Court of Appeals Concludes that Claimant was Entitled to Payment for IME

P.M. Lattner Mfg. Co. v. Rife, No. 22-1421 (Iowa App. June 7, 2023)

The district court concluded that claimant was not entitled to payment for an IME and remanded the agency decision for consideration of the appropriate credit for a prior injury with the same employer.   The Court of Appeals remands to the commissioner to determine the fee related to claimant's right shoulder injury and also finds that the remand to determine credit was appropriate.

Claimant had earlier suffered an injury at work to his right shoulder which resulted in a full commutation of benefits.  As a part of this settlement, the employer received a credit for permanent impairment to claimant's shoulder against future injuries to the same shoulder. Nine years later, claimant suffered another injury to the shoulder and obtained an IME for the shoulder.  The commissioner concluded that claimant was entitled to payment for the IME and found that defendant was not entitled to credit for the prior shoulder injury.

With respect to the IME issue, the district court found that because claimant refused to meaningfully comply with requested evaluations by defendants, payment for the IME was not appropriate.  The Appeals Court notes that defendants did not challenge payment for the entire IME, only the portion of the IME that related to a right ankle injury.  This issue was not raised or decided by the commissioner.  The Court finds that error was not preserved on the issued of whether 85.39 was triggered and thus was not appropriate before the Court.  The Court also concludes, however, that payment for the right ankle portion of the exam was preserved.  The Court indicates that it had previously held that 85.39(2) provides for reimbursement for an impairment rating rather than the cost of an examination.  Citing MidAmerican Cosnt. LLC v. Sandlin, No. 22-0471 (Iowa App. Feb. 22, 2023).  The Court then concludes that the employer was not responsible to reimburse costs from the examination that did not relate to the impairment of the compensable right shoulder injury.  The case was remanded to the commissioner for further proceedings on this issue.

Claimant argued on the credit issue that credit was not possible because the code did not provide a means of apportioning an unscheduled and scheduled injury.  The Court concludes that section 85.34(7) did not address the question of apportioning unscheduled versus scheduled injuries and finds that the statute was unambiguous in finding that the employer was not liable for an employee's pre-existing disability.  The Court finds that the agency misinterpreted 85.34(7).  The Court finds that although there was no express method to apportion these benefits, under Warren Properties v. Stewart, the "lack of express means ot apportion benefits does not preclude the application of 85.34(7).  The Court finds that because claimant had suffered an earlier compensable injury with the same employer, the employer was entitled to a credit for the payment of benefits for that injury.  The credit issue was remanded to the agency to determine the appropriate credit, without any discernable stantard for determining how the credit was to be applied.