Under Iowa Workers’ Compensation law if an employee suffers a compensable injury, and then develops a second injury as a result of the original injury, then the second injury is also compensable as a workers’ compensation claim.  This sequence of the original work injury causing a second work injury is called a sequela of injuries.

The recent December 17, 2018 appeal decision of the Commissioner in the case of Kirkendall v. Cargill Meat Solutions Corp. and The Insurance Company of the State of Pennsylvania is a good example of a sequela injury case.

The Claimant injured her right shoulder when she fell on ice on December 10, 2009.  After a period of conservative treatment the Claimant began a series of right shoulder surgeries.  The first right shoulder surgery was on April 7, 2010.  The second right shoulder surgery was on December 17, 2010.

By the late summer of 2012 the Claimant began having left shoulder pain which the doctors attributed to her overusing her left shoulder to compensate for her injured right shoulder.  Since the left shoulder problems developed as a result of the Claimant’s right shoulder injury, the left shoulder became compensable under the work comp system as a sequela injury.

Starting in the summer of 2012 the Claimant began a period of approximately four years of multiple injections into both her right and left shoulders.

On April 19, 2016 the Claimant underwent her third right shoulder surgery.  This third right shoulder surgery was a total shoulder replacement.

The treating physician gave the Claimant a 19.4% impairment rating for her right shoulder.  The treating physician also assigned permanent restrictions of minimal repetitive work over shoulder height and no lifting over 30 to 40 pounds.  The treating physician also gave the opinion that the Claimant did not have any permanent impairment to her left shoulder.

The Claimant underwent an independent medical exam.  The finding physician gave an 18% whole person impairment rating relating to the right shoulder.  The IME physician also gave more stringent restrictions of no lifting of greater than 10 pounds occasionally, or 5 pounds frequently, along with no lifting over shoulder level with the right arm.

The IME physician also gave the opinion that the Claimant had suffered a 2% whole body impairment to her left shoulder, and should follow restrictions for the left arm of no lifting greater than 10 pounds occasionally, 15 pounds frequently, and no lifting over 5 pounds above shoulder height.

The Workers’ Compensation Commissioner found that the IME physician’s restrictions were more persuasive because they were consistent with the actual work Claimant had been able to do since her injuries.

The Deputy Workers’ Compensation Commissioner who heard this case awarded the Claimant 60% industrial disability which entitled her to 300 weeks of permanent partial disability benefits.

However, the Commissioner felt that the Claimant’s industrial disability was lower based on several factors.  After the Claimant’s injury in 2009 she had been able to bid out of the more strenuous job that she then held, and had worked an easier “neck bone” job ever since.  The employer’s business was busy, and the Claimant had generally been able to work 48 hour work weeks since her injury.  She also was the secretary for the Local Union.  The Claimant also had very high seniority with the employer based on her 30 years of work.  Therefore, the Commissioner reduced the award to 35% industrial disability which equals 175 weeks of permanent partial disability benefits.