Court of Appeals Agrees with District Court's Reversal of Commissioner's Denial of Benefits

 Culpepper v. CNH Industrial America LLC, No. 24-2040 (Iowa App. Oct. 29, 2025)

The agency denied claimant's alleged back pain, rejecting the report of the treating physician and also finding claimant had not provided timely notice of the decision.  On judicial review, the district court reversed both findings and remanded the claim to the agency for further proceedings.  The Court of Appeals affirms the holdings of the district court.

Claimant alleged that he suffered a neck injury while at work and alleged injury dates of 6/8/21, 9/3/21 and 10/29/21. Dr. Abernathey, the treating physician, provided statements concerning the injury on three occasions.  In the first two of those statements, which were referenced in the opinion of the deputy, Dr. Abernathey indicated that work activities did not "cause" the work injury.  In the third report, not discussed by the deputy, Dr. Abernathey opined "within a reasonable degree of medical certainty that [Culpepper's] work activiies . . . as part of his job as a quality specialist resulted in an aggravation to his cervical spine necessitating his need for surgery." Defendants suggested that the third report reflected a change in Dr. Abernathey's opinion, justifying its exclusion. In the earlier reports, Dr. Abernathey had indicated that the work injury had not caused the cervical spine problem, found that the need for cervical fusion was more likely than not related to his underlying degenerative condition and was not caused by the 2021 work injury.  In reviewing these statements, the Court noted that the third statment was not inconsistent with the earlier statements, but simply found that the work injury aggravated the underlying condition requiring surgery.  The Court found that an employee is entitled to "full compensation when workplace activity aggrvates a preexisting condition that did  not previously cuase a degree of disability." Citing Floyd v. Quaker Oats, 646 NW2d 105 (Iowa 2002); Rose v. John Deere Ottumwa Works, 76 NW2d 756 (Iowa 1956). Claimant was asymptomatic prior to the work injury and thus Dr. Abernathey's opinion that the work injury had aggravated the underlying condition suppported the district court's conclusion that the agency's causation finding was not supported by substantial evidence.

On the notice issue, the deputy concluded that had sought treatment for neck pain on 6/8/21 and that he had reported such pain prior to this date, but not action had been taken by the employer. The 6/8/21 report led to an appointment with the employer's physician.  The agency found that this amounted to a lack of timely notice, as there was no explanation in the record as to why the employer did not act on the alleged earlier notices of injury. The Court noted that because lack of notice was an affirmative defense, the burden of demonstrating lack of notice was on the employer. The agency erred in placing the burden on claimant rather than on the employer. Claimanat, according to the Court, knew or should have known he had a work-related injury by June 2021.  Even discounting Culpepper's testimony, CNH knew of Culpepper's condition when it referred him for medical treating.  His first appointment was in August of 2021, which is within the 90 day windown allowed by 85.23.