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.

The claimant was initially evaluated at the Iowa Methodist Occupational Health and Wellness Clinic.  This facility diagnosed her with bilateral hand, elbow, shoulder, and back strain related to repetitive work.  She was given bilateral braces and elbow pads and started on medication.

This initial treatment did not resolve her symptoms, and the claimant was referred to Bill Koenig, M.D.  Dr. Koenig found carpal tunnel and cubital tunnel on the left but no problems on the right.

The claimant was also seen by Michael Ganier, M.D. who also diagnosed her with only left sided problems.

The claimant was then seen by John L. Gaffey, M.D.  Dr. Gaffey diagnosed the claimant with bilateral upper extremity pain, numbness and tingling.  However, Dr. Gaffey did not think the problems were carpal tunnel or cubital tunnel or any type of nerve impingement.

The claimant was then seen by Steven Quam, D.O.  Dr. Quam diagnosed the claimant with bilateral upper extremity pain and also recommended a cervical MRI.  The MRI showed a number of disk bulges in the neck area.  Dr. Quam treated the neck problems with multiple epidural steroid injections.

The claimant was then sent to see Ericka Lawler, M.D. at the University of Iowa Hospitals & Clinics.  Dr. Lawler recommended a further referral for a shoulder evaluation.

The claimant was then seen by James Nepola, M.D. of the University of Iowa Hospitals & Clinics.  Dr. Nepola ultimately performed a left shoulder arthroscopy in which he resected the claimant’s distal clavicle and performed a subacromial decompression in the left shoulder.

Following a period of recovery and physical therapy Dr. Nepola rated the claimant’s left shoulder injury as an 11% impairment of the whole body and recommended permanent work restrictions of no repetitive reaching away from the claimant’s body or above shoulder height.

Unfortunately, the shoulder surgery did not resolve the claimant’s problems.  Claimant returned to see Dr. Lawler and underwent ten surgeries for carpal tunnel, cubital tunnel, and various trigger fingers.  Dr. Lawler deferred to Dr. Nepola’s restrictions on the left upper extremity.  Dr. Lawler gave the opinion that on the right side of the claimant could not lift greater than 15 pounds or repetitively grip with her right hand.

Wal-Mart had the claimant seen by Charles Mooney, M.D. for a defense medical exam.  Dr. Mooney gave the opinion that the claimant’s job activities at Wal-Mart were not a cause of any of her injuries.

Dr. Quam gave supplemental opinion that the claimant also had suffered a neck injury from her work at Wal-Mart.

The Commissioner analyzed the conflicting opinions and concluded that:

  1. The claimant’s injuries to her left shoulder, both hands, both elbows, all of her trigger finger injuries, and her neck injury were work related.
  2. The claimant’s right shoulder injury was not work related.

The Commissioner found that the claimant’s age, high school education, and work restrictions prevented her from doing many of the jobs that she had performed in the past and many alternate jobs that she would otherwise be appropriate for.

Therefore, the Commissioner awarded her 275 weeks of permanent partial disability benefits, and appointed and authorized Dr. Quam to provide medical care for the neck injury.