NWCDN Members regularly post articles and summary judgements in workers’ compensations law in your state.
Select a state from the dropdown menu below to scroll through the state specific archives for updates and opinions on various workers’ compensation laws in your state.
Contact information for NWCDN members is also located on the state specific links in the event you have additional questions or your company is seeking a workers’ compensation lawyer in your state.
Legal Update by Attorneys Nicholas Cooling & Alison Stewart and Law Clerk Jordan Gehlhaar
Recently, Deputy Workers’ Compensation Commissioner William Grell issued anarbitration decision defining what constitutes the “shoulder” under Iowa law. One of the main issues was whether the claimant’s work injury should be compensated with permanent disability benefits as a scheduled member injury to the left shoulder, as a bilateral shoulder injury, or as an unscheduled injury. Ultimately, the Iowa statute was construed liberally, for the benefit of the injured worker.
While completing maintenance work as an employee of McDonald’s on April 18, 2018, Claimant Smidt tripped over a box and struck his left side on a steel beam. His injuries included tears of the supraspinatus and infraspinatus tendons, or rotator cuff.
Prior to amendments to the Iowa Workers’ Compensation laws in July of 2017, the shoulder was considered proximal to the arm, and was compensated as industrial disability, an unscheduled injury. Through the 2017 amendments, the Iowa legislature specified that injuries to the “shoulder” should be compensated as scheduled member injuries on a 400-week schedule. However, the deputy concluded, the legislature’s language was ambiguous as to what constitutes the “shoulder.”
Claimant argued that the injuries were proximal to the glenohumeral (shoulder) joint, and should be an unscheduled injury compensated with industrial disability pursuant to Iowa Code Section 85.34(2)(v) (2017). The defendants argued the injury was limited to the left shoulder and should therefore be compensated as a scheduled member injury pursuant to Iowa Code Section 85.34(2)(n) (2017).
The Deputy Commissioner determined that the legislature made a conscious decision to add the “shoulder” as a scheduled member injury, resulting in significantly less compensation to an injured worker. Additionally, it was determined that the legislature likely knew, based on prior decisions, that an injury to the rotator cuff would be proximal to the “shoulder” joint, and therefore compensable to the body as a whole. The deputy reasoned that there is a difference between the “shoulder” and the surrounding anatomic parts (tendons and muscles) that operate the shoulder, which is consistent with Dr. Kuhnlein’s opinion in the case, as well as prior Commissioner’s findings inNazarenus v. Oscar Mayer & Co. in 2008.
Mr. Smidt was involuntarily terminated at the change of management and later found employment as a part-time truck driver. Considering the traditional industrial disability factors, the deputy made an award of 40% industrial disability.
Overall, these findings are consistent with those in Chavez v. MS Technology, LLC, File No. 5066270 (Feb. 5, 2020) andDeng v. Farmland Foods, Inc., File No. 5061883 (Feb. 28, 2020) – two similar decisions since the 2017 amendment. In effect, this decision indicates the agency’s progression since the 2017 amendments, toward body as a whole classification when injury of the shoulder is involved. Under the current case law, any time the injury extends into the proximal portion of the shoulder joint, we can expect the agency to find a body as a whole injury, where industrial disability analysis may be appropriate. However, as this decision suggests, additional guidance in the form of statutory language and parameters of what constitutes “shoulder,” is necessary and Peddicord Wharton will continue to monitor the case law as this issue continues to develop.
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NOTICE TO THE PUBLIC
The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. This disclosure is required by rule of the Supreme Court of Iowa.
Peddicord Wharton Legal Updates are intended to provide information on current developments in legislation impacting our clients. Readers should not rely solely upon this information as legal advice. Peddicord Wharton attorneys would be pleased to answer any questions you may have about this update. ©2020 Peddicord Wharton. All Rights Reserved.
On Friday, May 1, 2020, the Supreme Court of Iowa issued its decision in Anita Gumm v. Easter Seals, in which the Supreme Court agreed with the arguments that had been extensively briefed and then argued by attorneysLee Hook andTyler Smith on behalf of Easter Seals. 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 cumulative injury claim if the cumulative injury is based solely on aggravation of the earlier traumatic injury.
FACTUAL BACKGROUND
The Claimant, Anita Gumm, sustained a serious left ankle fracture on October 28, 2008, while she was working, and subsequently underwent an ORIF procedure. Ms. Gumm received weekly benefits, and she received the last weekly benefit check on May 21, 2010. Ms. Gumm sought medical treatment for her ankle in the weeks, months, and years following the date of the injury, but also following the date of her last benefit check. Pursuant to Iowa Code §85.26(2), Ms. Gumm had until May 21, 2013, to file a Review Re-opening Petition. Ms. Gumm filed multiple petitions on February 24, 2014, alleging cumulative injuries (with various manifestation dates) to her left ankle with sequela complaints to her back including an altered gait. The case went to hearing on March 12, 2015. The Deputy found that Ms. Gumm failed to prove by a preponderance of the evidence that she sustained a “distinct and discrete” new cumulative injury, pursuant toEllingson, and awarded Ms. Gumm no additional benefits as her claim for any additional disability based on a worsening of her ankle (and sequela symptoms) for which she had previously received weekly benefits was time-barred by the three-year statute of limitations. Ms. Gumm argued at Hearing that the “distinct and discrete” requirement as set forth inEllingson was not applicable but rather Floyd should control, which Ms. Gumm argued would allow her to recover benefits for the amount of the “increase in disability” to her ankle and sequela symptoms that could be attributed to her cumulative work duties.
LEGAL ISSUES AND ARGUMENTS
In reaching its decision, the Supreme Court addressed two prior Supreme Court of Iowa cases on point:Ellingson v. Fleetguard, Inc., 599 N.W.2d 440 (Iowa 1999) and Floyd v. Quaker Oats, 646 N.W.2d 105 (Iowa 2002). At each stage of the case, Easter Seals arguedEllingson was dispositive, and Claimant argued Floyd was dispositive. In the end,the Supreme Court, affirmed Ellingson and re-stated the acute-then-cumulative-injury claim (for same body part) standard: that the cumulative injury must be a “distinct and discrete” disability, not disability as a result of an aggravation of a previous traumatic injury. The Court framed the issue in Gumm as “whether the claimant has suffered an aggravation of her previous compensable injury or a distinct and discrete cumulative injury.”
The Court found that the Commissioner’s application of the distinct and discrete standard inEllingson was appropriate and therefore the Commissioner’s finding that Ms. Gumm failed to meet her burden of proof for a cumulative injury claim was based on substantial evidence and thus should not be disturbed because, as the Court inGumm noted: “whether a claimant has suffered an aggravation of a previous traumatic injury or a distinct and discrete cumulative injury is a fact issue to be determined by the commissioner.”
Overall, Gumm further supports and establishes the “distinct and discrete” standard for cases that involved traumatic-then-cumulative-injury claims initially put forth inEllingson and also accepted in Excel Corp. v. Smithart. 654 N.W.2d 891, 898 (Iowa 2002) (“The separate and discrete requirement prevents a worker from transforming a chronic condition into multiple injuries, and obtaining the multiple separate recoveries feared by [employers]. Thus, employers are protected against paying for the prior disability over and over by the separate and discrete requirement.”). The Supreme Court ultimately held:
We therefore believe that the distinction drawn in Ellingson andSmithhart between cumulative aggravation of an existing compensable injury through the daily grind of working and a new, discrete injury remains valid in Iowa. In the former case, review-reopening is the recognized remedy if the claimant desires additional disability benefits. A claimant cannot avoid legislatively imposed restrictions by reclassifying an injury as a new injury unless the facts support that classification.
Regarding Floyd, the Court also articulated that Floyd is an exception toEllingson: “[W]here the claimant was precluded from recovering payments for the original trauma, the claimant would be permitted to recover payments on a cumulative-injury basis for subsequent aggravation of the trauma.” The Court further noted thatFloyd recognizes “that a claimant who is suffering the mounting, cumulative effects of a workplace trauma does not have to prove a distinct and discrete injury when the claimant never received an award for that trauma.”
CONCLUSION
In sum, this case is a win for employers and workers’ compensation carriers in Iowa as it affirmed theEllingson standard that a claimant must prove a – distinct and discrete – new cumulative injury was sustained, not an aggravation or increase in previous disability, when a claimant is alleging a cumulative injury to a body part that was previously injured as part of an acute or traumatic work injury.
Legal Update by Attorneys Alison Stewart & Steve Durick
1. Is a positive COVID-19 diagnosis a compensable work injury?
In Iowa there is not a black and white answer about compensability relating to the coronavirus. These claims must be evaluated on a case by case basis.
Iowa is a combination between positional risk (were they at work when it happened?) and increased risk (did work increase the odds of the injury?). Thus, it would be possible for the worker to establish a causal relationship if the worker could prove they were exposed to COVID-19 at work. In parts of the state where there is community spread, however, it would be more difficult for a worker to establish the work caused the infection when the worker could have caught it elsewhere in the community. Healthcare workers would be an exception to this analysis, most likely. It would likely be easier for a healthcare worker to establish a causal link, depending on their field. In many ways this virus, because of its ubiquitous nature, is not unlike the common cold or flu in the context of compensability. As the virus continues to spread, it will become more and more difficult to determine its source. Again, these cases should be analyzed on a case by case basis. Peddicord Wharton attorneys are happy to discuss these cases with you at any time.
More simply, the employee will have to provide a positive test result and a clear link between work and their exposure.
2. What is the interplay between COVID-19 and the Occupational Disease Statute?
Chapter 85A, the occupational disease chapter, is applied infrequently in Iowa. Claimants typically bring actions under Chapter 85 whenever possible.
We typically see these claims generate from a long-standing exposure to something over time. Historically, there was a list of qualifying diseases, but that list no longer exists. To qualify as an occupational disease, according to Iowa Code section 85A.8, the following requirements must be present:
· Arise out of and in the course of employment.
· Direct causal connection with the employment.
· Followed as a natural incident from an injurious exposure occasioned by the nature of the work.
· Incidental to the character of the business, occupation or process in which the employee was employed and not independent of the employment.
· Appear to have its origin in a risk connected with the employment and to have resulted from that source as an incident and rational consequence.
Note, a disease which follows from a hazard to which an employee has or would have been equally exposed outside of said occupation isnot compensable as an occupational disease. The compensability analysis for an alleged occupational disease is really no different than the traditional compensability analysis described above in the COVID-19 context.
According to the Iowa Practice Series on Workers’ Compensation, the use of the term “date of injury” is not appropriate in the context of occupational disease because there is no “injury” suffered. 15 Lawyer & Lawyer,Iowa Practice Series: Workers Compensation, 18:4 (2019-2020). Disablement is the term used.Id. Iowa Code section 85A.4, explains that the “event or condition where an employee becomes actually incapacitated from performing the employee’s work or from earning equal wages in other suitable employment because of an occupational disease.”
In short, we do not expect Claimants to pursue work related COVID-19 claims as an occupational disease. More likely the claim would be brought under chapter 85 with Claimant needing to prove causation as they would with any work injury in Iowa regardless of whether the claim is brought under Chapter 85 or 85A.
3. What about a claim for psychiatric injury where the worker has either contracted COVID-19 as a result of a work exposure, or is merely fearful of contracting the virus?
In Iowa, if an injured employee sustains a compensable physical injury and subsequently develops a psychological injury (i.e. anxiety, depression, etc.), such a psychological injury is deemed a compensable injury as well as long as it is causally related to the physical injury. These types of injuries in Iowa are classified as “physical-mental” injuries. The psychological injury can be a new injury (no prior psychological history) or be an aggravation of a pre-existing/underlying mental condition/injury. In the current situation involving COVID-19, if an injured worker is determined to have contracted COVID-19 at the work place and subsequently develops a psychological injury as a result (or experiences an aggravation of an underlying mental condition), the psychological injury will be deemed to be a compensable injury.
Iowa also recognizes “non-traumatic” mental injuries as being compensable – although the burden of proof is quite difficult. See Dunlavey v. Economy Fire & Casualty Co., 526 N.W.2d 845 (Iowa 1995). These injuries in Iowa are classified as “mental-mental” injuries. In “mental-mental” injuries, the mental injury is not preceded by a “physical” injury. To prove a “mental-mental” injury, the injured employee must establish both medical and legal causation. Legal causation requires the injured employee prove that the mental injury was proximately caused by workplace stress of greater magnitude than day-to-day mental stress experienced by other workers employed in the same or similar jobs, regardless of their employer. In other words, the injured employee must establish that his or her stress is not common to other employees in similar work (from an objective standpoint). This is a very difficult burden of proof to carry for the injured worker. Additionally, the injured worker must also establish medical causation which will require expert medical testimony. In the current situation involving COVID-19 – and specifically where an injured worker has developed a psychological injury due to fear of contracting COVID-19 – the injured worker will be required to prove that his or her mental injury was “caused by workplace stress of greater magnitude than day-to-day mental stress experienced by other workers employed in the same or similar jobs. . .” The injured worker will be required to prove that his or her stress in that regard is not common to other employees in similar work – which will be very difficult, if not impossible to do, under this current COVID-19 situation.
4. What is the appropriate benefit commencement date for compensable COVID-19 claims?
If the employee is taken off work by a medical professional for a presumed case of COVID-19 before having a positive test result, the appropriate commencement date would be the fourth date of disability (after the waiting period). If lost time continues beyond the 14th day, the compensation during the third week must be increased to include the three-day waiting period. Iowa Code § 85.32 (2019). It is appropriate to wait to commence benefits until a positive test result is ascertained, but the worker should then be brought current on benefit entitlement at that time.
5. How do COVID-19 related shutdowns or layoffs impact temporary benefit entitlement for non-COVID-19 related claims?
If an injured worker is off work or on restrictions and a suitable offer of employment cannot be made (which is the case if the employer is closed or shut down), then temporary benefits are owed.
Support for this can be found here:
Iowa Code section 85.33(3) states that the employer shall pay to an employee for an injury producing TTD, weekly compensation benefits until:
· the employee has returned to work or
· is medically capable of returning to employment substantially similar to the employment in which the employee was engaged at the time of injury, whichever occurs first.
Likewise, Iowa Code section 85.34 states that healing period is owed until:
· the employee has returned to work,
· is put at MMI,
· or it’s medically indicated that the employee can return to substantially similar employment.
Relating to TPD benefits, Iowa Code 85.33(2) says TPD are owed when an employee is not capable of returning to substantially similar employment but is able to perform other work consistent with the employee’s disability.
The only exception to these entitlements is where suitable work is offered and refused. Iowa Code section 85.33(3)(a) instructs that if an employer offers an employee suitable work and that worker refuses, then temporary benefits are not owed.
6. Do we expect to see longer periods of temporary benefit entitlement for non-COVID-19 claims because of the impact of COVID-19?
It’s possible because some providers have been suspended non-essential medical treatment. In addition, other companies have either had to shut down because of a positive case or have been subjected to a government shutdown. As discussed above, if an injured worker is off work or on restrictions and a suitable offer of employment cannot be made (which is the case if the employer is closed or shut down), then temporary benefits are owed.
7. Will there be any permanent benefit entitlement as a result of a compensable COVID-19 claim?
We do not know the answer to this question yet, but similar to other injuries in Iowa, Claimant would have to have sustained permanent damage as a result of the illness.
NOTICE TO THE PUBLIC
The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. This disclosure is required by rule of the Supreme Court of Iowa.
Peddicord Wharton Legal Updates are intended to provide information on current developments in legislation impacting our clients. Readers should not rely solely upon this information as legal advice. Peddicord Wharton attorneys would be pleased to answer any questions you may have about this update. ©2020 Peddicord Wharton. All Rights Reserved.
Legal Update by Attorneys Nick Cooling & Alison Stewart
Iowa Workers’ Compensation Commissioner Responds to Coronavirus
On Friday, March 13, 2020, Iowa Workers’ Compensation Commissioner Cortese filed anOrder responding to Coronavirus concerns. In-person hearings will be suspended beginning March 18, 2020 and continuing through June 16, 2020. During this time period scheduled hearings will be held using CourtCall, the agency’s video hearing technology. Fees for the service will be covered by this agency.
For any compensability questions relating to contraction of Coronavirus by Iowa employees, please contact any of the Peddicord Workers’ Compensation Attorneys to discuss further. Analyzing these situations on a case-by-case basis is appropriate.
Shoulder Definition Clarified
The agency filed two arbitration decisions clarifying how the agency defines the shoulder. Recall that the shoulder was added to the schedule in July 2017 and has been compensated based upon 400 weeks since that time. A scheduled member injury has been limited to the impairment rating of an expert.
The decisions are Chavez v. MS Technology, LLC,File No. 5066270 (Feb. 5, 2020) and Deng v. Farmland Foods, Inc.,File No. 5061883 (Feb. 28, 2020). We expect the decisions to be appealed. In light of these decisions, however, the current agency law is that where the injury to the shoulder extends into the proximal portion of the shoulder joint (the portion nearer to the center of the body), it is a body as a whole injury and an industrial disability analysis may be appropriate. The agency cited pre-legislative change cases where the shoulder was defined as the ball and socket between the arm (humerus) and the trunk (scapula), which is medically called the glenohumeral joint. The agency then reasoned that the legislature was aware of this definition when they drafted the 2017 amendment and found that injuries extending into the body side of the glenohumeral joint are body as a whole injuries. Consider the below diagram for additional context relating to the anatomy of the shoulder:
Importantly, any time the injury extends into the proximal portion of the shoulder joint, including where the surgery performed involves a distal clavicle resection (which is where the surgeon shaves the tip of the clavicle), we can expect the agency to find a body as a whole injury since the clavicle is proximal to the glenohumeral joint. The cases cited in theChavez decision in arriving at the shoulder definition now being applied by the agency specifically identify the distal clavicle as part of the body as a whole. The agency will likely then apply an industrial disability analysis where the Claimant has not returned to work, with the same hours and earnings. If there is a return to work, we would expect the agency to apply a body as a whole rating to 500 weeks like they would for a typical body as a whole injury with a return to work.
Additionally, in the Deng case, penalty benefits were awarded where Defendants did not pay permanency following an IME report from Claimant’s expert containing a permanency rating, despite the authorized treating physician not yet placing the claimant at MMI or assigning impairment. The deputy found that since the authorized treater provided permanent restrictions after a valid FCE, this was the equivalent to MMI, even though the treating doctor didn’t come out and say that in his report. Penalty was awarded from the date that permanent restrictions were provided, not the MMI date in Claimant’s IME report.
These decisions may be appealed, but we will not know the outcome of any appeal(s) for more than a year.
Iowa Supreme Court Reduces Punitive Damages Award in Bad Faith Case
Thornton v. American Interstate Insurance Company, arising out of a compensable work injury where the carrier delayed benefits owed, the Iowa Supreme Court of Iowa recently took up the issue of the level of conduct necessary to justify an award of punitive damages in a bad faith case. Ultimately the punitive damages were reduced, however, the decision did not provide a definitive ratio between punitive and compensatory damages. However, it is instructive as to the level of conduct that will justify certain awards for punitive damages.
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NOTICE TO THE PUBLIC
The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. This disclosure is required by rule of the Supreme Court of Iowa.
Peddicord Wharton Legal Updates are intended to provide information on current developments in legislation impacting our clients. Readers should not rely solely upon this information as legal advice. Peddicord Wharton attorneys would be pleased to answer any questions you may have about this update. ©2020 Peddicord Wharton. All Rights Reserved.
Happy New Year from Peddicord Wharton! Here is what’s new in Iowa:
Legal Update by Attorney Alison Stewart, an attorney with Peddicord Wharton. Peddicord Wharton is a member of the National Workers’ Compensation Defense Network. If you have any questions about this submission or Iowa workers’ compensation in general, please contact Alison by e-mailing her at alison@peddicord.law or by calling her directly at 515-243-2100.
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NOTICE TO THE PUBLIC
The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. This disclosure is required by rule of the Supreme Court of Iowa.
Peddicord Wharton Legal Updates are intended to provide information on current developments in legislation impacting our clients. Readers should not rely solely upon this information as legal advice. Peddicord Wharton attorneys would be pleased to answer any questions you may have about this update. ©2020 Peddicord Wharton. All Rights Reserved.
On September 24-25, 2019, the National Workers' Compensation Defense Network (NWCDN) held its annual conference in Chicago, IL at the Intercontinental Hotel with an impressive mix of over 200 workers' compensation professionals from the U.S. and Canada. Attorneys attending from Peddicord Wharton were: Lee Hook, Steve Durick, Adam Bates, Nick Cooling, and Alison Stewart.
The program was filled with cutting-edge presentations and included topics such as “The Ethical Challenges of Anti-Engagement” addressing how interactions with the injured workers can promote improved outcomes. Also discussed was “Advocacy-Based Claims Management,” presented by a Senior Fellow at Sedgwick Institute, considered a champion of workers' compensation reform. Bob Wilson of workerscompensation.com was a keynote speaker and contributor on these topics.
A panel of 22 lawyers discussed state and local trends in workers' compensation. Another topic was an in-depth analysis of an SO-state survey on the status of marijuana in worker's compensation. There were several networking breaks throughout the event, ending with a presentation from Dr. Danzhu Guo of the Ovation Hand Institute on the medical advancements in the treatment of carpal tunnel syndrome.
About the National Workers' Compensation Defense Network
NWCDN is an organization comprised of workers' compensation attorneys from 45 states and Canada. Through its online network, member attorneys can be contacted individually or through a coordinated group response to address the latest trends in workers' compensation law. Through its comprehensive network, NWCDN takes a local approach to workers' compensation law and combines it into a national perspective. Annually, NWCDN sponsors an invitation-only national conference for business, risk and insurance professionals. In October 2020, NWCDN will hold its next national conference in Philadelphia, PA.
Legal Update by Attorneys Alison Stewart andNick Cooling
A new electronic filing system has been implemented beginning July 22, 2019. The new system is known as Workers’ Compensation Electronic System, or WCES (pronounced “wick-ess”). The system will provide for electronic filing of all pleadings and documents with the Division and is intended to provide for more efficient scheduling of hearings, comprehensive case management, and greatly improved EDI transactions. New Administrative Rules have been passed and provide instructions for parties about how to appropriately navigate the new system. Those rules can be found at Iowa Administrative Code 876-2.5
Most of the changes will affect the practitioners, but Iowa Workers’ Compensation Insurance Carriers should be aware of the following:
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NOTICE TO THE PUBLIC
The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. This disclosure is required by rule of the Supreme Court of Iowa.
Peddicord Wharton Legislative Updates are intended to provide information on current developments in legislation impacting our clients. Readers should not rely solely upon this information as legal advice. Peddicord Wharton attorneys would be pleased to answer any questions you may have about this update. ©2019 Peddicord Wharton. All Rights Reserved.
Legal Update by Attorney Tyler Smith
Gumm v. Easter Seal Society of Iowa, File No. 18-1051 (Iowa, May 15, 2019)
The issue in this case involved whether a claimant, after sustaining a traumatic, acute injury, is allowed to bring a cumulative injury claim with regard to symptoms/injuries to that same body part. The Court of Appeals addressed the two Supreme Court of Iowa cases that have addressed acute-then-cumulative injury claims: Ellingson v. Fleetguard (requiring claimant to show a “distinct and discreet” disability/injury as a result of cumulative work duties) andFloyd v. Quaker Oats (allowing a cumulative injury claim in the certain circumstance where the claimant had not been compensated via an award, volunteered benefits, etc. and doing so was unavailable due to the statute of limitations). In this case, the Court of Appeals reversed and remanded the Commissioner’s finding that the claimant failed to establish a distinct and discreet disability/injury underEllingson. The Court of Appeals extended/expanded the Floyd case in holding that if a claim relating to the first injury is barred by the statute of limitations (regardless of whether benefits had been paid with regard to the initial acute injury), a cumulative injury claim can be made for the increase in disability brought on by subsequent work duties. Appellees have filed Applications for Further Review.
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NOTICE TO THE PUBLIC
The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. This disclosure is required by rule of the Supreme Court of Iowa.
Peddicord Wharton Legislative Updates are intended to provide information on current developments in legislation impacting our clients. Readers should not rely solely upon this information as legal advice. Peddicord Wharton attorneys would be pleased to answer any questions you may have about this update. ©2019 Peddicord Wharton. All Rights Reserved.
Legal Update by Attorney Alison Stewart
Two recent Iowa Supreme Court decisions have addressed liability of workers’ compensation carriers and third-party administrators. In both cases, the Court declined to extend liability.
Clark, et al v. Ins. Co. of the State of Penn., File No. 17-2068 (Iowa, May 3, 2019)
Recently, the Iowa Supreme Court addressed whether Iowa Code section 517.5, which mandates that no inspection of any place of employment made by insurance inspectors shall be the basis for imposition of civil liability upon the inspector or insurance carrier, is constitutional. In Clark, the plaintiffs alleged employees of the insured were exposed to hazardous chemicals while manufacturing wind blades and that the workers’ compensation carrier’s failure to inspect the employer was the cause of plaintiffs’ injuries. These claims were brought in district court. The Iowa Supreme Court disagreed and outlined a detailed history of the policy behind the exclusive remedy doctrine which requires injury claims brought by employees against their employer must be brought before the workers’ compensation commissioner. This means that immunity remains for carriers who either fail to inspect or negligently inspect the premises of an insured.
De Bois v. Broadspire, File No. 18-1227 (Iowa, May 10, 2019)
The Iowa Supreme Court ruled an injured worker cannot sue a workers’ compensation third party administrator for civil bad faith. In Iowa, an injured worker can establish damages beyond those entitlements provided pursuant to the workers’ compensation chapter where benefits are denied without a reasonable basis and that the carrier knew or should have known its refusal or delay was without such a basis. The Court reasoned that the duties imposed upon a workers’ compensation insurer are non-delegable, and thus, the acts of a third-party administrator, are the acts of the insurer. The liability of third party administrators remains limited to the contractual obligation they have to their insurers.
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NOTICE TO THE PUBLIC
The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. This disclosure is required by rule of the Supreme Court of Iowa.
Peddicord Wharton Legislative Updates are intended to provide information on current developments in legislation impacting our clients. Readers should not rely solely upon this information as legal advice. Peddicord Wharton attorneys would be pleased to answer any questions you may have about this update. ©2018 Peddicord Wharton. All Rights Reserved.
Legal Update by Attorney Alison Stewart
Governor Reynolds has signed a bill relating to workplace idiopathic falls (SF 507). This bill has become law in response to the 2018 Iowa Supreme Court decision,Bluml v. Long John Silvers, where the Court said there was no blanket rule rendering certain categories of workplace idiopathic falls non-compensable, so long as the employee proved that a condition of the employment increased the risk of injury (e.g. a hard floor). In Bluml, an employee had a seizure while working and fell straight backward onto a ceramic tile floor, striking the back of his head. More information about this decision can be found in an earlier post on this blog, dated November 28, 2018. The Court had held each case like this should be considered on a case by case basis opening the door for an employee to establish an injury resulting from an idiopathic fall onto a hard surface could be found compensable. With this new bill now on the books, however, “personal injuries due to idiopathic or unexplained falls from a level surface onto the same level surface do not arise out of and in the course of employment and are not compensable under this chapter.”
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NOTICE TO THE PUBLIC
The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. This disclosure is required by rule of the Supreme Court of Iowa.
Peddicord Wharton Legislative Updates are intended to provide information on current developments in legislation impacting our clients. Readers should not rely solely upon this information as legal advice. Peddicord Wharton attorneys would be pleased to answer any questions you may have about this update. ©2019 Peddicord Wharton. All Rights Reserved.