Iowa Workers' Compensation

  Green v. North Central Iowa Regional Solid Waste Authority , No. 21-0490 (Iowa April 14, 2023) Claimant filed a workers' compensation claim against his employer for an injury that occurred at work.  As a part of the case, the employer agreed that claimant's work had caused her cerebral hemorrhage.  The employer paid temporary benefits for the injury for three months, but the employer argued that the injury had not resulted in a permanent injury.  The agency agreed that no permanent injury had occurred and an appeal to the district court affirmed this result.  Claimant subsequently filed a review-reopening claim (in a timely manner based on the earlier payment of temporary benefits), arguing that her injury had become permanent over time.  The agency, on summary judgment, concluded that claimant had previously litigated the issue of permanency and found that the claim was barred under res judicata principles. On judicial review, the district court conclude...

As presented by the Supreme Court in Gumm v. Easter Seal Society of Iowa, Inc. , No. 18-1051 (Iowa May 1,  2020), the issue before the court was "whether a workers' compensation claimant who receives disability benefits for a traumatic injury can later recover disability benefits on a separate disability claim if the cumulative injury is based solely on aggravation of the earlier traumatic injury."  The court unanimously concluded that Ms. Gumm could not recover. Claimant initially suffered a fracture of her right ankle, for which she was paid WC benefits following surgery.  The last payment of benefits for the injury was on May 10, 2010.  Claimant continued to suffer from right ankle pain and in January of 2012 returned to the treating physician.  The physician believed that this could have been from a coincidence or from compensating for her right ankle pain. On April 11, 2012, she underwent another surgery, returning to full-duty work on May 3.  Cla...

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...

In Brinck v. Siouxland Mental Health Center , No. 17-1774 (Iowa App. Sept. 12, 2018), claimant filed a review reopening action alleging that his mental disorder was caused by his earlier work injury.  The commissioner dismissed the action, finding that the mental health problems were not related to the work injury and further concluding that even if they had been related, this had been litigated previously and was barred by res judicata.  The Court of Appeals affirms the decision of the agency. The court begins its opinion by noting that generally speaking, after an employee is awarded benefits for an injury sustained at work, the cause is closed, whether by judicial decision or settlement. Under the review-reopening provisions of the statute, however, the case may be reopened if the claimant demonstrates that the employee's current condition is proximately caused by the original injury. Claimant was a doctor at the mental health facility who fell and hit his head.  A...

Linares v. Tyson Fresh Meats , No. 17-1409 (Iowa App. June 6, 2018) involved a situation where claimant was originally awarded a 40% industrial disability as a result of his injury.  As a result of the injury, claimant was sent to work on a line which involved less physical work.  The persons who were on this line were later laid off and claimant filed a review reopening petition, claiming that his economic circumstances had changed as a result of the layoff. Both the arbitration and appeal decisions concluded that the permanent work restrictions were known to the parties at the time of the arbitration decision and were considered at that time in determining claimant's industrial loss.  Since the restrictions had not changed, there was no physical change and there was no economic change, according to the commissioner because the layoffs were not related to claimant's condition, but affected all employees equally. The district court affirmed, finding that claimant's co...

In Ayala v. Tyson Foods, Inc. , No. 16-0505 (Iowa App. Jan. 11, 2017), claimant was initially provided a 45% industrial award.  Claimant subsequently filed a review-reopening petition after he had surgery and his impairment rating was increased from 13% to 23%.  Although the commissioner acknowledged this medical evidence, he found there had been no change in claimant's earning capacity, as claimant had no earnings loss and his work restrictions were largely unchanged or lessened. Claimant contended that the commissioner's decision was irrational, illogical and wholly unjustifiable.  The court rejected this contention, noting that functional impairment was a single, but not controlling factor in determining the extent of industrial disability.  The court also concluded that the decision of the commissioner was supported by substantial evidence, again noting that there was evidence that claimant's earning capacity remained unchanged.  The decision of the commis...

Defendants in O'Reilly Auto Parts v. Kuder , No. 15-0890 (Iowa App. Sept. 14, 2016), filed an appeal of the commissioner's decision refusing to reopen a permanent total disability award.  Defendants claimed that the commissioner committed legal error when considering whether Kuder's economic circumstances had changed, applied an improper burden of proof and reached his decision without support of substantial evidence. Defendants had filed the review reopening action within one month of the appeal decision finding permanent total disability.  Claimant was working part time at the time of the decision granting PTD benefits, but later lost that job when he moved to a smaller community.  Defendants' vocational expert opined that claimant, who had a shoulder injury, had an industrial loss, but that there were many jobs for which claimant was qualified, even with restrictions.  The deputy found that claimant was just as disabled as he was at the time of the original arbi...

In Wehde v. Georgia Pacific and Second Injury Fund , No. 15-0045 (Iowa App. No. 15-0045), the Court of Appeals addressed an issue where claimant had filed an original action against the employer and Fund and had prevailed and later filed a review reopening action.  In this action, claimant prevailed against the employer, and received an additional award of 8% for her left leg, but no additional impairment for her right leg and no additional industrial disability benefits from the Fund.  The agency concluded that there was an increased loss of earning capacity as a result of her additional loss of use to the left knee.  The agency assessed the costs for the left leg to the employer, ordered shared costs for the right leg, and costs relating to the loss of earning capacity were assessed to claimant. The district court affirmed and the case was appealed. The Court of Appeals concluded that although the treating doctor had not imposed restrictions in the original action, th...

In Grahovic v. Second Injury Fund of Iowa , No. 14-1295 (Iowa App.  June 10, 2015), the court was presented with a situation where claimant sought review of an earlier denial of a claim against the Fund.  Claimant had suffered multiple scheduled injuries, but liability of the SIF had been denied previously.  The court found that a review reopening was improper in the circumstances of the case. Claimant had a left leg injury in 1997, and a right leg injury in 2001.  He settled a claim against the Fund in 2003 on a closed file basis.  Claimant later had an injury to his left knee in 2005.  He brought a claim against the Fund with the left knee injury of 2005 being the second injury and the right leg injury of 2001 being the first injury.  He settled with the employer and went to hearing against the Fund.  The agency found that claimant failed to prove his left leg injury and even if he did, had failed to prove that this caused permanent disability...

In Tyson Foods v. Gaytan , No. 14-1397 (Iowa App. March 25, 2015), the Court of Appeals summarily affirmed a finding of permanent total disability in a review reopening case.  The court noted that their review of final agency action was severely circumscribed and noted that it was the workers' compensation commissioner who weighed the evidence and measured the credibility of witnesses.  The court found that the district court had considered the issues, applied the correct standard of review principles and affirmed the commissioner's decision pursuant to Iowa Ct. R. 21.26.

The court in Lull-Gumbusky v. Great Plains Communications , No. 13-1886 (Iowa App. Feb. 11, 2015) addressed a number of issues and affirmed the decision of the commissioner on all issues. The first issue presented to the court involved the exhibits presented by claimant.  The deputy found at hearing that the exhibits did not conform to the format outlined in the hearing report, because they were organized chronologically rather than chronologically by provider.  At hearing, the deputy indicated that the noncompliance would lead to the exclusion of evidence.  Claimant did not conform his exhibits and some of the exhibits were excluded.  The Court of Appeals noted that the agency had broad discretion in oversight and determinations about the admissibility of evidence and affirmed the exclusion of certain evidence. The commissioner found that review reopening was not appropriate because substantial evidence supported the conclusion of the commissioner that the facts...

Following the settlement of a claim for 12% industrial disability and healing period benefits, claimant filed for review-reopening.  The agency concluded that claimant had established a material change in conditions since the time of the settlement, found that additional permanent impairment had been established and concluded that past and future medical expenses should be paid by defendants.  The district court affirmed the finding that there had been a change in circumstances and that claimant was entitled to medical care, but remanded the case for a finding of whether additional industrial disability had been incurred.  On appeal, the Court of Appeals affirms the findings of the district court.   Anderson News v. Reins , No. 14-0038 (Iowa App. Nov. 13, 2014). Following the settlement, claimant continued to treat with Dr. Kirkland, and he indicated that claimant did not have any further impairment or restrictions.  Because of the closure of claimant's employ...

The court in Hill Concrete v. Dixson , No. 13-1778 (Iowa App. Oct. 15, 2014), addressed issues of healing period benefits in a review-reopening proceeding.  Defendants argued that healing period benefits can only be awarded on review reopening when the claimant's condition warrants additional benefits under section 86.14(2) rather than when claimant had reached MMI under section 85.34(1).  The court initially concludes that the timeframe for healing period benefits under 85.34(1) applies in review reopening proceedings, Since the decision of the agency finding that MMI had not occurred until May 4, 2012, the award of healing period benefits from July 16, 2010 to May 4 was appropriate. The case had originally been settled by the parties for 55% industrial disability, and claimant subsequently developed pain in his hip resulting in a hip arthroplasty.  Dr. Mahoney took him off work following the arthroplasty, and ultimately found MMI on May 4, 2012.  The agency award...

In Hallett v. Bethany Life Communities , No. 13-1591 (Iowa App. Aug. 27, 2014) the Iowa Court of Appeals concluded that the review reopening statute required claimant to prove a change in her physical or economic condition in order to establish eligibility for additional benefits on review reopening.  In doing so, the court affirmed the decision of the agency, at both the deputy and appeal levels, which had also required claimant to demonstrate a change. Claimant had argued that the statute, section 86.14 of the Iowa Code, did not contain the word change, and provided that a review-reopening was appropriate if claimant demonstrated that her condition warranted an increase in compensation.  The court rejected this argument, finding that the argument is "foreclosed by a string of controlling authority to the contrary."  The court cited Kohlhaas v. Hog Slat, Inc. , 777 N.W.2d 387, 392 (Iowa 2009) among other cases which had used the word change in a review reopening case. ...

In Searle Petroleum, Inc. v. Mlady , No. 12-2008 (Iowa App. December 5, 2013), the Court of Appeals addressed issues concerning substantial evidence and the appropriate commencement date for permanent total disability benefits and interest in a review-reopening proceeding.  The agency had concluded that claimant had demonstrated that he was entitled to additional benefits on review-reopening, and awarded permanent total disability.  The agency had indicated that benefits commenced on the date of the injury. In the initial decision, the commissioner had concluded that claimant had an industrial disability of 80%.  On review reopening, the agency found that given claimant's physical condition, he had been unable to secure employment and also noted that there had been no improvement in the claimant's employability. The commissioner affirmed, finding that there had been a deterioration of claimant's condition.  The agency found that benefits commenced as of the date of...

Hernandez v. Osceola Foods , No. 12-1658 (Iowa App. April 24, 2013) involved a review-reopening claim following an earlier settlement.  At the time of the settlement, claimant had 30 pound restrictions and was working for Osceola Foods.  She remained there for two years after the settlement, but was fired for falsely filling out an employment application for her husband.  She sought other work, and began to work for another company, Farley's and Sanders Candy.  In her application for Farley's, which was through a temporary agency, she did not reveal that she had restrictions, and indicated she was able to perform all duties, which included lifting up to 50 pounds.  A few months later, when the new employer found out about the restrictions, Ms. Hernandez was fired. Claimant sought review-reopening and was denied at the agency level, with the agency finding that claimant's loss of earnings was due to her dishonest conduct rather than to her work injury.  Th...

In Kramer v. Terex , No. 12-1370 (Iowa App. March 13, 2013), the court of appeals affirmed a decision of the commissioner denying further benefits on a review-reopening claim.  The original decision had awarded benefits of 40%, and on review-reopening the commissioner concluded that claimant had not met his burden of proof of demonstrating changed economic circumstances.  On appeal, the court cited the district court's "well-reasoned" decision and affirmed without comment.  IRAP 6.1203.  

In Sanchez v. Celadon Trucking Services , No. 12-0895 (Iowa App. Feb. 13, 2013), the Court of Appeals addressed a review-reopening question which was combined with questions concerning the proceeds of a third party action, and the employer's subrogation rights from that proceeding.  Claimant had originally been awarded a 25% industrial disability, and later filed for review reopening, and also sought an adjudication of the extent of the employer's remaining lien from the third-party settlement. The deputy found that claimant was not entitled to additional benefits, finding that claimant lacked credibility. The deputy also found that the employer's calculation of the lien was correct and ordered that the lien be honored by claimant.  The commissioner summarily affirmed the decision on both points.  The district court affirmed the commissioner's decision. The court notes that on the review-reopening questions, its task was limited to determining whether substantial ev...

In Verizon Business Network Serv., Inc. v. McKenzie , No. 11-1845 (Iowa App. Oct. 17, 2012), the court grappled with issues involving review reopening and the commencement date of such benefits, and also concluded that weight loss surgery was not related to the work injury. The case had previously been remanded by the court in November of 2010, to be reconsidered under the review-reopening standard set forth in Kohlhaas .  Claimant had initially been found to have a 25% industrial loss as a result of her back injury, and the commissioner had concluded on the initial review reopening that she was permanently and totally disabled.  The court also indicated that the commissioner should reconsider payment for the bypass surgery under Bell Bros. v. Gwinn .  Finally, the agency was to redetermine the correct date for commencement of benefits. On remand, the commissioner found that claimant was unable to work due to her spine injury.  The commencement date for benefits ...

Following the decision of the Supreme Court in Kohlhaas v. Hog Slat, Inc. , 777 N.W.2d 387 (Iowa 2009), the case was remanded to the agency for a determination of whether claimant met the qualifications for review-reopening absent the "contemplation" standard.  On review, the commissioner again decided against claimant, and the case was decided by the Court of Appeals on March 28, 2012.  Kohlhaas v. Hog Slat, Inc. , No. 11-1177 (Iowa App. March 28, 2012). On appeal, Kohlhaas argued that the commissioner read the remand order from the Supreme Court too narrowly.  The court noted that in order to prevail on review reopening, the claimant must demonstrate that following the original settlement, the claimant must demonstrate he suffered an impairment or lessening of earning capacity proximately caused by the original injury.  Citing Simonson v. Snap-On Tools Corp. , 588 N.W.2d 430, 434 (Iowa 1999).  The agency concluded that claimant had failed to demonstrate incr...