The Iowa Workers’ Compensation Commissioner entered an Appeal Decision in the case of Kuehl v. Foley Company and CNA Insurance on February 3, 2021.  The case is an example of how work injuries that are impacted by psychological issues are handled in Iowa work comp law.

The injured worker did not graduate from high school or obtain a GED.  The Claimant began working as a crane operator when he was 17 years old and continued in that profession for 30 years until he was injured in July of 2017.  The Claimant was climbing into an excavator when he slipped and fell about 3 to 5 feet and landed on his right heel, and felt immediate pain in his back.

The Claimant went through extensive medical care and evaluation.  All of the doctors agreed that the Claimant did suffer some type of low back injury from the fall, and all of the doctors agreed that the Claimant did not require surgery.  The Claimant went through physical therapy without improvement. He took a number of different medications without improvement.  The Claimant generally resisted epidural steroid injections, when these were given, they also did not help.  MRI and EMG testing did not reveal any significant problems.

The Claimant had a fall at home on January 7, 2019 and stated that he could no longer move his legs.  The Claimant was hospitalized for 8 days, but the physicians could not find any explanation for the alleged paralysis.  Additionally, the doctors noted that the Claimant would occasionally cross and uncross his legs while he was awake, and regularly moved his legs while he was sleeping.

The Claimant was seen by a number of mental health providers, who generally agreed that the Claimant would benefit from counseling, but that the Claimant was not interested in pursuing counseling.

Two of the doctors believed that the Claimant’s low back injury qualified for an 8% whole person impairment rating.  One doctor thought that the Claimant had a 0% impairment rating.

On the issue of restrictions, the one doctor gave the opinion that no restrictions were necessary.  Two doctors recommended a 20-pound lifting restriction with no repetitive bending, turning, or twisting at the waist, and sitting and standing as tolerated.

The Claimant testified that he was essentially bedridden and could only manage to get around enough to go to the bathroom, let his dogs outside, and cook meals.

The Deputy Commissioner that presided at the trial gave an analysis that recognized the conflicting nature of the evidence:

  1. The Deputy found that the Claimant seemed honest and credible while testifying.
  2. However, the Deputy also recognized that the defense had raised good points calling the Claimant’s motivation into question.
  3. The Deputy found that the Claimant did not make a good faith effort to return to work or make a good faith effort to find alternate work.
  4. The Deputy noted the Claimant had been granted Social Security Disability, and this may have been a factor in his reluctance to return to work.
  5. The Deputy recognized that the Claimant was not an ideal patient. He frequently failed to cooperate with his treatment providers relating to either physical or mental issues.
  6. The Deputy noted that many of the doctors believed that there was some type of mental health component to the Claimant’s physical complaints.
  7. In the end, the Deputy found that considering the Claimant’s age, his limited educational background, his employment history, his lack of motivation to return to the workforce, his functional abilities, and the evidence showing a relatively mild back injury, the Claimant could not qualify for permanent total disability under Iowa workmens’ compensation law.
  8. However, the Deputy found that the Claimant was entitled to 70% industrial disability which would work out to be 350 weekly payments of permanent partial disability at the Claimant’s rate of $808.31 per week.

Both parties appealed.  The Claimant requested that the award be increased to permanent total disability.  The defense argued that the Claimant should receive nothing or only a very modest award.  The Workers’ Compensation Commissioner affirmed the award of 350 weeks of permanent partial disability benefits.

An injured worker does not need a perfect case in order to recover.  However, the Claimant was fortunate to receive an award of 70% industrial disability.  In similar cases, the claimants frequently receive nothing or much smaller awards.

A claimant will always do better by cooperating with medical care and making a good faith effort to return to work or alternate employment.