Illegal drug use, failure to attend aqua therapy don't block comp
Case name: Des Moines Public Schools v. Ault, No. 0-753/10-0813 (Iowa Ct. App. 11/24/10).
Ruling: The Iowa Court of Appeals held that a school custodian was totally and permanently disabled and entitled to benefits.
What it means: In Iowa, a worker's unreasonable refusal of treatment is proof that her aggravated condition is not causally connected to the employment or is an intervening act breaking the chain of causation.
Summary: A school custodian injured her back while moving a filing cabinet at work. She had surgery. When the custodian tried to return to work, she complained of pain. In addition to ongoing pain after her surgery, the custodian's incision from the surgery repeatedly became infected, and she was diagnosed with major depressive disorder. Her physical and mental problems were also accompanied by personal issues, including physical fights with her husband and others, weight gain, and the alleged use of illegal drugs. Her medical records confirmed her desire to return to work. The Iowa Court of Appeals held that the custodian was totally and permanently disabled and entitled to benefits.
The school contended that the custodian's failure to cooperate with medical providers and negligent behavior should bar her from receiving benefits. It argued that the custodian failed to attend aqua therapy sessions and did not complete functional capacity evaluations. The court found that her behavior did not rise to the level of willful refusal of care. Although she regularly cancelled and rescheduled appointments, she usually had valid reasons such as health complications, personal issues, or a lack of transportation. Her explanations for leaving appointments were in part due to her depression and anxiety. The school did not claim that her illegal drug use or physical altercations were an intervening cause aggravating her injuries.
The school also argued that the custodian did not suffer from a permanent and total disability. The court noted that some doctors determined that work would be beneficial to the custodian's health. However, the combination of her physical state, mental and emotional faculties, education, and experience severely limited her options for employment. She had lifting, sitting, and standing limitations. Intelligence tests indicated potential learning disorders. Her only work experience was performing physical work that she could no longer perform. The court noted that the custodian's failure to complete functional capacity tests and vocational rehabilitation did not aid the disability determination.
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January 17, 2011
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