Iowa Workers' Compensation

In Polaris Industries, Inc. v. Doty , No. 16-0961 (Iowa App. Jan. 25, 2017), the COA affirmed the decision of the agency finding that claimant had established eligibility for TTD benefits, medical expenses and penalty.  Claimant was diagnosed with impingement syndrome, which defendants' original orthopaedic surgeon, Dr. Hough, related to claimant's work.  Dr. Hough, following an MRI showing a rotator cuff tear, recommended surgery.  Rather than proceeding with the surgery, defendants had Dr. Blow, a physical medicine doctor, perform a defense medical exam.  Dr. Blow concluded the problems were age related and did not recommend surgery.  Dr. Blow placed claimant at MMI, despite the facto that she had not had surgery.  Dr. Hough subsequently recommended surgery again and placed her on restrictions.  Dr. Hines, who performed an IME for claimant, found causation and also recommended surgery. The hearing deputy found it was a strain to accept that claiman...

Stowe v. Second Injury Fund of Iowa , No. 16-0599 (Iowa App. Jan. 25, 2107) presented the somewhat unusual situation where the commissioner had disposed of a case on summary judgment grounds.  Claimant had settled her case against the employer on an agreement for settlement and in the settlement documents had indicated that the injury was an injury to the left thumb.  When claimant brought an action against the Fund, the Fund filed for summary judgment, claiming that an injury to the thumb was not a qualifying injury for SIF purposes.  The deputy and commissioner agreed and the case was dismissed. Claimant filed a petition for judicial review and the district court reversed the decision of the agency, finding that the commissioner erred in ruling as a matter of law the settlement agreement precluded claimant from seeking Fund benefits on the basis of a hand injury.  The court noted that the Fund was not a party to the settlement agreement and also found there was n...

In Ayala v. Tyson Foods, Inc. , No. 16-0505 (Iowa App. Jan. 11, 2017), claimant was initially provided a 45% industrial award.  Claimant subsequently filed a review-reopening petition after he had surgery and his impairment rating was increased from 13% to 23%.  Although the commissioner acknowledged this medical evidence, he found there had been no change in claimant's earning capacity, as claimant had no earnings loss and his work restrictions were largely unchanged or lessened. Claimant contended that the commissioner's decision was irrational, illogical and wholly unjustifiable.  The court rejected this contention, noting that functional impairment was a single, but not controlling factor in determining the extent of industrial disability.  The court also concluded that the decision of the commissioner was supported by substantial evidence, again noting that there was evidence that claimant's earning capacity remained unchanged.  The decision of the commis...

The Court of Appeals affirmed the decision of the commissioner dismissing claimant's case on grounds of lack of notice and statute of limitations.   Ross v. American Ordnance , No. 16-0787 (Iowa App. Jan. 11, 2017). Claimant hurt her shoulder on November 1, 2012 and told her supervisor about this injury.  She was asked whether she needed to see a doctor but claimant indicated she was not hurt that bad.  She did not fill out an injury report.  She continued to have problems with her shoulder and saw a doctor for a cortisone injection on January 11, 2013.  An incident report was made on March 14, 2013 and claimant was diagnosed with a rotator cuff tear and later had surgery. At hearing, claimant testified that she told her supervisor she had hurt her shoulder.  The supervisor testified that claimant told him her shoulder "hurts a little bit."  He was not sure claimant was relating her injury to work and did not ask whether she was injured while worki...

In Westling v. Hormel Foods Corporation, No. 16-0236 (Iowa App. Jan. 11, 2017), the Court of Appeals affirmed the decision of the deputy denying claimant treatment for his right knee.  The authorized provider had indicated that claimant wait until he had "more trouble" before considering revision of claimant's total knee replacement.  The deputy concluded that claimant failed to show the services provided by the doctor were unreasonable. Claimant had originally seen Dr. Crane, but following one of his surgeries, he developed a DVT and opted to have knee replacement surgery with Dr. Wolbrink.   When he began to have further difficulties, he sought treatment with Dr. Alvine, but the employer instead approved care with Dr. Crane again.  Dr. Crane evaluated claimant's knee (claimant alleged this took only five minutes), concluded that a revision of the total knee surgery was not necessary and indicated that claimant should wait.  Claimant expressed dissatisfaction...

United Fire and Casualty v. Cedars Sinai Medical Center , No. 15-1769 (Iowa App.  Dec. 21, 2016) address an issue not commonly before the courts - the reasonable costs of medical care.  The hospital in this case charged more than $3 million in medical fees for treatment of an injured construction worker.  The insurer filed an action under section 85.27(3) arguing that the commissioner erred in selecting the medical-fee reviewer, refusing to allow United Fire to submit certain evidence and accepting certain filings from Cedars Sinai.  United Fire also alleges that Cedars Sinai did not have standing and that there was a accord and satisfaction.  Because United Fire failed to preserve error and cannot show the medical fee dispute process should be repeated, the commissioner's action and action of the district court is affirmed. Following claimant's over 100 day stay in the hospital, the hospital, through a third party notified the agency of its intent to use the ...

In a case litigated by Jamie Byrne of Neifert, Byrne & Ozga, the Court in JBS Swift and Co. v. Ochoa , No. 15-0840 (Iowa Dec. 30, 2016) affirmed that under the 2004 amendments to the workers' compensation statute, a claimant could receive a first award of permanent partial disability benefits and then, based on a new injury, receive a permanent total disability award and that these awards can run concurrently.  The Court affirmed the action of the Iowa Court of Appeals, which had held that the general assembly removed the barriers to collecting two streams of benefits at the same time, so long as there were two separate injuries and the second injury resulted in permanent total disability benefits. Claimant suffered an initial hernia, which was found to be the cause of  70% industrial disability. She returned to work following this injury and subsequently developed neck and shoulder difficulties.  As a result of these problems, she left work and was subsequently ter...