Court of Appeals Affirms Permanent Total Award

Medplast v. Pruis, No. 21-1650 (Iowa App. Dec. 7, 2022)

In this action, claimant was found to have sustained injuries to his head, neck vision and mental health arising out of and in the course of his employment.  As a result of these injuries, he was found permanently and totally disabled.  The Court affirms on substantial evidence grounds.

While climbing on a machine, claimant hit the right side of his head on a bar, which jarred his teeth and caused him to drop back to the floor.  He felt immediate pain in his neck, head and shoulders.  He went to the office and vomited while at work.  He was taken to the emergency room by his daughter when he returned home and was diagnosed with a very severe concussion and traumatic brain injury.  He was never able to return to work because of his continuing symptoms.

Claimant treated for these injuries, but treatment was ultimately ended after neuropsychological assessments by Dr. Daniel Tranel.  He subsequently experienced a regression in his symptoms, although he tried to pursue treatment on his own.  Dr. Tranel found that claimant did not have cognitive impairment or neurological dysfunction, but instead had depression.  He returned claimant to work with no restrictions.  He suggested that claimant was malingering.  Dr. Broghammer found that claimant's injuries were due to the again process and had nothing to do with work.

Dr. Harbach concluded that claimant's work injury had lit up pre-existing degenerative conditions.  Dr. Taylor, claimant's IME agreed and also diagnosed traumatic brain injury with post-concussive syndrome.  Dr. Fitzgerald, who had provided claimant treatment for his balance and cognition losses, concluded that claimant had deficits in his right and left eyes and could not complete a workday because of high fatigueability. Dr. Patra, who also performed an IME, concluded claimant had a major depressive disorder, mild neurocognitive disorder and post-concussive syndrome.  She noted that 10% of persons with TBI have persistent post-concussive symptoms and found that claimant was in that group.  She indicated claimant had a 22% whole person impairment,  

Based on the evidence presented, the deputy and commissioner found claimant had sustained a work injury and was permanently and totally disabled.  The Court of Appeals concluded, with respect to the causation finding, that the employer "simply ask(s) us to reweigh the competing expert opinions."   The Court noted that this was outside the mission of the Court and affirmed this decision on substantial evidence grounds.

With respect to the permanent total disability finding, the Court noted the employer's argument that claimant had returned to other work following the injury.  The Court found, however, that this work was a far cry from the skilled work he had previously performed and also noted he had never returned to work with the employer.  The Court also noted that claimant left his other jobs due to poor performance.  These difficulties led claimant's vocational expert to conclude that claimant would be unable to perform any jobs in the labor market.  The Court concluded that the agency had considered the proper factors in determining industrial disability and that the findings of the agency were supported by substantial evidence.  The decision of the agency was therefore affirmed.