2026 Workers' Compensation Appeal Decisions

 January 2026

Madrid v. Mexico Lindo Grill & Cantina, No. 24700714.01 (Arb./App. Jan. 2, 2026)

In this case, the interim commissioner, who heard the case as a deputy, makes an arbitration decision which he indicates is a final agency decision for purposes of administrative efficiency, citing 10A.321(5) and 17A.15(1).  Neither of these sections really appears to justify the arbitration decision as appeal decision result.  10A.321(5) indicates that the decision of the WC commissioner is final agency action, but this particular provision does not indicate that an appeal under 10A.321(1) is forfeited in this situation.  It's certainly more efficient, but raises questions as to the legality of the order under Iowa law and also seems to raise due process concerns. That having been said, for purposes of this reviewing appeal decisions, this decision will be considered as such.

The issues in the case involve whether claimant sustained a work-related injury, whether the claim is barred under 85.16 as a willful act by a third party directed against claimant for reasons personal to claimant and the extent of temporary or permanent disability. There is also a rate issue, with both parties being chastised for not providing accurate records sufficient to determine claimant's rate.  Ultimately, claimant's rate of $900 is accepted, because it seems to take into account claimant's wages and tips

The injury occurred when claimant and a co-worker bumped into each other, causing claimant to spill food on her clothes. Words were exchanged and a video shows that when claimant was rolling silverware, there was an additional exchange, with the other employee and claimant was struck on the left side of her face. The commissioner finds that the incident occurred at work while both were performing work duties and notes that claimant and the other employee did not know each other outside of work. The testimony of claimant is accepted and defendants' 85.16 claim is rejected.

Claimant did not get treatment for her injuries because she could not afford care.  She did not have any specific restrictions applicable to the work injury. She subsequently was fired by the employer, but was earning approximately $900 per week at another job. Dr. Bansal diagnosed PTSD, which the commissioner accepts inasmuch as there was no contrary evidence presented. He recommended restrictions of not working during periods of high crowd dednsity and being able to take breaks as needed.  Although the commissioner acknowledges critiques of Dr. Bansal's opinions by defendants, since there was no other medical testimony presented, his opinions are accepted. The commissioner finds a 10% loss of earning capacity, given claimant's relatively young age, and relatively minor loss of income.  No healing period is awarded as claimant did not establish she was kept from work because of the injury. Claimant was found to be eligible for ongoing mental health care.  Penalty benefits were denied as defendants' 85.16 claim was a "weak, but arguably viable basis for denial."  Dr. Bansal's report was not compensated as claimant did not introduce specific costs for assessment.