Lack of evidence of permanent injury dooms claims for benefits
Case name: Broadlawns Medical Center v. Sanders, No. 9-296/08-1643 (Iowa Ct. App. 06/17/09).
Ruling: The Iowa Court of Appeals reversed an award of temporary partial and permanent partial disability benefits to a nurse's aide, and reversed an award of penalty benefits.
What it means: In Iowa, expert testimony is necessary to prove a mental injury is permanent and a reviewing deputy may not substitute his judgment for that of an expert. Evidence that an employee still has the skills, ability, and capability of performing all of her duties after a work accident may support an employer's argument that she was able to return to "substantially similar employment" and thus was not entitled to additional TPD benefits.
Summary: A nurse's aide for two psychiatric houses discovered a client who had hung herself. She filed claims for TPD and PPD benefits, asserting that she suffered a permanent mental injury. She was able to immediately return to work and perform her regular job duties without medical restrictions, other than to avoid returning to the location of the suicide. Her employer argued the aide was not entitled to TPD benefits because she returned to "substantially similar employment." The Court of Appeals agreed, finding the aide resumed identical job duties, and found that lost overtime hours from being unable to work at both houses was not a "change in employment" which would entitle her to additional TPD benefits.
The court also disagreed with a deputy's determination that the aide's mental injury was permanent. The aide argued the permanent restriction from working at one house limited her earning capacity and thus established a permanent injury. The court pointed out that expert medical evidence was needed to establish the permanency of her mental injury. It explained that the aide's doctors had testified to her improvement, but the deputy did not properly base his decision on expert testimony or the doctor's prognosis, but merely substituted his opinion.
The aide argued she was entitled to penalty benefits because she was not paid for days she missed due to her condition. Iowa law provides that an employee is not entitled to penalty benefits where her TPD or PPD benefits are "fairly debatable." The court determined that because the aide was able to return to substantially similar employment, her employer had appropriately questioned her entitlement to TPD benefits, thus making its obligation to pay "fairly debatable." Similarly, the court found no support for her contention that her injury was permanent.
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August 17, 2009
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