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Showing posts with the label substantial evidence

Court of Appeals Affirms Commissioner's Finding on Rate, Award of Penalty Benefits

  US Nursing Corp. v. Decormier , No. 25-0407 (Iowa App. Dec. 3, 2025) Claimant suffered an injury at work.  Under her contract at work, she was initially guaranteed 48 hours of work per week at $65 per hour, with $97.50 overtime.  She received a $10 per hour raise the week before she was injured. The deputy concluded her weekly rate was $1562.50 and denied penalty benefits.  On appeal, the commissioner agreed with the weekly rate but awarded a $5500 penalty.  Defendants filed a judicial review, which affirmed the decision of the commissioner The fighting issue with respect to the rate was whether section 85.36(6) or 85.36(9) was to be applied. The commissioner found that 85.36(6) appied, as claimant had worked at US Nursing for not only ten weeks in Sioux City but on an earlier assignment.  Defendants' argument that 85.36(9) applied because claimant had earned no wages or less than the usual wages customary in the industry was denied, as defendants' own wi...

Court of Appeals Affirms Commissioner's Rating of Distal Clavicle Excision Which Used a 25% Modifier

  Koeller v. Cardinal Logistics Management Corp. , No. 25-0172 (Iowa App. Dec. 3, 2025) Claimant suffered an injury to his shoulder and was found to need a shoulder surgery , which included a distal clavicle excision .  Dr. Bollier , the physician who performed the surgery, provided a 6% permanent impairment rating based on loss of range of motion . No rating was provided for the distal clavicle excision, as Dr. Bollier did not believe this was related to the work injury. Dr. Taylor , claimant's IME physician , provided a 19% upper extremity impairment rating, which included a 10% rating for the distal clavicle excision.  In making this rating, Dr. Taylor indicated he did not use the 10% modifier from Table 16-18 of the AMA Guides because he believed that Table 16-27 was inadvertently listed as one of the tables to which the modifier should be applied.  Dr. Crites performed a record review and also found that the modifier did not apply and gave the full 10% impair...

Court of Appeals Affirms Denial of Permanency Benefits on Substantial Evidence Grounds

  Hayes v. Christian Retirement Homes, Inc. , No. 24-1991 (Iowa App. Oct. 1 2025) Claimant suffered an alleged work injury.  Prior to this injury, claimant had a lengthy history of injury, which had resulted in a 20 pound lifting restriction prior to the time he began working for the employer. In his position with the employer, claimant was required to lift between 25 and 50 pounds.  Claimant tripped while at work, fell to the cemet and hit his head.  He claimed injuries to his low back, leg and right ankle.  He was diagnosed with right sided sciatic radicular pain and lumbago with sciatica.  A CT scan desmonstrated severe degenerative disc disease.  Surgery was recommended by the surgeon chosen by the employer who related the surgery to claimant's work injury. A DME found that claimant's proposed back surgery was not related to the work injury, but to claimant's underlying conditions. The DME concluded claimant had back strain, with no permanent impai...

Court of Appeals Affirms Finding Claimant Suffered a Mental Health Condition Arising Out of His Employment, Concludes That Claimant's Injuries are to be Determined Industrially

  Turner v. NCI Building Systems , No. 23-1003 (Iowa App. Jan. 9, 2025) Claimant was found to have suffered a mental health injury at work, but that injury was found not to be permanent.  The commissioner also concluded claimant had suffered injuries to his bilateral lower extremities, left shoulder and thoracic spine and awarded a 40% industrial disability. Claimant sought to have the report of a pain psychologist, provided two days after hearing, into evidence and this request was initially denied by the deputy, but allowed by the commissioner. The district court affirmed the decision of the commissioner, denying both the employer's appeal and claimant's cross-appeal. The Court notes first that challenging the agency's decision on the basis that the decision was illogical, irrational or wholly unjustifiable was a "heavy lift." The Court considered the admission of the pain psychologist's decision and noted that the lateness of the report was due to the fact ...

Court of Appeals Affirms Ruling Finding that Claimant's Injuries Were Related to Work and Conclusion Claimant was Permanently and Totally Disabled

  H.J. Heinz Co. v. Tilton , No. 24-0236 (Iowa App. Dec. 18, 2024) In this action, which had previously been before the Court of Appeals twice, the Court affirms a decision finding that the date of discovery of the injury was April 15, 2013, that the filing of the action was timely and that claimant was permanently and totally disabled based on aggravations of her back and mental conditions. Claimant had a long history of treatment for back problems, beginning in 2000, approximately a year after she began working for the employer.  She continued to treat for the injury throughout the years and in 2010 her chiropractor indicated that her disc bulges and bone spurs were permanent and could cause her to miss work, but also finding she was not currently incpacitated.  Claimant received a great deal of treatment in 2010 and left the employer on April 13, 2013 on disability.  At hearing, medical testimony indicated that claimant's work had been a substantial contributing f...

Court of Appeals Affirms PTD Award on Substantial Evidence Grounds

XPO Logistics v. Ivester , No. 23-1357 (Iowa App. Aug. 21, 2024) Claimant was found to have sustained permanent total disability from a back injury affecting both his left and right side.  Although defendants admitted that claimant had sustained an injury to his left back, they argued that the symptoms from the left-sided back injury had largely abated and claimant was not entitled to PTD based only on his symptoms to the left back.  Defendants argued that the symptoms to the left back, which arose following surgery to his left back, were not related to his work.  In finding permanent total disability, the deputy and commissioner relied on the unrefuted opinions of two experts, Dr. Mathew and Dr. Segal, that the "ongoing low back and lower extremity symptoms, including his right-side symptoms, are related to the work injury of June 8, 2016." On appeal, the employer argued that since the surgery was to the left side, symptoms on the right side with no immediate onset could...

Court of Appeals Holds that Injuries to Two Shoulders Are Not to be Considered Industrially Under 85.34(2)(v)

Nordstrom v. Carmer , No. 23-1423 (Iowa App. May 8, 2024) Claimant suffered an accepted injury to her right shoulder in August of 2018. She subsequently developed pain in her left shoulder due to overcompensating for her right shoulder injury with her other arm. Claimant's IME physician opined that the left shoulder injury was due to overcompensation due to the right shoulder injury while defendants' doctor indicated that the left shoulder injury was due to rheumatoid arthritis and was not work-related.  The commissioner concluded that both shoulder injuries arose out of and in the course of employment and found that the injuries should be treated as unscheduled under 85.34(2)(v).  The district court affirmed the decision of the commissoiner. On appeal, the Court of Appeals first concludes that the report of Dr. Segal, claimant's IME doctor, was supported by substantial evidence.  The Court noted that the decision concerning medical causation was essentially within the do...

Supreme Court Holds That Simultaneous Injury to Separate Body Parts is Not to be Considered as an Unscheduled Injury Under 85.34(2)(v)

Bridgestone Americas, Inc. v. Anderson , No. 22-1328 (Iowa March 29, 2024) In this case of first impression,  claimant suffered simultaneous injuries to his arm and shoulder arising out of his work.  The commissioner concluded that because such simultaneous injuries were not encompassed under the listing of scheduled member injuries in 85.34(2)(a)-(u), it should be considered under the catch-all provisions of 85.34(2)(v), which requires injuries not encompassed under 85.34(2)(a)-(u) to be considered industrially under the Code.  The commissioner concluded that claimant had suffered a 50% industrial disability. This finding was affirmed by the district court. The employer appealed to the Supreme Court, raising three issues.  First, there was insufficient evidence to support the conclusion that claimant's injuries arose out of employment. Second, the injuries should be compensated as unscheduled injuries.  Third, the 50% award was excessive.  The Court conclu...

Court of Appeals Rules Failure to Comply with Iowa Drug-Testing Statute Does Not Bar Admission of Drug Tests in Workers' Compensation Claim, Finds Claimant Failed to Rebut Presumption He Was Intoxicated

Davis v. Gordon Food Service, Inc. , No. 22-1944 (Iowa App. Feb. 21, 2024) Claimant suffered an injury at work.  Pursuant to the employer's drug policy, claimant took a drug test following the injury, which was positive for methamphetamines.  The test was not conducted in accordance with 730.5, which requires that two samples be taken to allow the person being tested to have the samples independently tested.  At hearing, the deputy concluded that the violation of 730.5 did not make the admission of the drug test inadmissible for purposes of the workers' compensation act.  The deputy also concluded that claimant did not rebut the presumption that he was intoxicated under 85.16 of the Code, despite the fact that claimant testified that he had not taken drugs for four days before the injury and there was no testimony that claimant was acting in an intoxicated manner and no evidence that intoxication led to the injury.  The commissioner affirmed, as did the district...

Court of Appeals Affirms Finding that Claimant Provided Timely Notice of His Injury

Kraft Heinz Co. v. Bynum , No. 23-0045 (Iowa App. Feb. 7, 2024) Claimant was initially employed with Kraft through a temporary employment agency.  Claimant was hired by Kraft in January of 2019.  In early February, claimant was diagnosed with a hernia and he notified the employer of his problems and need for surgery.  Following his return to work, he continued to have pain, was taken off work and received short term disability benefits.  Claimant wrote a letter to the employer in June of 2019 indicating that he had told numerous people at work about his injury and felt he should be receving workers' compensation benefits.  The commissioner concluded that the employer failed to prove that it did not receive timely notice as "it had not rebutted credible testimony that Bynum had informed multiple supervisors of the injury within the ninety-day period."  The district court concluded that substantial evidence supported the commissioner's decision. On appeal, th...

Court of Appeals Reverses District Court Holding that Res Judicata Barred Review-Reopening Claims; Affirms Award of Permanent Total Disability

  Interstate Power & Light Co v. Moyer , No. 22-1917 (Iowa App. Dec. 20, 2023) Claimant suffered a crush injury to his foot and was awarded permanent partial disability benefits.  Three years later, claimant filed for review-reopening and was awarded permanent total disability.  Following the initial injury to the foot, claimant developed back problems that ultimately led to the implantation of a  lumbar neurostimulator and an operation (a gastrocnemius release) on claimant's calf.  Claimant continued to have low back and hip pain.  Claimant also developed mental health problems, diagnosed as pain disorder with psychological factors, including major depressive disorder. Defendants' doctors found the mental health problems were not work-related, but claimant's IME doctor concluded that the depression was related to claimant's physical injuries. At hearing, defendants argued that an increased award was barred by res judicata and that permanent and total d...

Court of Appeals Affirms Denial of Workers' Compensation Benefits; Rules on Credit Issue

Thomas v. Archer Daniels Midland Company , No. 23-0323 (Iowa App. Nov. 8, 2023) Claimant initial suffered a compensable injury to his right eye in 2017.  He subsequently sustained several injuries in 2018 while stepping off a pontoon boat, which he attributed to a lack of depth perception as a result of his eye issues.  The deputy ruled in favor of claimant, but the commissioner reversed, finding that the 2018 injuries were not a sequelae of the original eye injuries.   The Court of Appeals concluded that the decision of the commissioner was supported by substantial evidence and affirmed the decision of the commissioner.  The Court noted that medical causation was a question of fact vested in the commissioner's discretion and noted that although claiant speculated that his fall was caused by his right eye injuries, claimant could not specifically recall what happened and there were no witnesses to provide context.  The speculation of medical experts that vi...

Court of Appeals Affirms Denial of Benefits on Substantial Evidence Grounds

  Spence v N&L Parkison Trucking, Inc. , No. 23-0144 (Iowa App. Oct. 25, 2023) Claimant filed a workers' compensation claim alleging that he suffered a shoulder injury at work.  The doctors who he saw related to the injury found that claimant had a rotator cuff injury, but noted claimant had related them to the pain in his shoulder from an earlier two weeks earlier.  An IME related claimant's injury to the work events and provided him with a 12% impairment to the body as a whole as a result of the injury.  The deputy found claimant was not credible in part due to his past crimes of dishonesty and denied benefits and the commissioner affirmed.  The district court affirmed the decision of the agency. The Court of Appeals rejected claimant's argument that the decision of the commissioner was not supported by substantial evidence.  The Court noted that due regard must be given to the commissioner discretion to accept or reject testimony based on witness cre...

Appeals Court Affirms Denial of Second Injury Fund Benefits

  Liford v. Christensen Farms and Second Injury Fund , No. 22-1747 (Iowa App. Aug. 9, 2023) Claimant was denied benefits from the Fund for a left knee injury because this injury was found to be a sequella of an earlier right knee injury and not a separate and distinct second injury.  The left knee injury was traced by the physicians to claimant's "babying" his right knee following an injury to that knee.  The deputy found the left knee injury was a sequela, based on the opinions of Dr. Vincent and Dr. Kuhnlein.  These findings were affirmed by the commissioner and the district court. On appeal, claimant argues that the underlying decisions incorrectly interpreted Gumm v. Easter Seal Society of Iowa , 943 N.W.2d 23, 25 (Iowa 2020).  Claimant argues that Gumm should only be applied where a cumulative injury stems from the aggravation of an earlier injury, not in cases where a sequela injury develops.  The Court rejects this view of Gumm , finding that a secon...

Appeals Court Affirms Commissioner's Denial of Benefits to Claimant

  Shrum v. Boldt Group, Inc. , No. 22-0710 (Iowa App. June 7, 2023) In this action, the deputy concluded that claiant had sustained injuries to his right should, right bicep and right neck.  On appeal, the commissioner concluded that claimant's conditions did not arise out of employment and reversed the award.  Claimant appealed and the district court affirmed the decision of the commissioner. On review, claimant alleged that substantial evidence supported the "deputy's" findings that claimant's injuries arose out of employment.  The Court notes, however, that it is the commissioner's final decision that is subject to judicial review, not the deputy's decision, citing Giere v. Aase Haugen Homes, Inc. , 146 N.W.2d 911, 915 (Iowa 1966).  Thus, on review, the court's role was to determine whether the commissioner's decision was supported by substantial evidence. In affirming the decision of the commissioner, the Court found that the decision was ...

Court of Appeals Affirms Denial of Review Reopening Claim

  Barry v. John Deere Dubuque Works , No. 22-1000 (Iowa App. May 24, 2023) Claimant suffered from bilateral carpal tunnel syndrome and was awarded an 11% whole person impairment rating following hearing.  Claimant subsequently developed additional problems with his bilateral hands and arms and sought review reopening based on changes in physical condition.  Dr. Mathew, who conducted an IME on the review reopening, concluded that claimant had additional permanent impairment and had also developed shoulder difficulties as a result of his work activities.  Additional restrictions were also imposed.  The agency concluded that claimant had not demonstrated a physical change in condition sufficient to justify additional benefits and the district court affirmed this holding.  The agency concluded that Dr. Mathew’s report was not credible because it was based on incorrect sections of the AMA Guides. The Court concluded that the agency had not abused its discretion ...

Court of Appeals Affirms Grant of Alternate Medical Care

  Waterloo Community School District v. DeMaldonado No. 22-0845 (Iowa App. Feb. 8, 2023) Claimant had years of treatment, primarily physical therapy, for numerous injuries sustained while working.  After several years of treatment, she sought alternate medical care in the form of pain management recommended by her treating physician, which was denied by the employer.  In the application for alternate medical care, the deputy concluded that claimant had proved that the care provided was unreasonable but denied that the employer had abandoned care.  The school district appealed to the district court, which affirmed the decision of the commissioner. As an initial matter, the Court of Appeals addressed an argument made by claimant that the employer's judicial review petition had not been timely filed.  The claimant had initially filed for alternate medical care, but had dismissed the petition and then refiled.  In the judicial review action, the employer had a...

Court of Appeals Affirms Award of Alternate Medical Care

  Waterloo Community School District v. DeMaldonado , No. 22-0845 (Iowa App. Feb. 8, 2023) Claimant was injured at work and received treatment for several years.  After a time, she became dissatisfied with care, as the employer refused to authorize pain management, referred her to providers unsuited to treating her condition, lied about the authorization for care and interfered with care she sought from her own selected providers.  After filing an application for alternate medical care, the deputy ordered defendants to provide pain management with Dr. Mathew.  There was found to be insufficient proof that the employer had abandoned DeMaldonado's care.  Defendants were cautioned, however, not to interfere with the medical judgment of its own treating physician.  The district court affirmed the decision of the agency. On appeal, claimant first raised an issue of the timeliness of of the judicial review petition.  Claimant had filed an alternate care peti...

Court of Appeals Affirms Permanent Total Award on Substantial Evidence Grounds

  Regional Care Hospital Partners, Inc. v. Marrs No. 22-0959 (Iowa App. Feb. 8, 2023) This action, previously before the Court Regional Care Hosp. Part., Inc. v. Marrs , No. 19-2138 (Iowa App. Feb. 17, 2021) was a decision by the commissioner finding claimant had suffered a permanent total disability.  Defendants argued that because a FCE had placed claimant in the light work category, she was not permanently and totally disabled.  That FCE, however, had also indicated that claimant should limit sitting and standing to a rare basis, 1-5% of an 8 hour day.  Claimant had also testified that she spent most of the day laying down.  Defendants also aruged that a vocational report had found that jobs were available for claimant and claimant argues that the VE never met with her and that she could not perform the jobs listed by the VE.  Based on this, the deputy concluded claimant had an 80% industrial disability.  The commissioner awarded permanent and tota...

Court of Appeals Affirms Permanent Total Award

Medplast v. Pruis , No. 21-1650 (Iowa App. Dec. 7, 2022) In this action, claimant was found to have sustained injuries to his head, neck vision and mental health arising out of and in the course of his employment.  As a result of these injuries, he was found permanently and totally disabled.  The Court affirms on substantial evidence grounds. While climbing on a machine, claimant hit the right side of his head on a bar, which jarred his teeth and caused him to drop back to the floor.  He felt immediate pain in his neck, head and shoulders.  He went to the office and vomited while at work.  He was taken to the emergency room by his daughter when he returned home and was diagnosed with a very severe concussion and traumatic brain injury.  He was never able to return to work because of his continuing symptoms. Claimant treated for these injuries, but treatment was ultimately ended after neuropsychological assessments by Dr. Daniel Tranel.  He subsequently...