The recent February 14, 2019 Iowa Workers’ Compensation Appeal Decision in the case of Bonde v. Pro Cooperative and Nationwide Agribusiness dealt with a situation in which there were no witnesses to the injury.
The Claimant reported that he fell while at work and injured his low back. The Claimant explained he had slipped and fell on some loose soybeans on the icy parking lot. There were no witnesses to the fall. The fall itself happened on Thursday, February 19, 2015. The Claimant was able to continue working throughout the day. The Claimant came to work on the next day, on Friday, and was also able to work the entire day although he was in pain. The Claimant was off work on Saturday and Sunday. By Monday the Claimant’s back pain was worse and he reported the injury.
The employer and insurance carrier did not give the Claimant any instructions on going to a physician. They did not provide any workers’ compensation benefits, and they did not give the Claimant any guidance on whether or not he should come into work.
The Claimant began pursuing medical care on his own with his family doctor. The Claimant called in to the employer to report his progress on numerous occasions.
The employer terminated the Claimant about a month after the accident but did not tell him that he had been terminated until the case went into litigation.
The employer did not report the injury to the workers’ compensation insurance company until months after the accident. The work comp insurance company eventually issued a denial of the claim based on “lack of information.”
The workers’ compensation carrier rejected the defense arguments on causation and ruled that the Claimant had carried his burden of proof that he had suffered a work injury based on several factors:
- The Claimant was credible at the work comp trial.
- The Defendants’ explanation of his injury was consistent throughout his medical care.
- The Commissioner did not find it was uncommon that the Claimant suffered an injury on Thursday and did not decide it was a serious matter that should be reported until the following Monday.
As mentioned above, the Claimant did attempt to pursue medical care on his own. He underwent an MRI that found a herniated disk in his low back. He was scheduled for back surgery, but ultimately his private health insurance would not cover the procedure, and the back surgery did not take place. The Commissioner ordered that the employer and insurance carrier should be responsible for all medical bills relating to the injury, and that the Defendants should authorize and pay for the recommended low back surgery.
The Claimant was not able to work from late February of 2015 up through the trial on August 24, 2017. The Defendants argued that they should not be responsible for paying healing period benefits because none of the doctors involved in the case clearly stated that the Claimant was unable to work.
The Commissioner found that the lack of clarity in the medical records was because of the defense refusal to properly handle the case. Therefore, the Commissioner ruled that the Claimant was entitled to healing period benefits for all of the weeks that he had been off work between the injury and the trial. The Commissioner ordered that the Defendants should continue to pay the Claimant healing period benefits until such time as the back surgery had occurred and the Claimant reached maximum medical improvement from the back surgery. Once the Claimant reached maximum medical improvement from the back surgery the Defendants should pay the Claimant permanent partial disability benefits.
The Commissioner approved a $10,000.00 penalty award against the Defendants based on their unreasonable conduct. The Commissioner approved the trial judge’s reasoning in support of the penalty award:
“The employer simply decided the injury did not make sense to them and, based upon the evidence before me, performed no meaningful investigation. In fact, the employer did not even turn the injury into their carrier so that the carrier could perform a meaningful and timely investigation. The employer ceased communicating with the claimant and summarily removed him from the payroll without even communicating the same to him. This behavior appears to me, based upon this record, to simply be wishful thinking that Mr. Bonde would go away. Given the length of the delay and the lack of investigation and compliance with Iowa law, I find that a penalty of $10,000.00 is appropriate to deter the defendants from engaging in such conduct in the future.”