Neifert, Byrne & Ozga, P.C.

Welcome to the blog for Neifert, Byrne & Ozga, P.C., devoted to developments in the field of workers' compensation in the State of Iowa. We hope the blog provides helpful information to users, including updates of Iowa Supreme Court and Court of Appeals cases of interest to claimants and workers' compensation practitioners.

Neifert, Byrne & Ozga represents only injured workers in workers' compensation claims in Iowa. This blog is meant to provide accurate and updated information on state of workers' compensation claims in our state. Should you have further questions, please contact us at Neifert, Byrne & Ozga, P.C, 1441 29th Street, Suite 111, West Des Moines, IA 50266. Tel. 888-926-2117 (toll free). Visit us on the web at www.nbolawfirm.com or www.iowa-workers-comp.com.

Wednesday, November 25, 2015

Court of Appeals Affirms Commissioner on Case Involving Intervening Cause, Reverses District Court on Medical Bill Issue

Carl A. Nelson & Co. v. Sloan, No. 15-0323 (Iowa App. Nov. 25, 2015), involves issues concerning causation and intervening cause as well as the payment of medical bills.  The district court upheld the commissioner's decision concerning causation, but did not allow payment of medical bills directly to claimant.

Claimant suffered an injury to his back on August 15, 2011 and was returned to full duty work on August 24.  On October 30, 2011, claimant and a friend were moving go-kart frames into a trailer.  Claimant had a sudden onset of pain and numbness in the back and legs while doing this.  He subsequently had surgery and was found to be at MMI on January 14, 2013.

At the arbitration level, the deputy concluded that the go-kart incident was an intervening and superseding cause for claimant's back problems and denied benefits.  On appeal, the commissioner reversed, finding that the greater weight of the evidence supported the finding that claimant's work injury was a proximate and natural cause of the disability he suffered at the time of the hearing.  The commissioner stated that chain of causation is broken only when claimant's conduct amounts to an intentional violation of an express or implied prohibition and medically supersedes the claimant's original condition.  The commissioner concluded that claimant was simply engaged in a normal activity of living and that claimant's conduct was not contrary to any duty he owed his employer.

The commissioner also awarded the costs for medical care, with the bulk of these costs to be paid to the medical provider, but costs paid by claimant's private health insurance reimbursed directly to claimant.  In support, claimant cited to Midwest Ambulance Service v. Ruud, 754 N.W.2d 860, 867-868 (Iowa 2008).

On appeal, the court concludes that substantial evidence supported the claim that claimant's injuries were related to his original work injury.  Dr. Bussey had opined that claimant continued to suffer from back pain and radiculopathy even after he was returned to full duty work.  The commissioner noted that claimant returned to full duty work not because his condition had abated but because he couldn't afford to be off work.  Giving deference to the commissioner's fact finding, the court concludes that substantial evidence supported the decision.

With respect to the intervening cause question, the court noted that the commissioner's conclusion was taken from Larson's treatise on workers' compensation.  The court noted that the basic rule is that a subsequent injury, whether a new injury or aggravation, "is compensable if it is the direct and natural result of a compensable primary injury."  Citing Larson's and Oldham v. Scofield & Welch, 266 N.W.480, 482 (Iowa 1936) ("employer is liable for all consequences that naturally and proximately flow from the accident").  The court noted that the commissioner's conclusion that claimant's back had been rendered more vulnerable by the initial injury was supported by substantial evidence.  The activities in which claimant was engaged while off duty were no more strenuous than those in which he engaged at work.  The court concluded that the commissioner's interpretation was not illogical, irrational or wholly unjustifiable.

On the medical expense issue, the Court of Appeals, citing Ruud, reversed the decision of the district court, noting that an employee who pays group health premiums has in effect paid for the medical expenses covered by the group plan and the claimant is therefore entitled to be paid directly for past medical expenses.  The court found Ruud "definitive" and reinstated the decision of the agency.  The court reversed the commissioner to the extent that he used the phrase "bills which have been paid" rather than the phrase "past medical expenses paid," which had been used in Ruud.

The Sloan case is a potentially important case in all situations involving intervening causes for injury.  The Court of Appeals concludes that Larson's analytical approach to this issue is sound and adopts the "direct and natural consequences" rule from Larson's.  Although Oldham had long ago adopted similar verbiage, this is the first recent appellate court decision adopting that language.  Because of the potential significance of the case, it would not be surprising if further review is sought.

Saturday, November 14, 2015

Court of Appeals Affirms Running Healing Period Award

In Eaton Corp. v. Archer, No. 15-0255 (Iowa App. Nov. 12, 2015), the commissioner addressed a claim where claimant developed carpal tunnel syndrome.  There was a dispute concerning causation and a dispute over whether claimant was able to return to substantially similar work.  The commissioner concluded that claimant's injury was related to his work activities, and concluded that claimant could not return to former work, given the continuing pain in his hands.

Following the injury, claimant missed work because of the pain in his hands and was discharged by the employer.  On appeal, the primary issue was the healing period issue.  The employer claimed that claimant could return to his former work, and cited their IME physician, Dr. Hsu, in support.  Claimant countered with the IME of Dr. Gammel.  The agency concluded, based on the opinion of Dr. Gammel and claimant's testimony that he could not return to substantially similar work.

The district court affirmed and on appeal the Court of Appeals affirmed as well.  In affirming, the court noted that carpal tunnel syndrome was noted as a repetitive trauma or cumulative injury.  The court concluded that substantial evidence supported the agency's decision.

Court of Appeals Affirms Small Disability Award on Substantial Evidence Grounds

In Harrison v. Greenfield Manor, No. 15-0223 (Iowa App. Nov. 12, 2015), the commissioner awarded claimant a 5% industrial disability award, based on the fact that the doctors who had examined claimant and found that his injury was minor and did not lead to restrictions.  The district court and court of appeals affirmed on substantial evidence grounds.

Court of Appeals Affirms Commissioner's Award, Reverses District Court in Avascular Necrosis Case

In Tameklo v. Tyson Foods, Inc., No. 15-0222 (Iowa App. Nov. 12, 2015), the commissioner addressed a situation where claimant suffered a shoulder injury and later developed avascular necrosis.  The commissioner concluded that the avascular necrosis was related to work and awarded healing period benefits.

Tyson challenged the finding that claimant's avascular necrosis arose out of employment. The first two physicians that saw claimant did not conclusively indicate one way or another whether the injury was related to employment.  Claimant's IME physician, Dr. Bansal, concluded that the avascular necrosis was related to employment, noting that claimant did not have avascular necrosis prior to the surgery, and that the shoulder that was injured was the only location where claimant had avascular necrosis.  The district court reversed the decision of the commissioner, but on appeal, the Court of Appeals reinstated the decision of the commissioner,finding that the commissioner's decision was supported by substantial evidence.