Articles Posted in Work Aggravations To Pre-Existing Conditions

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.

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.

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.

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.

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.

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.

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:

In this post I am going to talk about the discovery process in Iowa work injury cases. Discovery is just the legal term for the process of investigating the case and asking the other side questions in a formal process. Both the injured worker and the defendants get to conduct discovery.

Under the discovery rules neither side gets to keep very many things secret. One policy idea behind not allowing secrets is that if each side has a clear and complete view of the case they can probably work out a fair settlement. A second policy idea behind the discovery process is to have the cases tried and decided on the merits, and avoid what used to be called “trial by ambush.”

Today I am going to start by talking about the usual discovery that the defendants conduct. In a later post I will talk about the discovery I conduct on behalf of injured workers.

MENTAL INJURIES ARE COMPENSATED AS INDUSTRIAL DISABILITY INJURIES. Under Iowa law mental injuries are compensable in the workers’ compensation system. Mental injuries are unscheduled injuries. Therefore, the emphasis in figuring out the amount of damages is based on determining how much the mental injury reduces the injured worker’s future earning capacity. (See here and here for longer discussions on how industrial disability injuries are valued).

AGGRAVATION OF PRE-EXISTING MENTAL HEALTH ISSUES. Similar to physical injuries, an aggravation of a pre-existing mental health issue is still compensable under Iowa law as long as the aggravation is substantial. As an example, look at the Iowa Supreme Court case of Cedar Rapids Community School District v. Pease, 807 N.W.2d 839 (Iowa 2011). In the Pease case the claimant did have a pre-existing history of depression. However, the Workers’ Compensation Commissioner, and later the Iowa Supreme Court, found that the claimant’s physical injury caused a substantial aggravation of her depression, and that the claimant was entitled to receive weekly benefits for this increase in her depression.

MENTAL-MENTAL INJURIES. Mental health injuries that arise without physical injury are frequently called “mental-mental” injuries. By contrast, mental injuries which are connected to a physical work injury are called “physical-mental” injuries. There are some important differences in how these two different types of mental injuries are treated. I will first talk about mental-mental injuries.

Frequently a worker will have a pre-existing health condition. The pre-existing condition can be the result of numerous causes, including but not limited to the natural aging process, a prior work injury, or an accident unrelated to work.

Sometimes a pre-existing condition will make the worker more susceptible to a work injury. For example, a worker that has had prior shoulder or back surgery might be injured doing a job that would not have hurt a worker who did not have a pre-existing problem. The worker with the pre-existing condition is sometimes called an “eggshell plaintiff” because they are more easily injured than an average person. However, under Iowa work comp law even though a worker might be an eggshell plaintiff, if he gets hurt on the job he is entitled to receive workers’ compensation benefits.

Sometimes a worker may have a pre-existing condition that is completely latent or symptom free and does not cause him any problems. If a worker with such an asymptomatic condition is injured on the job he will generally be entitled to be compensated for the entire resulting disability from the injury even though the final disability is caused by a combination of the pre-existing condition and the work injury.