Bilateral Injuries in Iowa Workers’ Compensation Law

Today I am going to talk about the special treatment of bilateral injuries in Iowa work comp cases. Usually injuries to the arms, hands, feet, legs, or eyes are treated as scheduled injuries. In a scheduled injury case a worker is paid compensation for an injury to the scheduled body part based on the functional/physical impairment to the body part.

For instance, under Iowa workers’ compensation law an arm is worth a maximum of 250 weeks. In order to figure out how much particular an arm injury is worth the worker needs to be evaluated by a physician who calculates an impairment rating. Usually the impairment ratings are based on the AMA Guides to the Evaluation of Permanent Impairment (5th Edition). By way of example, if the doctor ends up deciding that the injury is a 10% impairment of the arm that means that the worker is entitled to receive 25 weeks of permanent partial disability benefits. (Maximum value of arm is 250 weeks x 10% impairment rating = entitlement to 25 weeks of permanent partial disability benefits). (See here for a longer explanation on how scheduled injuries are evaluated and compensated under Iowa law).

However, bilateral injuries to some body parts are handled differently under Iowa workers’ compensation law. Iowa Code Section 85.34(2)(s) provides:

“The loss of both arms, or both hands, or both feet, or both legs, or both eyes, or any two thereof, caused by a single accident shall equal five hundred weeks and shall be compensated as such; however, if said employee is permanently and totally disabled the employee may be entitled to (permanent total disability benefits).”

In other words, if you are injured in a single accident, and a combination of any two of the listed body parts are hurt in the accident, you are entitled to have your injuries evaluated under this special analysis which will usually result in a higher award of benefits.

Compensation for bilateral work injuries are still calculated under a functional/physical impairment analysis, rather than an industrial disability analysis. (See here for a discussion on how an industrial disability analysis is performed). However, the maximum recovery becomes based on a percentage of 500 weeks rather than the lower number of weeks that are the maximum for the various body parts individually.

By way of example, a fairly common injury that ends up affecting both arms or hands is bilateral carpal tunnel syndrome. If you have a carpal tunnel injury only on one side, you would usually end up being compensated based on the impairment to one arm, which as discussed above is worth a maximum of 250 weeks. However, if you have carpal tunnel on both sides arising out of the same accident, the two injuries are combined together, and you are paid based on a maximum of 500 weeks.

The analysis and math under the AMA Guides and the Iowa workers’ compensation law is somewhat complicated. However, if you had carpal tunnel injuries on each side that came from separate accidents and resulted in impairment ratings of 5% of each hand, the total recovery for the two sides would be 22 weeks of permanent partial disability benefits.

By contrast, if you develop bilateral carpal tunnel syndrome out of the same accident, and have the same 5% hand impairments, the total value of the injuries ends up increasing to 30 weeks of permanent partial disability benefits.

Also keep in mind that if you have an injury to two separate body parts that did not arise out of the same accident, you potentially have a special claim against the Second Injury Fund for additional benefits. (See here for a longer discussion about what is required for Second Injury Fund claim, and how it works).

Finally, Iowa Code Section 85.34(2)(s) provides that if an injury to some combination of the two listed body parts is severe enough, the worker is entitled to receive permanent total disability benefits. (See here for a longer explanation of what is required to qualify for permanent total disability benefits and how permanent total disability benefits are paid). American National Can Company v. Gilleland, 674 N.W.2d 684 (Iowa App. 2003) is an example of a worker with bilateral carpal tunnel injuries that ended up receiving permanent total disability benefits. In the Gilleland case the claimant was 58 years old, had less than a 10th grade education, only had experience as a factory production worker, and as a result of her severe bilateral carpal tunnel condition could no longer work as a factory production worker. Therefore, the Iowa Court of Appeals affirmed the decision of the Iowa Workers’ Compensation Commissioner that the claimant was entitled to receive permanent total disability benefits.