Court of Appeals Affirms District Court Decision in Review Reopening Case
Following the settlement of a claim for 12% industrial disability and healing period benefits, claimant filed for review-reopening. The agency concluded that claimant had established a material change in conditions since the time of the settlement, found that additional permanent impairment had been established and concluded that past and future medical expenses should be paid by defendants. The district court affirmed the finding that there had been a change in circumstances and that claimant was entitled to medical care, but remanded the case for a finding of whether additional industrial disability had been incurred. On appeal, the Court of Appeals affirms the findings of the district court. Anderson News v. Reins, No. 14-0038 (Iowa App. Nov. 13, 2014).
Following the settlement, claimant continued to treat with Dr. Kirkland, and he indicated that claimant did not have any further impairment or restrictions. Because of the closure of claimant's employer, she was working in a different job at the time of the hearing, doing similar work, but paying .25 per hour less. Dr. Quenzer, who had performed an earlier surgery, found that there was a 4% increase in the impairment to her upper extremity. Dr. Basil (Bansal?) found a 4% increase in impairment plus some loss in claimant's range of motion. Dr. Quenzer recommended a high yield MRI of the claimant's shoulder to determine whether surgery would be appropriate.
The court noted that worsening of a claimant's physical condition was a way to satisfy the review reopening requirements, but noted that the principles of res judicata applied. The employer argued that there must be "a substantial worsening of the claimant's condition to permit a review reopening." The court rejected the argument that Kohlhaas v. Hog Slat, Inc., 777 N.W.2d 387, 392 (Iowa 2009) had imposed a requirement that a "substantial worsening" was required. The court concluded that the commissioner's finding that claimant had suffered a worsening of her condition was supported by substantial evidence.
The court also agreed with the district court that the commissioner had failed to explicitly consider whether claimant had suffered a loss of earning capacity that would warrant an increase in benefits. The decision of the commissioner had not demonstrated how there had been a loss of earning capacity since the time of the settlement and noted that "her economic condition has actually improved considerably." The court remanded for the agency to make a finding of claimant's loss of earning capacity.
On the issue of future care, the finding that Dr. Quenzer had recommended a high yield MRI and the commissioner's confirmation of this fact was found to be supported by substantial evidence, and this finding was also affirmed.
Following the settlement, claimant continued to treat with Dr. Kirkland, and he indicated that claimant did not have any further impairment or restrictions. Because of the closure of claimant's employer, she was working in a different job at the time of the hearing, doing similar work, but paying .25 per hour less. Dr. Quenzer, who had performed an earlier surgery, found that there was a 4% increase in the impairment to her upper extremity. Dr. Basil (Bansal?) found a 4% increase in impairment plus some loss in claimant's range of motion. Dr. Quenzer recommended a high yield MRI of the claimant's shoulder to determine whether surgery would be appropriate.
The court noted that worsening of a claimant's physical condition was a way to satisfy the review reopening requirements, but noted that the principles of res judicata applied. The employer argued that there must be "a substantial worsening of the claimant's condition to permit a review reopening." The court rejected the argument that Kohlhaas v. Hog Slat, Inc., 777 N.W.2d 387, 392 (Iowa 2009) had imposed a requirement that a "substantial worsening" was required. The court concluded that the commissioner's finding that claimant had suffered a worsening of her condition was supported by substantial evidence.
The court also agreed with the district court that the commissioner had failed to explicitly consider whether claimant had suffered a loss of earning capacity that would warrant an increase in benefits. The decision of the commissioner had not demonstrated how there had been a loss of earning capacity since the time of the settlement and noted that "her economic condition has actually improved considerably." The court remanded for the agency to make a finding of claimant's loss of earning capacity.
On the issue of future care, the finding that Dr. Quenzer had recommended a high yield MRI and the commissioner's confirmation of this fact was found to be supported by substantial evidence, and this finding was also affirmed.
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