Articles Posted in Workers’ Compensation Injuries

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Iowa workers’ compensation is an adversary system of justice.  The insurance companies will sometimes reject legitimate work injuries, and will frequently pay less than the full value of a work injury.  If your claim is rejected or underpaid you have the right to hire your own lawyer to contest the dispute.

Our lawyers have reviewed the cases of many injured workers that have been rejected or denied by work comp insurance companies.  In many of these rejected and denied cases we have been able to obtain our clients money and medical care.

Similarly, many people have come to us after being offered or paid small amounts of money.  In many of those cases we have been able to obtain additional compensation benefits for the clients.

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I decided to look for a Christmas related topic for this work comp blog entry.  The 2002 workers’ compensation case of Smith v. Carl A. Nelson & Company and Wausau Insurance Companies had a Christmas tie-in.  The Claimant was a construction worker with Carl A. Nelson & Company and generally performed concrete work.  The Claimant was laid off during the winters.  The Claimant underwent regular performance reviews and his productivity before his work injury had always been rated as “exceptional.”

In May of 1999 the Claimant suffered a low-back injury.  The Claimant received conservative treatment and did not undergo surgery.  However, he was off work for the remainder of the 1999 construction.  The Claimant was not able to return to work until May of 2000.  The Claimant testified that he had a difficult time performing his usual duties during the 2000 construction season and co-workers had to help him.

In late fall of 2000 the Claimant was placed on his usual winter lay off.  At the start of the lay off the Claimant was not worried about his job, but he testified he figured he was in trouble when he was not invited to the annual Christmas party.  The Claimant was not called back to work in the spring of 2001.

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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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The Iowa Workers’ Compensation law on when an employee is entitled to work comp benefits from a fall on the job has been very uncertain for a number of years.  On November 16, 2018 the Iowa Supreme Court issued a decision that helps clarify the Iowa law.  The Supreme Court case was Bluml v. Dee Jay’s, Inc. d/b/a Long John Silvers and Commerce & Industry Insurance Company.  In the Bluml case the Iowa Supreme Court set out different rules for different types of fall situations:

  1. Where an employee falls from an elevated position such as a ladder or scaffolding the injury will generally be compensable under Iowa Workers’ Compensation law.
  1. Where an employee falls while on stairs the injury will also generally be compensable under Iowa Workers’ Compensation law.
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Iowa law provides that for work injuries prior to July 1, 2017 an employer is fully liable for compensating all of an injured worker’s disability that arises out of and in the course of the employee’s employment with the employer.

However, Iowa Code Section 85.34(7)(b)(2) provides that where a worker suffers two industrial disability injuries with the same employer, the worker should be paid industrial disability based on the combined disability from the two injuries; and the employer should receive a credit for the benefits paid for the first injury.

The Iowa Workers’ Compensation Commissioner filed an Appeal Decision on November 5, 2018 in the case of Ditsworth v. ICON Ag, Federated Insurance and Nationwide Insurance examining an apportionment situation.

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Under Iowa law the amount of compensation an injured worker is entitled to receive is determined by one of two methods.  If the injury is to a body part listed in the schedule of Iowa Code Section 85.34, the disability is measured functionally.  The most persuasive functional measurements are pursuant to the AMA Guides to the Evaluation of Permanent Impairment.  The scheduled injuries and the maximum permanent compensation for each body part are as follows:

Shoulder. . . 400 weeks of permanent partial disability benefits;

Leg . . . 220 weeks of permanent partial disability benefits;

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If a work comp case goes to trial and the injured worker has not yet reached maximum medical improvement, and is not capable of working, then the worker is given what is called a running award.  This means that the Claimant is entitled to receive weekly healing period benefits until the worker does reach maximum medical improvement or is able to return to work.  On reaching maximum medical improvement or returning to work, the worker would then be entitled to receive permanent partial disability benefits.

Kramer v. Dohrn Transfer Company, Inc. and American Zurich Insurance Co. is a July 12, 2018 appeal decision from the Iowa Workers’ Compensation Commissioner that deals with a contested running award situation.  The employee was a truck driver who suffered a mental health injury from a May 23, 2014 motor vehicle accident while driving for his employer.  The other vehicle involved in the accident failed to stop at a stop sign.  The 18-year-old driver of the other vehicle died in the accident.

The Claimant was very distraught about the accident and stayed off work until June 4, 2014.  The Claimant then returned to work through January 14, 2015.  During the approximate seven months between June 4, 2014 and January 14, 2015 the Claimant was having a lot of problems.  He blew up at his supervisors one day when they asked him to deliver tires.  One of his supervisors took him off work for a day because the Claimant was having problems.  The Claimant saw a number of doctors and received medication.  The Claimant reported to his doctors that he was anxious about driving.  The Claimant’s mother also died on July 20, 2014 and this was an additional source of stress.

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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.

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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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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.

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