Discussion Questions

The injured worker injured his/her back and shoulder at work.The shoulder was injured performing a specific activity followed by a popping sensation.The shoulder pain came on instantly.However, the back pain came on gradually with no specific event.The injured worker believes the back condition is related to years of hard work for the employer involving bending, twisting and lifting. How long does the injured worker have to file a claim with the Iowa Workers’ Compensation Commissioner for each injury?

You should note that the time deadline for filing a petition is called the "statute of limitations". The statute of limitations is found in Iowa Code §85.26 which provides that the injured worker must file a petition with the Iowa Workers’ Compensation Commissioner within two years from the occurrence of the injury when no weekly benefits have been paid or within three years from the last date weekly benefits were paid.

For the shoulder injury the injury occurred when the worker performed the specific activity which caused the popping sensation in his shoulder. With respect to the back injury which isclaimed to be a gradual or cumulative injury, the two-year deadline will not begin to run until the injured worker knows or should know that the condition is serious enough to have a permanent adverse impact on the injured workers'employment, i.e., the injured worker knows or should know the nature and seriousness, and probable compensable character of his injury or condition.

Of course if weekly benefits were paid than the deadline for filing a petition with the workers' compensation commissioner is three years from the last payment of weekly compensation.

Following an injury at work, while the employee was at the hospital a post-injury drug test was administered. The results of the test were positive. Can the employer and insurance carrier deny the injury based upon a positive post-injury drug test?

Maybe. Iowa Code § 85.16 (2) reads "[n]o compensation under this chapter shall be allowed for an injury caused by ... the employee's intoxication, which did not arise out of and in the course of employment but which was due to the effects of alcohol or another narcotic, depressant, stimulant, hallucinogenic, or hypnotic drug not prescribed by an authorized medical practitioner, if the intoxication was a substantial factor in causing the injury." The Iowa Supreme Court has held that for the intoxication defense to apply, “the intoxication must have been both the cause in fact of the injury and a substantial factor in producing it.” Garcia v. Naylor Concrete Co., 650 N.W.2d 87, 90 (Iowa 2002). The Court in Garcia determined that a worker is intoxicated when one or more of the following apply: “(1) The person’s reason or mental ability has been affected; (2) the person’s judgment is impaired; (3) the person’s emotions are visibly excited; and (4) the person has, to any extent, lost control of bodily actions or motions.”

Therefore, the Iowa Workers’ Compensation Commissioner will address two issues when coming to their decision. First, it must be determined that the level of intoxication affected or impaired the worker’s reason, mental ability, or judgment, or caused the worker to lose control of his bodily actions or motions. This issue typically needs to be addressed by a medical expert. However, witness testimony concerning the worker’s behavior immediately proceeding the injury may be relevant.

Second, it must be determined whether the intoxication was a substantial factor in causing the injury. If the injury would have happened regardless of the intoxication, then the intoxication is likely not a basis for the denial.

At the time the worker was injured, he/she was in violation of a work rule. Can the employer and insurance carrier deny the injury based upon the violation of work rule defense?

Maybe. The Iowa Supreme Court held that a carpenter forfeited his right to benefits under the Iowa Workers’ Compensation Act by engaging in conduct that violated the instructions of the employer. Buehner v. Hauptly, 161 N.W.2d 170, 171 (Iowa 1968). According to the facts of that case, the carpenter was repeatedly instructed by his job foreman to refrain from riding on a hoist that was designed to haul lumber and materials. Unfortunately, the carpenter decided to ride the hoist to the ground and was fatally injured. The Court held: “Under all the facts the deceased employee’s act in attempting to descend by means of the hoist was not only in direct violation of an enforced employer’s rule, but completely rash and outside the reasonable requirements of his job.” Accordingly, the Court held that the fatal injury did not arise out of and in the course of his employment.

If an employer and insurance carrier want to rely on this defense, they likely will need to prove the following: the work rule was in place at the time of the injury, prior to the injury the injured worker had been informed of the work rule, prior to the injury the injured worker or other employees had been disciplined for violating the work rule, the injured worker could not have avoided violating the work rule when performing his/her job duties, and that violation of the work rule was the cause of the injury.