Court of Appeals Concludes That Injury to the Skin Under the Guides is to be Treated as a Scheduled Injury

LaGuerre v. JBS USA Holdings, Inc., No. 24-2049 (Iowa App. Oct. 29, 2025)

Claimant suffered a degloving injury which resulted in skin being grafted from claimant's right thigh to his right arm.  The employer's expert provided claimant a 9% upper extremity impairment despite the fact that the Guides treat a skin injury as an injury to the whole body.  Claimant's expert provided a 7% body as a whole impairment for a class I skin impairment.  The deputy found that claimant had sustained a scheduled injury, but provided a 7% whole body rating as the Guides instructed. The commissioner affirmed, as did the district court.

On appeal, claimant argued that the legal question presented to the Court was whether the injury should be considered unscheduled because the Guides rates that impairment as a whole person impairment.  Claimant conceded that earlier precedent supported the deputy's decision to considered the injury a scheduled injury, but argued that the 2017 amendments creating 85.34(2)(x), which indicates that "the loss of percentage or permanent impairment shall be determined solely by utilizing the AMA Guides" rendered earlier precedent non-controlling. The Court of Appeals affirmed the decision of the agency, concluding that claimant's injury was a scheduled injury.

The Court discusses the underlying statutory scheme in some detail, noting that unscheduled injuries will often lead to larger awards.  Under this scheme, the employer argues the injuries are unscheduled since they affect the arm and the leg.  Claimant's argument is that the word "skin" is not enumerated in 85.34(2.  In addition, claimant argues that the Guides are the arbiter of what is a scheduled or unscheduled injury and since a skin injury is treated as a body as a whole injury, a skin injury should be considered unscheduled.

The Court first rejects claimant's argument that because of the absence of the word "skin" in 85.34(2), the injury must be treated as an unscheduled injury.  Although the argument had surface appeal, according to the Court, this interpretation would "undermine the entire statutory structure" and was also inconsistent with precedent. The Court notes that although "skin" is not mentioned, neither are body parts such as the muschle or bone and injuries to those parts of the body would not be treated as unscheduled injuries. Nor is the skin a bodily system such as the nervous or vascular systems. The Court cites Delaney v. SIF, 6 NW2d 714 (Iowa 2024), for the principle that the inquiry is fact-based, to be determined on a case by case basis.  If there is only localized loss the injury is scheduled.  But if the injury extends beyond the body part, the injury is unscheduled. Claimant argued that Delaney did not apply because it was a SIF case, but the Court rejects this argument, finding that "the relevant issue is the same." Based on the governing statutory text and the "wealth of precedent," claimant's argument was rejected.

The Court also rejects claimant's argument that the Guides req;uire that a skin injury be treated as unscheduled.  First,85.34(2)(x) does not indicate that the Guides are to be used to "dictate . . . the scheduling of an injuru." It merely indicates that the "extent of loss or percentage of permanent impairment shall be determine solely by utilizing the AMA Guides. The Court notes that there is no precedent indicating that the Guides are to be used to determine whether an injury is scheduled or not.  According to the Court, the Guides are only mandatory for "calculating the proportionate reduction in scheduled weeks" - not for determining the question of scheduled vs. unscheduled. If the use of a whole person injury mandates that an injury is unscheduled, this would render 85.34(2)(t) a nullity. That section requires that two unscheduled injuries occcurring at the same time to be treated in terms of 500 weeks, but not as unscheduled injuries.  In such a situation, the Guides treata the injury as a whole person injury and under claiant's theory, according to the Court, this would require that these injuries are unscheduled, directly contrary to the statutory scheme. Because claimant's argument would "confound the statutory scheme," the Court declines claimant's invitation to treat all whole  person impairments under the Guides as unscheduled injuries

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