BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         _________________________________________________________________
 
         
 
         
 
         CLIFFORD L. VANNATTA,
 
         
 
              Claimant,
 
                                                 File No. 700050
 
         VS.
 
                                                   R E V I E W
 
         YELLOW FREIGHT SYSTEM, INC.,
 
                                                R E 0 P E N I N G
 
              Employer,
 
                                                 D E C I S I 0 N
 
              Self-Insured,
 
              Defendant.
 
         _________________________________________________________________
 
         
 
         
 
                                   INTRODUCTION
 
         
 
              This is a proceeding in review-reopening from a memorandum 
 
         of agreement which was filed June 1, 1982 brought by Clifford L. 
 
         Vannatta, claimant, against Yellow Freight System, Inc., 
 
         employer, and self-insured defendant, for benefits as the result 
 
         of an injury that occurred on March 30, 1982.  A hearing was held 
 
         at Sioux City, Iowa, on December 17, 1986, and the case was fully 
 
         submitted at the close of the hearing.  The record consists of 
 
         claimant's exhibits 1 through 17; defendant's exhibits A through 
 
         M; the testimony of Clifford L. Vannatta (claimant), Marian 
 
         Vannatta (claimant's wife), and Duane Behrens (terminal manager).  
 
         Both attorneys submitted outstanding briefs.
 
         
 
                                 STIPULATIONS
 
         
 
              The parties stipulated to the following matters.
 
         
 
              1.  That an employer-employee relationship existed between 
 
         employer at the time of the injury.
 
         
 
              2.  That claimant sustained an injury on March 30, 1982 that 
 
         arose out of and in the course of his employment with the 
 
         employer
 
         
 
              3.  That the injury was the cause of temporary disability 
 
         claimant was entitled to and was paid temporary disability from 
 
         March 31, 1982 through July 4, 1982, and again from July 14, 1982 
 
         through March 14, 1983.
 
         
 
              4.  That the type of permanent disability, if the injury is 
 
         found to be a cause of permanent disability, is industrial 
 
         disability to the body as a whole.
 
         
 
              5.  That the commencement date of permanent disability 
 
         benefits, in the event such benefits are awarded, is March 15, 
 
         1983.
 
         
 
              6.  That all requested medical benefits have been or will be 
 
         paid by defendant.
 
         
 

 
              7.  That defendant claims no credit for any nonoccupational 
 
         group plan payments.
 
         
 
              8.  That defendant is entitled to a credit for 48 4/7 weeks 
 
         of compensation benefits paid at the rate of $196.77 per week 
 
         prior to the hearing for temporary disability benefits.
 
         
 
                                 ISSUES
 
         
 
              The issues presented by the parties for determination at the 
 
         time of the hearing are as follows:
 
         
 
              1.  Whether the injury is the cause of any permanent 
 
         disability.
 
         
 
              2.  Whether claimant is entitled to any permanent disability 
 
         benefits.
 
         
 
              3.  Whether claimant is an odd-lot employee and entitled to 
 
         the application of the so-called odd-lot doctrine.
 
         
 
              4.  What is the proper rate of weekly compensation for the 
 
         period beginning on March 30, 1982.
 
         
 
              5.  Whether claimant is entitled to a different rate of 
 
         compensation after he quit working on November 15, 1985 on the 
 
         theory of a cumulative injury.
 
         
 
                             SUMMARY OF THE EVIDENCE
 
         
 
              All of the evidence was examined and considered.  The 
 
         following is a summary of the pertinent evidence.
 
         
 
              Claimant is 62 1/2 years old, married, and has four adult 
 
         children.  He is six foot four inches tall and weighs 
 
         approximately 240 pounds.  He does not smoke or drink.  He is a 
 
         high school graduate.  Most of his past employments are as a 
 
         short haul truck driver, which involved loading and unloading 
 
         trucks and handling freight on the dock (Ex. 11).  Claimant also 
 
         has the ability to repair trucks as a mechanic and to repair 
 
         refrigeration units.  In 1977, claimant attended a two week 
 
         course to learn to repair refrigeration units.  Most of his adult 
 
         life claimant has been a licensed amateur radio operator.  He 
 
         likes and is good at anything electrical.  He has constructed 
 
         some primitive homemade computers as a hobby.  Claimant started 
 
         to work for employer part time in 1978 or 1979 and went on the 
 
         seniority list in the fall of 1980.  In the spring of 1982, just 
 
         prior to his injury, claimant was working three days a week for 
 
         employer.  This is as much time as he could work based on his 
 
         seniority at that time.
 
         
 
              On March 30, 1982, at approximately 5:00 p.m., claimant was 
 
         involved in a one motor vehicle accident near Sioux Falls, South 
 
         Dakota.  The tractor and trailer that he was driving were almost 
 
         empty.  Claimant was driving south on Interstate 29 returning 
 
         home to Sioux City, Iowa.  As claimant crossed a bridge overpass 
 
         that crossed over Interstate 229, his vehicle went through the 
 
         bridge guardrail on the west side of the road, fell several feet, 
 
         and landed upright on the roadway below.  The distance of the 
 
         fall appears in different exhibits variously between 25 feet and 
 
         57 feet.  In any event, it was a long way to be airborne in a 
 
         tractor and trailer before landing,on the roadway below.  There 
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page   3
 
         
 
         
 
         was a dispute as to whether claimant was blown off the bridge or 
 
         was not blown off the bridge.  In any event, it is a fact, based 
 
         upon the newspaper photograph and a snapshot, claimant's vehicle 
 
         did pass through the guardrail and landed upright on the roadway 
 
         below (Ex. 1 & 1A).  Other snapshots show that the tractor and 
 
         trailer were damaged extensively and that both units were a total 
 
         loss (Ex. 2-6).  Other snapshots show that claimant received a 
 
         severe vertical laceration on his right forehead and ecchymosis 
 
         and swelling of both eyes (Ex. 7-10).
 
         
 
              Claimant crawled out through the windshield and was 
 
         ambulatory at the scene of the accident.  A passing motorist took 
 
         claimant to Sioux Valley Hospital in Sioux Falls, South Dakota.  
 
         He was seen there by Merit G. Warren, M.D., and Dr. Delperdang 
 
         (full name unknown), the emergency room physicians.  Dr. Warren 
 
         reported that claimant received a six to seven centimeter 
 
         laceration to the right forehead, hematoma of the nose, abrasion 
 
         of the right knee, and contusion of the right anterior ribs.  
 
         X-rays of claimant's spine and chest were normal.  Both eyes were 
 
         markedly ecchymotic and the upper eyelids were beginning to swell 
 
         shut with edema fluid.  Otherwise, claimant's physical 
 
         examination was normal.  Dr. Warren estimated claimant could 
 
         return to light work in about five days.  Claimant was admitted 
 
         overnight and released to his wife the following day (Ex.D, 
 
         pp.1-4).
 
         
 
              Claimant then consulted his family physician of many years 
 
         standing, H. E. Rudersdorf, M.D., a family practitioner in Sioux 
 
         City, Iowa.  Dr. Rudersdorf's records show twenty-three typed 
 
         office note entries from April 1, 1982 through November 14, 1985 
 
         (Ex.  C).  Sutures were removed as an outpatient on April 5, 1982 
 
         (exhibit H, page 4).  On April 19, 1982, Dr. Rudersdorf found the 
 
         laceration well healed and that the clinically diagnosed 
 
         fractured ribs on the right were resolving.  On April 20, 1987 
 
         and April 21, 1987, claimant was hospitalized after an episode
 
         
 
         
 
         
 
         of headaches, nausea, and vomiting at home.  R. Hiemstra, M.D., 
 
         said claimant related to him that he had a flu-like headache, but 
 
         he just could not get the patient to describe it as throbbing, 
 
         sharp or dull.  A CT scan ruled out a subdural hematoma.  Dr. 
 
         Hiemstra said claimant's symptoms disappeared rapidly after 
 
         learning that there was no intercranial bleeding.  Dr. Hiemstra 
 
         stated that the headaches, nausea and vomiting were due to stress 
 
         (Ex.  H, p. 1-4).
 
         
 
              On May 17, 1982, Dr. Rudersdorf noted that claimant 
 
         complained of recurring headaches and that they were either 
 
         caused or associated with the previous trauma (Ex.  C, p. 2).  On 
 
         June 3, 1982, he recorded that claimant was to increase his 
 
         activities and to return to work in two weeks time (Ex.  C, p. 
 
         2).  On June 17, 1982, the doctor told claimant to continue to 
 
         increase his activities to be able to return to work (Ex.  C, p. 
 
         3).  Then, on July 1, 1982, Dr. Rudersdorf released claimant to 
 
         return to work on July 6, 1982 (Ex.  C, p. 4).
 
         
 
              Claimant only worked for a few days, more specifically, July 
 
         5, 6, and 7, and then again on July 12 and 13.  On July 16, 1982, 
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page   4
 
         
 
         
 
         claimant came to see Mike Jung, M.D., an associate of Dr. 
 
         Rudersdorf.  Dr. Jung reported as follows:
 
         
 
              Patient of Dr. Rudersdorf who comes in stating that 
 
              he's had some dizzy weak spells at work and feels that 
 
              it is unsafe to his health to continue working.  He 
 
              states that he feels that this is related to the 
 
              injuries that he received in the accident back in late 
 
              March.  He wishes to get an excuse from work until this 
 
              gets resolved.  States that his vision comes and goes, 
 
              the dizzy spells come and go, describes no true 
 
              vertigo, no true syncopal or fainting episodes.  No 
 
              chest pain or shortness of breath.  He does state that 
 
              he sweats quite a bit. (Ex.  C, p. 4)
 
         
 
              Dr. Jung's examination was essentially normal and disclosed 
 
         no organic reason for claimant's symptoms.  He diagnosed 
 
         dizziness of unknown etiology.  He instructed claimant that he 
 
         was probably out of shape and needed to increase his muscle tone 
 
         to tolerate working.  He recommended claimant take a week from 
 
         the job to build himself back up.  He did not feel the dizziness 
 
         would cause any permanent disability, that rather it was 
 
         transient.  He recommended claimant build up his work tolerance 
 
         and return to work in one week (Ex.  C, p. 4).
 
         
 
              Claimant then saw Dr. Rudersdorf again on July 23, 1982.  
 
         The doctor stated that claimant is a very nervous, anxious type 
 
         patient who never takes a positive attitude.  His impression was 
 
         that claimant had a great deal of anxiety.  He recommended 
 
         claimant take two to four more weeks to lift weights, bicycle,
 
         
 
         
 
         
 
         
 
         and, lift, and generally improve his work tolerance.  Dr. 
 
         Rudersdorf concluded as follows:
 
         
 
         
 
              Dizziness of unknown etiology 780.4.  2) Anxiety, 
 
              acute. 3000.  I do not feel there is a good organic 
 
              explanation for these symptoms at all and I have known 
 
              the patient over 30 years and his wife agrees that he 
 
              has never looked on the bright side of things.  Has 
 
              been nervous, anxious, and tense.  Feel that he needs 
 
              mainly reassurance because he will worry about anything 
 
              and everything.  He is reassured that there wasn't any 
 
              brain tumor or brain injury at this time as far as we 
 
              know.  Cat scans and all the other tests are all within 
 
              normal limits.  Is taking no medications at this time 
 
              outside of the new Valium (Ex.  C, p. 5).
 
         
 
              On August 6, 1982, Dr. Rudersdorf made the following notes:
 
         
 
              This is a man who was involved in a truck accident 
 
              march 30, 1982.  Continues to complain vehemently and 
 
              out of proportion of pain in his right lower ribs 
 
              anterior and laterally.  Complains of headaches over 
 
              his left eye, tenderness in the scar that goes 
 
              obliquely across his forehead  from left to the right 
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page   5
 
         
 
         
 
              eyebrow.  Clearly out of proportion to his findings 
 
              (Ex.C, p.6).
 
         
 
              On August 27, 1982, Dr. Rudersdorf began to consider a 
 
         neurologic consultation (Ex.C, p.6), and did arrange for a 
 
         complete neurological examination September 10, 1982 to determine 
 
         whether these complaints were trauma syndrome or if he just has 
 
         an inadequate personality.  Dr. Rudersdorf said he explained to 
 
         claimant that these are probably muskuloskeletal type headaches 
 
         which are called tension headaches (Ex.C, p.7).
 
         
 
              Claimant saw William P. Isgreen, M.D., a neurologist, on 
 
         September 15, 1982 who hospitalized claimant for various tests.  
 
         Dr. Isgreen wrote to Dr. Rudersdorf on September 15, 1982 that 
 
         the headache pattern was a bit unusual for post-traumatic 
 
         syndrome (Ex.B, p.14).  Dr. Isgreen wrote to the employer's 
 
         claims examiner on September 18, 1982 that claimant's story was a 
 
         little bit suspect for functional problems (Ex.  B, p. 13).  At 
 
         the time claimant saw Dr. Isgreen he was complaining of sinus 
 
         drainage.  Therefore, Dr. Isgreen was exploring a possible 
 
         diagnosis of hypoliquorrhea, secondary to a dural tear, leaking 
 
         CSF (cerebral spinal fluid) out of the nose (Ex.  B, p. 17).  
 
         Claimant was hospitalized from September 27, 1982 to October 2, 
 
         1982 (Ex.  H, pp. 5-8).    Michael Jones, M.D., an 
 
         otolaryngologist and head and neck surgeon, found that claimant 
 
         had normal sinuses (Ex.  H, pp. 6 & 7).    Also, a radioactive 
 
         ytterbium test conducted by Dr. Jones was normal and ruled a 
 
         chronic CSF leak
 
         
 
         
 
         (Ex.H, p.5).  Also, an EEG, hypertensive IVP, chest x-ray, skull 
 
         x-rays, and a CAT scan of the brain were all normal.  The 
 
         ytterbium scan failed to demonstrate a dural tear with a CSF 
 
         leak.  The MMPI was also normal (exhibit H, page 8).  Dr. Isgreen 
 
         concluded on October 25, 1982 as follows:
 
         
 
              The only thing then that we can come up with is 
 
              complaints of discomfort.  One obviously can't reject 
 
              the man's complaints out of hand, but on the other 
 
              hand, there is no obvious structural change to account 
 
              for the complaints.  Since the complaints followed the 
 
              accident, it's not altogether unfair to blame the 
 
              injury for the headaches.
 
         
 
              However, in the face of no structural damage, the 
 
              problem should resolve itself without any permanent 
 
              impairment.  Any impairment that he has now as a matter 
 
              of fact would only be secondary to pain and that in a 
 
              sense stretches the definition of impairment (Ex.B, 
 
              p.11).
 
         
 
              Dr. Isgreen's office note for October 26, 1982 commented 
 
         that all of the studies on claimant were totally unremarkable.  
 
         He recommended the pain clinic in Omaha because a lot of 
 
         claimant's problems stem from an inability to deal with 
 
         frustration (Ex.B, p.9).
 
         
 
              On January 7, 1983, Dr. Rudersdorf strongly urged claimant 
 
         to drop his opposition and to attend the pain clinic with a view 
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page   6
 
         
 
         
 
         toward getting back to work.  He pointed out to claimant that he 
 
         was actually better a few weeks after the accident and that he 
 
         had not been able to find any organic cause for his headaches.  
 
         Dr.ERudersdorf's continuing diagnosis was headache, 
 
         post-traumatic celphalgia (Ex.C, p.8).
 
         
 
              Claimant was seen by F. Miles Skultety, M.D., at the 
 
         University of Nebraska Pain Management Center, Omaha, beginning 
 
         January 30, 1983 and was discharged on February 25, 1983.  Dr. 
 
         Skultety noted that claimant had difficulty giving a clear cut 
 
         history of the development of his pain.  When asked to describe 
 
         the pain in his head he made a number of statements which were 
 
         not pain descriptions (Ex.  E, p. 1).  It was pointed out to 
 
         claimant that he was a "catastrophizer" and that this increased 
 
         his tension level.  It was also noted that he was probably 
 
         receiving some benefit or secondary gain from this (Ex.  E, p. 
 
         11).  Claimant's condition improved immensely at the pain center. 
 
          He exercised a great deal.  He quit taking Tylenol.  His 
 
         attitude changed.  He returned to work in mid-March 1983.  At the 
 
         time of his discharge from the Pain Management Center, Dr. 
 
         Skultety concluded as follows:
 
         
 
              I also feel that the prognosis is fair to good.
 
         
 
              The possibility exists that he may have problems at 
 
              some time in the future because of his tendency to 
 
              catastrophize everything, thus increasing his stress 
 
              level.  On the other hand, considering the fact that he 
 
              has probably been like this all of his life, even prior 
 
              to his original injury and had no serious problem I 
 
              think the chances are that he will continue to do well 
 
              (Ex.E, p.12).
 
         
 
              Dr. Rudersdorf noted on March 14, 1983 that claimant had 
 
         returned to work (Ex.C, p.10).  On April,8, 1981, he commented 
 
         that claimant was tolerating and handling work well with only 
 
         slight headaches and some pain in his right side (Ex.C, p.11).  
 
         On June 10, 1983, claimant continued to have numerous complaints 
 
         such as (1) numb ache in his forehead; (2) when he talks he can 
 
         hear his voice echo in his ears; and (3) right side pain.  Dr. 
 
         Rudersdorf attributed this to a low tolerance for pain and being 
 
         an unhappy person (Ex.C, p.12).  He finally discharged claimant 
 
         on August 26, 1983 (Ex.C, p.13).
 
         
 
              About a year later, on October 19, 1984, claimant again saw 
 
         Dr. Rudersdorf complaining of tiredness and headaches (Ex.C, 
 
         p.14).  Then, a year after that, on August 27, 1985, he saw Dr. 
 
         Rudersdorf complaining of headaches and right side aches and 
 
         stated he was thinking about a lawsuit.  At this time, Dr. 
 
         Rudersdorf sent claimant to the pain clinic in Iowa City (Ex.C, 
 
         p.15).  At Iowa City, Viney Kumar, M.D., a neurologist, 
 
         administered a supraorbital nerve block injection (Ex.F, pp.1 & 
 
         2).  Claimant testified that the shots relieved his headaches but 
 
         caused him unbearable dizziness, nausea and emotional turmoil.
 
         
 
              Claimant testified and other evidence shows that claimant 
 
         actually returned to work on March 14, 1983.  He regularly worked 
 
         approximately 40 or more hours per week driving trucks and 
 
         loading and unloading trucks on the dock.  He performed his job 
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page   7
 
         
 
         
 
         as a driver and freight handler for approximately two years and 
 
         nine months until he voluntarily retired on November 15, 1985 
 
         with a termination date of November 30, 1985 (Ex.J, p. 69-72).  
 
         Claimant testified that he quit because his head hurt, his right 
 
         side hurt, and his back hurt.  Each day it got worse.  It was 
 
         killing him to continue working.  He testified that he had 
 
         planned to work until age 65 in order to get a pension of $1,000 
 
         per month from the Teamsters.  However, since he retired early, 
 
         he only receives $765 per month.
 
         
 
              On November 13, 1985, just three days before he retired, 
 
         claimant was found physically sound on an ICC physical 
 
         examination for the DOT in order to maintain his license to drive 
 
         a truck.  However, the examining physician, Randy Asmin, M.D., 
 
         referred claimant to his own personal physician for chronic pain 
 
         syndrome (Ex.C, p.16; Ex.J., p.70).
 
         
 
         
 
              Dr. Rudersdorf commented on November 14, 1985 that claimant 
 
         planned to retire on disability and also requested treatment at 
 
         the Mayo Clinic (Ex.C, p.16).  Dr. Rudersdorf wrote to claimant's 
 
         counsel on December 13, 1985 that claimant's wife had cancer of 
 
         the female genital system, had surgery, and was receiving 
 
         chemotherapy.  Her prognosis was very guarded.  The doctor 
 
         believed that the illness of claimant's wife aggravated his 
 
         condition and that partly due to this was his reasoning for 
 
         retiring at this time.  Claimant's diagnosis continued to be 
 
         post-traumatic celphalgia.  Dr. Rudersdorf thought claimant could 
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page   8
 
         
 
         
 
         continue to work if he avoided continuous lifting over 
 
         twenty-five pounds and continuous long-haul truck driving.  The 
 
         doctor thought claimant would benefit from behavioral 
 
         modification therapy from a neurologist by the name of Dr. Nitz 
 
         (full name unknown), but felt claimant probably would not 
 
         cooperate with it (Ex.  C, pp. 18 & 19).
 
         
 
              In his deposition on December 9, 1986, which was a few days 
 
         prior to this hearing, Dr. Rudersdorf testified that he has been 
 
         a family practitioner since 1943.  He has cared for claimant and 
 
         his family since 1960.  Claimant did not have any complaints of 
 
         headache pain or right side pain prior to the injury of March 30, 
 
         1982 (Ex. 17, pp. 1-5).  Dr. Rudersdorf reaffirmed that his 
 
         diagnosis was post-traumatic celphalgia due to the injury of 
 
         March 30, 1982 because claimant did not have these symptoms or 
 
         headaches prior to that time (Ex. 17, p. 17).  Dr. Rudersdorf 
 
         stated that he believes claimant's condition will be permanent 
 
         and not temporary (Ex. 17, pp. 18 & 19) and that claimant cannot 
 
         return to his former employment of driving, loading and unloading 
 
         trucks.  Furthermore, Dr. Rudersdorf now believes that claimant 
 
         cannot do any kind of job (Ex. 17, p. 21).  Even though there is 
 
         no organic injury and the impairment is based entirely on 
 
         subjective symptoms, Dr. Rudersdorf believed his opinion was 
 
         correct because claimant is believable and honest.  Simply 
 
         because we cannot see or measure pain doesn't mean it isn't there 
 
         (Ex. 17, pp. 18 & 21).  The doctor conceded on cross-examination 
 
         that he could not give an organic explanation of claimant's pain 
 
         (Ex. 17, p. 25); that anxiety and tension aggravated his 
 
         condition (Ex. 17, p. 32); his wife's cancer probably increased 
 
         his anxiety (Ex. 17, p. 33); that all of Dr. Isgreen's objective 
 
         tests were normal (Ex. 17, pp. 34-36); and that Dr. Asmin thought 
 
         claimant could safely drive a truck even though he had chronic 
 
         pain (Ex. 17, pp. 37 & 38).
 
         
 
              Dr. Isgreen, who had discontinued seeing claimant in October 
 
         1982, saw him again at the request of claimant's counsel on May 
 
         20, 1986.  His office notes end as follows:
 
         
 
              DISCUSSION:
 
         
 
              The man has been decimated by his headache.
 
         
 
         
 
              I don't have really a good explanation for why the 
 
              headaches other than my initial notion of dural tear 
 
              and hypoliquorrhea with persistence [sic] of the 
 
              headache problem, perhaps due to receptor sensitivity 
 
              set.
 
         
 
              IMPRESSION: Post-traumatic headache syndrome. (Ex. 15, pp. 6 
 
              & 7; Ex.  B, pp. 6 & 7.)
 
         
 
              In his report to claimant's counsel, Dr. Isgreen states that 
 
         he, too, thought claimant's headaches were believable even though 
 
         they were subjective and could not be quantitated or qualitated.  
 
         He concluded his letter as follows:
 
         
 
              I think the man has a moderate permanent impairment on 
 
              the basis of his injury, and using the second edition 
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page   9
 
         
 
         
 
              of the AMA Guidebook, because of the intrusion into his 
 
              activities of daily living on a moderate basis, and the 
 
              independent description of the problem by his wife, I 
 
              don't think a permanent impairment number of 25 per 
 
              cent is an unjust figure.
 
         
 
              Certainly the man has reached maximum medical recovery.  
 
              There are no further neurodiagnostic studies that I 
 
              would suggest. (Ex. 15, p. 2; Ex.  B, p. 2.)
 
         
 
              Claimant was examined and evaluated by David J. Boarini, 
 
         M.D., a neurosurgeon in Des Moines, on November 17, 1986.  He 
 
         gave a deposition two days prior to hearing on December 15, 1986.  
 
         Dr. Boarini gave a final diagnosis of chronic 
 
         intractable.headache which he stated could not be described as 
 
         post-traumatic (Ex.  L, Dep.  Ex. 4).  He testified that he had 
 
         examined all of the medical evidence previously summarized in 
 
         this decision (Ex.  L, Dep.  Ex. 2).  Dr. Boarini reviewed and 
 
         briefly explained the significance of claimant's prior tests and 
 
         his own office examination, all of which were normal.  He 
 
         concluded as follows:
 
         
 
              Based on his history and his own reports, he's got chronic 
 
              headache, but he's got an entirely normal neurological exam, 
 
              and I could find no underlying abnormality to explain those 
 
              headaches. (Ex.  L, p. 12.)
 
         
 
              Dr. Boarini said he did not believe claimant has a dural 
 
         tear or a cerebral spinal fluid leak (Ex.L, p.12).  The following 
 
         colloquy then transpired:
 
         
 
              Q.  Do you have an opinion with reasonable medical certainty 
 
              as to what's causing his headaches that he complains of?
 
         
 
              A.  Well, these are chronic headaches with essentially 
 
              an entirely normal finding and all normal tests, so I 
 
              think they're a tension headache, a muscle headache 
 
              related to stress, anxiety.
 
         
 
              Q.  Did Mr. Vannatta tell you at the time of your 
 
              examination that his wife was suffering from cancer?
 
         
 
              A.  I don't recall that he mentioned that, no.
 
         
 
              Q.  Would concern over that kind of a problem also 
 
              produce tension headaches or stress headaches, or could 
 
              it?
 
         
 
              A.  Yes, it could.
 
         
 
              Q.  Do you have an opinion, Doctor, with reasonable 
 
              medical certainty, based on your examination and review 
 
              of the records, as to whether or not Mr. Vannattals 
 
              headaches should be described as post-traumatic?
 
         
 
              A.  No, I don't believe they should be.
 
         
 
              Q.  Why do you say that?
 
         
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page  10
 
         
 
         
 
              A.  Well, for two reasons.  One is the type of 
 
              headaches he has, but more importantly is their history 
 
              in relationship to the accident.  These headaches were 
 
              not disabling, in the sense that he was able to return 
 
              to work for quite a long time after the accident 
 
              occurred, and then subsequently he feels they're 
 
              incapacitating.  In fact, the history of post-traumatic 
 
              headaches is almost always that they shorten the--after 
 
              the accident they are severe and then will get better 
 
              over time, and these have been virtually the opposite 
 
              of that. (Ex.  L, pp. 12-14.)
 
         
 
              Dr. Boarini thought claimant could be gainfully employed and 
 
         that he could drive a truck as he did before, be a mechanic or a 
 
         radio operator.  He said claimant had no work restrictions and he 
 
         could not find any permanent impairment.  He stated that the AMA 
 
         Guides provide no impairment rating for chronic intractable 
 
         headache (Ex.  L, pp. 14-16).  Dr. Boarini reiterated that 
 
         post-traumatic headaches almost always are worse right after the 
 
         trauma, and then over time, diminish and disappear completely in 
 
         a matter of months (Ex.  L, p. 17).  He testified that he would 
 
         not expect post-traumatic headaches to persist for four years and 
 
         he would not expect them to worsen after claimant was able to 
 
         work for a couple of years (Ex.L, p.18).
 
         
 
              Claimant testified that he did not have headaches or right 
 
         rib pain before the injury.  Now, his daily activities are to 
 
         watch TV, do dishes, walk two and one-half miles a day, but 
 
         usually after two and one-half hours he has to sit down due to 
 
         headache, dizziness, and backache.  He reads, works on his car a 
 
         little, and works with his amateur radio a little bit.  He tries 
 
         to lie down and sleep.  He states he could drive a semi now, but 
 
         he could not do it all day long.  He would like to work today if 
 
         he could.  He testified that he has not applied for employment or 
 
         attempted to find employment since his retirement in November 
 
         1985.  Claimant admitted that after he returned to work in March 
 
         1983, he worked five days a week whereas before the accident he 
 
         only worked about three days a week.  His Teamsters retirement is 
 
         regular retirement, not disability retirement.  He is not 
 
         receiving social security benefits because he wants to wait until 
 
         he is age 65 in order to draw a larger benefit.  Claimant 
 
         testified that the pay stubs in claimant's exhibit 16 are his pay 
 
         stubs before he terminated his employment on November 15, 1985.  
 
         The pay records in claimant's exhibit are his pay records before 
 
         March 30, 1982 (Ex. 16A).
 
         
 
              Marian Vannatta testified that claimant never missed worked 
 
         or complained of headache prior to his accident of March 30, 
 
         1982.  He has a headache all the time now.  He does not mow the 
 
         yard because he cannot stand the noise and jerk of the mower.  On 
 
         road trips for the chemotherapy at Iowa City for her, she does 
 
         most of the driving.  She granted that claimant had other 
 
         stresses in his life after the injury of March 30, 1982.  Their 
 
         son-in-law had made threats against their daughter and 
 
         grandchildren and eventually committed suicide.  Also, claimant's 
 
         father died and both of her parents died after claimant's 
 
         accident.
 
         
 
              Duane Behrens testified that he is terminal manager for 
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page  11
 
         
 
         
 
         employer.  He was not there at the time of the accident on March 
 
         30, 1982.  He stated that the hours shown on exhibit 16A are the 
 
         employer's payroll records for this employee.  He stated that 
 
         these hours were not full-time hours because claimant did not 
 
         have enough seniority to work full time at that time.  After 
 
         claimant came back to work in March 1983, he did have enough 
 
         seniority and did bid and got a full-time job until he decided to 
 
         terminate his employment.  During the two years and nine months 
 
         when claimant worked full time, from March 1983 to November 1985, 
 
         claimant did everything that he was told to do and met all of his 
 
         expectations.  Claimant did complain of headache and the witness 
 
         believed that he did have headaches, but claimant did get the job 
 
         done.  During that period, claimant drove trucks, loaded and 
 
         unloaded on the dock, and operated a forklift.  If claimant 
 
         wished to return to work today, his seniority would allow him to 
 
         work full time.  Claimant's seniority makes him fourth in 
 
         seniority for five full-time bid jobs.
 
         
 
                            APPLICABLE LAW AND ANALYSIS
 
         
 
              The claimant has the burden of proving by a preponderance of 
 
         the evidence that the injury of March 30, 1982 is causally 
 
         related to the disability on which he now bases his claim. Bodish 
 
         v. Fischer, Inc., 257 Iowa 516, 133 N.W.2d 867 (1965).  Lindahl 
 
         v. L. 0. Boggs, 236 Iowa 296, 18 N.W.2d 607 (1945).  A 
 
         possibility is insufficient; a probability is necessary.  Burt v. 
 
         John Deere Waterloo Tractor Works, 247 Iowa 691, 73 N.W.2d 732 
 
         (1955).  The question of causal connection is essentially within 
 
         the domain of expert testimony.  Bradshaw v. Iowa Methodist 
 
         Hospital, 251 Iowa 375, 101 N.W.2d 167 (1960).
 
         
 
              However, expert medical evidence must be considered with all 
 
         other evidence introduced bearing on the causal connection.  
 
         Burt, 247 Iowa 691, 73 N.W.2d 732.  The opinion of experts need 
 
         not be couched in definite, positive or unequivocal language.  
 
         Sondag v. Ferris Hardware, 220 N.W.2d 903 (Iowa 1974).  However, 
 
         the expert opinion may be accepted or rejected, in whole or in 
 
         part, by the trier of fact.  Id. at 907.  Further, the weight to 
 
         be given to such an opinion is for the finder of fact, and that 
 
         may be affected by the completeness of the premise given the 
 
         expert and other surrounding circumstances.  Bodish, 257 Iowa 
 
         516, 133 N.W.2d 867. See also Musselman v. Central Telephone Co., 
 
         261 Iowa 352, 154 N.W.2d 128 (1967).
 
         
 
              Claimant did sustain the burden of proof by a preponderance 
 
         of the evidence that the injury of March 30, 1982 was the cause 
 
         of some permanent disability.  Dr. Rudersdorf, the treating 
 
         physician, testified that claimant suffered from post-traumatic 
 
         celphalgia.  The patient was complaining of headaches when he was 
 
         hospitalized on April 20, 1982.  Dr. Rudersdorf's office notes 
 
         first mentioned headache pain on May 17, 1982 and he did say that 
 
         he believed they were caused by or associated with the previous 
 
         trauma at that time (Ex.  C, p. 2).  And, although his office 
 
         notes (1) mention acute anxiety and that he has "known the 
 
         patient over 30 years and his wife agrees that he has never 
 
         looked on the bright side of things.  He has been nervous, 
 
         anxious and tense" (Ex.  C, p. 5); (2) that claimant needs "to 
 
         try to think positively which he hasn't been doing" (Ex.  C, p. 
 
         6); and (3) that his subjective complaints are clearly out of 
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page  12
 
         
 
         
 
         proportion to his physical findings (Ex.  C, p. 6); nevertheless, 
 
         Dr. Rudersdorf recorded on August 27, 1982 that he believed the 
 
         headaches and tension were post-trauma (Ex.  C, p. 6).  He also 
 
         consistently recorded this same diagnosis of headache, 
 
         post-traumatic celphalgia on October 18, 1982; January 7, 1983; 
 
         January 17, 1983; February 28, 1983; March 4, 1983; April 8, 
 
         1983; June 10, 1983; August 26, 1983; October 19, 1984; August 
 
         27, 1985; and November 14, 1985 (Ex.  C, p. 8-16) even though the 
 
         headaches were combined with chronic endogenous anxiety and 
 
         depression (Ex.  C, pp. 14-15).  Therefore, Dr. Rudersdorf's 
 
         opinion in his deposition a few days prior to the hearing of 
 
         post-traumatic celphalgia due to the injury of March 30, 1982 was 
 
         entirely consistent with his recorded opinion over the preceding 
 
         years ever since shortly after the injury of March 30, 1982.
 
         
 
              In September and October of 1982, Dr. Isgreen performed 
 
         extensive tests and put a great deal of thought into claimant's 
 
         complaints of pain, but he could find no organic cause for the 
 
         headaches.  Nevertheless, he did say that since the headaches 
 
         follow the accident it is not unfair to blame the injury of March 
 
         30, 1982 for the headaches (Ex.  B, p. 11).  Again, in May of 
 
         1986, Dr. Isgreen still had no good explanation for the 
 
         headaches, but his impression of post-traumatic headache syndrome 
 
         is nevertheless consistent with earlier findings (Ex. 15, pp. 6 & 
 
         7; Ex.  B, pp. 6-7).  His assessment, then, of permanent partial 
 
         impairment on the basis of the injury of March 30, 1982 which he 
 
         made on May 20, 1986 is consistent with his earlier findings of 
 
         causal connection (Ex. 15, p. 2; Ex.  B, p. 2).
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page  13
 
         
 
         
 
         
 
              Therefore, based on the testimony of the two treating 
 
         physicians, Dr. Rudersdorf and Dr. Isgreen, who tested, studied 
 
         and treated claimant's condition extensively, it is determined 
 
         that the injury of March 30, 1982 did cause some permanent 
 
         partial disability.
 
         
 
              This determination in no way discounts the testimony of Dr. 
 
         Boarini, who examined the medical records and the claimant and 
 
         concluded that claimant's symptoms did not follow a pattern of 
 
         post-traumatic headache in his opinion.  Dr. Boarini stated that 
 
         claimant's headaches were tension headaches related to stress and 
 
         anxiety.  Dr. Boarini may be entirely correct.  The evidence 
 
         certainly establishes that claimant has a personality highly 
 
         susceptible to stress and anxiety.  In addition, since the injury 
 
         of March 30, 1982, claimant has been subject to several very 
 
         difficult stresses.  His father died.  His wife's parents have 
 
         both died.  His son-in-law made threats on his daughter and his 
 
         grandchildren and eventually committed suicide.  And, his wife 
 
         has become ill with female genital cancer which has required 
 
         surgery and repeated chemotherapy.  However, the preponderance of 
 
         the evidence in this case, the greater weight of the evidence, 
 
         lies with Dr. Rudersdorf and Dr. Isgreen, who treated claimant 
 
         extensively and were responsible for his recovery or failure to 
 
         recover. .1 Deference, then, in this case is given to the two 
 
         treating p . nysicians who found that the headaches were 
 
         post-traumatic, which means they were caused by the trauma of the 
 
         accident of March 30, 1982.  See Rockwell Graphics Systems, Inc.
 
          v. Prince, 366 N.W.2d 187, 192 (Iowa 1985).
 
         
 
              If claimant has an impairment to the body as a whole, an 
 
         industrial disability has been sustained.  Industrial disability 
 
         was defined in Diederich v. Tri-City Railway Co., 219 Iowa 587,. 
 
         593, 258 N.W. 899, 902 (1935) as follows: "It is therefore
 
         plain that the legislature intended the term 'disability' to mean 
 
         'industrial disability' or loss of earning capacity and not a 
 
         mere 'functional disability' to be computed in the terms of 
 
         percentages of the total physical and mental ability of a normal 
 
         man."
 
         
 
              The opinion of the supreme court in Olson v. Goodyear 
 
         Service Stores, 255 Iowa 1112, 1121, 125 N.W.2d 251, 257 (1963) 
 
         cited with approval a decision of the industrial commissioner for 
 
         the following proposition:
 
         
 
              Disability * * * as defined by the Compensation Act 
 
              means industrial disability, although functional 
 
              disability is an element to be considered . . . In 
 
              determining industrial disability, consideration may be 
 
              given to the injured employee's age, education, 
 
              qualifications, experience and his inability, because 
 
              of the injury, to engage in employment for which he is 
 
              fitted. * * * *
 
         
 
              Dr. Rudersdorf agreed that even without the accident 
 
         claimant would have been one to stew and fret about his wife's 
 
         condition (Ex. 17, p. 33).  The pain center characterized 
 
         claimant as a "catastrophizer" and that this personality trait 
 
         will increase his tension level, and that he was probably 
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page  14
 
         
 
         
 
         receiving some benefit or secondary gain from it (Ex.  E, p. 11).  
 
         From the standpoint of his physical injuries, Dr. Warren thought 
 
         claimant could return to light duty work approximately five days 
 
         after the injury (Ex.  D, pp. 1-4).  Dr. Rudersdorf attempted to 
 
         get claimant back to work a short time after the accident, but 
 
         claimant resisted vehemently due to his many subjective symptoms.  
 
         Claimant did return to work in July 1982, but left after only 
 
         working five days and convinced Dr. Asmin and Dr. Rudersdorf that 
 
         he could not work due to his subjective symptoms.  After the pain 
 
         clinic experience, claimant did work full time, five days a week, 
 
         for two years and nine months from March 1983 to November 1985.  
 
         This is more than he worked before the injury because he only 
 
         worked three days a week at that time.  Behrens said that 
 
         claimant performed all the duties of his job as a driver and 
 
         freight dock worker.  Claimant voluntarily retired at the end of 
 
         November 1985.  He retired as a matter of his own voluntary, 
 
         personal, individual decision and took a Teamsters pension in the 
 
         amount of $765 per month.  None of the doctors that he had seen 
 
         previously, in particular his treating physicians Dr. Rudersdorf 
 
         and Dr. Isgreen, ordered, recommended, or even suggested that he 
 
         quit his job.  No other medical practitioners recommended that 
 
         claimant quit his job.  Even though it is advanced that claimant 
 
         quit on November 15, 1985 because he could no longer stand the 
 
         pain, claimant never consulted a physician for his pain after his 
 
         retirement.  He last saw Dr. Rudersdorf on November 14, 1985, the 
 
         day before he retired.  Nor is there any evidence that he 
 
         consulted any other health  practitioner for this pain.  
 
         Claimant's retirement seems to be entirely his own personal 
 
         choice.  Dr. Rudersdorf thought it was influenced by the the 
 
         discovery of his wife's illness earlier that year.
 
         
 
              Claimant is age 62 and many people do retire at that age.  
 
         In determining permanent partial disability consideration must be 
 
         given to an employee's plans for retirement.  Swan v. Industrial 
 
         Engineering Equipment Co., IV Iowa Industrial Commissioner 
 
         Report, 353 (1984) and his retirement benefits.  McDonough v. 
 
         Dubuque Packing Co., I-1 Iowa Industrial Commissioner Decisions 
 
         152 (1984).
 
         
 
              If claimant were permanently and totally disabled and not 
 
         able to perform any job or gainful occupation as Dr. Rudersdorf 
 
         testified in his deposition, then claimant would be clearly 
 
         eligible for social security disability benefits.  Yet, at the 
 
         hearing claimant testified that he had not applied for social 
 
         security benefits of any kind.   His testimony was that he wanted 
 
         to wait until age 65 in order to receive a larger amount of 
 
         money.   However, if claimant were, in fact, totally and 
 
         permanently disabled, he is eligible for and could be drawing the 
 
         maximum amount of social security as social security disability 
 
         benefits.  But, claimant has not applied for any social security 
 
         benefits and did not indicate any intention of doing so.
 
         
 
              It should also be noted that Behrens testified claimant is 
 
         fourth on the seniority list for five bid jobs.  He stated that 
 
         claimant could be working full time now if he chose to do so.  
 
         Dr. Rudersdorf's opinion that claimant can not do any job is not 
 
         reasonable inasmuch as claimant was fully performing a five day a 
 
         week job until he chose to retire from it.  There was no evidence 
 
         that claimant's condition has worsened since his retirement.  In 
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page  15
 
         
 
         
 
         fact, he has not sought any medical treatment since November 14, 
 
         1985, the day before he retired.  It is also noted that Dr. 
 
         Rudersdorf previously recommended that claimant see a neurologist 
 
         by the name of Dr. Nitz for behavioral modification therapy (Ex.  
 
         C, pp. 18 & 19).
 
         
 
              As far as permanent impairment ratings, Dr. Rudersdorf did 
 
         not give a specific permanent impairment rating as such.  He 
 
         simply stated that claimant could no longer do his old truck 
 
         driving job and that he did not think he could do any job at this 
 
         time.  Dr. Isgreen rather generally stated 'I don't think a 
 
         permanent impairment number of 25 percent is an unjust figure" 
 
         (Ex. 15, p. 2; Ex.  B, p. 2).
 
         
 
              There is a common misconception that industrial disability 
 
         is greater than functional impairment and that it is an add-on; 
 
         i.e., something to be examined on top of functional impairment 
 
         but such is not the case.   Industrial disability can be the same 
 
         as, less than, or greater than functional impairment.  Lawyer & 
 
         Higgs, Iowa Workers' Compensation --- Law and Practice,  13-5.  
 
         In this case, claimant's industrial disability is found to be 
 
         less than the rather general impairment rating advanced by Dr. 
 
         Isgreen above.
 
         
 
              It is possible and proper to allow permanent partial 
 
         disability for physical trauma which causes nervous injury, 
 
         Newman v. John Deere, 372 N.W.2d 199 (Iowa 1985), Larson, 
 
         Workers' Compensation Law,  42.22, page 7-601.  Larson does not 
 
         cite any Iowa cases and claimant's brief does not cite any Iowa 
 
         cases.  In this case, however, claimant's primary complaint and 
 
         the object of his very comprehensive medical treatment and 
 
         testing is headache pain.  Dr. Rudersdorf, Dr. Isgreen, Dr. Jung, 
 
         Dr. Hiemstra, Dr. Asmin, Dr. Skultety, and Dr. Boarini could not 
 
         find any organic, physical, objective, medical cause for 
 
         claimant's headache pain.  Indeed, claimant's own description of 
 
         the headache pain varied from doctor to doctor and from time to 
 
         time.  Dr. Skultety said that claimant could not describe a clear 
 
         cut history of how this pain developed and he made a number of 
 
         statements that were not pain descriptions at all (Ex.  E, p. 1).  
 
         It has been held by this agency that pain that is not 
 
         substantiated by clinical findings is not a substitute for 
 
         impairment, Waller v. Chamberlain Manufacturing, II Iowa 
 
         Industrial Commissioner Report 419, 425 (1981).
 
         
 
              There is an abundance of evidence from Dr. Rudersdorf that 
 
         claimant's long time personality has been one of tension and 
 
         anxiety and that claimant has been basically a tense, nervous, 
 
         and anxious person.  Dr. Skultety and other members of his staff 
 
         at the Pain Management Center characterized claimant as a 
 
         catastrophizer.  There is no evidence that the injury of March 
 
         30, 1982 was the cause of this personality or character trait 
 
         which appears to be largely the cause of claimant's current 
 
         suffering.  There is a great deal of evidence that other factors 
 
         such as aging, illness, and death in claimant's personal life may 
 
         be a significant influence on his current condition.  Also, Dr. 
 
         Skultety predicted that claimant would have problems in the 
 
         future because of his tendency to catastrophize everything which 
 
         increased his stress level.  He felt that claimant had probably 
 
         been like this all of his life and even prior to the injury of 
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page  16
 
         
 
         
 
         March 30, 1982 (Ex.  E, p. 12).
 
         
 
              As for claimant's ability to work, in spite of his chronic 
 
         pain syndrome, Dr. Asmin found claimant physically sound to drive 
 
         a tractor and trailer over the road and approved his ICC license 
 
         on November 12, 1985, just three days before claimant retired 
 
         (Ex.  C, p. 16; Ex.  J, p. 70).  Claimant is not drawing a 
 
         disability pension from the Teamsters.  It is a regular 
 
         retirement pension.  Claimant has not applied for social security 
 
         disability benefits.
 
         
 
              At the same it must be remembered that claimant was involved 
 
         in a very serious motor vehicle accident.  His tractor and 
 
         trailer fell several feet airborne to the lower level and landed 
 
         upright on its wheels.  The tractor and trailer each were a total 
 
         loss.  Claimant suffered a seven centimeter laceration on his 
 
         right forehead that took eighteen stitches to close and left a 
 
         visible scar.  Claimant's face received a traumatic blow that 
 
         caused both of his eyes to be ecchymotic and swollen for several 
 
         days.  Claimant had a hematoma on his nose.  He was clinically 
 
         diagnosed as having fractured ribs.  Claimant testified that he 
 
         still suffers with headaches and right rib pain.  Claimant 
 
         testified that he consumes as many as sixteen aspirins or Tylenol 
 
         a day in order to control his pain.  There was no evidence that 
 
         he does not actually experience this pain.  Claimant's wife, 
 
         Behrens, Dr. Rudersdorf, Dr. Isgreen, and Dr. Asmin all believed 
 
         that he actually experienced this headache pain.  Claimant 
 
         testified that it is true that he was able to work, but it was 
 
         very difficult and he suffered a great deal and consumed a lot of 
 
         analgesics in order to do so.  Therefore, based on all of the 
 
         foregoing considerations, it is determined that claimant has 
 
         sustained a 15 percent industrial disability to the body as a 
 
         whole.
 
         
 
              Claimant asserts that he is an odd-lot employee citing 
 
         Guyton v. Irving Jensen Company, 373 N.W.2d 101 (Iowa 1985).  
 
         The Guyton principle is triggered when the employee makes prima 
 
         facie showing that he cannot find any employment in any 
 
         well-known branch of the labor market.  In order to apply the 
 
         Guyton rule, it is normally incumbent upon the injured worker to 
 
         demonstrate a reasonable effort to secure employment in the area 
 
         residence.  In this case, claimant testified that he has not 
 
         applied for employment or made any attempt to find employment 
 
         since he retired in November 1985.  Therefore, the Guyton 
 
         principle cannot be applied to this case.  The ICC physical 
 
         examination that claimant passed three days prior to his 
 
         retirement indicates that claimant was capable of continuing in 
 
         the full-time job that he was performing at that time, but he 
 
         chose to retire instead of continuing to work.  Behrens further 
 
         testified that with claimant's seniority he could be employed now 
 
         full time if he chose to work.  Thus, it is determined that 
 
         claimant did not make out a prima facie case.  Claimant is not 
 
         permanently disabled under the odd-lot principle of the Guyton 
 
         case.
 
         
 
              Claimant asserts that his rate of compensation beginning on 
 
         March 30, 1982 should be determined by only using the thirteen 
 
         weeks in which claimant completed thirty or more hours of work.  
 
         Claimant then went back through thirty-four weeks of employment 
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page  17
 
         
 
         
 
         in order to isolate out thirteen weeks in which he had more than 
 
         thirty hours of employment.  Claimant asserts that only thirty 
 
         hour weeks comply with the wording of the first unnumbered 
 
         paragraph of Iowa Code section 85.36 that states the rate is to 
 
         be based on "earnings of an employee to which such employee would 
 
         have been entitled had he worked the customary hours for the full 
 
         pay period in which he was injured."  The testimony of claimant 
 
         and Behrens indicated that claimant worked the hours at that time 
 
         which claimant's seniority permitted.  The hours for the thirteen 
 
         weeks prior to the injury look very similar to the hours worked 
 
         in the thirteen weeks prior to that (Ex. 16A, p. 3).  Therefore, 
 
         the thirteen week period prior to the injury represents 
 
         claimant's customary wages at that time.  The evidence is 
 
         insufficient to show that claimant's customary work week prior to 
 
         the injury was a thirty hour work week as asserted by claimant.  
 
         Therefore, claimant's contention that the proper rate of 
 
         compensation as illustrated on exhibit 16A, pages 1 and,2, cannot 
 
         be accepted as correct.
 
         
 
              Neither can defendant's rate calculation in his brief be 
 
         applied to this case.  This is a correct method of calculation, 
 
         but it does not result in the highest rate that can be applied to 
 
         this case under the Code.  Defendant applied Iowa Code section 
 
         85.36(10) and divided the last twelve calendar months earnings by 
 
         twelve.  This resulted in a gross wage of $314.27 per week and a 
 
         weekly compensation rate of $193.09.
 
         
 
              The employer's claims examiner made a calculation which used 
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page  18
 
         
 
         
 
         Iowa Code section 85.36(6). This also is a correct method of 
 
         computation, and it also allows claimant the highest weekly rate 
 
         of compensation.  It divides the earnings for the thirteen weeks 
 
         immediately preceding the injury by thirteen and arrives at a 
 
         gross weekly rate of $321 per week and a weekly compensation rate 
 
         of $196.70 per week.  Therefore, it is determined that $.196.70 
 
         is the weekly. rate of compensation to be applied to this case.
 
         
 
              Claimant asserts that he received a cumulative injury and, 
 
         therefore, his rate of compensation after he quit working 
 
         allegedly due to the pain should be based on the thirteen week 
 
         period prior to November 15, 1985.  This contention must be 
 
         rejected because there is no evidence that claimant suffered a 
 
         gradual or cumulative injury.  The evidence is that claimant was 
 
         injured in the motor vehicle accident on March 30, 1982.  On 
 
         April 20, 1982, he was hospitalized for headache pain.  He first 
 
         mentioned headache pain in Dr. Rudersdorf's notes on May 17, 
 
         1982.  He has complained of this same headache pain ever since.  
 
         There was no evidence of repeated traumas or gradual onset.  
 
         Therefore, the weekly rate of compensation is $196.70 as 
 
         previously determined.  Claimant's calculations on the rate as 
 
         proposed in exhibit 16 then cannot be accepted as the proper rate 
 
         in this case based upon the cumulative injury theory.
 
         
 
                             FINDINGS OF FACT
 
         
 
              WHEREFORE, based upon the evidence presented, the following 
 
         findings of fact are made:
 
         
 
              That claimant sustained an injury on March 30, 1982 in a 
 
         serious one vehicle truck accident.
 
         
 
              That shortly after the accident, claimant began to complain 
 
         of headaches and has continued to complain of headaches until the 
 
         present time.
 
         
 
              That numerous and very comprehensive medical testing and 
 
         evaluating failed to establish an organic cause for claimant's 
 
         headaches.
 
         
 
              That claimant did sustain serious trauma to his whole body 
 
         and in particular to his face and head in the motor vehicle 
 
         accident.
 
         
 
              That Dr. Rudersdorf and Dr. Isgreen, claimant's two treating 
 
         physicians, stated that in their opinion the injury of March 30, 
 
         1982 was the cause of claimant's continuing headaches which Dr. 
 
         Rudersdorf called post-traumatic celphalgia and Dr. Isgreen 
 
         called post-traumatic headache syndrome.
 
         
 
              That both of these doctors and Dr. Skultety acknowledged 
 
         claimant was tense, nervous, and anxious by nature.
 
         
 
              That Dr. Skultety and the Pain Management Center personnel 
 
         characterized claimant as a catastrophizer type personality, and 
 
         that this characteristic would increase his tension level in the 
 
         future.
 
         
 
              That claimant eventually returned to work on March 14, 1983 
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page  19
 
         
 
         
 
         and performed all of the duties of a truck driver and freight 
 
         dock employee for two years and nine months until his voluntary 
 
         retirement on November 15, 1985.
 
         
 
              That no medical practitioner ordered, recommended, or even 
 
         suggested that claimant quit his employment on November 15, 
 
         1985.
 
         
 
              That claimant did not seek any medical attention or 
 
         treatment for headaches after he retired on November 15, 1985 
 
         with Dr. Rudersdorf or anyone else.
 
         
 
              That claimant began drawing a pension of $765 per month from 
 
         the Teamsters in November 1985 at age 62.
 
         
 
              That the Teamsters pension is a regular pension and not a 
 
         disability pension.
 
         
 
              That claimant has not applied for social security disability 
 
         benefits.
 
         
 
              That claimant has not applied for regular social security 
 
         benefits at age 62.
 
         
 
              That claimant has not sought or attempted to find any 
 
         employment since he retired on November 15, 1985.
 
         
 
              That claimant's rate of compensation is properly calculated 
 
         for the highest benefit pursuant to Iowa Code section 85.36(6) 
 
         using the thirteen weeks prior to his injury for the 
 
         calculation.
 
         
 
              That there is no evidence of repeated trauma or gradual 
 
         onset of injury, but rather the only injury date in evidence is 
 
         March 30, 1982.
 
         
 
              That claimant suffered a severe laceration of the forehead, 
 
         ecchymotic and swollen eyes, a hematoma of the nose, and right 
 
         anterior rib injuries.
 
         
 
              That claimant's physical injuries appeared to heal well, but 
 
         that claimant still complains of headache pain and right rib pain 
 
         as a result of the accident on March 30, 1982.
 
         
 
              That claimant takes as many as sixteen aspirins or Tylenol 
 
         per day in order to alleviate his subjective symptoms of pain.
 
         
 
              That even though claimant worked full time for two years and 
 
         nine months after the injury, nevertheless, claimant's wife, 
 
         Behrens, Dr. Rudersdorf and Dr. Isgreen testified that they 
 
         believed claimant suffered the headache pain he claimed in his 
 
         testimony.
 
         
 
              That claimant sustained an industrial disability of 15 
 
         percent of the body as a whole.
 
         
 
                            CONCLUSIONS OF LAW
 
         
 
              WHEREFORE, based upon the evidence presented and the 
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page  20
 
         
 
         
 
         principles of law previously discussed, the following conclusions 
 
         of law are made:
 
         
 
              That the injury of March 30, 1982 was the cause of some 
 
         permanent disability.
 
         
 
              That claimant is entitled to seventy-five (75) weeks of 
 
         permanent partial disability as industrial disability to the body 
 
         as a whole.
 
         
 
              That claimant did not make out a prima facie case that he is 
 
         an odd-lot employee.
 
         
 
              That the proper rate of weekly compensation is calculated by 
 
         using Iowa Code section 85.36(6), using the thirteen weeks of 
 
         employment immediately preceding the injury.
 
         
 
              That claimant did not sustain a cumulative injury that would 
 
         entitle him to a rate of compensation based upon his earnings at 
 
         the time he retired from employment.
 
         
 
                                      ORDER
 
         
 
              THEREFORE, IT IS ORDERED:
 
         
 
              That defendant pay to claimant seventy-five (75) weeks of 
 
         permanent partial disability benefits as industrial disability to 
 
         the body as a whole at the rate of one hundred ninety-six and 
 
         70/100 dollars ($196.70) per week commencing on March 15, 1983 in 
 
         the total amount of fourteen thousand seven hundred fifty-two and 
 
         50/100 dollars ($14,752.50).
 
         
 
              That defendant pay this amount in a lump sum.
 
         
 
              That interest will accrue under Iowa Code section 85.30.
 
         
 
              That defendant will pay the cost of this action pursuant to 
 
         Division of Industrial Services Rule 343-4.33.
 
         
 
              That defendant file claim activity reports as requested by 
 
         this agency pursuant to Division of Industrial Services Rule 
 
         343-3.1.
 
         
 
              Signed and filed this 20th day of August, 1987.
 
         
 
         
 
         
 
         
 
         
 
                                            WALTER R. McMANUS, JR.
 
                                            DEPUTY INDUSTRIAL COMMISSIONER
 
         
 
         
 
         Copies To:
 
         
 
         Mr. Michael P. Jacobs
 
         Attorney at Law
 
         300 Toy National Bank Bldg.
 

 
         
 
         
 
         
 
         VANNATTA V. YELLOW FREIGHT SYSTEM, INC.
 
         Page  21
 
         
 
         
 
         Sioux City, Iowa 51101
 
         
 
         Mr. Frank T. Harrison
 
         Attorney at Law
 
         Terrace Center, Suite 111
 
         2700 Grand Avenue
 
         Des Moines, Iowa 50312
 
         
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                                                 1402.40; 1803;4100;
 
                                                 3002; 2209
 
                                                 Filed 8-20-87
 
                                                 Walter R. McManus, Jr.
 
         
 
                    BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         _________________________________________________________________
 
         
 
         
 
         CLIFFORD L. VANNATTA,
 
             
 
             Claimant,
 
                                                  File No. 700950
 
         VS.
 
                                                    R E V I E W
 
         YELLOW FREIGHT SYSTEM, INC.,
 
                                                 R E 0 P E N I N G
 
              Employer,
 
                                                  D E C I S I 0 N
 
              Self-Insured,
 
              Defendant.
 
         _________________________________________________________________
 
         
 
         
 
         1402.40; 1803
 
         
 
         Claimant drove his nearly empty semi-tractor and trailer through 
 
         the guardrail, fell several feet, and landed upright on the 
 
         roadway below.  He received a 7 cm. vertical laceration on his 
 
         right forehead, ecchymotic and swollen eyes, hematoma of the 
 
         nose, and clinically diagnosed fractured right ribs.  The 
 
         physical injuries healed but claimant continued to have 
 
         complaints of headaches for which he received much testing, 
 
         evaluation and treatment.  No organic cause could be found but 
 
         everyone believed he had the headaches for which he took up to 16 
 
         analgesics a day.  After a healing period of about a year he 
 
         returned to work but continued to complain of headaches.  After 
 
         working two years and nine months he quit because he could not 
 
         stand the ,pain any longer.  It also happened that he was age 62 
 
         and took a Teamsters pension of $765 a month and his wife was 
 
         diagnosed with cancer.  It was found that claimant voluntarily 
 
         retired and he was awarded 15% permanent partial disability for 
 
         the headaches due to the severe head trauma.  His personal 
 
         physician and neurologist said the headaches were post-trauma.  
 
         Neurologist awarded 25% permanent functional impairment.
 
         
 
         4100
 
         
 
         Claimant did not make out a prima facie case of odd-lot because 
 
         he never sought employment after he retired.  Furthermore, he 
 
         passed his ICC physical examination for the DOT three days before 
 
         he retired and employer testified he could have his old job back 
 
         if he wanted it because he had the seniority to get it.
 
         
 
         
 
         3002
 
                                                
 
                                                         
 
         
 
         Claimant was not allowed to isolate out the weeks of work in 
 
         which he had more than thirty hours of work for his rate because 
 
         it was not proven that this was a customary week for him.  
 
         Rather, rate was computed under ICS 85.36(6) using the last 
 
         thirteen weeks.
 
         
 
         2209
 
         
 
         Claimant did not prove gradual onset or repetitive,trauma and, 
 
         therefore, was not entitled to a higher rate after he quit 
 
         working based on McKeever.
 
 
 
         
 
 
 
 
            
 
            Page   1
 
            
 
            
 
            
 
            
 
            
 
                     before the iowa industrial commissioner
 
            ____________________________________________________________
 
                                          :
 
            DALE E. LARSON,               :
 
                                          :
 
                 Claimant,                :
 
                                          :
 
            vs.                           :
 
                                          :      File No.701560
 
            EICHLEAY CORPORATION,         :
 
                                          :        A P P E A L
 
                 Employer,                :
 
                                          :      D E C I S I O N
 
            and                           :
 
                                          :
 
            AETNA CASUALTY & SURETY       :
 
            COMPANY,                      :
 
                                          :
 
                 Insurance Carrier,       :
 
                 Defendants.              :
 
            ___________________________________________________________
 
            
 
                              statement of the case
 
            
 
                 Defendants appeal from a deputy industrial 
 
            commissioner's decision awarding permanent partial 
 
            disability benefits based on an industrial disability of 60 
 
            percent and awarding healing period benefits from April 8, 
 
            1982 to December 20, 1985.
 
            
 
                 The record on appeal consists of the transcript of the 
 
            hearing and joint exhibits 1 through 10.  Both parties filed 
 
            briefs on appeal.  Defendants filed a reply brief.
 
            
 
                                      issues
 
            
 
                 The issues on appeal are:
 
            
 
                   I.  Whether there is a causal connection between 
 
            claimant's alleged injury of April 8, 1982 and claimant's 
 
            permanent disability?
 
            
 
                  II.  Whether the greater weight of the evidence 
 
            supports an industrial disability award of 60 percent as a 
 
            result from an alleged injury of April 8, 1982?
 
            
 
                 III.  Whether the greater weight of the evidence 
 
            demonstrates that the claimant's healing period ended prior 
 
            to December 20, 1985?
 
            
 
                  
 
            
 
            
 
            Page   2
 
            
 
            
 
            
 
            
 
            review of the evidence
 
            
 
                 The deputy's decision dated March 30, 1989 adequately 
 
            and accurately reflects the pertinent evidence and it will 
 
            not be reiterated herein.
 
            
 
                                  applicable law
 
            
 
                 The citations of law in the deputy's decision are 
 
            appropriate to the issues and evidence.  Additional agency 
 
            decisions will be discussed as necessary in the analysis.
 
             
 
            
 
                                     analysis
 
            
 
                 The analysis of the evidence in conjunction with the 
 
            law in the deputy's decision is adopted.  The following 
 
            additional comments are appropriate.
 
            
 
                 The deputy's analysis of the nature and extent of 
 
            claimant's industrial disability is adopted and becomes the 
 
            final agency decision on the issue of industrial disability.
 
            
 
                 The greater weight of the evidence supports a 
 
            conclusion that a casual connection exists between 
 
            claimant's work-related injury and his industrial 
 
            disability.  Claimant's treating physician, Dr. Hoover 
 
            opined that claimant recovered completely from his 
 
            automobile accident in January or early February and noted 
 
            that claimant had returned to work at the time of his 
 
            injury.  (Joint exhibit 1, Page 45).  Dr. Hoover opined that 
 
            claimant's present back problem was related to the work 
 
            injury which occurred on April 8, 1982.  (Jt. ex. 1, p. 27).
 
            
 
                 Parties stipulated that if it is determined that 
 
            claimant is entitled to healing period benefits then it runs 
 
            from April 8, 1982 to December 20, 1985.  See prehearing 
 
            report dated September 20, 1988 and the transcript of the 
 
            hearing page 4, line 1 through 6.  Parties will be bound by 
 
            stipulations unless they are clearly contrary to the law.  
 
            One of the conditions that ends healing period is when "it 
 
            is medically indicated that significant improvement is not 
 
            anticipated".  (Iowa Code section 85.34(1)).  It was held in 
 
            a decision by this agency:
 
            
 
                 That a person continues to receive medical care 
 
                 does not indicate that the healing period 
 
                 continues.  Medical treatment which is maintenance 
 
                 in nature often continues beyond that point when 
 
                 maximum medical recuperation had been 
 
                 accomplished.  Medical treatment that anticipates 
 
                 improvement does not necessarily extend healing 
 
                 period particularly when the treatment does not in 
 
                 fact improve that condition.
 
            
 
            Derochic v. City of Sioux City, II Industrial Commissioner 
 
            Report 112, 114 (1982).
 
            
 
                 In addition, a recent agency decision is pertinent:
 
            
 

 
            
 
            Page   3
 
            
 
            
 
            
 
            
 
                 As the name implies, permanent impairment is not 
 
                 subject to improvement.  A rating of permanent 
 
                 impairment indicates that the healing period has 
 
                 ended and further improvement is not anticipated.  
 
                 This satisfies the requirements of Iowa Code 
 
                 section 85.34(1).
 
            
 
                 ...
 
            
 
                 The fact that claimant may need to undergo further 
 
                 treatment does not mean that claimant is still in 
 
                 healing period.  Claimant's healing period can end 
 
                 and permanency begin with further treatment 
 
                 anticipated at a later time.
 
            
 
            Brown v. Weitz Company, Appeal Decision, March 13, 1990.
 
            
 
                 Claimant was admitted for treatment in a chronic pain 
 
            program at Sister Kenny Institute from December 1, 1985 
 
            through December 20, 1985.  Claimant's overall progress in 
 
            the program was considered good and claimant continued to 
 
            improve in his overall physical conditioning as well as his 
 
            mental outlook.  (Jt. ex. 1, p. 78).  Evidence in the record 
 
            exists to support the conclusion that the parties' 
 
            stipulation to healing period from April 8, 1982 to December 
 
            20, 1985 is consistent with Iowa Code section 85.34(1). 
 
            
 
                                 findings of fact
 
            
 
                 1.  Claimant sustained a back injury arising out of and 
 
            in the course of his employment with defendants on April 8, 
 
            1982.
 
            
 
                 2.  Claimant had a long history of back problems 
 
            including a laminectomy as a result of a prior work-related 
 
            injury.
 
            
 
                 3.  Claimant was born April 13, 1928 and is approaching 
 
            normal retirement age.
 
            
 
                 4.  Claimant received his GED in 1964.
 
            
 
                 5.  Claimant received training and became certified as 
 
            a chemical dependency counselor subsequent to his injury on 
 
            April 8, 1982.
 
            
 
                 6.  Claimant's past work experience includes carpentry 
 
            and millwright.
 
            
 
                 7.  Claimant's treating physician opined that there is 
 
            a casual connection between claimant's April 2, 1982 injury 
 
            and claimant's permanent partial disability. 
 
            
 
                 8.  Claimant is unable to return to any position in the 
 
            construction industry where there is climbing, twisting, 
 
            bending or stooping as a result of claimant's April 8, 1982 
 
            work injury.
 
            
 
                 9.  Claimant has not been motivated to seek employment 
 
            in the field of chemical dependency counselor.
 

 
            
 
            Page   4
 
            
 
            
 
            
 
            
 
            
 
                 10. Claimant has a functional impairment of 20 percent 
 
            of the body as a whole as a result of his preexisting 
 
            injuries.
 
            
 
                 11. Claimant has an additional functional impairment of 
 
            30 percent of the body as a whole as a result of his April 
 
            8, 1982 work-related injury.
 
            
 
                 12. Claimant was in healing period from April 8, 1982 
 
            through December 20, 1985.
 
            
 
                 13. Claimant suffered a 60 percent loss of earning 
 
            capacity as a result of the injury he sustained on April 8, 
 
            1982.
 
            
 
                                conclusions of law
 
            
 
                 Claimant established by a preponderance of the evidence 
 
            that the work-related injury of April 8, 1982 was the cause 
 
            of permanent partial disability.
 
            
 
                 Claimant established by a preponderance of the evidence 
 
            that he is entitled to healing period benefits from April 8, 
 
            1982 through December 20, 1985 at the weekly rate of $280.95 
 
            per week.
 
            
 
                 Claimant established that he is entitled to 300 weeks 
 
            of permanent partial disability based upon an industrial 
 
            disability of 60 percent of the body as a whole.
 
            
 
                 WHEREFORE, the decision of the deputy is affirmed.
 
            
 
                                      order
 
            
 
                 THEREFORE, it is ordered:
 
            
 
                 That defendants are to pay unto claimant healing period 
 
            benefits beginning April 2, 1982 through May 10, 1983 at a 
 
            weekly rate of two hundred eighty and 95/100 dollars 
 
            ($280.95).
 
            
 
                 That defendants are to pay unto claimant three hundred 
 
            (300) weeks of permanent partial disability benefits at the 
 
            rate of two hundred eighty and 95/100 dollars ($280.95) per 
 
            week.
 
            
 
                 That payments that have accrued shall be paid in a lump 
 
            sum together with statutory interest thereon pursuant to 
 
            Iowa Code section 85.30.
 
            
 
                 That defendants shall be given credit for all benefits 
 
            previously paid to claimant.
 
            
 
                 That defendants shall pay the costs of the appeal 
 
            including the costs of transcription of the hearing before 
 
            the deputy.
 
            
 
                 That defendants file claim activity reports pursuant to 
 
            Division of Industrial Services Rule 343-3.1(2).
 

 
            
 
            Page   5
 
            
 
            
 
            
 
            
 
            
 
                 Signed and filed this ____ day of July, 1990.
 
            
 
            
 
            
 
            
 
                                          
 
            ________________________________
 
                                                   CLAIR R. CRAMER
 
                                           ACTING INDUSTRIAL 
 
            COMMISSIONER
 
            
 
            Copies To:
 
            
 
            Mr. David Drake
 
            Attorney at Law
 
            West Towers Office
 
            1200 35th St., Ste. 500
 
            West Des Moines, Iowa 50265
 
            
 
            Mr. Glenn Goodwin
 
            Ms. Lorraine J. May
 
            Attorneys at Law
 
            4th Floor Equitable Bldg.
 
            Des Moines, Iowa 50309
 
            
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                                          1802; 5-1803
 
                                          Filed July 30, 1990
 
                                          CLAIR R. CRAMER
 
            before the iowa industrial commissioner
 
            ____________________________________________________________
 
                                          :
 
            DALE E. LARSON,               :
 
                                          :
 
                 Claimant,                :
 
                                          :
 
            vs.                           :
 
                                          :      File No. 701560
 
            EICHLEAY CORPORATION,         :
 
                                          :        A P P E A L
 
                 Employer,                :
 
                                          :      D E C I S I O N
 
            and                           :
 
                                          :
 
            AETNA CASUALTY & SURETY       :
 
            COMPANY,                      :
 
                                          :
 
                 Insurance Carrier,       :
 
                 Defendants.              :
 
            ___________________________________________________________
 
            
 
            1802
 
            Parties stipulated that if it is determined that claimant is 
 
            entitled to healing period benefits then it runs from April 
 
            8, 1982 to December 20, 1985.  Parties will be bound by 
 
            stipulations unless they are clearly contrary to the law.  
 
            Claimant's overall progress continued to improve while in a 
 
            chronic pain program.  Evidence in the record exists to 
 
            support the conclusion that the parties' stipulation to 
 
            healing period from April 8, 1982 to December 20, 1985 is 
 
            consistent with Iowa Code section 85.34(1).
 
            
 
            5-1803
 
            Claimant sustained a back injury which resulted in permanent 
 
            disability.  Claimant proved entitlement to 300 weeks of 
 
            permanent partial disability based upon an industrial 
 
            disability of 60 percent of the body as a whole.
 
            
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                   BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         DALE E. LARSON,
 
         
 
              Claimant,
 
                                                 File No. 701560
 
         vs.
 
                                                   R E V I E W -
 
         EICHLEAY CORPORATION,
 
                                                 R E 0 P E N I N G
 
              Employer,
 
                                                  D E C I S I 0 N
 
         and
 
                                                     F I L E D
 
         AETNA CASUALTY & SURETY
 
         COMPANY,                                   MAR 30 1989
 
         
 
              Insurance Carrier,           IOWA INDUSTRIAL COMMISSIONER
 
              Defendants.
 
         
 
         
 
                                  INTRODUCTION
 
         
 
              This is a review-reopening proceeding brought by Dale E. 
 
         Larson, claimant, against Eichleay Corporation, employer, and 
 
         Aetna Casualty & Surety Company, insurance carrier, defendant.  
 
         The case was heard by the undersigned in Des Moines, Iowa on 
 
         September 20, 1988.
 
         
 
              The record consists of the testimony of claimant.  The 
 
         record also consists of joint exhibits 1 through 10.
 
         
 
                                    ISSUES
 
         
 
              As a result of the prehearing report and order submitted and 
 
         approved on September 20, 1988, the issues presented by the 
 
         parties are:
 
         
 
              1)  Whether claimant received an injury which arose out of 
 
         and in the course of employment;
 
         
 
              2)  Whether there is a causal relationship between the 
 
         alleged injury and the disability;
 
         
 
              3)  Whether claimant is entitled to temporary disability/ 
 
         healing period benefits or permanent partial or total disability 
 
         benefits; and,
 
         
 
              4)  Whether claimant is an odd-lot doctrine employee.
 
         
 
                               FACTS PRESENTED
 
         
 
              At the time of the hearing, claimant was 60 years old.  He 
 
         is single and currently living alone.  Claimant received his GED 
 
                                                
 
                                                         
 
         in 1964.  He also successfully completed a four year 
 
         apprenticeship program in carpentry.  Following his 
 
         apprenticeship, claimant worked as a carpenter and as a 
 
         millwright for many years.  After the alleged injury on April 8, 
 
         1982, claimant entered the Minneapolis Community College where he 
 
         received a two year certificate as a chemical dependency 
 
         counselor.  Claimant concluded an internship program at a VA 
 
         hospital.  However, claimant did not seek full or part-time 
 
         employment in this area, once he had received his certificate.
 
         
 
              Claimant has a history of prior back problems.  As early as 
 
         1962, he had sought medical attention for his back.  Medical 
 
         records for Robert McCoy, M.D., indicate that in October of 1962, 
 
         claimant was suffering from back strain because of work related 
 
         lifting and driving duties.  Then in September of 1971, claimant 
 
         was admitted to a hospital because he had a "herniated 
 
         intervertebral disc."
 
         
 
              In June of 1976, a laminectomy was performed on claimant.  
 
         The medical records for June 11, 1976 indicate postoperatively:
 
         
 
              POSTOP DIAG:  Herniation L3-4 disc, left, foraminal 
 
              encroachment due to epiphyseal joint degenerative disease, 
 
              L3-4.
 
         
 
         Allegedly this injury was work related.  The claimant received an 
 
         impairment rating of 30 percent of the spine and 20 percent of 
 
         the body as a whole.  Claimant was paid the requisite benefits.  
 
         He reported he returned to work after two months.
 
         
 
              In March of 1982, claimant was involved in an automobile 
 
         accident in Denver, Colorado.  According to claimant's testimony, 
 
         his head struck the back windshield.  Claimant was hospitalized 
 
         for neck pain for several days as a result.
 
         
 
              Subsequent to the automobile accident, claimant commenced 
 
         his employment with defendant.  Claimant testified, while working 
 
         for defendant, he slipped.  At the time, claimant was engaged in 
 
         "torquing up bolts on a mill."  Claimant slipped and fell between 
 
         the motor base and the mill while the torque wrench he was using 
 
         fell on him.  Claimant stated he reported the injury to someone 
 
         in defendant's office.
 
         
 
              According to claimant's,testimony, he did not feel a great 
 
         deal of pain immediately after the injury but gradually the pain 
 
         increased.  Medical notes indicate claimant telephoned N. W. 
 
         Hoover, M.D., on April 22, 1982, concerning claimant's work 
 
         injury.  The notes indicate:
 
         
 
              Mr. Larson called to say that he was getting along 
 
              reasonably well until two weeks ago when he was carrying a 
 
              heavy object at work and slipped and fell as he did.  Since 
 
              then, he has had severe pain in his low back with numbness 
 
              of one buttock. This is different from pain he has had 
 
              before.  He has stayed at home during the past two weeks and 
 
                                                
 
                                                         
 
                   has tried to be inactive but hasn't been able to stay in bed 
 
              because he lives alone.  Therefore, he agrees that he should 
 
              come into the hospital and stay at the hospital at this 
 
              time.  Note that he left last time because of some type of 
 
              personal problem.  He is coming into Mercy tomorrow, April 
 
              23.
 
         
 
              The medical records established that claimant was 
 
         hospitalized.  The CT scan taken subsequent to the injury in 
 
         April of 1982 indicated, "a significant disc protrusion though 
 
         the radiologist reported a slight bulging of the L5-S1 
 
         intervertebral disc."
 
         
 
              Claimant did not return to work as a millwright.  According 
 
         to Dr. Hoover's note of July 6, 1982:
 
         
 
              ... As I indicated in my last note, this patient's usual 
 
              occupation over the past many years is of such strenuous 
 
              nature that it is impractical for him to continue to go back 
 
              to it.  He wishes to undergo vocational retraining which I 
 
              think would be a very practical goal.  Apparently, to make 
 
              that possible it is necessary that evaluation of his 
 
              impairment be done.  This is an early time for such an 
 
              evaluation coming only 3 months from his time of injury and 
 
              therefore I emphasized that the reasons for the early 
 
              evaluation is the patient's need for it to establish a base 
 
              for his negotiation.  I cannot assume that this is 
 
              indicative of his ultimate condition but at the present time 
 
              I find him to be impaired to the degree of 50% of the lumbar 
 
              spine and note also that that impairment implies 100% 
 
              permanent partial disability with respect to his usual 
 
              occupation or any other for which he has competence training 
 
              or experience.
 
         
 
              Claimant reported he completed his education as a substance 
 
         abuse counselor.  However, he testified it was impossible for him 
 
         to work as a counselor because he was always focusing on his own 
 
         pain.  Claimant does do volunteer counseling through his local 
 
         AA. Claimant did state that he currently engages in hunting for 
 
         antiques and restoring them.  He also noted that he swims 
 
         regularly and the swimming eases his back pain.  Claimant 
 
         reported he lives in Arizona from December or January through 
 
         March.
 
         
 
              Claimant also testified that he participated in the pain 
 
         center at the Sister Kenny Institute in Minneapolis, Minnesota.  
 
         He believed the institute assisted him in improving his mental 
 
         outlook.
 
         
 
              Finally, claimant testified he had received vocational 
 
         rehabilitation counseling from Richard McCluhan.  Claimant 
 
         indicated Mr. McCluhan had provided various job applications to 
 
         him relative to employment as a substance abuse counselor. 
 
         Claimant stated no interviews were set up by Mr. McCluhan, but 
 
         that claimant reported to the counselor, he was unable to work.
 
                                                
 
                                                         
 
         
 
                               APPLICABLE LAW
 
         
 
              An employee is entitled to compensation for any and all 
 
         personal injuries which arise out of and in the course of the 
 
         employment.  Section 85.3(l).
 
         
 
              Claimant has the burden of proving by a preponderance of the 
 
         evidence that he received an injury on April 8, 1982, which arose 
 
         out of and in the course of his employment.  McDowell v. Town of 
 
         Clarksville, 241 N.W.2d 904 (Iowa 1976); Musselman v. Central 
 
         Telephone Co., 261 Iowa 352, 154 N.W.2d 128 (1967).
 
         
 
              The injury must both arise out of and be in the course of 
 
         the employment.  Crowe v. DeSoto Consol. Sch. Dist., 246 Iowa 
 
         402, 68 N.W.2d 63 (1955) and cases cited at pp. 405-406 of the 
 
         Iowa Report.  See also Sister Mary Benedict v. St. Mary's Corp., 
 
         255 Iowa 847, 124 N.W.2d 548 (1963) and Hansen v. State of Iowa, 
 
         249 Iowa 1147, 91 N.W.2d 555 (1958).
 
         
 
              The words "out of" refer to the cause or source of the 
 
         injury.  Crowe, 246 Iowa 402, 68 N.W.2d 63 (1955).
 
         
 
              The words "in the course of" refer to the time and place and 
 
         circumstances of the injury.  McClure v. Union et al. Counties, 
 
                               
 
                                                
 
                                                         
 
         188 N.W.2d 283 (Iowa 1971); Crowe, 246 Iowa 402, 68 N.W.2d 63 
 
         (1955).
 
         
 
              "An injury occurs in the course of the employment when it is 
 
         within the period of employment at a place the employee may 
 
         reasonably be, and while he is doing his work or something 
 
         incidental to it."  Cedar Rapids Comm. Sch. Dist. v. Cady, 278 
 
         N.W.2d 298 (Iowa 1979); McClure, 188 N.W.2d 283 (Iowa 1971); 
 
         Musselman, 261 Iowa 352, 154 N.W.2d 128 (1967).
 
         
 
              The claimant must prove by a preponderance of the evidence 
 
         that his injury arose out of and in the course of his employment. 
 
         Musselman, 261 Iowa 352, 154 N.W.2d 128 (1967).
 
         
 
              In the course of employment means that the claimant must 
 
         prove his injury occurred at a place where he reasonably may be 
 
         performing his duties.  McClure, 188 N.W.2d 283 (Iowa 1971).
 
         
 
              Arising out of suggests a causal relationship between the 
 
         employment and the injury.  Crowe, 246 Iowa 402, 68 N.W.2d 63 
 
         (1955).
 
         
 
              The claimant has the burden of proving by a preponderance of 
 
         the evidence that the injury of April 8, 1982 is causally related 
 
         to the disability on which he now bases his claim.  Bodish v. 
 
         Fischer, Inc., 257 Iowa 516, 133 N.W.2d 867 (1965).  Lindahl v. 
 
         L.O. Boggs, 236 Iowa 296, 18 N.W.2d 607 (1945).  A possibility is 
 
         insufficient; a probability is necessary.  Burt v. John Deere 
 
         Waterloo Tractor Works, 247 Iowa 691, 73 N.W.2d 732 (1955).  The 
 
         question of causal connection is essentially within the domain of 
 
         expert testimony.  Bradshaw v. Iowa Methodist Hospital, 251 Iowa 
 
         375, 101 N.W.2d 167 (1960).
 
         
 
              The opinions of experts need not be couched in definite, 
 
         positive or unequivocal language.  Sondag v. Ferris Hardware, 220 
 
         N.W.2d 903 (Iowa 1974).  An opinion of an expert based upon an 
 
         incomplete history is not binding upon the commissioner, but must 
 
         be weighed together with the other disclosed facts and 
 
         circumstances.  Bodish, 257 Iowa 516, 133 N.W.2d 867 (1965).  The 
 
         expert medical evidence must be considered with all other 
 
         evidence introduced bearing on the causal connection between the 
 
         injury and the disability.  Burt, 247 Iowa 691, 73 N.W.2d 732 
 
         (1955).  In regard to medical testimony, the commissioner is 
 
         required to state the reasons on which testimony is accepted or 
 
         rejected.  Sondag, 220 N.W.2d 903 (1974).
 
         
 
              While a claimant is not entitled to compensation for the 
 
         results of a preexisting injury or disease, the mere existence at 
 
         the time of a subsequent injury is not a defense.  Rose v. John 
 
         Deere Ottumwa Works, 247 Iowa 900, 908, 76 N.W.2nd 756, (1956).  
 
         If the claimant had a preexisting condition or disability that is 
 
         aggravated, accelerated, worsened or lighted up so that it results 
 
         in disability, claimant is entitled to recover.  Nicks v Davenport 
 
         Produce Co., 254 Iowa 130, 115 N.W.2d 812, (1962).
 
         
 
                                                
 
                                                         
 
              When an aggravation occurs in the performance of an 
 
         employer's work and a causal connection is established, claimant 
 
         may recover to the extent of the impairment.  Ziegler v. United 
 
         States Gypsum Co., 252 Iowa 613, 620, 106 N.W.2d 591, (1960).
 
         
 
              The Iowa Supreme Court cites, apparently with approval, the 
 
         C.J.S. statement that the aggravation should be material if it is 
 
         to be compensable.  Yeager v. Firestone Tire & Rubber Co., 
 
         253.Iowa 369, 112 N.W.2d 299 (1961); 100 C.J.S. Workmen's 
 
         Compensation section 555(17)a.
 
         
 
              Our supreme court has stated many times that a claimant may 
 
         recover for a work connected aggravation of a preexisting 
 
         condition.  Almquist v. Shenandoah Nurseries, 218 Iowa 724, 254 
 
         N.W. 35 (1934).  See also Auxier v. Woodward State Hospital Sch., 
 
         266 N.W.2d 139 (Iowa 1978); Gosek v. Garmer and Stiles Co., 158 
 
         N.W.2d 731 (Iowa 1968); Barz v. Oler, 257 Iowa 508, 133 N.W.2d 
 
         704 (1965); Olson v. Goodyear Service Stores, 255 Iowa 1112, 125 
 
         N.W.2d 251 (1963); Yeager, 253 Iowa 369, 112 N.W.2d 299 (1961); 
 
         Ziegler, 252 Iowa 613, 106 N.W.2d 591 (1960).
 
         
 
              An employer takes an employee subject to any active or 
 
         dormant health impairments, and a work connected injury which 
 
         more than slightly aggravates the condition is considered to be a 
 
         personal injury.  Ziegler, 252 Iowa 613, 620, 106 N.W.2d 591 
 
         (1960), and cases cited.
 
         
 
              An employee is not entitled to recover for the results of a 
 
         preexisting injury or disease but can recover for an aggravation 
 
         thereof which resulted in the disability found to exist.  Olson, 
 
         255 Iowa 1112, 125 N.W.2d 251 (1963); Yeager, 253 Iowa 369, 112 
 
         N.W.2d 299 (1961); Ziegler, 252 Iowa 613, 106 N.W.2d 591 (1960). 
 
         See also Barz, 257 Iowa 508, 133 N.W.2d 704 (1965); Almquist, 218 
 
         Iowa 724, 254 N.W. 35 (1934).
 
         
 
              If a claimant contends he has industrial disability he has 
 
         the burden of proving his injury results in an ailment extending 
 
         beyond the scheduled loss.  Kellogg v. Shute and Lewis Coal Co., 
 
         256 Iowa 1257, 130 N.W.2d 667 (1964).
 
         
 
              Functional impairment is an element to be considered in 
 
         determining industrial disability which is the reduction of 
 
         earning capacity, but consideration must also be given to the 
 
         injured employee's age, education, qualifications, experience and 
 
         inability to engage in employment for which he is fitted.  Olson, 
 
         255 Iowa 1112, 125 N.W.2d 251 (1963).  Barton v. Nevada Poultry, 
 
         253 Iowa 285, 110 N.W.2d 660 (1961).
 
         
 
              A finding of impairment to the body as a whole found by a 
 
         medical evaluator does not equate to industrial disability.  This 
 
         is so as impairment and disability are not synonymous.  Degree of 
 
         industrial disability can, in fact, be much different than the 
 
         degree of impairment because in the first instance reference is 
 
         to loss of earning capacity and in the latter to anatomical or 
 
         functional abnormality or loss.  Although loss of function is to 
 
                                                
 
                                                         
 
         be considered and disability can rarely be found without it, it 
 
         is not so that a degree of industrial disability is 
 
         proportionally related to a degree of impairment of bodily 
 
         function.
 
         
 
              Factors to be considered in determining industrial 
 
         disability include the employee's medical condition prior to the 
 
         injury, immediately after the injury, and presently; the situs of 
 
         the injury, its severity and the length of healing period; the 
 
         work experience of the employee prior to the injury, after the 
 
         injury and potential for rehabilitation; the employee's 
 
         qualifications intellectually, emotionally and physically; 
 
         earnings prior and subsequent to the injury; age; education; 
 
         motivation; functional impairment as a result of the injury; and 
 
         inability because of the injury to engage in employment for which 
 
         the employee is fitted. Loss of earnings caused by a job transfer 
 
         for reasons related to the injury is also relevant.  These are 
 
         matters which the finder of fact considers collectively in 
 
         arriving at the determination of the degree of industrial 
 
         disability.
 
         
 
              There are no weighting guidelines that indicate how each of 
 
         the factors are,to be considered.  There are no guidelines which 
 
         give, for example, age a weighted value of ten percent of the 
 
         total value, education a value of fifteen percent of total, 
 
         motivation - five percent; work experience - thirty percent, etc. 
 
         Neither does a rating of functional impairment directly correlate 
 
         to a degree of industrial disability to the body as a whole.  In 
 
         other words, there are no formulae which can be applied and then 
 
         added up to determine the degree of industrial disability.  It 
 
         therefore becomes necessary for the deputy or commissioner to 
 
         draw upon prior experience, general and specialized knowledge to 
 
         make the finding with regard to degree of industrial disability.  
 
         See Peterson v. Truck Haven Cafe, Inc., (Appeal Decision, 
 
         February 28, 1985); Christensen v. Hagen, Inc., (Appeal Decision, 
 
         March 26, 1985).
 
         
 
              Under the odd-lot doctrine, which was formally adopted by the 
 
         Iowa Supreme Court in Guyton, supra, a worker becomes an odd-lot 
 
         employee when an injury makes the worker incapable of obtaining 
 
         employment in any well-known branch of the labor market.  An 
 
         odd-lot worker is thus totally disabled if the only services the 
 
         worker can perform are so limited in quality, dependability, or 
 
         quantity that a reasonably stable market for them does not exist. 
 
         Id., citing Lee v. Minneapolis Street Railway Company, 230 Minn. 
 
         315, 320, 41 N.W.2d 433, 436 (1950).  The rule of odd-lot 
 
         allocates the burden of production of evidence.  If the evidence 
 
         of degree of obvious physical impairment, coupled with other facts 
 
         such as claimant's mental capacity, education, training or age, 
 
         places claimant prima facie in the odd-lot category, the burden 
 
         should be on the employer to show that some kind of suitable work 
 
         is regularly and continuously available to the claimant.  
 
         Certainly in such a case it should not be enough to show that 
 
         claimant is physically capable of performing light work and then 
 
         round out the case for non-compensable by adding a presumption 
 
                                                
 
                                                         
 
         that light work is available.. Guyton, 373 N.W.2d at 105,
 
         
 
              When a worker makes a prima facie case of total disability 
 
         by producing substantial evidence that the worker is not 
 
         employable in the competitive labor market, the burden to produce 
 
         evidence of suitable employment shifts to the employer.  If the 
 
         employer fails to produce such evidence and the trier of fact 
 
         finds the worker falls in the odd-lot category, the worker is 
 
         entitled to a finding of total disability.  Even under the 
 
         odd-lot doctrine, the trier of fact is free to determine the 
 
         weight and credibility of the evidence in determining whether the 
 
         worker's burden of persuasion has been carried.  Only in an 
 
         exceptional case would evidence be sufficiently strong to compel 
 
         a finding of total disability as a matter of law.. Guyton 373 
 
         N.W.2d at 106.  The court went on to state:
 
         
 
              The commissioner did not in his analysis address any of the 
 
              other factors to be considered in determining industrial 
 
              disability.  Industrial disability means reduced earning 
 
              capacity.  Bodily impairment is merely one factor in a 
 
              gauging industrial disability.  Other factors include the 
 
              worker's age, intelligence, education, qualifications, 
 
              experience, and the effect of the injury on the worker's 
 
              ability to obtain suitable work.  See Doerfer Division of 
 
              CCA v. Nicol, 359 N.W.2d 428, 438 (Iowa 1984).  When the 
 
              combination of factors precludes the worker from obtaining 
 
              regular employment to earn a living, the worker with only a 
 
              partial functional disability has a total disability.  See 
 
              McSpadden v. Big Ben Coal Co., 288 N.W.2d 181, 192 (Iowa 
 
              1980).
 
         
 
              In Diederich v. Tri-City R. Co., 219 Iowa 587, 258 N.W. 899 
 
         (1935) the court, addressing the issue of the meaning of 
 
 
 
                               
 
                                                         
 
         disability stated:
 
         
 
                   What is "permanent total disability"?  Does this clause 
 
              refer to "functional disability" or to "industrial 
 
              disability"?
 
         
 
                   For clearness we shall use the term "industrial 
 
              disability" as referring to disability from carrying on a 
 
              gainful occupation--inability to earn wages.  By "functional 
 
              disability" we shall refer to the disability to perform one 
 
              or more of the physical movements which a normal human being 
 
              can perform.
 
         
 
                   ....
 
         
 
                   It is obvious that "disability" here used cannot refer 
 
              to mere "functional disability',...
 
         
 
                   It is...plain that the legislature intended the term 
 
              "disability" to mean "industrial disability" or loss of 
 
              earning capacity and not a mere "functional disability" to 
 
              be computed in terms of percentages of the total physical 
 
              and mental ability of a normal man.
 
         
 
                   ....
 
         
 
              ... [T]he Compensation law was passed for the purpose of 
 
              compensating the working man when injured.  The loss which 
 
              this claimant suffered due to the injury which he received 
 
              while in the employ of the company is the inability to carry 
 
              on the work he was doing prior to the time of the injury, or 
 
              any work which he could perform.  This man at fifty-nine 
 
              years of age, after thirty years as a street car motorman, 
 
              with little education, cannot find or hold a position that 
 
              would not require some manual labor, and, of course, due to 
 
              the condition of his back, he cannot perform such work.  To 
 
              say that he might become a stenographer or a lawyer or a 
 
              clerk or a bookkeeper is to suppose the impossible, for a 
 
              fifty-nine-year old man, with no education, is not capable 
 
              of securing or filling any such position.  His disability 
 
              may be only a twenty-five or thirty per cent disability 
 
              compared with the one hundred per cent perfect man, but, 
 
              from the standpoint of his ability to go back to work to 
 
              earn a living for himself and his family, his disability is 
 
              a total disability, for he is not able to again operate the 
 
              street car and perform the work which the company demanded 
 
              of him prior to the time of the accident.
 
         
 
                                     ANALYSIS
 
         
 
              In the case at hand, claimant has proven by a preponderance 
 
         of the evidence that he has received an injury which arose out of 
 
         and in the course of claimant's employment.  Claimant described 
 
         the incidents leading up to the injury.  Here, the cause or 
 
         source of the injury was the fall while "torquing up bolts on a 
 
                                                
 
                                                         
 
         mill." The injury occurred while claimant was performing his 
 
         normal work routine.  These were duties performed on behalf of 
 
         defendant; employer, and pursuant to direction from defendant.
 
         
 
              Claimant has also established by a preponderance of the 
 
         evidence that his injury on April 8, 1982, is causally related to 
 
         the disability on which he now bases his claim.  There is medical 
 
         testimony to substantiate the necessary causal connection.  Dr. 
 
         Hoover writes in his letters of June 29, 1982 and December 16, 
 
         1982:
 
         
 
              June 29, 1982
 
         
 
              ...Note that Mr. Larson was injured in the course of his 
 
              work on April 8, 1982, when he pulled torque wrench, lost 
 
              his footing as he did, and fell.  He twisted his back in 
 
              doing so.  He was hospitalized for acute back pain and 
 
              seemed to improve over a period of six days.  He was then 
 
              discharged from the hospital and next examined on May 7 when 
 
              he was. standing with a list to the right, walking with 
 
              difficulty, and obviously having more pain than when he had 
 
              been discharged.  Therefore, he was readmitted to the 
 
              hospital in my absence and cared for by Dr. Emerson for the 
 
              period 5/21 to 5/24...
 
         
 
              December 16, 1982
 
         
 
              Mr. Larson has been under my care since his injury of April 
 
              8, 1982.  That injury occurred in the course of his 
 
              employment resulting from a fall when he lost his footing 
 
              while pulling on a heavy torque wrench.  The injury caused 
 
              acute lumbar strain and damage to the lumbosacral 
 
              intervertebral disc.  CT scan made on May 10, 1982, 
 
              demonstrated bulging of the disc.
 
         
 
              The patient's condition is such that he has not recovered 
 
              sufficiently to return to his previous heavy physical work 
 
              and, therefore, with respect to his usual occupation or any 
 
              other for which he has competence or training, he remains 
 
              100% disabled.
 
         
 
              There is also the testimony of claimant.  During redirect 
 
         examination, he testified that the pain he experienced in April 
 
         of 1982, subsequent to his fall on the eighth was different than 
 
         the back pain he had experienced prior to the eighth.  After the 
 
         work injury, claimant stated, he experienced low back pain which 
 
         radiated down into his buttocks.  At all times prior to the April 
 
         8, 1982 injury, claimant was able to return to work.  Even after 
 
         the hospitalization in March of 1982, claimant was able to 
 
         continue working as a carpenter/millwright, jobs which required 
 
         more than sedentary responsibilities.  In light of the foregoing, 
 
         it is the determination of the undersigned that claimant has 
 
         established the requisite causal connection.
 
         
 
              The third issue to address is the extent of claimant's 
 
                                                
 
                                                         
 
         healing period.  Defendants paid healing period benefits through 
 
         July 6, 1982.  On August 4, 1982, defendants informed claimant 
 
         they were terminating claimant's healing period benefits pursuant 
 
         to Dr. Hoover's report of July 27, 1982.
 
         
 
              Section 85.34 of the Iowa Code (1987) defines healing 
 
         period. This section provides that:
 
         
 
              1.  Healing period.  If an employee has suffered a personal 
 
              injury causing permanent partial disability for which 
 
              compensation is payable as provided in subsection 2 of this 
 
              section, the employer shall pay to the employee compensation 
 
              for a healing period, as provided in section 85.37, 
 
              beginning on the date of injury, and until the employee has 
 
              returned to work or it is medically indicated that 
 
              significant improvement from the injury is not anticipated 
 
              or until the employee is medically capable of returning to 
 
              employment substantially similar to the employment in which 
 
              the employee was engaged at the time of injury, whichever 
 
              occurs first.
 
         
 
              In the case at hand, claimant seeks benefits for the period 
 
         from April 8, 1982 to December 20, 1985.  The undersigned finds 
 
         that the healing period ended on December 20, 1985.  On that 
 
         date, claimant was released from the Sister Kenny Institute.  
 
         This was the last mode of treatment in which claimant actively 
 
         participated.  Claimant's doctors encouraged claimant to return 
 
         to the work setting.  Maximum progress had been made concerning 
 
         claimant's pain management, and claimant's mental attitude seemed 
 
         to have been elevated.  Matthew Monsein, M.D., writes in his 
 
         report of December 27, 1985:
 
         
 
              Overall, I was satisfied with Dale's progress in our pain 
 
              management program.  He was quite active and participated in 
 
              all activities.  At the time of Dale's discharge from our 
 
              program, according to Dale, there really was not much 
 
              improvement in his experience of pain.  However, there was 
 
              improvement in Dale's attitude towards his pain and his 
 
              desire to return to a more productive lifestyle.
 
         
 
                   ...
 
         
 
              Dale has expressed a desire to return to work as a chemical 
 
              dependency counselor.  As you know, Dale has received a 
 
              degree in this.  He states that he will probably be going to 
 
              Arizona to see what opportunities are available in this 
 
              area. I have recommended to Dale that he discuss this with 
 
              Mr. McCluhan, his rehabilitation counselor, but certainly 
 
              from our standpoint he was encouraged to pursue this goal.
 
         
 
              It was at this point that claimant was medically capable of 
 
         returning to employment.  Claimant had no other significant 
 
         improvement after this date.  While it is true that Dr. Hoover 
 
         did provide an impairment rating on July 6, 1982, Dr. Hoover 
 
         expressly notes the evaluation is an early evaluation and not 
 
                                                
 
                                                         
 
         indicative of claimant's ultimate condition.  Therefore, this 
 
         evaluation was not used to consider whether claimant's healing 
 
         period ended on July 6, 1982.
 
         
 
              The next issue to discuss is the issue of permanency.  As 
 
         mentioned previously, claimant has had a long history of back 
 
         problems.  Claimant has also had a prior work related injury.  In 
 
         June of 1976, claimant had a laminectomy because of a herniated 
 
         lumbar disc and because of degenerative problems.  Dr. Hoover, in 
 
         1977, determined claimant was functionally impaired.  He wrote in 
 
         his report of June 17, 1977:
 
         
 
              I saw Mr. Larson finally on June 14, 1977 when he had 
 
              reached a point of maximal recovery.  He continues to have 
 
              stiffness and soreness in his back each morning.  He avoids 
 
              bending because of persistent pain.  He wears his corset 
 
              periodically as his symptoms require.  Nevertheless he has 
 
              made a recovery sufficiently good to allow him to return to 
 
              his usual occupation. on examination he was found to have 
 
              flattening of his lumbar spine, he bends to reach to twelve 
 
              inches from the floor, extension, side bending and rotation 
 
              are limited to about fifty per cent of normal range.  
 
              Straight leg raising is tight at 60 degrees on either side.  
 
              He has no motor weakness and no sensory loss.
 
         
 
              Mr. Larson has made a reasonably good recovery from surgical 
 
              removal of an acutely protruded mid lumbar disc but he has 
 
              residual disability as noted in the findings above.  I have 
 
              estimated his permanent partial disability at 30% of the 
 
              lumbar spine, or 20% of the man as a whole.
 
         
 
              Dr. Hoover, in his note of July 6, 1982, only provided a 
 
         preliminary rating of functional impairment.  He writes:
 
 
 
                               
 
                                                         
 
         
 
              ...I find him to be impaired to the degree of 50% of the 
 
              lumbar spine and note also that that impairment implies 100% 
 
              permanent partial disability with respect to his usual 
 
              occupation or any other for which he has competence, 
 
              training or experience.
 
         
 
              R. L. Emerson, M.D., is an orthopedic surgeon.  He was a 
 
         partner with Dr. Hoover.  Dr. Emerson assumed claimant as a 
 
         patient when Dr. Hoover left the area.  At first, Dr. Emerson 
 
         provided the following impairment rating:
 
         
 
              The impairment rating that I gave in May of 1983 was based 
 
              upon my examination in judgment of Mr. Larson's impairment. 
 
              This may or may not coincide with Dr. Hoover's previous 
 
              impairment rating.  It is not meant to be an additional 25% 
 
              added on to Dr. Hoover's 20% of a whole man.  It simply 
 
              means that I felt that Mr. Larson had an impairment of 25% 
 
              of the whole body.
 
         
 
              Later, Dr. Emerson concurred with the preliminary rating 
 
         provided by Dr. Hoover.  In his letter of April 12, 1984, Dr. 
 
         Emerson opines:
 
         
 
              I have recently seen Mr. Dale Larson on follow-up for low 
 
              back and lower extremity symptoms.  His condition seems to 
 
              have worsened since my last examination while he was in the 
 
              hospital.  Indeed, at the present time I would be in 
 
              agreement in Dr. Hoover's previous impairment rating of 50% 
 
              of whole man.  As you know, I have had to reply [sic] on Dr. 
 
              Hoover's previous notes fairly heavily in assessing Mr. 
 
              Larson.  I think that his impairment has changed from my 
 
              correspondence with you last fall.  At that point in time, I 
 
              felt that he had an impairment of 25% of whole body.  At the 
 
              present time I think it is more realistically 50%.
 
         
 
              David J. Boarini, M.D., is a neurological surgeon.  Pursuant 
 
         to a request from defendants, he saw claimant on May 14, 1987.  
 
         Dr. Boarini evaluated claimant in anticipation of this proceeding, 
 
         after seeing claimant only on the one occasion.  He opines in his 
 
         report of May 19, 1987:
 
         
 
              Upon examination, the patient is mildly obese but he has an 
 
              entirely normal gait and is able to heel and toe walk without 
 
              difficulty.  He has normal flexion of the lower back but very 
 
              slight limitation on extension and side bending.  
 
              Neurological examination shows normal strength in all muscle 
 
              groups in the lower extremities.  Sensory testing is intact 
 
              to pin and touch. The patient has a negative straight leg 
 
              raising sign bilaterally and symmetric and physiologic 
 
              reflexes at the knees and ankles.  Examination of the back 
 
              shows a well healed surgical incision and there is no 
 
              tenderness or spasm.
 
         
 
              I think this gentleman has chronic myofascial low-back pain. 
 
                                                
 
                                                         
 
                   He is status post lumbar laminectomy.  His neurological 
 
              examination is entirely normal and his only abnormality at 
 
              this time is a very minimal limitation in the range of 
 
              motion.  Based upon his having had a previous laminectomy 
 
              and his minimal loss in the range of,motion, I would give 
 
              him a permanent impairment rating of 8-9% of the whole man. 
 
               I really have no further recommendations for treatment.
 
         
 
              Dr. Boarini's evaluation is markedly disparate from either 
 
         Dr. Hoover or Dr. Emerson.  Furthermore, both Dr. Hoover, and 
 
         later, Dr. Emerson were treating physicians and orthopedic 
 
         surgeons.  Dr. Hoover had been treating claimant since 1976.  He 
 
         was quite familiar with claimant's history and condition.  
 
         Because of the expertise of Dr. Hoover and Dr. Emerson, greater 
 
         weight is accorded their impairment ratings.  See Reiland v. 
 
         Palco, Inc., Thirty-Second Biennial Report of the Industrial 
 
         commissioner 56 (1975); Dickey v. ITT Continental Baking Company, 
 
         Thirty-Fourth Biennial Report of the Industrial Commissioner 89 
 
         (1979).
 
         
 
              None of the three physicians determines whether any of the 
 
         functional impairment is attributable to claimant's preexisting 
 
         condition.  This, in and of itself, does not make it impossible 
 
         to determine the degree of functional impairment attributable to 
 
         the injury on April 8, 1982.  The undersigned finds that claimant 
 
         is functionally impaired by 30% to the whole man as a result of 
 
         the work injury on April 8, 1982.
 
         
 
              Claimant alleges he is permanently and totally disabled, or 
 
         that in the alternative, claimant alleges he is an odd-lot 
 
         employee under Guyton v. Irving Jensen Co., 373 N.W.2d 101 (Iowa 
 
         1985).  Claimant maintains he has been unable to reenter the 
 
         labor market due to his physical condition and to the pain which 
 
         he is experiencing.  Claimant asserts he is unable to work as a 
 
         substance abuse counselor despite his retraining, because 
 
         claimant will take out his frustrations on the clients.
 
         
 
              Defendants argue that claimant is quite capable of working 
 
         as a substance abuse counselor but claimant has not been 
 
         motivated to seek employment.
 
         
 
              The undersigned finds claimant is not permanently and 
 
         totally disabled, nor is claimant an odd-lot employee under 
 
         Guyton. Claimant has successfully completed a retraining program 
 
         in the area of substance abuse.  Claimant is to be commended.  
 
         Claimant's retraining program has included an internship program 
 
         at a VA hospital.  Claimant, to the satisfaction of his 
 
         supervisors, has completed his internship.  Testimony reveals 
 
         that claimant has been doing substance abuse counseling through 
 
         Alcoholics Anonymous on a volunteer basis.  Claimant, however, 
 
         has failed to make application for any positions, either full or 
 
         part-time, in the area of substance abuse.  No physician has 
 
         stated claimant is incapable of working in this area.  Quite the 
 
         contrary, rehabilitation has taken place.  Treating physicians 
 
         have continuously encouraged claimant to seek employment in this 
 
                                                
 
                                                         
 
         area in hopes that claimant's focus would be transferred from 
 
         himself to his job.  Since claimant is capable of counseling 
 
         chemical dependent individuals, he is not an odd-lot employee 
 
         under Guyton.
 
         
 
              However, claimant has established that he has an industrial 
 
         disability.  This finding is based on:  1) the aforementioned 
 
         considerations; 2) based upon the permanent functional impairment 
 
         ratings assigned by Dr. Hoover, Dr. Emerson, and Dr. Boarini; 3) 
 
         based upon personal observation of claimant; 4) based upon 
 
         claimant's testimony; and, 5) based upon agency expertise, (Iowa 
 
         Administrative Procedures Act 17A.14(s).  Claimant has 
 
         established there is a loss of earning capacity attributable to 
 
         claimant's back injury on April 8, 1982.  Claimant is unable to 
 
         return to any positions in the construction industry where there 
 
         is climbing, twisting, bending or stooping.  Claimant has shown 
 
         there has been a loss of earnings since the injury on April 8, 
 
         1982, and claimant is currently receiving social security 
 
         disability benefits.
 
         
 
              On the other hand, claimant has not been motivated to seek 
 
         employment in his new field as a substance abuse counselor. 
 
         Claimant maintains it is too painful to work.  No physician has 
 
         restricted claimant.  Claimant's physicians have repeatedly 
 
         encouraged him to seek employment.  Then there is the issue of 
 
         claimant's residence.  Claimant lives in Arizona for three to 
 
         four months out of the year.  This is a voluntary decision on his 
 
         part. However, this decision greatly affects claimant's 
 
         employability in Iowa, or in Arizona.  In light of the foregoing, 
 
         it is the decision of the undersigned that claimant, as a result 
 
         of this work related injury, has an industrial disability of 60 
 
         percent.
 
         
 
                     FINDINGS OF FACT AND CONCLUSIONS OF LAW
 
         
 
              WHEREFORE, based on the evidence presented and the 
 
         principles of law previously stated, the following findings of 
 
         fact and conclusions of law are made:
 
         
 
              FINDING 1.  Claimant sustained a back injury arising out of 
 
         and in the course of his employment on April 8, 1982.
 
         
 
              FINDING 2.  Claimant had a long history of prior back 
 
         problems including a laminectomy from a prior work injury.
 
         
 
              CONCLUSION A. As a result of the injury on April 8, 1982, 
 
         claimant has an attributable functional impairment of 30 percent 
 
         of the body as a whole.
 
         
 
              CONCLUSION B.  As a result of preexisting injuries, claimant 
 
         has an attributable functional impairment of 20 percent of the 
 
         body as a whole.
 
         
 
              FINDING 3.  Claimant has been retrained as a substance abuse 
 
         counselor subsequent to his injury on April 8, 1982.
 
                                                
 
                                                         
 
         
 
              CONCLUSION C.  Claimant has met his burden of proving he has 
 
         a 60 percent permanent partial disability attributable to his 
 
         work injury on April 8, 1982.
 
         
 
              FINDING 4.  Claimant was in the healing period from April 8, 
 
         1982 to December 20, 1985.
 
         
 
              CONCLUSION D.  Claimant is entitled to 192.857 weeks of 
 
         healing period benefits at the weekly rate of $280.95 per week.
 
         
 
                                    ORDER
 
         
 
              THEREFORE, defendants are to pay unto claimant three hundred 
 
         (300) weeks of permanent partial disability benefits at the rate 
 
         of two hundred eighty and 95/100 dollars ($280.95) per week.
 
         
 
              Defendants are to pay unto claimant one hundred ninety-two 
 
         point eight-five-seven (192.857) weeks of healing period benefits 
 
         at the rate of two hundred eight and 95/100 dollars ($280.95) per 
 
         week.
 
         
 
              Payments that have accrued shall be paid in a lump sum 
 
         together with statutory interest thereon pursuant to Iowa code 
 
         section 85.30.
 
         
 
              Defendants are to be given credit for all benefits 
 
         previously paid to claimant.
 
         
 
              Costs of this action are assessed against the defendants 
 
         pursuant to Division of Industrial Services Rule 343-4.33.
 
         
 
              Defendants shall file a claim activity report upon payment 
 
 
 
                                    
 
                                                         
 
         of this award.
 
         
 
              Signed and filed this 30th day of March, 1989.
 
         
 
         
 
         
 
         
 
         
 
         
 
                                       MICHELLE A. McGOVERN
 
                                       DEPUTY INDUSTRIAL COMMISSIONER
 
         
 
         Copies To:
 
         
 
         Mr. David Drake
 
         Attorney at Law
 
         West Towers Office
 
         1200 35th St., STE 500
 
         West Des Moines, Iowa.  50265
 
         
 
         Mr. Glenn Goodwin
 
         Ms. Lorraine J. May
 
         Attorneys at Law
 
         4th Floor Equitable Bldg.
 
         Des Moines, Iowa  50309
 
         
 
         
 
         
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                
 
 
            
 
 
 
                     
 
                          
 
                                            1803
 
                                            Filed March 30, 1989
 
                                            MICHELLE A. McGOVERN
 
         
 
                  BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         DALE E. LARSON,
 
         
 
              Claimant,
 
                                                 File No. 701560
 
         vs.
 
                                                  R E V I E W -
 
         EICHLEAY CORPORATION,
 
                                                R E 0 P E N I N G
 
              Employer,
 
                                                  D E C I S I 0 N
 
         and
 
         
 
         AETNA CASUALTY & SURETY
 
         COMPANY,
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
              Claimant awarded 60 percent industrial disability subsequent 
 
         to injury of claimant's back.  Claimant neglected to return to 
 
         work after having successfully completed a retraining program as 
 
         a substance abuse counselor.
 
         
 
                  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                    BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         DALE ISEMAN,
 
                                                     File No. 701889
 
              Claimant,
 
                                                      R E V I E W -
 
         VS.
 
                                                    R E 0 P E N I N G
 
         AUTOMATIC SPRINKLER
 
         CORPORATION OF AMERICA,                     D E C I S I 0 N
 
         
 
              Employer,
 
         
 
         and
 
         
 
         KEMPER INSURANCE COMPANY,
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
         
 
                              STATEMENT OF THE CASE
 
         
 
              This is a proceeding in review-reopening brought by Dale 
 
         Iseman, claimant, against Automatic Sprinkler Corporation of 
 
         America, employer, hereinafter referred to as ASC, and Kemper 
 
         Insurance Company, insurance carrier, defendants, for further 
 
         benefits as a result of an injury on May 3, 1982.  A memorandum 
 
         of agreement for this injury was filed on June 4, 1982.  On 
 
         December 30, 1986 a hearing was held on claimant's petition and 
 
         the matter was considered fully submitted at the close of this 
 
         hearing.
 
         
 
              Claimant is alleging in this proceeding that he is 
 
         permanently injured as a result of an injury to both of his 
 
         wrists from a fall while working for ASC and is seeking permanent 
 
         disability benefits in this proceeding.  Defendants agree that 
 
         they are liable for an injury in this case and that the injury 
 
         caused both temporary and permanent disability, but disagrees as 
 
         to the extent of permanent disability benefits to which claimant 
 
         is entitled.
 
         
 
              The parties have submitted a prehearing report of 
 
         contested issues and stipulations which was approved and 
 
         accepted as a part of the record of this case at the time of 
 
         hearing.  Oral testimony was received during the hearing from 
 
         claimant.  The exhibits received into the evidence at the time 
 
         of hearing are listed in the prehearing report.  All of the 
 
         evidence received at the hearing was considered in arriving at 
 

 
         
 
         
 
         
 
         ISEMAN V. AUTOMATIC SPRINKLER CORP.OF AMERICA
 
         Page   2
 
         
 
         
 
         this decision.
 
         
 
              The prehearing report contains the following 
 
         stipulations:
 
         
 
              1.  On May 3, 1982 claimant received an injury which arose 
 
         out of and in the course of his employment with ASC;
 
         
 
              2.  Claimant is entitled to healing period benefits from 
 
         May 4, 1982 through July 3, 1985 and the commencement date for 
 
         permanent disability benefits in this case shall be July 4, 
 
         1985; and,
 
         
 
              3.  Claimant's rate of weekly compensation in the event of 
 
         an award of weekly benefits from this proceeding shall be 
 
         $359.12.
 
         
 
              The prehearing report submits only the issue of the extent 
 
         of claimant's entitlement to permanent disability benefits for 
 
         determination in this decision.
 
         
 
                              FINDINGS OF FACT
 
         
 
              1.  Claimant was a credible witness.
 
         
 
              Claimant's appearance and demeanor at the hearing indicated 
 
         that he was testifying in a candid and truthful manner.
 
         
 
              2.  Claimant has been employed by ASC since March 1974 as a 
 
         pipe fitter foreman.
 
         
 
              Claimant was a working foreman.  In addition to his duties 
 
         as a journeyman pipe fitter, claimant was responsible for 
 
         directing the work of his crew and insuring that proper materials 
 
         were available.  Claimant stated in his testimony that he set the 
 
         pace for his fellow workers.  Claimant described pipe fitting as 
 
         "back breaking," heavy work which involved the installation of 
 
         air and water pipes for sprinkler systems.  The materials were at 
 
         times very heavy and much of the work was performed above ground, 
 
         usually in excess of twenty to twenty-five feet.  Pipe fitters 
 
         are required to work both from ladders and power lifts.  At the 
 
         time of the work injury, claimant was earning approximately 
 
         $17.70 per hour.
 
         
 
              3.  As stipulated, on May 3, 1982 claimant suffered an 
 

 
         
 
         
 
         
 
         ISEMAN V. AUTOMATIC SPRINKLER CORP.OF AMERICA
 
         Page   3
 
         
 
         
 
         injury which arose out of and in the course of his employment 
 
         with ASC.
 
         
 
              Claimant's credible testimony and his medical records 
 
         submitted into the evidence established that on the alleged 
 
         injury date, claimant was working above ground on a boom of a 
 
         power lift when he fell approximately twenty feet onto a hard 
 
         "concrete like" surface crushing both of his wrists and injuring 
 
         his face.  The wrists injuries are described by his primary care 
 
         physician, Thomas L. Von Gillern, M.D., an orthopedic surgeon, as 
 
         "bilateral comminuted intra-articular distal radial fractures
 
         with wrist dislocations."  After the injury, both of claimant's 
 
         arms were placed into hard casts extending from the hand to the 
 
         elbow.
 
         
 
              4.  As stipulated, the work injury was a cause of a 
 
         temporary period of total disability while claimant was 
 
         recovering from the injury from May 4, 1982 through July 3, 
 
         1985.
 
         
 
              Recovery from the injury was very slow.  Although his face 
 
         "healed pretty much" according to claimant's testimony, his 
 
         wrists have been a continuous problem since the date of injury.  
 
         Claimant developed post traumatic arthritis in both wrists which 
 
         was worse on the left side.  Claimant underwent several surgical 
 
         procedures, the last of which involved a complete fusion of the 
 
         left wrist.  Although Dr. Von Gillern wishes to hold off a fusion 
 
         of the right wrist at the present time, the doctor states that in 
 
         all likelihood such a fusion will be necessary in the future.  
 
         Upon a release to work "on a trial basis" by Dr. Von Gillern, 
 
         claimant returned to pipe fitting work in the summer of 1986.
 
         
 
              5.  The work injury of May 3, 1982 was a cause of a fifty 
 
         three (53) percent permanent partial impairment to claimant's 
 
         body as a whole as a result of a functional loss of his right and 
 
         left arms.
 
         
 
              No previous medical history of any wrist or arm problems or 
 
         permanent impairment of either arms was offered into the evidence 
 
         of this case.  Claimant's credible testimony and the personal 
 
         observations of the movement of claimant's wrists at the time of 
 
         hearing by this deputy commissioner established that the loss of 
 
         use of claimant's wrists and arms is very severe.  Claimant has 
 
         permanent loss not only in the movement of the wrists but in 
 
         strength and dexterity of the hands and arms.  Pain from 
 
         arthritis and cold weather is a chronic problem which will 
 
         probably never subside during the rest of claimant's life and 
 
         work activity only aggravates this pain.  Claimant is under a 
 
         permanent restriction against heavy work and heavy use of his 
 
         arms and hands according to his physician, Dr. Von Gillern.
 
         
 
              The finding as to the specific percentage of functional 
 
         calculated using the impairment ratings of the offering opinions 
 
         as to functional impairment in Von Gillern.  Dr. Von Gillern 
 
         rated claimant as a thirty-six percent body as a whole impairment 
 
         his left extremity problems and twenty-seven body as a whole 
 
         impairment from his right extremity problems.  Unfortunately, Dr. 
 
         Von Gillern did not give a total body as a whole impairment 
 
         rating.  It therefore was necessary to use the Guidelines for 
 

 
         
 
         
 
         
 
         ISEMAN V. AUTOMATIC SPRINKLER CORP.OF AMERICA
 
         Page   4
 
         
 
         
 
         Evaluating Functional Impairment published by the American 
 
         Medical Association, Third Edition, which was officially noticed 
 
         at the request of the parties to impairment was only physician 
 
         this case,
 
         
 
         Dr. suffering from as a result of percent of the arrive at a 
 
         workable combined value figure of fifty-three percent of the body 
 
         as a whole, using the combined value chart in exhibit 10.
 
         
 
              Defendants in their brief argue that Dr. Von Gillern used 
 
         the AMA Guidelines improperly in calculating the body as a whole 
 
         impairments from the extremity problems.  Defendants point out 
 
         that in exhibit 1, Dr. Von Gillern rates the left upper extremity 
 
         as twenty-seven percent and the right upper extremity as twenty 
 
         percent which converts under the AMA Guidelines to a sixteen 
 
         percent and twelve percent body as a whole impairment 
 
         respectively.  Defendants, however, take issue with Dr. Von 
 
         Gillern's addition of twenty percent body as a whole impairment 
 
         for additional functional loss to the extremity due to a loss of 
 
         strength.  Defendants contend that under the guidelines, the 
 
         additional twenty percent impairment to the extremities under the 
 
         applicable table set forth in the guidelines would result in an 
 
         additional body as a whole impairment of only twenty-four 
 
         percent, not forty percent as the doctor calculates in his 
 
         report.
 
         
 
              Defendants' argument was rejected.  First, the doctor at no 
 
         time states in his written reports that he relied upon the AMA 
 
         Guidelines for his ratings and his failure to strictly adhere to 
 
         such guidelines is not dispositive of this issue.  As will be 
 
         noted in the conclusions of law section of this decision, the AMA 
 
         Guidelines are not the only guidelines recognized by this agency 
 
         as aids to arrive at impairment ratings.  Secondly, loss of 
 
         strength due to nerve loss is dealt with in chapter 2, pages 61 
 
         through 84 of the AMA Guidelines, an entirely different section 
 
         than that which was reproduced in exhibit 10.  After careful 
 
         review of chapter 2 by this deputy commissioner, a rating of 
 
         impairment for nerve loss in addition to loss of motion is 
 
         certainly not as clear as defendants contend in their brief.  
 
         Finally, the views of Dr. Von Gillern are the only opinions 
 
         offered in this case as to the extent of claimant's functional 
 
         impairment.  This deputy commissioner has neither the desire nor 
 
         the authority to "second guess" an experienced orthopedic surgeon 
 
         as to the rating of functional impairment for an orthopedic 
 
         problem without at least some other medical authority pointing 
 
         out the alleged error of Dr. Von Gillern's methodology.
 
         
 
              6.  A finding could not be made that the work injury of May 
 
         3, 1987 was a cause of a total loss of earning capacity.
 
         
 
              There is little question that, measured industrially, 
 
         claimant has a very severe loss of earning capacity as a result 
 
         of the work injury.  After reasonable efforts, claimant has been 
 
         unable to locate work more suited to his disability.  However, 
 
         given the law of this case, the only issue before this deputy 
 
         commissioner is whether or not the claimant has a total, not a 
 
         partial, loss of earning capacity.  Given the evidence in this
 
         
 
         case, a finding of a total loss of earning capacity could not be 
 

 
         
 
         
 
         
 
         ISEMAN V. AUTOMATIC SPRINKLER CORP.OF AMERICA
 
         Page   5
 
         
 
         
 
         made.
 
         
 
              Since the summer of 1986, claimant has been able to overcome 
 
         his severe injuries and return to substantially the same work he 
 
         was performing at the time of the work injury.  Claimant was 
 
         unemployed at the time of hearing only because of a temporary 
 
         layoff due to lack of available work.  Claimant fully expected to 
 
         return to work within a few weeks.  Admittedly, claimant is 
 
         unable to perform many of the work tasks that he was able to 
 
         perform before May 1982, but through assistance from,fellow 
 
         employees and accommodations by his employers, he is able to 
 
         function as a pipe fitter.  Claimant is credible when he states 
 
         that he does not know how much longer he will be able to function 
 
         in this job.  However, when and if his employability status 
 
         changes, this agency can review such a change in status at that 
 
         time to determine the effect such a change would have upon his 
 
         earning capacity.  Also, it is noted that Dr. Von Gillern 
 
         believes that claimant will have to undergo further surgery on 
 
         his right hand.  If the surgery occurs, this agency can review 
 
         the effects of such a surgery on his earning capacity at that 
 
         time as well.  It should be noted that this decision makes no 
 
         attempt to measure claimant's disability should this second wrist 
 
         fusion take place.
 
         
 
              Claimant has suffered a loss in actual earnings from 
 
         employment due to,his work injury, but at the present time 
 
         claimant earns only approximately $1.00 or $2.00 less per hour 
 
         than he would be earning as a full working foreman.
 
         
 
              Claimant is forty-one years of age, has earned his GED, and 
 
         exhibited average intelligence at the hearing.  His lack of 
 
         formal education indicates a low potential for successful 
 
         vocational rehabilitation.  However, he has experience as a first 
 
         level supervisor which can be transferrable to new lines of 
 
         industry.  Claimant has not demonstrated a prima facie case that 
 
         the services he can perform are so limited in quality, quantity, 
 
         and dependability that a reasonable, stable market for them does 
 
         not exist.
 
         
 
                                CONCLUSIONS OF LAW
 
         
 
              In this case there was no controversy raised by the parties 
 
         concerning the applicable law to be followed in determination of 
 
         the issue.  The foregoing findings of fact were made under the 
 
         following principles of law.
 
         
 
              Claimant must establish by a preponderance of the evidence 
 
         the extent of weekly benefits for permanent disability to which 
 
         he is entitled.  As claimant has shown that the work injury 
 
         involved a permanent impairment to two upper extremities from a 
 
         single accident, the extent of disability is measured pursuant to 
 
         Iowa Code section 85.34(2)(s).  Measurement of claimant's 
 
         entitlement to disability benefits under this subsection is 
 
         peculiar.  Normally, if the injury is only to a single extremity, 
 
         the amount of disability is measured only functionally as a 
 
         percent of loss of use.  This percentage of loss of use is then 
 
         multiplied by the maximum allowable weeks of compensation set 
 
         forth in the specific subsections in 85.34(2)(a-r) to arrive at 
 
         the permanent disability benefit entitlement.  These disabilities 
 

 
         
 
         
 
         
 
         ISEMAN V. AUTOMATIC SPRINKLER CORP.OF AMERICA
 
         Page   6
 
         
 
         
 
         are termed "scheduled member" disabilities.  Barton v. Nevada 
 
         Poultry Co., 253 Iowa 285, 110 N.W.2d 660 (1961).  "Loss of use" 
 
         of a member is equivalent to "loss" of the member.  Moses v. 
 
         National Union C.M. Co., 194 Iowa 819, 184 N.W. 746 (1922).  For 
 
         all other injuries, including those involving injuries to the 
 
         body as a whole, the degree of permanent disability must be 
 
         measured pursuant to Iowa Code section 85.34(2)(u).  However, 
 
         unlike scheduled member disabilities, the degree of disability 
 
         under this provision is not measured solely by the extent of a 
 
         functional impairment or loss of use of a body member.  A 
 
         disability to the body as a whole or an "industrial disability" 
 
         is a loss of earning capacity resulting from the work injury.  
 
         Diederich v. Tri-City Railway Co., 219 Iowa 587, 593, 258 N.W. 
 
         899 (1935).  A physical impairment or restriction on work 
 
         activity may or may not result in such a loss of earning 
 
         capacity.  The extent to which a work injury and a resulting 
 
         medical condition has resulted in industrial disability is 
 
         determined from examination of several factors.  These factors 
 
         include the employee's medical condition prior to the injury, 
 
         immediately after the injury, and presently; the situs of the 
 
         injury, its severity, and the length of healing period; the work 
 
         experience of the employee prior to the injury, after the injury, 
 
         and potential for rehabilitation; the employee's qualifications 
 
         intellectually, emotionally, and physically; earnings prior and 
 
         subsequent to the injury; age; education; motivation; functional 
 
         impairment as a result of the injury; and, inability because of 
 
         the injury to engage in employment for which the employee is 
 
         fitted.  Loss of earnings caused by a job transfer for reasons 
 
         related to injury are also relevant.  Olson v. Goodyear Service 
 
         Stores, 225 Iowa 1112, 1121, 125 N.W.2d 251, 257 (1963); Peterson 
 
         v. Truck Haven Cafe, Inc., (Appeal Decision Filed February 28, 
 
         1985).
 
         
 
              Under Iowa Code section 85.34(2)(s), if the industrial 
 
         disability is partial, then the extent of the permanent 
 
         disability benefit entitlement is measured only functionally as a 
 
         percentage of loss of use to each extremity which is then 
 
         converted by medical opinion into a percentage of the body as a 
 
         whole and combined together into one body as a whole value.  If 
 
         it is found that the industrial disability is total, or in other 
 
         words, a total loss of earning capacity is found to have occurred 
 
         from a loss of two extremities, then claimant is entitled to 
 
         permanent total disability benefits under Iowa Code section 
 
         85.34(3).  See
 
         
 
         
 
         
 
         
 
         Simbro v. DeLong's Sportswear, 332 N.W.2d 886 (Iowa 1983); 
 
         Burgett v. Man an So Corp., III Iowa Industrial Commissioner 
 
         Report 38 (Appeal Decision 1982).
 
         
 
              In the case sub judice, the findings of fact concerning 
 
         functional impairment mentions that the AMA Guidelines are not 
 
         the only guidelines considered by this agency in evaluating 
 
         functional impairments.  Division of Industrial Services Rule 
 
         343-2.4 (formerly Industrial Commissioner Rule 500-2.4) states as 
 
         follows:
 
         
 

 
         
 
         
 
         
 
         ISEMAN V. AUTOMATIC SPRINKLER CORP.OF AMERICA
 
         Page   7
 
         
 
         
 
              The Guides to the Evaluation of Permanent Impairment 
 
              published by the American Medical Association are adopted as 
 
              a guide for determining permanent partial disabilities under 
 
              section 85.34(2) "aO - "r" of the Code....Nothing in this 
 
              rule shall be construed to prevent the presentations of 
 
              other medical opinion or guides for the purpose of 
 
              establishing that the degree of permanent impairment to 
 
              which the claimant would be entitled would be more or less 
 
              than entitlement indicated in the AMA guide.
 
         
 
              In the case sub judice, it could not be found that claimant 
 
         had suffered a total loss of earning capacity as a result of the 
 
         May 1982 injury.  Consequently, the extent of claimant's 
 
         entitlement to permanent disability benefits was measured solely 
 
         functionally.  Based upon a finding of a combined fifty-three 
 
         percent impairment to the body as a whole as a result of the 
 
         permanent injuries to two scheduled members, claimant is entitled 
 
         as a matter of law to 265 weeks of permanent partial disability 
 
         benefits under Iowa Code section 85.34(2)(s) which is fifty-three 
 
         percent of the 500 weeks allowable for a simultaneous injury to 
 
         two extremities in that subsection.
 
         
 
                                      ORDER
 
         
 
              IT IS THEREFORE ORDERED as follows:
 
         
 
              1.  Defendants shall pay to claimant two hundred sixty-five 
 
         (265) weeks of permanent partial disability benefits at the rate 
 

 
         
 
         
 
         
 
         ISEMAN V. AUTOMATIC SPRINKLER CORP.OF AMERICA
 
         Page   8
 
         
 
         
 
         of three hundred fifty-nine and 12/100 dollars ($359.12) per week 
 
         from July 4, 1985.
 
         
 
              2.  Defendants shall pay accrued weekly benefits in a lump 
 
         sum and shall receive credit against this award for all weekly 
 
         benefits previously paid.
 
         
 
              3.  Defendants shall pay interest on benefits awarded herein 
 
         as set forth in Iowa Code section 85.30.
 
         
 
         
 
         
 
         
 
              4.  Defendants shall pay the costs of this action pursuant 
 
         to Division of Industrial Services Rule 343-4.33 (formerly 
 
         Industrial Commissioner Rule 500-4.33).
 
         
 
              5.  Defendants shall file activity reports on the payment of 
 
         this award as requested by this agency pursuant to Division of 
 
         Industrial Services Rule 343-3.1 (formerly Industrial 
 
         Commissioner Rule 500-3.1).
 
         
 
              Signed and filed this 27th day of February, 1987.
 
         
 
         
 
         
 
         
 
                                            LARRY P. WALSHIRE
 
                                            DEPUTY INDUSTRIAL COMMISSIONER
 
         
 
         
 
         Copies To:
 
         
 
         Mr. Daniel Churchill
 
         Attorney at Law
 
         1610 Fifth Avenue
 
         Moline, Illinois 61265
 
         
 
         Mr. Roger A. Lathrop
 
         Ms. Vicki L. Seeck
 
         Attorneys at Law
 
         600 Union Arcade Bldg.
 
         111 E. Third Street
 
         Davenport, Iowa 52801
 
         
 
         
 
         
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                                              1803
 
                                              Filed:  February 27, 1987
 
                                              LARRY P. WALSHIRE
 
         
 
                     BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         DALE ISEMAN,
 
                                                  File No. 701889
 
              Claimant,
 
                                                    R E V I E W -
 
         VS.
 
                                                  R E 0 P E N I N G
 
         AUTOMATIC SPRINKLER
 
         CORPORATION OF AMERICA,                   D E C I S I 0 N
 
         
 
              Employer,
 
         
 
         and
 
         
 
         KEMPER INSURANCE COMPANY,
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
         
 
         
 
         
 
         1803
 
         
 
              Citing a prior agency precedent, it was held that 
 
         entitlement to permanent total disability benefits under Iowa 
 
         Code section 85.34(2)(s) is measured industrially, but if a total 
 
         loss of earning capacity cannot be found, entitlement to 
 
         permanent disability benefits is then measured solely 
 
         functionally using the Simbro v. DeLong's Sportswear standard.  
 
         However, in the case at bar, a total loss of earning capacity was 
 
         not found and based upon the uncontroverted views of the treating 
 
         physician, claimant was awarded disability benefits for a 
 
         fifty-three percent body as a whole functional impairment as a 
 
         result of simultaneous injuries to claimant's wrists.