized that “a claim brought by a claimant against the SIF is distinct from a claim brought by a claimant against an employer and an insurance carrier,” such that the claim against the employer was not “regarding the subject matter of the compromise.” Compromise settlements between an employee and the Second Injury Fund of Iowa will not always bar an employee from seeking benefits from their employer, but the extent of any bar will depend on the subject matter of the compromise. In this instance, the dispute was as to the applicability of the Second Injury Fund Act related to the prior loss in 2008.
As for the applicability of the discovery rule, the Court held that for purposes of section 85.26, the two-year statutory period begins to run when the employee knows or should have known that an injury is work-related, without regard to whether the injury is also serious enough to be compensable. The Claimant knew that he had a right-arm injury that was work-related more than two years before he sought benefits, and his claim is therefore barred as untimely. This holding modifies the prior common law discovery rule that would have tolled the statute of limitations until the injured worker also knew of the seriousness of the claimed injury.
Finally, the Court determined that Claimant was not entitled to reimbursement for Dr. Sassman’s examination under Iowa Code 85.39. The Claimant’s Petition had been untimely, meaning his injury was not compensable, and, as a result, was not entitled to reimbursement.
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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. ©2024 Peddicord Wharton. All Rights Reserved.
Legal Update by Attorney Morgan Todd Borron
In 2017, the Iowa Legislature overhauled Iowa Code Chapter 85 and made numerous amendments to previously established workers’ compensation statutes, and the impact of those amendments continues to be the center of much of the workers’ compensation litigation in Iowa today.
Iowa Code § 85.39 was one of the statutes subject to the 2017 amendments. Attorneys Stephen W. Spencer and Christopher S. Spencer of Peddicord Wharton recently had the opportunity to bring a case to the Iowa Supreme Court to clarify the impact that the 2017 amendment has had on reimbursement of independent medical examinations (“IME”) per § 85.39. The case was retained by the Iowa Supreme Court on further review from a decision of the Iowa Court of Appeals.
In Mid American Construction, LLC v. Sandlin, Claimant presented for an exam with Dr. Kennedy. There was a dispute as to whether Dr. Kennedy was retained by the Employer and Insurance Carrier for purposes of triggering Iowa Code § 85.39, but the issue was decided in favor of the Claimant on factual grounds. Thereafter, Sandlin’s counsel arranged for Claimant to be evaluated by Dr. Taylor for an IME and requested reimbursement for Dr. Taylor’s fees associated with the IME, in the amount of $2,020, per Iowa Code § 85.39. Defendants contended that, per Iowa Code § 85.39 as amended in 2017, Claimant was only entitled to reimbursement for the cost to obtain an impairment rating of his own to rebut the rating of Dr. Kennedy, and not the cost of the entire IME.
The Iowa Court of Appeals found that the 2017 amendment to Iowa Code § 85.39 limited the Claimant to solely the costs to perform an impairment rating. On further review, the Iowa Supreme Court held that Iowa Code § 85.39, as amended, entitles employees to the reasonable cost of an examination conducted by a physician of their choosing, in addition to the cost of that physician’s determination of impairment, and not merely the cost assessed for the impairment rating itself. See Mid American Construction, LLC v. Sandlin, No. 22-0471, 2024 WL 500652 at *1, *9 (Iowa Ct. App. Feb. 9, 2024). Further, that the reasonableness of the IME physician’s fees for the examination are to be analyzed in conjunction with what physicians in that locality typically charge for an IME, “including costs of reviewing medical records, conducting a physical examination, opining on causation, assessing permanent impairment, assigning restrictions, and addressing further treatment recommendations.” Id. at *9 (quoting Turner v. NCI Bldg. Sys., Inc., Iowa Workers’ Comp. Comm’n No. 1652235.01, 2022 WL 1787301 at *26 (Feb. 24, 2022).
If you'd like to sign up for our e-newsletter, please click here.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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. ©2024 Peddicord Wharton. All Rights Reserved.