Opinion ID: 1869390
Heading Depth: 1
Heading Rank: 7

Heading: TPD benefits prior to date of manifestation. Iowa Code section 85.33 provides, in relevant part:

Text: 2. Temporary partial disability or temporarily, partially disabled means the condition of an employee for whom it is medically indicated that the employee is not capable of returning to employment substantially similar to the employment in which the employee was engaged at the time of injury, but is able to perform other work consistent with the employee's disability. Temporary partial benefits means benefits payable, in lieu of temporary total disability and healing period benefits, to an employee because of the employee's temporary partial reduction in earning ability as a result of the employee's temporary partial disability. Temporary partial benefits shall not be considered benefits payable to an employee, upon termination of temporary partial or temporary total disability, the healing period, or permanent partial disability, because the employee is not able to secure work paying weekly earnings equal to the employee's weekly earnings at the time of injury. 3. If an employee is temporarily, partially disabled and the employer for whom the employee was working at the time of injury offers to the employee suitable work consistent with the employee's disability the employee shall accept the suitable work, and be compensated with temporary partial benefits. If the employee refuses to accept the suitable work with the same employer, the employee shall not be compensated with temporary partial, temporary total, or healing period benefits during the period of the refusal. If suitable work is not offered by the employer for whom the employee was working at the time of the injury and the employee who is temporarily partially disabled elects to perform work with a different employer, the employee shall be compensated with temporary partial benefits. Iowa Code § 85.33(2)-(3). Iowa Code section 85.32 provides that except for injuries resulting in permanent partial disability, compensation shall begin on the fourth day of disability after the injury.  (Emphasis added.) [10] Larson contends the agency erred in its remand decision by awarding temporary partial disability benefits for periods prior to April 26, 1996, and extending as far back as 1992. As this argument challenges the agency's interpretation of a provision of law, a function not clearly vested in the agency, Mycogen Seeds, 686 N.W.2d at 464, we are not constrained by deference to the agency's decision on this issue. Iowa Code § 17A.19(10)( c ). When called upon to interpret a statute, we first determine whether the legislative enactment is ambiguous. If it is clear and unambiguous, we give [the] statute a plain and rational meaning. In re T.S., 705 N.W.2d 498, 502 (Iowa 2005) (citing ABC Disposal Sys., Inc. v. Dep't of Natural Res., 681 N.W.2d 596, 603 (Iowa 2004)). If, on the other hand, the statute is ambiguous, we rely on well-established rules to aid our interpretation. City of Waukee v. City Dev. Bd., 590 N.W.2d 712, 717 (Iowa 1999). A statute or rule is ambiguous if reasonable minds could differ or be uncertain as to the meaning of the statute. Carolan v. Hill, 553 N.W.2d 882, 887 (Iowa 1996). Ambiguity may arise in two ways: (1) from the meaning of particular words; or (2) from the general scope and meaning of a statute when all its provisions are examined. Id. (citation omitted). We conclude the phrase after the injury in section 85.32 is ambiguous when applied to cumulative injuries which develop gradually and progressively rather than suddenly, traumatically, or discretely. Reasonable minds could differ or be uncertain as to whether the phrase after the injury in a cumulative injury case means a temporary partial disability can be compensable only if it arises after the manifestation date, or whether it can be compensable even if it arises before the manifestation date as a consequence of a cumulative injury process which subsequently progresses to the point of manifestation. The ambiguity within the statute is made apparent in the arguments advanced in this case by Larson and Thorson. Larson contends it can have no liability to Thorson for workers' compensation benefits until after April 26, 1996, the manifestation date found by the commissioner. Thorson advances a much different interpretation of the phrase after the injury in section 85.32. She notes cumulative injuries develop gradually and progressively, and employees who suffer them will have periods of temporary, but progressively more profound, restriction or dysfunction until the injury becomes so disruptive as to satisfy the manifestation standard. As the deterioration of their functioning advances toward manifestation, employees who experience cumulative trauma may require medical treatment, modifications of their work activities, and adjustments of their work schedules in order to continue their employment. Such employees may continue to work, as Thorson did, but experience temporary reductions of their earnings and require medical treatment long before their cumulative injuries are manifest under the standard established in our prior decisions. Furthermore, Thorson posits the legislature's use of the phrase after the injury rather than after the date of injury or after the date of manifestation of the injury leaves room for the likelihood that the drafters intended to provide a remedy for temporary partial disability, if any, that occurs prior to the date of manifestation. We interpret the phrase after the injury in section 85.32 to permit an award of temporary partial disability benefits upon proof of a diminution of a claimant's earnings during periods of temporary incapacity caused by a work-related condition which later manifests as a cumulative injury. Our resolution of this issue is faithful to the well-established rule that chapter 85 is liberally construed in favor of the employee, with any doubt in its construction being resolved in the employee's favor. Teel v. McCord, 394 N.W.2d 405, 406-07 (Iowa 1986). Invocation of this rule is appropriate under the circumstances presented here because we do not believe the General Assembly intended to deny a remedy under chapter 85 to employees who suffer a temporary reduction of earnings before a work-related cumulative injury progresses to the point of manifestation as we have defined it in our cases. We therefore affirm the commissioner's interpretation of section 85.32 as authorizing an award of temporary partial disability benefits for periods prior to the date of manifestation upon proof that a claimant's earnings were diminished temporarily as a result of a work-related cumulative injury process. 2. Thorson's proof of the TPD claim. Having concluded an award for temporary partial disability benefits may, upon proper proof, be established for periods prior to the date of a cumulative injury's manifestation, we next address whether the record in this case contains substantial evidence supporting the commissioner's award in this case. Larson contends the award is not supported in the record because, although Thorson testified she lost an unquantified amount of overtime wages in the year before the arbitration hearing held on November 21, 2000, she supplied no proof that the diminution of earnings claimed for the earlier relevant periods (prior to November 21, 1999) were caused by the work-related cumulative injury. [11] Noting that some of Thorson's claimed periods of temporary partial disability included holidays or vacations, Larson contends substantial evidence in the record does not support a finding that any diminution of overtime earnings was caused by the claimed cumulative injury. Thorson contends her proof of a causal connection between the claimed diminution of her earnings (a loss of overtime hours and related pay) and the cumulative injury is adequate in this case. First, she emphasizes that she worked under a medical restriction for light duty during the weeks for which she seeks temporary partial disability benefits. Second, Thorson relies on the medical records evidencing her long history of chronic pain symptoms, and her testimony establishing that she turned down voluntary overtime during the year prior to the arbitration hearing when she didn't think [she] could work past 3:30. In the alternative, Thorson points out section 85.33 does not expressly require proof of a causal connection between her cumulative injury and the diminution of her earnings, and she asserts an award of temporary partial disability benefits may be supported by mere proof of a diminution of her earnings during weeks she worked under a light duty restriction from her treating physician. In furtherance of her position on this point, Thorson notes section 85.33 provides a formula for calculating permanent partial disability benefits, but gives no indication that proof of a causal connection between a work-related cumulative injury and a reduction in earnings is required. Although we reject Thorson's contention that she had no burden to produce evidence of a causal connection between the cumulative injury and the claimed diminution of earnings during the relevant weeks to support an award of temporary partial disability benefits under section 85.33, we conclude she did produce substantial evidence of a causal connection in this case. Thorson worked under a physician-imposed light-duty restriction during the relevant weeks, and the medical records clearly evidence she was suffering from chronic pain in multiple parts of her body throughout that time. This evidence is minimally sufficient to support a causal nexus between Thorson's cumulative injury and the claimed diminution of her earnings for the relevant weeks. Although Larson contends on appeal that Thorson might have worked less during some of those weeks not because of an injury, but because holidays, funerals, or vacations reduced her availability for work, the weight to be given such evidence was a matter for the commissioner to decide. We therefore affirm on this issue. F. Medical Benefits Prior to Date of Manifestation. Similar to its challenge to the agency's award of TPD benefits prior to the date of manifestation, Larson challenges the deputy commissioner's award of medical benefits prior to the date of manifestation. The medical benefits statute, Iowa Code section 85.27(1), requires the employer to pay medical and transportation expenses for all injuries compensable under this chapter. Interpretation of section 85.27(1) has not clearly been vested in the discretion of the workers' compensation commissioner, and we therefore owe no deference to the agency's interpretation. Iowa Code § 17A.19(10)( c ). The plain language of section 85.27(1) requires the employer to pay for all medical costs incurred as a result of an injury compensable under chapter 85. Section 85.27(1) does not expressly limit the employer's liability for medical costs to costs incurred following manifestation of a compensable workers' compensation claim. The only statutory requirement for compensability is that the treatment be for an injury compensable under the chapter. Work-related cumulative injuries are, of course, compensable under chapter 85, and consequently section 85.27(1) requires the employer to compensate the employee for reasonable medical costs incurred as a result of such injuries. We find no language in the statute suggesting that an employer is without obligation to provide reasonable medical treatment for work-related health problems in advance of the date of manifestation of a cumulative injury. We conclude the agency did not err in construing section 85.27(1) to require Larson to pay for medical treatment for Thorson's work-related condition that later manifested as a cumulative injury. G. Reimbursement for Multiple IMEs. Iowa Code section 85.39 provides, in relevant part, as follows: If an evaluation of permanent disability has been made by a physician retained by the employer and the employee believes this evaluation to be too low, the employee shall, upon application to the commissioner and upon delivery of a copy of the application to the employer and its insurance carrier, be reimbursed by the employer the reasonable fee for a subsequent examination by a physician of the employee's own choice, and reasonable necessary transportation expenses incurred for the examination. Iowa Code § 85.39 (emphasis added). Larson was ordered to pay for Dr. Ban's October 2000 examination under this statute. Having paid for the prior examination, Larson contends the plain language of section 85.39 precludes its liability for the subsequent examination by Dr. Kuhnlein. We agree, and therefore reverse that part of the commissioner's remand decision ordering Larson to pay for the Kuhnlein examination. [12]