An injured worker does not have to be absolutely helpless in order to be awarded permanent total disability benefits under Iowa work comp law. A worker is considered to be permanently and totally disabled when an injury prevents the worker from performing the type of jobs his experience, training, education, intelligence and physical capacities would otherwise permit him to perform. Additionally, a finding that a worker could theoretically perform some small amount of work does not necessarily rule out an award of permanent total disability benefits.
Older workers with preexisting problems can suffer a moderate injury that knocks them out of the workforce and entitles them to an award of permanent total disability.
Byers v. Guardsmark, LLC and New Hampshire Insurance Company is a January 17, 2019 Appeal Decision from the Iowa Workers’ Compensation Commissioner that provides a good example of an older worker who ends up being awarded permanent total disability.
From 1998 to 2014 the claimant had been unemployed as a result of a back injury and receiving Social Security Disability benefits and then Social Security retirement benefits. In 2014, at age 72, the claimant had begun to work as a security guard.
All of the parties agree that the claimant fell at work when he was walking up some muddy stairs on September 1, 2014.
While the parties agree that the claimant did fall, the claimant’s account of the fall changed quite a bit over the years. Initially he described losing his balance and grabbing the hand rail and slamming his back into the railing. In later accounts he testified that he fell over the railing and dropped approximately 30 feet to the ground. The Workers’ Compensation Commissioner did not find the later accounts of the fall to be credible, but did not hold that against the claimant.
The claimant did suffer severe injuries in the fall including multiple herniated disks in his low back and cauda equina syndrome. Cauda equina syndrome results from the compression of the sac of nerves and nerve roots at the base of the spine and can lead to very serious problems.
The claimant underwent major low back surgery about 10 days after the fall. From the time of the surgery up through the original workers’ compensation trial in April of 2017 the claimant was generally non-compliant and uncooperative with his medical care providers. However, the defense experts generally agreed that the fall had severely limited the claimant’s ability to walk and left the claimant with chronic pain.
At trial the defendants argued in part that the claimant had suffered a prior serious back injury in the late 1990s that resulted in the claimant being awarded Social Security Disability. The claimant had been unemployed between 1998 and 2014, and the claimant testified that he had considered himself retired until he was hired for the security job in 2014. The defense point was that the claimant was already very physically limited before the 2014 fall.
The Commissioner agreed that the claimant’s prior back injury in the 1990s severely limited his earning capacity prior to his employment with the security company. However, by hiring the claimant the security company obviously showed that they believed that the claimant still had some residual earning capacity. The Commissioner found that the claimant’s earning capacity was severely damaged by the September 1, 2014 work injury.
The Commissioner also acknowledged that the claimant had not made any attempt to return to work since the 2014 injury, and that he was often uncooperative with his treating physicians. Nonetheless, the Commissioner found that the claimant’s injury left him permanently and totally disabled. Therefore, the Commissioner awarded the claimant permanent total disability benefits for the rest of his life.
The claimant’s changing account of how he was injured, and his lack of cooperation with his medical providers could have led to a different work comp result if the claimant’s injury had been less serious. I always recommend to my clients that they make their best efforts to try to find a job that they can perform with their limitations and restrictions, and that they cooperate with the medical care providers. I have found this advice leads to the best results in contested cases.
As mentioned above, a key teaching point from the Byers case is that even if an older worker had a lot of physical problems that limited their abilities, if a work injury severely decreases the claimant’s remaining abilities, the claimant will be entitled to a substantial workers’ compensation award.