Court of Appeals Affirms Payment of Temporary and Permanent Benefits in Total Knee Replacement Case

In Plumrose USA v. Hathaway, No. 13-0495 (Iowa App. Jan. 23, 2014), claimant suffered an injury to his right knee when he fell down a flight of stairs, cause a medial meniscal tear and patella tendon tear.  Claimant had a past history of knee injuries, including three surgeries.  He had been told that he would need knee replacement surgery at some point in the future.  Following the accident, conservative care was initially provided, but ultimately a total knee replacement was recommended.

Defendants denied the claim, based on a doctor's report that there was no way of knowing when a TKR would have been needed.  This same doctor later indicated that the TKR was directly related to claimant's acute exacerbation of his chronic knee arthritis, and opined that there was a 50% impairment to the leg.  The arbitration and appeal decisions concluded that the knee injury was compensable, and ordered payment of temporary and permanency benefits.

Before the court, the employer argued that because the TKR would have been been needed at some point regardless of the accident, it did not arise out of and in the course of employment.  The court, citing Rose v. John Deere Ottumwa Works, 76 N.W.2d 756, 759 (Iowa 1956), found that the mere existence of a pre-existing condition was not a defense.  The court also noted that there was no treatment for the knee in the six months prior to the injury.  The court concluded that substantial evidence supported the commissioner's conclusion that the accident had aggravated claimant's pre-existing condition.  The court used the same rationale to find that temporary benefits were payable.