Following the 2017 amendments to the Iowa Workers’ Compensation Act, the Iowa Supreme Court has ruled on its first shoulder cases. The amendment to add Iowa Code section 85.34(2)(n) made shoulder injuries part of the schedule, compensating them based on the functional impairment rating out of 400 weeks. Before the amendment, shoulder injuries were treated as body as a whole injuries and compensated using an industrial disability analysis. Shoulder cases were also eligible for permanent total disability/odd lot benefits.
Recent Shoulder Cases
I previously wrote about the forerunning shoulder cases, Chavez v. MS Technology LLC and Deng v. Farmland Foods, Inc., when the Commissioner gave his rulings that those rotator cuff injuries were to the shoulder, not the body as a whole. In Chavez, the injured worker sustained tears to the supraspinatus, infraspinatus, and subscapularis muscles, as well as tears to the biceps tendon and labrum. The Commissioner found those injuries were to the rotator cuff, which is part of the shoulder.
Similarly in Deng, the injured worker sustained an injury to his infraspinatus muscle, which was also found to be part of the rotator cuff and shoulder. In both cases, the Commissioner awarded benefits based on the functional impairment ratings out of 400 weeks.
On appeal, the Commissioner’s rulings were upheld. The Iowa Supreme Court held that a “shoulder” is defined “to include the glenohumeral joint as well as all of the muscles, tendons, and ligaments that are essential for the shoulder to function.” (Emphasis added). The last part of this definition will likely be key in upcoming litigation – what is essential for the shoulder to function?
The Iowa Supreme Court gave its legal analysis in Chavez. Given the ambiguous language of section 85.34(2)(n), which does not define a “shoulder,” the Court looked at medical definitions of a shoulder. A commonality was that the rotator cuff includes the anterior, superior, and posterior aspects of the capsule of the shoulder joint, which is reinforced by other tendons and muscles. These are all required for the functionality of the shoulder, not just the shoulder joint, as argued by Chavez. Because the legislature had referenced joints in other sections of the Act but did not do so when discussing the shoulder as part of the schedule, the Court found it was the legislature’s intent to include the entire shoulder in the schedule, not just the shoulder joint.
Novel Argument
Chavez made an alternative argument to the Iowa Supreme Court. She argued that if her shoulder injury was limited to the schedule, she should still be compensated industrially because she had a simultaneous injury to her arm (via the biceps tendon tear and tenotomy performed during the rotator cuff repair surgery).
As discussed in a previous article, this is an argument being advanced at the agency level. Injured workers are arguing that if a work injury causes a disability to the shoulder and another scheduled member, the entire disability should be compensated industrially under the catch-all of section 85.34(2)(v).
As the argument goes, this catch-all section applies because two scheduled member body parts have been injured and no other section applies. They do not apply because those sections are either for single scheduled member body parts or they apply to two particularly designated scheduled member body parts injured as a result of the same work incident, which does not include the shoulder.
On this issue, the Iowa Supreme Court did not decide the merits. Rather, the Court found that because substantial evidence supported there was no permanent disability to the arm caused by the bicep tear, section 85.34(2)(v) was not applicable. There was nothing in the record to support a permanent impairment to the right arm apart from the shoulder. Thus, the issue of industrial disability under section 85.34(2)(v) was not applicable.
By not deciding the merits of this issue, this leaves the matter undecided and will continue to make an appeal case likely and/or an amendment by the legislature to add the shoulder to section 85.34(2)(t).
What does this mean for Iowa employers and insurance companies?
These two Iowa Supreme Court cases are a victory for employers and workers’ compensation insurance companies because they confirm rotator cuff injuries are to the shoulder and limited to the schedule. Arguments from injured workers that because the work injury was to the proximal part of the shoulder or outside of the shoulder joint, and therefore to the body as a whole under past case law, will be rejected. This gives certainty and finality to employers and insurance companies when they are paying permanent disability benefits and determining exposure on cases.
However, the question was left open as to whether a shoulder and another scheduled member injury caused by the same work incident could be compensated industrially in a case involving a shoulder injury.
In practice, this may mean that employers and insurance carriers consider getting expert opinions,
- limiting the work injury to a single body part,
- finding an injury to the other body part is still considered part of the shoulder because it is “essential for the shoulder to function” (as may be the case with a biceps tendon tear), or
- finding permanency is limited to the shoulder and there is no separate impairment for the other injured body part.
If the appellate courts do not provide a timely or satisfactory answer, it is likely the legislature will deal with the issue through a statutory amendment. Dentons Davis Brown’s Government Relations team will continue to monitor the situation.
Related Resources:
A New Trend in Worker’s Compensation Shoulder Cases
Status of Shoulder Injuries After the 2017 Amendments
