Iowa Top Court Clarifies that Vascular Disease Not Per Se Injury to Body as Whole

Des Moines, IA (WorkersCompensation.com) -- In workers' compensation law, administrative bodies are tasked with applying case law precedent to the best of their interpretive abilities, but sometimes it leads to interpretations that need clearing up.

In Delaney v. Second Injury Fund of Iowa, No. 23-0182 (Iowa 05/10/24), the Iowa Supreme Court specified that the state's Workers' Compensation Commission had applied its precedent erroneously for some 44 years.

Thirty-three years after suffering a qualifying injury to her lower left leg, the worker suffered an injury to her lower right leg in the course of her employment.

The later injury required knee surgery, which caused lymphedema in the worker's lower right leg and foot. The worker filed a claim for benefits against the store and Iowa's Second Injury Fund. She reached a settlement agreement with the store and went to arbitration against the Fund.

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A workers' compensation commissioner found that the lymphedema was a sequela of her work injury and that the lymphedema was per se an injury to the body as a whole, not an injury to a scheduled member. The commissioner concluded that because the worker suffered a sequela injury to the body as a whole, she was not entitled to Fund benefits under Iowa law.

The worker took the case to district court, which affirmed the agency's decision, prompting the worker to appeal to the Court of Appeals, which reversed. The Fund then appealed to Iowa's Supreme Court.

In Iowa, when an employee suffers a specified second injury, the employer is liable only for the degree of disability that would have resulted from the latter injury if there had been no preexisting disability. The Fund then becomes liable for the remainder of compensation that would be payable for the degree of permanent disability involved after deducting from that remainder the compensable value of the previously lost member or organ.

To trigger the Fund's liability, an employee must prove:

(1) She has either lost or lost the use of a hand, arm, foot, leg, or eye.
(2) She sustained the loss or loss of use of another such member or organ through a work-related, compensable injury.
(3) There is a permanent injury from the injuries.

Workers' Comp 101: The court in this case pointed out that the Workers' Compensation Commission has frequently cited Blacksmith v. All-American, Inc., 290 N.W. 2d 348 (Iowa 1980) for the proposition that injuries to the vascular system are per se unscheduled injuries. This "was and is error" because Blacksmith was a review reopening a case in which the employee sought additional benefits due to a change in his earning capacity caused by his work-related injury and not due to an increase in his functional impairment. Moreover, "there was no statement that vascular disease is per se an injury to the body as a whole."

The Iowa Supreme Court head that the commissioner erred when it concluded that an injury to the vascular system is, as a matter of law, an unscheduled injury to the whole body. In remanding the case back to the district court with instructions to remand the matter to the commissioner, the court explained that the Fund was liable for the cumulative effect of scheduled injuries resulting in industrial disability to the body as a whole. Additionally, the court noted that, in considering the Fund's liability, the commissioner was to consider only the extent to which the worker's earning capacity was diminished by the combined effect of the losses to her enumerated extremities.

Why is that important?

"This is a 'new and discrete assessment by the commissioner' that limits any potential double recovery," the court wrote.

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