Iowa Workers Compensation Caselaw Update
April 5, 2021 | Smith, Mills & Schrock Law
Voluntary Resignation Does NOT Trigger Industrial Disability under Iowa Code 85.34 (2)(v)
The Iowa District Court of Polk County issued a ruling on April 21, 2021 in the case of Pavlich v. Martinez, Case No. CVCV060634, holding that since Claimant returned to work for Defendant Employer at the same or higher wages he was entitled only to the functional impairment ratings. The District Court further found Martinez’s voluntary resignation from Defendant Employer did not trigger entitlement to an industrial disability analysis under the new statutory changes. Iowa Code 85.34(2)(v) was amended in 2017 to add the following:
1. If a claimant returns to work or is offered work with any employer at the same or greater wages, the claimant is only entitled to permanent disability benefits according to the functional impairment ratings.
2. If a claimant returns to work with the defendant-employer and later voluntarily resigns, the claimant is only entitled to permanent disability benefits according to the functional impairment ratings.
In this case, Claimant sustained a work related injury on April 16, 2018. After the accident, Claimant eventually returned to full duty work for Defendant Employer driving local routes. He continued in his regular position until voluntarily resigning from Defendant Employer to take a different position. At the time of the arbitration hearing, he was earning more at his new job. When assessing permanent disability benefits, the Deputy Commissioner followed Iowa Code § 85.34(2)(s) (2016) which states injuries to two scheduled members in a single accident is compensated on a functional basis based upon 500-weeks. Claimant was awarded the combination of his scheduled member impairment ratings.
On appeal, the Commissioner reversed how the Deputy Commissioner calculated permanency benefits. In short, the Commissioner determined Claimant should be awarded benefits based on an industrial disability rather than the functional impairment ratings. The Commissioner found, since Claimant suffered more than two scheduled member injuries in the same accident and was no longer working for Defendant Employer, permanency should have been assessed as an industrial disability under section 85.34(2)(v). This was the first Appeal Decision issued by the Commissioner dealing with these statutory changes.
The Commissioner interpreted the new statutory changes to only address the scenario when a claimant returns to work or is offered work by the defendant employer. Although Claimant did return to the same employer at the same wages, he voluntary quit that position to obtain a higher paying position. The Commissioner found the voluntary resignation “triggered his entitlement to benefits using the industrial disability analysis.” The District Court disagreed.
Iowa Workers Compensation Caselaw Update
February 10, 2021 | Smith, Mills & Schrock Law
Shoulders in Iowa Workers Compensation:
The Iowa Workers Compensation Commissioner has issued multiple appeal decisions addressing post-July 1, 2017 shoulder claims. Since the 2017 legislative changes to Iowa Code Chapter 85 added the shoulder to the list of scheduled member injuries, there have been multiple arbitration decisions that have compensated shoulders industrially rather than as scheduled member injuries. However, the Commissioner’s opinion directly contrasts to those prior arbitration decisions and has finally drawn a bright line as to how the agency will define the shoulder going forward.
Specifically, in Deng v. Farmland Foods, Inc., File No. 5061883, overturned the arbitration decision awarding industrial disability for a shoulder injury and instead found that the muscles that make up the rotator cuff are included in the definition of ‘shoulder’ under Iowa Code §85.34(2)(n), and that the claimant should therefore be compensated based upon functional disability of the scheduled member. The commissioner reasoned that the glenohumeral joint and its surrounding muscles, tendons, bones, and surfaces are ‘extremely intricate and intertwined’. He found that it was ultimately difficult to separate the claimant’s injured infraspinatus from the glenohumeral joint considering the muscle’s primary purpose is to stabilize the socket of the shoulder- ie: the functionality of the shoulder is dependent on these surrounding anatomical parts. Because of the importance of such muscles to the function of the joint, the commissioner concluded that excluding everything but the glenohumeral joint itself from the definition of a shoulder under §85.34(2)(n) would lead to the ‘absurd result’ of excluding injuries that are commonly considered shoulder injuries. Therefore, the commissioner ultimately concluded that a ‘shoulder’ under §85.34(2)(n) is not limited to the glenohumeral joint, but rather that the muscles that make up the rotator cuff should be included within the definition of ‘shoulder’.
The commissioner also addressed compensation of functional disability for the shoulder since there is not a method to assess impairment to the shoulder specifically under the AMA Guides. He noted that historically, the agency did not utilize whole person impairment ratings for a single scheduled member injury. Therefore, the commissioner ultimately concluded that it was appropriate to apply the upper extremity impairment rating for a shoulder injury, and compensate the claimant based upon 400 weeks of benefits under §85.34(2)(n).
In addition to the specific rulings about the shoulder, the commissioner affirmed the deputy’s finding that Claimant reached MMI as of the date her treating physician assigned permanent restrictions rather than the date that permanent impairment was assigned. The commissioner reasoned that Claimant was released from care when she was assigned permanent restrictions and Claimant’s condition continued to be stable at the time of her evaluation for an impairment rating- therefore, she had reached MMI when she was assigned restrictions and released from care, despite her return four months later for evaluation of impairment. Based upon this conclusion, the commissioner also affirmed the deputy’s award of penalty benefits. In applying this rationale to other cases, therefore, permanency benefits should be volunteered during the pendency of receipt of an impairment rating if permanent restrictions are assigned, a claimant is released from care, and permanency is anticipated.
While there will likely continue to be some debate going forward as to compensability for shoulder injuries based upon the specific muscles injured, it is now apparent that injuries to muscles that are essential to the function of the glenohumeral joint will be considered shoulder injuries under §85.34(2)(n), which provides some much-needed clarity as to how the legislative changes effective July 1, 2017 will be adopted by the Iowa workers’ compensation agency.
Iowa Workers Compensation Caselaw Update
February 10, 2021 | Smith, Mills & Schrock Law
Mental-Mental Claims for First Responders in Iowa Workers Compensation:
The Iowa Workers Compensation Commissioner issued an appeal decision in the case of Tripp v. Scott Emergency Communication Center, File No. 5066673, addressing the standard for mental-mental claims made by first responders. The appeal decision upholds agency precedent adopting the test under Brown v. Quik Trip Corporation, 641 N.W.2d 725 (Iowa 2002) that legal causation is met only when a claim is based on a manifest happening of a sudden traumatic nature from an unexpected cause or unusual strain. The Commissioner explains that “whether the traumatic event at issue steams from an unexpected cause or an unusual strain is determined by a subjective standard that takes into account claimant’s occupation.” In this appeal decision, the injured worker was an emergency dispatcher and handled a call for a dying infant. Defendants provided evidence the injured worker had previously handled calls involving the death of an infant. Thus, the Agency concluded that given the nature of the job of an emergency operator, taking a call regarding a dying or dead infant cannot be said to be an unexpected cause or an unusual strain.
This decision highlights the debate between the objective versus subjective legal standard in mental-mental claims. The Commission held, “an objective standard is a legal standard that is based on conduct and perceptions external to a particular person. The objective standard requires the finder of fact to view the circumstances from the standpoint of the hypothetical reasonable person, without regard to the claimant’s personal views or experiences. The subjective standard is a legal standard that is peculiar to a particular person and based on the person’s individual views and experiences.” In this case, the Agency determined the emergency call handled by the inured worker was considered a day to day stress of an emergency operator and applying the subjective standard, there was little evidence the emergency call in question exceeded the day to day stress of an emergency operator.
Iowa Workers Compensation Caselaw Update
April 16, 2020 | Smith, Mills & Schrock Law |
Smith, Mills & Schrock Law successfully defended the case of McDougal v. Menard, Inc., File No. 5066644, April 15, 2020, before the Iowa Workers’ Compensation Commissioner. Claimant alleged a work related injury to her back as a result of her work duties. Defendants disputed claimant’s allegations based on prior medical evidence of lower back pain with radicular pain in the back of claimant’s leg and her lack of credibility in reporting the claim and her symptoms. The Deputy agreed with Defendants’ evidence that Claimant failed to meet her burden of a work related injury and claimant took nothing in the form of benefits.
Iowa Workers Compensation Caselaw Update
April 14, 2020 | Smith, Mills & Schrock Law |
How to Successfully Utilize Functional Capacity Evaluations before the Agency:
Smith, Mills & Schrock law defended the case of Grugan v. Walmart, File No. 5063207, March 16, 2020, before the Iowa Workers Compensation Commissioner. Defendant appealed the Deputy Commissioner’s arbitration award finding Claimant had sustained 70 percent industrial disability as a result of a stipulated work injury to her back. Attorneys for the firm argued Claimant’s functional limitations did not significantly change following the work injury based on functional capacity evaluations performed before the work injury and following. Claimant contrasted these reports with testimony of an increase in her symptoms. However, the Agency agreed with Defendant’s expert that an FCE is an objective conclusion that should be given greater weight. Based on these arguments, the Commissioner reduced Claimant’s award from a 70 percent to a 35 percent industrial disability award for the work-related back injury.