Articles Posted in Strategy Advice

Under Iowa workers’ compensation law the issue of apportionment has been an unclear area that has led to a great deal of litigation.  Iowa Code Section 85.34(7)(b)(1) covers injuries that occurred before July 1, 2017 and provides:

“If an injured employee has a preexisting disability that was caused by a prior injury arising out of and in the course of employment with the same employer, and the preexisting disability was compensable under the same paragraph of subsection 2 as the employee’s present injury, the employer is liable for the combined disability that is caused by the injuries, measured in relation to the employee’s condition immediately prior to the first injury.  In this instance, the employer’s liability for the combined disability shall be considered to be already partially satisfied to the extent of the percentage of disability for which the employee was previously compensated by the employer.”

The Iowa Workers’ Compensation Commissioner issued a decision on August 31, 2018 in the case of Haltom v. JBS USA, LLC and American Zurich Insurance Company.  The Haltom case deals with the issue of apportionment, and also addresses a complex set of facts involving multiple injuries.

Under Iowa law the Defendants in workers’ compensation cases are required to provide reasonable medical care for work-related injuries.  An injured worker who is unhappy with the medical care they are receiving can bring what is called an application for alternate medical care to attempt to get his medical care changed.  An application for alternate medical care is not automatically approved, and it is not enough that the injured worker is dissatisfied with the care that he has been receiving.  The Iowa rules require that the injured worker must show that the care was not offered promptly, was not reasonably suited to treat the injury, or that the care was unduly inconvenient.

Additionally, the Iowa Workers’ Compensation Commissioner can order alternate medical care when the employer-authorized care has not helped, and the injured worker can show that the authorized care is inferior or less extensive than the care requested by the injured worker.

Another important rule in Iowa workers’ compensation is that the employer’s right to select the provider of medical treatment for an injured worker does not include the right to choose how the injured worker should be diagnosed, evaluated, treated or other matters of professional medical judgment.  In other words, work comp defendants are not entitled to interfere with the medical judgment of their own treating doctors.

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.

Under Iowa law head and back injuries are both compensated under an industrial disability analysis.  Industrial disability tries to measure a worker’s loss of earning capacity, and not just the functional disability from an injury.  Functional impairment is an element to be considered in determining the loss of earning capacity, but consideration must also be given to the injured worker’s age, education, qualifications, experience, motivation, loss of earnings, severity situs of the injury, work restrictions, inability to engage in employment for which the worker is fitted, and the employer’s offer of work or failure to so offer.  Loss of industrial disability/loss of earning capacity is paid as a percentage of 500 weeks.

In the recent July 3, 2018 appeal decision of Bahe v. Iowa Department of Transportation, the Workers Compensation Commissioner affirmed a decision relating to a case in which the worker suffered both a head injury and back injuries.

The claimant was injured while operating a snow plow during a blizzard as part of his job with the DOT.  The snow plow went off the road and into a ditch.  The claimant was unconscious when he was found by emergency responders.  The medical providers documented that he had a large contusion on the top of his head.  The initial assessment by the doctors was that the claimant had suffered a closed head injury and concussion.

The first blog post I ever wrote over six years ago was entitled, “The Most Important Work Comp Advice: Always Tell the Truth.”  You can read that blog post here.  There are very few perfect work comp cases, and I am very comfortable addressing the weaknesses in my cases.  However, if a work comp judge decides that a claimant is not honest, then the case is in big trouble.

The Work Comp Commissioner issued an appeal decision in the case of Hall v. Apple Creek Kennel and Travelers Property Casualty Company of America on June 29, 2018.  The claimant was found to be dishonest, but fortunately for her just managed to avoid having her workers’ compensation benefits taken away.  All of the risk and danger could have been avoided if the claimant had been straightforward in her testimony.

The story started back on April 21, 2013.  The claimant was 32 years old and was working as a veterinary assistant.  This was a type of job she had generally worked since she graduated from high school.

This post will discuss the combination of three Iowa work comp legal doctrines.

First, under Iowa workers’ compensation law there is a special type of claim called a Second Injury Fund claim that allows a worker to receive industrial disability benefits for scheduled injuries.  The requirements for a Second Injury Fund claim are as follows:

  1. The worker has to have a prior injury to a hand, arm, foot, leg, or eye. This first injury can be from a work injury, a sports injury, a motor vehicle accident or from any source.

For injuries that occurred prior to July 1, 2017 the rules for when a workers’ compensation claim can be brought in Iowa law can be found here on our website.

For injuries that occurred on or after July 1, 2017 the rules have changed.  Fewer trucks drivers can now bring claims in Iowa.  Iowa Code Section 85.71 provides that where a truck driver is injured outside the State of Iowa, the truck driver is only entitled to bring a claim under Iowa law if at the time of the injury one of the following are applicable:

  1. The employer has a place of business in the state and the employee regularly works at or from that place of business.

In Iowa workers’ compensation cases the employer and insurance company have the right to choose the medical care providers for the injured worker.

If the worker is unhappy with the medical care they can file a Petition for Alternate Medical Care to have the care changed.  The employer’s obligation is to provide reasonable care.  The Claimant has the burden of proof to show that the authorized care is unreasonable.  Determining what care is reasonable is a question of fact.  As a general matter when the evidence shows that the employer-authorized medical care has not been effective, and that the authorized care is inferior to the requested care, the Petition for Alternate Medical Care will be granted.

On April 4, 2018 the Commissioner issued an alternate medical care decision in the case of Bushbaum v. Custom Wood Products which involves a worker’s request for alternate medical care, and also a complaint that the defendants had abandoned providing any medical care.  If the Commissioner finds that the defendants have abandoned medical care in a case, then the Commissioner will allow the worker to choose his future medical care.

If an injured worker in an Iowa workers’ compensation case is found to have suffered permanent total disability, then the worker is entitled to receive weekly benefits for the rest of their life.

Under Iowa law, permanent total disability does not mean a state of absolute helplessness.  Permanent total disability occurs when the injury wholly disables the employee from performing work that the employee’s experience, training, education, intelligence and physical capabilities would otherwise permit the employee to perform.  A finding that an injured worker could perform some work despite the worker’s physical and educational limitations does not rule out a finding of permanent total disability.

In a recent May 3, 2018 appeal decision in the case of Houston v. Harding Enterprises, LLC d/b/a Tuffy Auto Service Center and Accident Fund National Insurance Company, the Iowa Workers’ Compensation Commissioner reviewed and approved a decision in which permanent total disability benefits had been awarded.

In some Iowa work comp cases foot or leg injuries end up causing low back problems to the injured worker because of changes in their gait.  Iowa workers’ compensation law provides that if a worker suffers an injury to one part of the body that ends up causing an injury to a second part of the body, both of the injured body parts are compensable under Iowa work comp law.  The most common type of a spill over injury is a worker who injures his foot or leg and ends up with a limp.  Sometimes the limp will unfortunately cause hip or low back problems.  In this situation the worker is entitled to receive compensation for both the original leg injury and the later back injury that develops as a result of the limp.

Additionally, an injury to a scheduled member that results in an injury to an unscheduled member will be treated as a combined unscheduled injury.  For example, if the worker injures his leg, the maximum recovery the worker can receive is 220 weeks of permanent partial disability benefits.  If the worker has a 10% impairment of the leg, he is therefore entitled to 22 weeks of permanent partial disability benefits.

If the same worker’s leg injury causes back problems, the injury to both the leg and back shift out of the scheduled injury category to the unscheduled category.  For unscheduled injuries the worker is entitled to be compensated for the extent to which the injuries affect the worker’s future earning capacity.  Generally, a worker will receive higher compensation for an unscheduled injury than for a scheduled injury.