Court of Appeals Affirms Denial of Benefits Due to Claimant's Failure to Prove a Work-Related Injury

Smith v. TPI Iowa, No. 20-1269 (Iowa App. July 21, 2021) - Claimant allegedly suffered a shoulder injury for which he had surgery. Defendants denied the claim based on the report of Dr. Aviles.  Claimant sought an IME with Dr. Stoken in which she indicated that claimant had an impairment that was causally related to the subject injury, but did not express an opinion that the subject injury was related to Smith's employment.  

The agency found claimant had failed to demonstrate an injury that arose out of and in the course of employment.  On appeal, the Court of Appeals notes that although claimant suffered an injury, he did not prove that the injury was causally related to employment through medical testimony.  Neither Dr. Aviles not Dr. Sullivan (who performed the surgery) found that claimant's injury arose out of employment.  Because Dr. Stoken's opinion did not specifically connect the injury to claimant's work, the court concluded that substantial evidence supported the decision of the agency.  The court noted that even if Dr. Stoken's opinions were found to tie the injury and claimant's work together, there was still substantial evidence to support the decision of the agency.  The denial of benefits was affirmed.