Supreme Court Holding Denies Cumulative Injury Alleged in Review Reopening Action Following Initial Acute Injury

As presented by the Supreme Court in Gumm v. Easter Seal Society of Iowa, Inc., No. 18-1051 (Iowa May 1,  2020), the issue before the court was "whether a workers' compensation claimant who receives disability benefits for a traumatic injury can later recover disability benefits on a separate disability claim if the cumulative injury is based solely on aggravation of the earlier traumatic injury."  The court unanimously concluded that Ms. Gumm could not recover.

Claimant initially suffered a fracture of her right ankle, for which she was paid WC benefits following surgery.  The last payment of benefits for the injury was on May 10, 2010.  Claimant continued to suffer from right ankle pain and in January of 2012 returned to the treating physician.  The physician believed that this could have been from a coincidence or from compensating for her right ankle pain. On April 11, 2012, she underwent another surgery, returning to full-duty work on May 3.  Claimant continued to suffer from pain and saw her doctor on May 16, 2013.  Another surgery was performed on October 23, 2013.  By January of 2014, claimant had back pain attributable to the ankle injury.  

Claimant filed two petitions in February of 2014, one indicating she had an acute injury in 2008 and noting that the statute of limitations on this claim had expired.  The second petition alleged cumulative injuries with dates of March 6,  2012, May 16, 2013 or January 15, 2014.  The agency, relying on Ellingson, 599 N.W.2d 440, concluded that the aggravation of the original injury was not a distinct injury and thus the claim was outside of the statute. The injuries were found to be sequelae of the original injury.  The commissioner and district court affirmed this holding.  The Court of Appeals reversed in a 2-1 decision, finding that under Floyd v. Quaker Oats, 646 N.W.2d 105 (Iowa 2002), the court had created a circumscribed exception to Ellingson, allowing for recovery in a cumulative injury claim for any increase in functional disability shown to have occurred as a result of the day to day activities of claimant at the workplace subsequent to the original injury.

The Supreme Court reversed the decision of the COA and reinstated the denial of benefits.  The court noted that review-reopening actions were subject to a three year statute of limitations. The court noted that disputes could arise as to whether an injury was an aggravation of a previous injury or a discrete and distinct cumulative injury.  Citing Ellingson, the court concluded that Gumm's injury was an aggravation of a previous injury and thus was outside of the three year statute of limitations.  The court concluded that the question of aggravation versus discrete and distinct disability was a factual question for the agency and that this factual determination had the effect of a jury verdict.  The court interpreted Floyd as standing for the principle that a claimant who is suffering the cumulative effects of a workplace trauma does not have to prove a distinct and discrete injury when the claimant never received an award for that trauma.  The court notes that Floyd could be read more broadly, but stated that Floyd had not overruled Ellingson. The court also distinguished Ziegler v. U.S. Gypsum, 106 N.W. 591 (1960), finding that in Ziegler, claimant had established a new injury from lifting 50 pounds at work.  The court also cited cases from other jurisdictions finding that claimant could not file a claim for a fictional new injury, when this was a change of condition.  

The court ultimately concluded there was substantial evidence to support the commissioner's finding that Gumm did not suffer a distinct and discrete injury.  Because there was no distinct and discrete injury, claimant's claim was filed outside the statute of limitations and the claim was dismissed.