Court of Appeals Holds That a First Injury Against the Second Injury Fund Can Be Substantiated Despite the Lack of Medical Records to Document the Injury

In Huffey v. Second Injury Fund and Mail Contractors of America, No. 18-2055 (Iowa App. April 2, 2020), the court held, among other things, that claimant did not need to produce medical records concerning the first injury in order to establish a loss or loss of use under section 85.64 in SIF cases.  This action affirmed the decision of the district court, which had reversed the action of the agency.

Claimant brought an initial action against the employer.  The commissioner found that claimant had established a 2% injury to the right knee in 2011, but denied that claimant had a sequela injury to the left knee as a result of the right knee injury.  Claimant subsequently filed an action for a 2012 for a left knee injury.  The deputy awarded a 50% impairment for the left knee, which was reversed by the commissioner.  Claimant's SIF claim was for a right arm injury in 1999 and right knee injury in 2011.  Despite these allegations, the agency treated the right knee injury as the first injury and left knee injury as the second injury.  On judicial review, the district court reversed, finding that the agency had concluded that claimant had failed to demonstrate the first injury was a source of industrial disability and remanded as to the sequela question.

On appeal, the court finds that the first injury was the 1999 injury.  The Fund argued that there were no medical records to document the injury and thus there was no qualifiable first injury.  The court concluded that nothing in 85.64 required documentation of the first injury.  An agency could rely on claimant's own testimony, as well as a corroborative discussion of the 1999 surgery in the medical records, to establish the first injury.  Second, the court found that the first injury need not independently cause an industrial disability.  The court found that a first injury was demonstrated by the loss of physiological capacity of the body part and not by evaluating the impairment of earning capacity.  Citing SIF v. Braden, 459 N.W.2d 467, 470 (Iowa 1990).  The first injury does not have to result in industrial disability to constitute a loss of use under 85.64.  The claim was remanded to the commissioner for a determination of whether the two scheduled injuries resulted in industrial disability.  

The employer appealed the remand of the case to the agency for a determination of the sequela question.  The court finds that the actions of the agency on this issue were irrational and illogical because the commissioner apparently mistook this argument as an attempt to qualify for Fund benefits.  The court remands to the agency for further development of the sequela issue.