Articles Posted in Work Aggravations To Pre-Existing Conditions

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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.

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The details of workers’ compensation cases are critical, and our lawyers are always available for no cost and no obligation discussions. However, in this post I am going to try to answer the most common questions that we receive.

WORK COMP BENEFITS

What are the work comp benefits I am entitled to receive? There are three main areas of benefits:

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The Iowa Workers’ Compensation Commissioner issued an Appeal Decision on July 3, 2019 in the case of Rhonda Tucker v. Menards, Inc. and Praetorian Insurance Co. dealing with a review-reopening.

In a review-reopening action an injured worker can recover additional benefits if their condition has worsened since the original settlement or trial award.  The injured worker has the burden of proof to show that their condition has changed since the original award or settlement was made and that the change in condition relates back to the original injury.  The change of condition can either be based on physical changes or economic changes.

The claimant in the Tucker case was 58 years old.  She did not graduate from high school but did obtain a GED.  The claimant worked at Menards for 22 years.  She previously worked 15 years for a competing hardware chain, and a few years as a receptionist.

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A Somatic Symptom Pain Disorder is a condition in which the patient’s subjective pain profile is higher than what would be expected for the physical injury.  Doctors who work in the area of pain disorders find that approximately 5% of all pain clinic patients have Somatic Symptom Pain Disorder.  Under Iowa law an injured worker who has developed Somatic Symptom Pain Disorder is entitled to receive workers’ compensation benefits.

On February 26, 2019 the Iowa Workers’ Compensation Commissioner filed an Appeal Decision in the case of Swanger v. Cloverleaf Cold Storage and AIG Insurance that dealt with a Somatic Symptom Pain Disorder.

The Claimant suffered a stipulated low back injury on June 24, 2014.  An MRI showed a small low back disc herniation and an annular tear in the low back.

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Under Iowa workers’ compensation law a worker can bring a review-reopening action to obtain additional compensation after an open file settlement or trial award if his functional impairment or loss of earning capacity has increased.  The worker has to prove that his worsening condition was proximately caused by the original injury. The worsening can either be physical or a reduction in the worker’s earning capacity.

An interesting angle relating to review-reopening actions was addressed in the December 14, 2018 appeal decision of Hayes vs. Eagle Window & Door, Manufacturing, Inc. and Old Republic Insurance Company.  The Workers’ Compensation Commissioner ruled that a review-reopening action could be based on an injury that previously existed, but which was unknown or could not have been discovered by the exercise of reasonable diligence at the time of the prior settlement or award.

In the Hayes case the Claimant was originally injured back on July 20, 2010 when he received an electrocution injury while working.  The case went to hearing on May 6, 2013 and resulted in an award of 15 weeks of permanent partial disability benefits.  At the time of the May 6, 2013 arbitration hearing the doctors had only identified that the Claimant had incurred minor bilateral arm injuries from the electrocution.

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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.

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Unfortunately, injuries will sometimes worsen after a workers’ compensation case is resolved.  The Iowa Workers’ Compensation Commissioner recently issued an Appeal Decision in the case of Dautovic v. Concord Hospitality and PMA Insurance Group and Zurich American Insurance which analyzes the legal implications of a worsening injury.

The claimant in Dautovic began working for a Marriott Hotel run by Concord Hospitality in 1997.  The claimant’s job involved a lot of heavy work including deep cleaning of rooms and hallways, working with laundry, and moving furniture.

The claimant originally injured his low back on the job in early 2006 when lifting a bed frame.

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Sometimes a relatively minor physical injury can lead to a very severe mental injury, and even an inability to work.

The Iowa Workers’ Compensation Commissioner recently addressed such a situation in an Appeal Decision issued on December 12, 2017 in the case of Fitch v. Des Moines Public Schools and EMC Insurance Companies.

The Claimant in the Fitch case was a special education teacher who was assaulted by a student.  The Claimant suffered substantial cuts and bruises in the attack, but the physical injuries healed within several weeks.

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The Iowa Workers’ Compensation Commissioner entered an appeal decision on November 29, 2017 in the case of Heim v. A.Y. McDonald Mfg. Co.  The main issue in the Heim case was whether the worker had suffered permanent total disability.

Under Iowa law permanent total disability does not mean that a worker is injured so severely that they are helpless.  Instead, the test is whether the injury disables the employee from performing the type of work that their experience, training, education, intelligence and prior physical ability would otherwise permit them to perform.  (See here for a longer explanation of how pre-July 1, 2017 permanent total disability injuries are analyzed under the workers’ compensation system.  See here for an explanation of the change in how injuries are analyzed for post-July 1, 2017 Iowa work comp injuries.)

The claimant in the Heim case was 63 years old at the time of the workers’ compensation trial.  His formal education ended with high school.  His work history had generally involved physically demanding jobs.

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Today I am going to talk about the case of Plumrose USA and Zurich Ins. Co. v. Robert Hathaway which was issued by the Iowa Court of Appeals on January 23, 2014.

One of the big issues in the case was whether Mr. Hathaway was entitled to workers’ compensation benefits for a serious right knee injury in light of his long history of pre-existing knee problems.

The Court of Appeals summarized the Iowa work comp law on aggravation of pre-existing condition as follows:

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