During my career I have seen many people who had very real and very serious work injuries make their cases unnecessarily difficult.  Here is a list of some of the most common problems that I have seen.

  1. Denying activities you actually perform outside of work. In most workers’ compensation cases, and especially for cumulative trauma cases, the insurance company will interview the Claimant.  One of the standard areas of questioning is about what type of activities a worker engages in outside of employment.  Sometimes an injured worker will deny that they have a second job, or that they regularly chop their own firewood because they are worried that the claim will be denied based on these other activities.  An insurance company might deny a claim in which they are told the worker has a second job, but the worker still has a good chance to win at trial.  However, a worker who denied a second job or a strenuous hobby is going to be facing an uphill battle when the insurance company discovers the truth.  Believe me, the truth always comes out.
  1. Denying preexisting conditions or past injuries. Similarly, a worker with a shoulder injury might answer interview questions about a past shoulder injury or treatment with a false denial.  The fact that a worker has a preexisting problem is not a work comp defense.  If the employment substantially aggravates the preexisting condition, then the employer and insurance company are responsible for the injury.  However, denying the preexisting problem makes it easier for the insurance company to convince a work comp judge that the complaint is actually based on the preexisting problem.

Under Iowa law, injuries to body parts such as the head, neck, back, and hips were traditionally compensated based on their effect on a workers’ future earning capacity.

Among the statutory changes that went into effect for injuries after July 1, 2017 was an amendment to Iowa Code Section 85.34(2)(v) which provides:

“If a worker who is eligible for compensation under this paragraph (head, neck, back, or hip) 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.”

The Iowa Workers’ Compensation Commissioner entered an Appeal Decision on March 17, 2021 in the case of Baker vs. MSC Industrial Direct Co. and Ace American Insurance Co.  The Claimant was injured when a cabinet weighing between 750 and 1,000 pounds fell on him on April 17, 2017.  The Claimant’s main problems were headaches, thinking, memory and frequent seizure-like episodes.  The Claimant never returned to work after this injury.  The work comp insurance company directed the care in the case and the Claimant was seen by many health care providers.  The health care providers generally believed the Claimant had suffered a concussion and traumatic head injury that resulted in serious lingering problems.

The workers’ compensation insurance company solicited multiple defense medical opinions from non-treating physicians, and on the basis of these defense medical opinions terminated paying weekly benefits and providing medical care approximately three years after the injury.

The case came on for trial in front of a Deputy Workers’ Compensation Commissioner on March 9, 2020, and the trial decision was filed on July 31, 2020 finding in favor of the employer and insurance carrier on the issues of weekly benefits and medical care.  The Deputy Commissioner relied on the opinions of the non-treating medical experts. Three defense experts provided opinions based on record reviews without meeting the Claimant.  One additional expert met the Claimant on one occasion.  The defense experts gave the opinions that the Claimant’s problems were never correlated with any objective findings, and in various ways suggested that the Claimant had other stressors in his life, and he was taking advantage of the work incident.

The Iowa Workers’ Compensation Commissioner entered an Appeal Decision in the case of Kuehl v. Foley Company and CNA Insurance on February 3, 2021.  The case is an example of how work injuries that are impacted by psychological issues are handled in Iowa work comp law.

The injured worker did not graduate from high school or obtain a GED.  The Claimant began working as a crane operator when he was 17 years old and continued in that profession for 30 years until he was injured in July of 2017.  The Claimant was climbing into an excavator when he slipped and fell about 3 to 5 feet and landed on his right heel, and felt immediate pain in his back.

The Claimant went through extensive medical care and evaluation.  All of the doctors agreed that the Claimant did suffer some type of low back injury from the fall, and all of the doctors agreed that the Claimant did not require surgery.  The Claimant went through physical therapy without improvement. He took a number of different medications without improvement.  The Claimant generally resisted epidural steroid injections, when these were given, they also did not help.  MRI and EMG testing did not reveal any significant problems.

The Iowa Workers’ Compensation Commissioner filed an Appeal Decision on March 5, 2021 in the case of Brandt v. CRST Van Expedited, Inc. and Liberty Mutual Insurance Group.  The case is a good example of how eye injuries are handled under Iowa workers’ compensation law.

The Claimant was born and raised in the Netherlands.  The Claimant was injured in June of 2013 while she was working as a semi-truck driver in the United States.   A bungee cord snapped, and the hook struck her directly in the right eyeball.

Generally, the maximum recovery for injury to a single eye is 140 weeks of PPD benefits.  Injuries to both eyes can be compensated by up to 500 weeks of PPD benefits.  In addition to her eye injury, the Claimant also suffered from post-traumatic headaches, dizziness, neck pain, shoulder pain and post-traumatic stress disorder.  Under Iowa law the combination of a scheduled injury such as the Claimant’s eye injury along with these other injuries which are body as a whole injuries, results in all of the injuries being assessed and compensated together on the basis of industrial disability.

One of the most common type of case in Iowa workers’ comp is when a worker has preexisting back problems that are aggravated by his job duties.  As the Iowa Supreme Court has stated many times:

“While a claimant is not entitled to compensation for the result of a preexisting injury or disease, its mere existence at the time of a subsequent injury is not a defense.  If the claimant had a preexisting condition or disability that is materially aggravated, accelerated, worsened or lighted up so that it results in disability, claimant is entitled to recover.”

A recent example of the application of the law of preexisting conditions is set out in the December 17, 2020 Appeal Decision of Hays v. Central Iowa Fencing, Ltd. And Grinnell Select Insurance.

Ashley Heinrich v. Area Ambulance Authority, Inc. and Accident Fund Insurance Co. of America is an Appeal Decision filed by the Iowa Workers’ Compensation Commissioner on December 18, 2020.  The Claimant quit her job and obtained new employment while her work comp case was pending.  Fortunately, the case turned out fine for the Claimant, but I have seen a lot of cases where leaving for a new job has a very negative impact on the case.

The dangers of leaving a job while you have a work comp case pending are:

  1. To the extent the injury worsens or new problems are identified, the job change gives the first employer a good start to the argument that the problem is from the new job.

Set out below are the questions I get asked most frequently about work comp and my answers.  I am setting out a lot of questions and giving general answers.  However, the details do matter in Iowa work comp law so you should follow up with a lawyer to figure out how the law applies to your exact situation:

  1. What is workers’ compensation? Workers’ compensation is a statutory system to provide medical care and cash money for employees that are injured on the job.
  1. Does workers’ compensation cover pre-existing problems? Iowa workers’ compensation does not cover pre-existing problems unless the work aggravates or worsens the pre-existing problem.  For example, many people have pre-existing back problems but are able to do their job.  If the employment ends up aggravating your back condition, then you are entitled to receive workers’ compensation benefits.

The recent Appeal Decision in the case of Michael Warren v. Altec, Inc. and Sentinel Insurance Company is an example of how post-concussion injury cases are handled in Iowa workers’ compensation.

The claimant was injured on March 22, 2017 when a J-hook he was using came unhooked from a tank he was pulling, and the claimant fell back and struck his head and was knocked unconscious.  The claimant’s initial symptoms were a mild headache, dizziness and nausea.  The local physician recommended waiting on a neurology referral to see if claimant’s symptoms would clear up on their own.

Unfortunately, the claimant’s symptoms did not clear up and he was referred to see Beth Triebel, O.D. at Vision Park in Des Moines.  Dr. Triebel’s diagnosis was bilateral myopia, presbyopia, vertical heterophoria, and post-concussion syndrome.  Dr. Triebel changed the prescription of the Claimant’s glasses.  Dr. Triebel also ordered vision therapy which ran from October 19, 2017 through July 24, 2018.

HERE IS WHEN YOU DO NOT NEED A LAWYER:

You do not immediately need a lawyer as long as the employer and insurance company are providing medical care and you are being paid your regular wages or being paid workers’ compensation benefits for missed work.

If everything goes smoothly your case should generally proceed along the following lines: