Going all the way back to 1920, Iowa workers’ compensation law has always been that employers hire an employee subject to any active or dormant health problem which renders a worker susceptible to injury, and the employer must exercise care to avoid injury to both the weak and infirm and the strong and healthy.

A material aggravation, worsening, lighting up or acceleration of any prior condition has been viewed as a compensable event ever since the initial enactment of the Iowa Workers’ Compensation Statutes.

Over the years there have been numerous Iowa workers with preexisting conditions who recovered workers’ compensation benefits based on the principle that the worker’s physical labor accelerated their preexisting condition.

Acceleration of a preexisting condition can involve any body part, but acceleration frequently comes up in knee cases where a worker had a preexisting problem that was probably headed towards a knee replacement, but the job accelerated the knee problems and resulted in an earlier knee replacement.

In this post I am going to talk about a decision from November of 2017 in the case of Triplett v. City of Des Moines.  The claimant worked for the Street Division Department of Des Moines, Iowa.  The claimant had been a City employee for 39 years.  His job involved a substantial amount of driving, snow plowing, shoveling, raking and rolling asphalt.  The parties agreed that the claimant’s job duties were manual and physical in nature.  Over the years the claimant developed right knee pain and symptoms. Medical records showed that as early as 2007 the claimant was receiving medical care for his knee, including steroid injections.

In May of 2016 the claimant reported his ongoing right knee symptoms as a work injury.  This report began the process of the claimant of being evaluated by a number of medical providers.

The claimant was first seen by a Physician’s Assistant who gave the opinion that the cause of claimant’s right knee condition was “undetermined.”  Based on this opinion the employer denied liability for the knee condition and provided no treatment or benefits.

The claimant saw his first orthopedic surgeon who gave the opinion that the knee arthritis was from multiple factors including the claimant’s weight, genetics, any past injuries and use of the knee over time.  The first surgeon also gave the opinion that the claimant’s work could aggravate his underlying arthritis.

The claimant saw a second orthopedic surgeon who thought a knee replacement was necessary, but did not give an opinion on causation.

The claimant saw a third orthopedic surgeon who gave the opinion that the work performed by the claimant over a period of 39 years was a substantial accelerating factor in the claimant’s knee condition.  The third orthopedic surgeon also recommended a total knee replacement.

The claimant did undergo the knee replacement, and the disputed case went to trial.  The Deputy Workers’ Compensation Commissioner ruled that the claimant’s work activities for the City of Des Moines over a period of 39 years caused an aggravation of his osteoarthritis in his right knee and accelerated his arthritis and need for a total knee replacement.  The claimant was awarded medical benefits, healing period benefits for the time he was off work, and 110 weeks of permanent partial disability benefits.

Please be sure to contact our office if you have any questions about acceleration of a preexisting condition, or any other issues involving Iowa workers’ compensation law.