Articles Posted in Medical Care

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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.

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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.

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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.

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The Iowa Workers’ Compensation Commissioner filed an Appeal Decision on November 3, 2020 in the case of Mary Coleman Duchesneau v. Wal-Mart Stores, Inc.  The claimant alleged injuries to her bilateral hands, bilateral wrists, bilateral elbows, bilateral shoulders and her neck.  The claimant was seen by a large number of physicians that gave differing opinions concerning the diagnosis of her injuries, the recommended treatment and the causes of her injuries.

Ultimately, the Workers’ Compensation Commissioner found that most of the claimed injuries were work related.  The Commissioner also found that the claimant had suffered 55% industrial disability and therefore was entitled to 275 weeks of permanent partial disability benefits at the claimant’s weekly rate of $338.36.

The claimant was 59 years old at the time of the workers’ compensation trial and had worked at Wal-Mart since 2003.  Over her life she had worked in a number of fields including carpentry, janitorial, retail sales, baking, dry cleaning, child care, cab driving, cashier, and photo manager.  At Hy-Vee she primarily had worked as a deli merchandise supervisor.  The claimant developed problems with both of her hands and arms which radiated up to her shoulders.  The claimant believed her problems were a result of using a handheld device to put prices on deli items for 3 to 4 hours a day.

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The Iowa Workers’ Compensation Commissioner filed an appeal decision on December 19, 2019 in the case of Nguyen v. Des Moines Public Schools and EMC Risk Services.  I think the case is a good example of the situation where there are a lot of complicated and conflicting factors that the Work Comp Commissioner has to take into account in assessing the extent of damages.

In this case the claimant was a 34 year old woman who was born in Vietnam.  She graduated from high school and attended one year of college in Vietnam.  When the claimant was 18 she married her husband moved with him to the United States. The claimant became a U.S. Citizen in 2008.

The claimant has never taken any formal language classes, but speaks English well.  The claimant explained that she has more difficulty reading and writing the English language.

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On September 25, 2019 the Iowa Court of Appeals ruled in favor of one of my clients where we were requesting a second IME at the expense of the Defendants in the case of Ostwinkle v. Mathy Construction Company.

The background of the case is as follows.  The worker suffered an accepted low back injury on July 23, 2013.

On August 12, 2016 Chad Abernathey, M.D. provided an impairment rating for the Employer and Insurance Carrier.

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The Supreme Court filed a very interesting decision on May 31, 2019 in the case of Robert W. Milas, M.D. v. Society Insurance and Angela Bonlander.

Dr. Milas brought a lawsuit against a workers’ compensation insurance company and one of its adjusters alleging that they went back on a promise to pay Dr. Milas $14,325.87 for a complex neck surgery, and that those actions constituted both breach of contract and fraudulent misrepresentation.

Dr. Milas is a board-certified neurosurgeon in the Quad Cities.  The disputes began when Society Insurance hired Dr. Milas to perform a neck surgery for an injured worker.

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Under Iowa workers’ compensation law the insurance company and employer cannot interfere with the medical judgment of their own treating physician.  Schwers v. Nordstrom Distribution Center is a December 17, 2018 Alternate Medical Care Decision from the Workers’ Compensation Commissioner that deals with this rule.

The Claimant injured her back on August 10, 2017.  Nordstrom Distribution Center is self-insured for work comp injuries.  Nordstrom accepted the injury and provided medical care.  Dr. Michael Chapman performed a low back fusion surgery on the Claimant.

Unfortunately, the Claimant continued to have low back pain.  Dr. Chapman referred the Claimant to pain doctor #1 who performed a number of tests and a diagnostic medial branch block, and gave the opinion that a medial branch problem and facet disease could be ruled out as a cause of the Claimant’s back pain.

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The Iowa Workers’ Compensation Commissioner filed an Appeal Decision on November 30, 2018 in the case of Clay v. Bridgestone Americas and Old Republic Insurance Co.  The case involved a hernia claim with an injury date of October 25, 2013 and a low back claim with an injury date of June 27, 2014.  In this blog post I am going to first talk about hernia injuries, and then talk about the importance of maximum medical improvement in Iowa work comp cases.

  1. HERNIA INJURIES IN IOWA WORK COMP CASES

The Claimant had some abdominal pain in May and June of 2013.  The doctors were not able to find any explanation for the pain.  On October 25, 2013 the Claimant lifted a 50-pound bag as part of her job and felt a twinge in her stomach.  The October 25, 2013 pain continued and the Claimant saw several physicians before she was diagnosed with a hernia on December 27, 2013.

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In this blog post I am going to talk about two recent Iowa work comp alternate medical care decisions, and some related strategy advice.

  1. Be polite. The recent October 2, 2018 Alternate Medical Care Decision in the case of Stewart v. Hy-Vee, Inc. and EMC Property and Casualty Company involved an accepted left knee injury.  During the course of the case the claimant moved from Iowa to Lake Charles, Louisiana. The Defendants arranged care with an orthopedic surgeon at the Imperial Health Center located in Lake Charles, Louisiana.

 
The claimant was late for her first appointment with the orthopedic surgeon.  The claimant said she was 30 minutes late, and the doctor’s office said she was 90 minutes late.  The appointment had to be rescheduled.

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