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Showing posts with the label IME Costs

Supreme Court Holds that Scheduled Member Injury Cannot be Apportioned Against Unscheduled Injury, But Can Be Apportioned Against the Functional Portion of the Earlier Injury

P.M. Lattner Manufacturing Co. v. Rife , No. 22-1421 (Iowa Feb. 9, 2024) Claimant suffered a right shoulder injury in 2009, which ultimately resulted in a commutation settlement for 29.6% of the body as a whole.  Claimant subsequently suffered another injury to the right shoulder in 2018, following changes to the Code which made shoulder injuries unscheduled.  At hearing, claimant was awarded a 19% functional impairment for the injury to his right shoulder.  The employer argued that the entire award should be credited given that the earlier commutation resulted in a greater award than the second right shoulder injury.  The commissioner rejected this argument, but noted that defendants could arguably be entitled to a credit for the functional portion of the injury.  In this case, however, defendants failed to prove the amount of the credit and thus no credit was awarded. A secondary issue was also presented regarding payment of the IME.  The commissioner awa...

Court of Appeals Finds that Opinion of DME Doctor Finding No Causation Can Be Triggering Mechanism for Payment of IME

Kern v. Fenchel, Doster & Buck, P.L.C , No. 20-1206 (Iowa App. Sept. 1, 2021) Claimant suffered an injury while working, but when sent for an examination with a doctor engaged by the employer, that doctor found that the injury was not causally related to work.  Claimant subsequently had an IME with Dr. Bansal, who found causation and permanent impairment.  The commissioner found that claimant had suffered a permanent impairment as a result of an injury arising out of and in the course of employment.  Claimant's request for penalty benefits was denied.  A request for reimbursement of the IME was also denied, with the commissioner concluding that a finding of no causal connection was not tantamount to a finding of no impairment.  Citing DART v. Young , the commissioner denied reimbursement under 85.39.  Costs under rule 4.33 were also denied. On appeal, the Court of Appeals agreed that the case was governed by DART v. Young , noting that employers were "n...

Court of Appeals Affirms Award of IME in Review Reopening Case

In Ostwinkle v. Mathay Construction Co. , No. 19-0341 (Iowa App. Sept. 25, 2019), the Court of Appeals affirmed the award of a second IME in a review reopening case under section 85.39 of the Code.  After filing his review reopening case, claimant sought and was granted an IME by the commissioner, which was duly paid by defendants.  Claimant subsequently dismissed the review reopening petition, and later refiled following the issuance of a second impairment rating by defendants' physician.  Claimant sought another IME, which was granted by the deputy.  Defendants appealed and  the commissioner and district court affirmed. On appeal to the Court of Appeals, the decision of the agency was affirmed. Defendants argued that 85.39 permits payment for only a single IME.  Claimant argued that the statute allows a second IME if there is a second impairment rating by defendants' physician, which had occurred in this case.  The court concluded that Kohlha...

Court of Appeals Decides Successive Disability Case

In Hansen v. Snap-On Tools Manufacturing Company , No. 12-1038 (Iowa App. Feb. 27, 2013), among the issues addressed by the court was the questions of successive disabilities under section 85.34(7)(b) of the Code.  The court seems to conclude that section 85.34(7)(b) does not apply to unscheduled injuries, which would, if affirmed, have a serious impact on the current law concerning that section of the act. Hansen  also addresses issues concerning costs, extent of impairment, healing period and temporary partial benefits. Claimant sustained two injuries at work, a left shoulder injury in 2005 and an injury to her right hand and arm in 2007 which was traumatic.  The shoulder injury was cumulative, although there was medical evidence that there was a later acute injury to the shoulder superimposed on the cumulative process.  The commissioner concluded that claimant was entitled to 15% industrial disability, did not specifically accept or reject claimant's computatio...