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 Claimant’s more significant injury was an immediate aggravation of her preexisting anxiety, depression, and post-traumatic stress disorder.

The Claimant was able to return to teaching after the assault but within a few months the Claimant’s supervisors were unhappy with her classroom performance.  The Claimant’s mental condition was further aggravated by the criticism from the school administrators.  Within a few more months all the parties agreed that the Claimant could no longer work because of her worsening mental condition.

Under Iowa law, employers take an employee subject to any active or dormant health problems.  If a worker suffers a substantial aggravation of a preexisting condition it is viewed as a compensable work injury in Iowa.  The Claimant only needs to show that the work injury was a substantial factor in the aggravation of a preexisting condition.  The work injury does not have to be the only cause.  The work injury does not have to be the primary cause or the most substantial cause.  The work injury just needs to be one of the substantial factors causing the aggravation of a preexisting condition.  The Iowa law on aggravation of preexisting conditions applies to both physical injuries and mental injuries.

The Claimant’s long time treating psychiatrist gave the opinion that the Claimant’s preexisting mental health issues were aggravated by the physical assault.

The Defendants hired an expert who gave the opinion that the work injury was not a substantial contributing factor to the Claimant’s increased mental health problems.

The Claimant was also seen for an independent medical examination.  The psychologist who performed the independent medical examination noted that the Claimant had a long history of previous trauma, and the previous trauma was the reason that the Claimant’s response to the assault by her student was more severe than some people might have expected.  The IME expert gave the opinion that while there were several factors that led to the Claimant’s mental condition deteriorating to the point that she could not work, the assault by the student was one of the substantial factors.

The Defendants argued on appeal that the Claimant should not be compensated for the aggravation of a preexisting mental condition because the physical injuries she suffered were not permanent.

The Iowa Workers’ Compensation Commissioner ruled in his Appeal Decision that the physical injuries that the Claimant suffered did not have to be permanent in order for the Claimant to be entitled to compensation for the aggravation of her preexisting mental condition.  The Commissioner also ruled that the Claimant was entitled to permanent total disability benefits because the assault at school had eventually rendered her incapable of working.

Please be sure to contact us if you have any questions about aggravation of preexisting conditions or mental injuries in Iowa workers’ compensation cases.