The Iowa Workers Compensation Commissioner entered a recent Appeal Decision on March 19, 2019 in the case of Tammy Roberson v. Sears Holdings Corporation and Indemnity Insurance Company of North America which highlights the importance of expert opinions in Iowa work comp cases. In some situations it is very clear that an injury was caused by work. This would be where a worker is struck by a forklift, cut by a knife, etc. However, in many other situations, it is not always clear whether an injury was caused by cumulative trauma at work or whether an injury was unrelated to work and just caused by natural degenerative changes.
Under Iowa law, the cause of an injury is essentially within the domain of expert testimony. The Work Comp Commissioner considers the expert medical evidence along with all of the other evidence in the case. Testimony from non-medical witnesses may be used to support or attack expert opinions. The amount of weight to be given to an expert opinion is determined initially by the Deputy Work Comp Commissioners at trial, and then by the Commissioner if the case is appealed. The Deputy Commissioners and the Commission have the power to accept or reject expert opinion either in whole or in part.
In the Roberson case, the Claimant was 53 years old at the time of trial. She had a high school education. The Claimant also had an extensive and varied work history. She had worked as a flagger on a construction crew. She had worked as a supervisor of tar pickers, power washers and ropers. The Claimant had also worked as a bartender, waitress and a cook. She had worked as a shipping and receiving clerk. She had worked as a CNA. She had worked as a planter in a greenhouse. She had worked in a grocery store as a cash register operator and stocking shelves and working at the customer service desk. She had worked for a railroad support company and drove railroad crews around the country. Her job with Sears Holdings Corporation included customer service, stocking, inventory, assembly, shipping, and operating a forklift.
The parties agreed that the Claimant did suffer a knee injury while operating a forklift on December 5, 2013. This injury led to surgery on February 4, 2014 and within a few months the Claimant was returned to full duty work. The Defendants paid the Claimant 22 weeks of permanent partial disability benefits for the injury to her knee.
The Claimant testified that her knee began to give her problems about three or four months after returning to work, but she did not seek any new medical care until April of 2015. By the time she raised new complaints, the Claimant had been back to full duty work for a year.
The doctors found that the Claimant had suffered further knee tears and a second surgery was performed on June 20, 2015.
The Claimant continued to have problems after the June 20, 2015 surgery and the doctors concluded that the Claimant would need a total knee replacement. The Defendants refused to authorize the knee replacement as a workers’ compensation expense, and the case went into litigation.
As a result of her bad knee and limping, the Claimant also began to develop low back and hip problems. The Claimant was not able to work for Sears Holdings Corporation after November 17, 2015, and was unable to obtain any alternate employment up to and including the issuance of the Commissioner’s Appeal Decision on March 19, 2019.
At trial the Defendants presented expert opinions that all of the problems with the Claimant’s knees were related to degenerative changes, and nothing about her work had aggravated or caused her knee problems.
The Claimant presented expert testimony that although she had bad knees that were undergoing degenerative changes, her work had indeed substantially aggravated and accelerated her knee problems.
The Commissioner found that it was a very close call between the competing expert opinions, but that the Claimant had carried her burden of proof to establish that her injuries were from work.
Therefore, the Commissioner ordered that the Defendants retroactively pay her healing period benefits covering the whole period of time that she was off work from November 17, 2015 to the present and continuing. The Commissioner also ordered that the Defendants authorize the necessary knee replacement surgery, and that the Defendants also provide medical assessment and care for the Claimant’s hip and low back problems.
Finally, Commissioner noted that when the Claimant reached maximum medical improvement she would be entitled to come before the Workers’ Compensation Commission again to receive permanent partial disability benefits for her knee, hip and back injuries.
Gilloon, Wright & Hamel, P.C. works with many physicians across the State to make sure that we can provide the best expert opinions for clients. Please contact us if you have any workers’ compensation questions.