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Showing posts from 2017

Court of Appeals Rejects Finding of Depression from Family Doctor, Finds that Admission of Late Report was not Prejudicial

In Bos v. Climate Engineers , No. 17-0159 (Iowa App. Nov. 22, 2017), the commissioner had concluded that claimant did not have a claim for depression following a shoulder injury and rejected the report of claimant's family physician that the depression was connected to the underlying injury.  The commissioner also allowed the admission of a vocational report from defendants even though the expert had not been named in a timely fashion and had not been produced until 18 days before hearing.  The district court affirmed the commissioner's action with respect to the doctor's findings, but rejected the admission of the late vocational report and remanded to the agency for further opinion. Both parties appealed to the Court of Appeals.  On the evidentiary issue, the court found that even though the opinion of the family doctor had been unrebutted, the commissioner was within his rights to reject that evidence.  The commissioner had found that it had been several months from

Court of Appeals Issues Decision on Validity of District Court Nunc Pro Tunc Order

Reihe v. Midwest Viking, Inc. , No. 17-0214 (Iowa App. Nov. 8, 2017), deals with the somewhat unusual situation where a district court remanded a matter to the workers' compensation commissioner for entry of an order nunc pro tunc correcting a compromise settlement agreement.  Claimant argues that the district court improperly considered extrinsic evidence and that reformation of the contract was barred by judicial estoppel. The settlement proposal that was agreed to indicated that defendants would pay roughly $75,000 less deductions of payment made to date (2/23/15), which totaled $21,080.12.  The settlement documents indicated the settlement was roughly $75,000 less weekly payment made from 3/5/15 until settlement approval.  Defendants would have received considerably more in credits under the original agreement than under the terms of the settlement documents.  The settlement documents were approved and defendants sent a check to claimant in an amount equivalent to the origina

Court of Appeals Decides Case Involving Accommodated Work

In Norton v. Hy-Vee, No. 16-1299 (Iowa App. Nov. 8, 2017), claimant's back and neck injury resulted in a 25% loss in hours in her work as a pharmacy tech.  Despite the injuries, she continued to work and was described as a motivated and valuable employee both before and after the injury.  Claimant argued that she was permanently and totally disabled, inasmuch as she would not have been able to work absent the accommodations provided by Hy-Vee.  The employer argued that claimant did not have a significant industrial disability because she continued to work.  The deputy and commissioner found that claimant was entitled to a 70% industrial disability.  The commissioner found that the award of permanent disability was based on claimant's ability to continue as a pharmacy tech and her ability to find new employment should she leave Hy-Vee. The district court affirmed, finding that the agency had correctly interpreted decisions focusing on claimant's ability to earn in the compet

Court of Appeals Affirms Finding that Claimant Did Not Give Timely Notice of Her Injury

In Callahan v. Horseshoe Casino , No. 16-2230 (Iowa App. Oct. 11, 2017), the court addressed an issue of notice to the employer under section 85.23 of the Iowa Code.  The claimant's back problems had manifested on October 10, 2011, and the commissioner determined that the employer did not have actual knowledge of the injury until August 13, 2012, making claimant's claim untimely.  The commissioner concluded that there was no credible evidence to support the deputy's finding to the contrary and found that the claim was time-barred. The Court of Appeals notes that the commissioner concluded that although the employer knew of the back injury, it did not know that the injury was related to work until 14 months after the injury had manifested.  The court viewed this as a question of substantial evidence and finds that the commissioner's finding that there was no actual notice the injury was work related until August of 2012 was supported by substantial evidence. The court

Court of Appeals Affirms Decision Finding that the Filing of Claimant's Petition was Untimely

In Myers v. R.R. Donnelly & Sons , No. 17-0306 (Iowa App. Sept. 13, 2017), the Court of Appeals upheld a decision of the agency concluding that claimant's petition was untimely and was not saved by the discovery rule.   Claimant was employed by Donnelly as a press operator until 2011, when he was moved to another position because he could not longer perform the duties of a press operator as a result of back problems.  The back problems had begun in 1999.  The agency concluded that claimant knew his back problems were related to his work by 2009.  On November 2012, claimant received permanent restrictions of no lifting of more than 40 pounds and was terminated because the employer could not accommodate his work restrictions.  Claimant filed a petition on April 2, 2013. The agency concluded that claimant's injury date was 2/25/09, when claimant's doctor diagnosed him with disabling mechanical back pain and referred him to his surgeon.  The deputy found that the man

Court of Appeals Affirms Award of 45 Weeks of Permanent Partial Disability

In Lopez v. Cargill Meat Solutions , No. 16-1421 (Iowa App. July 6, 2017), the court rejected claimant's allegations that his claim should have been considered as an industrial disability and affirmed the functional award of 45 weeks of benefits.  Claimant argued that his experts presented substantial, credible evidence of industrial disability and it was unfair, irrational and illogical to reject those opinions. The court concluded that the agency had given greater weight to certain expert opinions over others and thoroughly explained the reasons for doing so.  Because those findings were supported by substantial evidence and were not irrational, illogical or wholly unjustifiable, the decision of the agency stood.

Supreme Court Establishes Private Constitutional Right of Action Against Government Actors in Commissioner's Suit

Following the reduction of his salary by the Governor in 2010, former Commissioner Chris Godfrey filed an action against the State of Iowa and various state officials, including the Governor, alleging a variety of legal theories.  In Godfrey v. State of Iowa et al. , No. 15-0695 (Iowa June 30, 2017), the Court ruled, for the first time, that constitutional claims, in this cases allegations of deprivation of property rights without due process of law and deprivation of liberty interests without due process created causes of action directly under the Iowa Constitution. Four counts of the petition were at issue before the court.  Count VI alleged that Godfrey was deprived of his property rights in his salary because of partisan politics and sexual orientation.  Count VII alleged a damage to a protect liberty interest in his reputation without due process by falsely claiming poor work performance.  Count VIII alleged a violation of the equal protection of the laws for discrimination base

Supreme Court Decides Workers' Compensation Bad Faith Claim

In Thornton v. American Interstate Insurance Company , No. 15-1032 (Iowa May 19, 2017), plaintiff was awarded $284,000 in compensatory damages and $25 million in punitive damages by the jury in a case involving the payment of workers' compensation benefits in a permanent total disability case.  The Supreme Court concludes that the insurer lacked any reasonable basis to dispute PTD status and affirmed summary judgment for the claimant.  The Court also held, however, the district court erred in holding that the insurer acted in bad faith as a matter of law for resisting claimant's partial commutation petition.  The judgments for compensatory and punitive damages were reversed and remanded. Plaintiff had a serious injury while working as an over the road truck driver.  As a result of this injury, the insurance carrier began paying benefits and set its reserves in an amount based on a PTD finding. The evidence at trial  indicated that the insurance carrier and its attorney believ

Court of Appeals Affirms Denial of Alternate Medical Care

In Penny v. Whirlpool , No. 16-0495 (Iowa App. Feb. 8, 2017), the agency had denied claimant's request for alternate medical care with a neurosurgeon, finding that the care provided to claimant by the employer had not been unreasonable.  The Court of Appeals affirms the decision of the agency. Claimant had been seen by Dr. Matos and Dr. Abernathey.  Dr. Abernathey did not believe surgery was indicated, but claimant's pain persisted.  The employer set up additional testing to determine claimant's radicular symptoms, but claimant did not attend the appointments under the believe that Whirlpool did not consider his back injury to be work related. Claimant then sought care with a neurosurgeon.  The deputy concluded that since the employer had authorized care with two doctors, as well as authorized an MRI, physical therapy, acupuncture, an EMG and treatment at a pain clinic, the care authorized was not unreasonable.  The district court affirmed. On appeal to the Court of App

Court of Appeals Affrims Award of TTD Benefits, Medical Expenses and Penalties

In Polaris Industries, Inc. v. Doty , No. 16-0961 (Iowa App. Jan. 25, 2017), the COA affirmed the decision of the agency finding that claimant had established eligibility for TTD benefits, medical expenses and penalty.  Claimant was diagnosed with impingement syndrome, which defendants' original orthopaedic surgeon, Dr. Hough, related to claimant's work.  Dr. Hough, following an MRI showing a rotator cuff tear, recommended surgery.  Rather than proceeding with the surgery, defendants had Dr. Blow, a physical medicine doctor, perform a defense medical exam.  Dr. Blow concluded the problems were age related and did not recommend surgery.  Dr. Blow placed claimant at MMI, despite the facto that she had not had surgery.  Dr. Hough subsequently recommended surgery again and placed her on restrictions.  Dr. Hines, who performed an IME for claimant, found causation and also recommended surgery. The hearing deputy found it was a strain to accept that claimant's condition was not

Court of Appeals Reverses Commissioner's Summary Judgment Decision in Favor of SIF

Stowe v. Second Injury Fund of Iowa , No. 16-0599 (Iowa App. Jan. 25, 2107) presented the somewhat unusual situation where the commissioner had disposed of a case on summary judgment grounds.  Claimant had settled her case against the employer on an agreement for settlement and in the settlement documents had indicated that the injury was an injury to the left thumb.  When claimant brought an action against the Fund, the Fund filed for summary judgment, claiming that an injury to the thumb was not a qualifying injury for SIF purposes.  The deputy and commissioner agreed and the case was dismissed. Claimant filed a petition for judicial review and the district court reversed the decision of the agency, finding that the commissioner erred in ruling as a matter of law the settlement agreement precluded claimant from seeking Fund benefits on the basis of a hand injury.  The court noted that the Fund was not a party to the settlement agreement and also found there was no support in the re

Court of Appeals Affirms Denial of Additional Benefits in Review-Reopening Action

In Ayala v. Tyson Foods, Inc. , No. 16-0505 (Iowa App. Jan. 11, 2017), claimant was initially provided a 45% industrial award.  Claimant subsequently filed a review-reopening petition after he had surgery and his impairment rating was increased from 13% to 23%.  Although the commissioner acknowledged this medical evidence, he found there had been no change in claimant's earning capacity, as claimant had no earnings loss and his work restrictions were largely unchanged or lessened. Claimant contended that the commissioner's decision was irrational, illogical and wholly unjustifiable.  The court rejected this contention, noting that functional impairment was a single, but not controlling factor in determining the extent of industrial disability.  The court also concluded that the decision of the commissioner was supported by substantial evidence, again noting that there was evidence that claimant's earning capacity remained unchanged.  The decision of the commissioner was a

Court of Appeals Affirms Dismissal of Claim on Notice, Statute of Limitations Grounds

The Court of Appeals affirmed the decision of the commissioner dismissing claimant's case on grounds of lack of notice and statute of limitations.   Ross v. American Ordnance , No. 16-0787 (Iowa App. Jan. 11, 2017). Claimant hurt her shoulder on November 1, 2012 and told her supervisor about this injury.  She was asked whether she needed to see a doctor but claimant indicated she was not hurt that bad.  She did not fill out an injury report.  She continued to have problems with her shoulder and saw a doctor for a cortisone injection on January 11, 2013.  An incident report was made on March 14, 2013 and claimant was diagnosed with a rotator cuff tear and later had surgery. At hearing, claimant testified that she told her supervisor she had hurt her shoulder.  The supervisor testified that claimant told him her shoulder "hurts a little bit."  He was not sure claimant was relating her injury to work and did not ask whether she was injured while working.  The deputy conc

Court of Appeals Affirms Denial of Alternate Medical Care

In Westling v. Hormel Foods Corporation, No. 16-0236 (Iowa App. Jan. 11, 2017), the Court of Appeals affirmed the decision of the deputy denying claimant treatment for his right knee.  The authorized provider had indicated that claimant wait until he had "more trouble" before considering revision of claimant's total knee replacement.  The deputy concluded that claimant failed to show the services provided by the doctor were unreasonable. Claimant had originally seen Dr. Crane, but following one of his surgeries, he developed a DVT and opted to have knee replacement surgery with Dr. Wolbrink.   When he began to have further difficulties, he sought treatment with Dr. Alvine, but the employer instead approved care with Dr. Crane again.  Dr. Crane evaluated claimant's knee (claimant alleged this took only five minutes), concluded that a revision of the total knee surgery was not necessary and indicated that claimant should wait.  Claimant expressed dissatisfaction and r

Court of Appeals Decides Dispute Between Provider and Carrier Over Workers' Compensation Medical Payments

United Fire and Casualty v. Cedars Sinai Medical Center , No. 15-1769 (Iowa App.  Dec. 21, 2016) address an issue not commonly before the courts - the reasonable costs of medical care.  The hospital in this case charged more than $3 million in medical fees for treatment of an injured construction worker.  The insurer filed an action under section 85.27(3) arguing that the commissioner erred in selecting the medical-fee reviewer, refusing to allow United Fire to submit certain evidence and accepting certain filings from Cedars Sinai.  United Fire also alleges that Cedars Sinai did not have standing and that there was a accord and satisfaction.  Because United Fire failed to preserve error and cannot show the medical fee dispute process should be repeated, the commissioner's action and action of the district court is affirmed. Following claimant's over 100 day stay in the hospital, the hospital, through a third party notified the agency of its intent to use the agency review pr

Supreme Court Affirms that Permanent Partial and Permanent Total Disability Benefits Can be Awarded Simultaneously

In a case litigated by Jamie Byrne of Neifert, Byrne & Ozga, the Court in JBS Swift and Co. v. Ochoa , No. 15-0840 (Iowa Dec. 30, 2016) affirmed that under the 2004 amendments to the workers' compensation statute, a claimant could receive a first award of permanent partial disability benefits and then, based on a new injury, receive a permanent total disability award and that these awards can run concurrently.  The Court affirmed the action of the Iowa Court of Appeals, which had held that the general assembly removed the barriers to collecting two streams of benefits at the same time, so long as there were two separate injuries and the second injury resulted in permanent total disability benefits. Claimant suffered an initial hernia, which was found to be the cause of  70% industrial disability. She returned to work following this injury and subsequently developed neck and shoulder difficulties.  As a result of these problems, she left work and was subsequently terminated fo