Opinion ID: 1833658
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Heading: Cumulative Injury.

Text: We first recognized the concept of cumulative injury resulting from repetitive physical trauma in the workplace in McKeever Custom Cabinets v. Smith, 379 N.W.2d 368, 372-74 (Iowa 1985). In McKeever we adopted the rule that, in factually appropriate cases, liability exists for disability that gradually develops over a period of time. McKeever, 379 N.W.2d at 373 (citing 1B A. Larson, Workmen's Compensation § 39.10 (1985)). The employee in McKeever, a cabinet maker, quit his job as a result of work related wrist pain. Although he had suffered two nondisabling injuries, his claim for compensable disability stemmed from years of cumulative trauma to his wrist from hammering and sanding. Because recovery will be barred on any injury not filed within two years of its occurrence, see Iowa Code § 85.26(1), the question became: when did the `injury' occur for time-limitation purposes? Id. at 374. We ruled that the injury occurs when, because of pain or physical inability, [the employee] can no longer work. Id. The missed work test applied in McKeever proved problematic in a later case, Oscar Mayer Foods Corp. v. Tasler, 483 N.W.2d 824 (Iowa 1992). There an employee suffering a cumulative injury missed no work but suddenly found herself unemployed due to a strike that closed the plant. Citing Larson's treatise on worker's compensation, we found it appropriate in Tasler to fix the date of injury as of the time at which the `disability manifests itself.' Tasler, 483 N.W.2d at 829 (quoting 1B A. Larson, Workmen's Compensation § 39.10 (1991)). We went on to characterize manifestation as the date on which both the fact of the injury and the causal relationship of the injury to the claimant's employment would have become plainly apparent to a reasonable person. Id. (quoting Belwood Nursing Home v. Industrial Comm'n, 115 Ill.2d 524, 106 Ill.Dec. 235, 238, 505 N.E.2d 1026, 1029 (1987)). Applying this rule, we concluded Tasler's date of injury coincided with the date she was laid off due to the plant closing. Id. at 830. Our court of appeals applied Tasler in considering the date of cumulative injury in Venenga v. John Deere Component Works, 498 N.W.2d 422 (Iowa App.1993). Venenga, a materials handler and shavings hauler, suffered back pain from heavy lifting and a fall. His condition eventually rendered him unable to work. Venenga, 498 N.W.2d at 423. The district court, affirming the industrial commissioner, determined that Venenga's date of injury corresponded to his first hospitalization for back surgery. Id. at 423-24. The court of appeals reversed, holding that under the Tasler manifestation test, the date of injury fixed by the commissioner predated the time when the claimant, as a reasonable person, knew not only of the injury but of its impact on his employment. Id. at 425. The court reasoned that, because the company had been on strike while Venenga was hospitalized, he had suffered no compensable loss at that time. Only later, when the surgery failed to correct his impairment and Venenga was forced to quit working, did the impact of his injury manifest itself. Id. The court reasoned that mere knowledge of an injury, or receipt of medical care, was an insufficient basis on which to establish the date of injury for purposes of a cumulative-injury claim. Id. With these cases in mind, we turn to Hormel's arguments on appeal. A. Date of injury. Hormel contends the court erred in its selection of October 1, 1991 as the injury date because [Jordan] was quite well aware of the injury and possible work relationship of same as of September 15, 1988. Because this is an inherently fact-based determination, the agency's findings are entitled to substantial deference. Tasler, 483 N.W.2d at 829. The deputy's determination, however, must rest on the proper legal standardhere, the two-part Tasler manifestation test: the date on which the claimant, as a reasonable person, would be plainly aware of (1) the injury and (2) the causal relationship between the injury and claimant's employment. Id. Substantial record evidence supports the agency's and district court's conclusion that not until October 1, 1991 did Jordan have knowledge of the permanent impairment to his shoulder, nor did he realize the causal impact that injury would have on his job with Hormel. Venenga, 498 N.W.2d at 425. There can be no doubt that throughout the three-year period in question, Jordan had difficulty performing the heavy lifting and pushing required by his job. Moreover, he sought treatment during this period from a series of orthopedic specialists and physical therapists. Jordan nonetheless continued performing his assigned dutiesand was by all accounts an able, dependable Hormel employee. Having reviewed the numerous medical opinions offered into evidence, we find they support the deputy's conclusions as affirmed by the district court that Jordan first learned from his visit to Dr. Misol on October 1, 1991 that he would not recover from the cumulative injury to his shoulder, and that permanent restrictions on his work activities would be required. Contrary to Hormel's contentions, the fact that Jordan gained knowledge of his subluxated shoulder on prior medical visits is not dispositive in fixing the date of injury. On this point, we said in Tasler: We thus reject an interpretation of the term manifestation that will always require an employee suffering from a repetitive-trauma injury to fix, as the date of accident, the time at which the employee first became aware of the physical condition, presumably through medical consultation, since by their very nature, repetitive-trauma injuries often will take years to develop to the point where they will constitute a compensable workers' compensation injury. Tasler, 483 N.W.2d at 829-30. We also reject Jordan's invitation to add a third element of compensability to the Tasler manifestation test. Jordan contends that a workers' compensation injury does not occur until the claimant has received a permanency rating. We disagree. While it may be the fact that in some cases, as here, the claimant learns the extent of a cumulative injury and at the same time receives an impairment rating, such would not always be the case. The occurrence of the injury marks day one on the calendar for purposes of requiring notice within ninety days, and filing a claim within two years. McKeever, 379 N.W.2d at 375. At this stage, compensabilitythough a possibility, or even a probabilityremains an uncertainty. Whether the injury is, indeed, compensable will be determined at a later stage. See Miedema v. Dial Corp., 551 N.W.2d 309, 311 (Iowa 1996) (for injury to be compensable, claimant must prove by preponderance of the evidence causal connection between condition of employment and injury). Because the date of injury selected by the agency meets the legal test of Tasler and enjoys substantial support in the record, no ground for reversal appears. B. Statute of limitations. Relying on September 15, 1988 as the injury date, Hormel contends that Jordan's claim (filed September 2, 1992) was time barred under Iowa Code section 85.26(1). The statute provides: An original proceeding for benefits under this chapter ... shall not be maintained in any contested case unless the proceeding is commenced within two years from the date of the occurrence of the injury for which benefits are claimed or, if weekly compensation benefits are paid under section 86.13, within three years from the date of the last payment of weekly compensation benefits. Iowa Code § 85.26(1). With the date of cumulative injury fixed by the commissioner at October 1, 1991, however, Jordan's claim falls squarely within the two-year statutory period. Hormel's arguments to the contrary must fail. C. Notice. Iowa Code section 85.23 provides that within ninety days of the occurrence of an injury, the employer must either have actual notice or be given notice of the injury; otherwise no compensation shall be allowed. Hormel concedes on appeal that, as the agency found, it had actual notice that Jordan suffered a shoulder injury as early as August 15, 1988. Hormel argues, however, that if Jordan's cumulative injury date is actually October 1, 1991, then it received no noticeactual or otherwisewithin the statute's ninety-day time frame. Put another way, Hormel argues it was held to have known of Claimant's work-related injury more than three years before the injury occurred! The agency and district court attempted to explain what Hormel calls this absurd result by relying on the concept of delayed discovery of injury applied in Dillinger v. City of Sioux City, 368 N.W.2d 176, 181 (Iowa 1985). We agree with Hormel, however, thatunlike Dillinger this is not a discovery rule case. As we observed in McKeever, the discovery rule and cumulative injury rule are closely related but not the same. McKeever, 379 N.W.2d at 372-73. The discovery rule may apply where a compensable injury occurs at one time but the employee, acting as a reasonable person, does not recognize its nature, seriousness and probable compensable character until later. Orr v. Lewis Cent. Sch. Dist., 298 N.W.2d 256, 257 (Iowa 1980). The cumulative injury rule, however, treated by Professor Larson under the heading gradual injury, may apply when the disability develops over a period of time; then the compensable injury itself is held to occur at the later time. Id. at 373. Dillinger is distinguishable because the employer there had actual notice of the earlier traumatic injury later manifested under the discovery rule. Dillinger, 368 N.W.2d at 181. Jordan's injury, however, was not hidden until discovery; rather, it gradually developed. The deputy and district court were mistaken in their conclusion that actual notice of injury in 1988 necessarily extended to the cumulative injury Jordan first learned of in 1991. Nevertheless, the record reveals that Hormel indeed had actual notice of the developing injury. Hormel's managers were continually apprised of Jordan's shoulder problem. Cf. Tasler, 483 N.W.2d at 827 (claimant's plant records chronicled history of complaints during course of employment). The deputy found that Hormel's plant manager accommodated Jordan by assigning tasks that limited strenuous overhead lifting and pushing of heavy tubs. Also significant to the question of notice of cumulative injury was the deputy's finding that Hormel authorized a series of physicians to examine Jordan's shoulder from 1988 to 1991. In fact, Dr. Misol's October 1 memorandum on which Jordan based his claimed date of injury contained a signed notation that it was mailed to Hormel on November 22, 1991. The deputy further found that, at Hormel's request, physical therapist Bower assessed Jordan's shoulder on December 23, 1991, and gave an impairment rating (within six percentage points of Dr. Misol's rating) which Hormel relied on in paying permanent partial disability benefits. On this same date, Bower mailed Hormel a two-page letter describing in detail Jordan's increasing shoulder difficulty over the course of three years, his less than successful treatment, and the mixed medical opinions from numerous physicians. Clearly these exhibits contradict Hormel's contention that it had no actual notice of Jordan's cumulative injury within ninety days of October 1, 1991. D. Work-related injury. The burden rested upon Jordan, of course, to convince the agency by a preponderance of the evidence that his disability is causally related to injuries arising from his employment. Sanchez v. Blue Bird Midwest, 554 N.W.2d 283, 285 (Iowa App.1996). Hormel argues on appeal that Jordan failed to meet this standard of proof. According to Hormel, Jordan failed to tell examining physicians about nonwork related activities, such as playing sports and helping out at his brother's farm, that may have contributed to or caused his injury. In sum, Hormel maintains that much of the medical evidence was tainted, or at least rested on incomplete information. All the insufficiency arguments Hormel now raises were considered in detail by the deputy, who gave them little weight. Such judgment calls are clearly within the agency's domain. Burns v. Board of Nursing, 495 N.W.2d 698, 699 (Iowa 1993). Although the many medical opinions considered by the fact finders were not unanimous in their causation conclusions, substantial evidence supports the overall finding that cumulative work-related trauma caused Jordan's shoulder to subluxate, resulting in permanent partial impairment.