Iowa Workers' Compensation

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 evid...

Dotts v. City of Des Moines , No. 20-0954 (Iowa App. July 21,  2021) - In this somewhat unusual alternate medical care case, claimant filed for alternate medical care under 85.27 and was denied such care by the agency.  Claimant appealed and on judicial review, the district court considered the record, which did not include a transcript of the agency hearing.  The Court of Appeals noted that they also did not have a transcript of the agency hearing to decide whether substantial evidence supported the decision of the agency. The court notes that the reasonableness of the care provided by defendant was contingent on claimant's testimony that the doctor refused to see him and concessions allegedly made by the employer during the hearing.  Because the court did not have a transcript to review, the conclusion was reached that there was no ability to review the testimony to determine whether the decision was supported by substantial evidence.  The court notes tha...

 In American Home Assurance v. Liberty Mutual Fire Insurance Co. , No. 20-0769 (Iowa App. July 21, 2021), claimant filed for workers' compensation benefits and was awarded those benefits against American Home, which American home paid.  Claimant later filed a review-reopening petition, at which point American Home discovered it was not the insurer on the claim as of the time of injury.  American then filed an application for payment of benefits under 85.21.  Claimant later filed a petition for contribution under section 85.21, seeking repayment of all benefits paid from Liberty Mutual, the insurer on the claim as of the time of injury. Liberty argued that they were only responsible for benefits paid after an 85.21 order had been issued. The deputy found Liberty was on the hook for all benefits paid, but the commissioner partially reversed, finding that "because American Home failed to seek an Iow Code section 85.21 consent order prior to the arbitration hearing, Libe...

Pesicka v. Snap-On Logistics Co ., No. 19-1759 (App. July 21, 2021) involved a claim in which claimant initially suffered an injury resulting in a 13% impairment to his right leg, settled by the parties on an agreement for settlement basis.  Subsequent to the settlement agreement, claimant underwent eight additional surgeries, including surgeries to amputate all of the toes on his right foot.  Claimant filed a review-reopening action.  Claimant's IME physician found that claimant had established a 36% right foot impairment, which was equivalent to a 25% right lower extremity impairment.  Claimant was also found to  have a 5% impairment of the left knee.   At hearing, the hearing report indicated that the parties stipulated that the impairment was an impairment to the right leg  Claimant's counsel, however, also argued at hearing that claimant should receive a minimum of 100 weeks of benefits due to the valuations for the loss of all of his toes. T...