BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
        
 
        
 
        LUCILLE A. SCHULTZ,
 
        Individually and as Executor
 
        of the Estate of
 
        Edwin A. Schultz,                   File No. 752752
 
        
 
            Claimant,                         A P P E A L
 
        
 
        vs.                                  D E C I S I O N
 
        
 
        DUNHAM-BUSH, INC.
 
        
 
            Employer,
 
            Self-Insured,
 
            Defendant.
 
        
 
        
 
                                 STATEMENT OF THE CASE
 
        
 
        Defendant appeals from an arbitration and death benefits decision 
 
        awarding claimant death benefits, temporary total disability 
 
        benefits, medical expenses, and burial expenses from an injury on 
 
        November 14, 1983. The record on appeal consists of the 
 
        transcript of the hearing; joint exhibits 1 through 20; 
 
        claimant's exhibits A and B; and defendant's exhibit I. Both 
 
        parties filed briefs on appeal.
 
        
 
                                      ISSUE
 
        
 
        The issue on appeal is whether there is a causal connection 
 
        between the work injury of November 14, 1983 and claimant's 
 
        decedent's death.
 
        
 
                                 REVIEW OF THE EVIDENCE
 
        
 
        The arbitration and death benefits decision adequately and 
 
        accurately reflects the pertinent evidence and it will not be set 
 
        forth herein.
 
        
 
                                 APPLICABLE LAW
 
        
 
        The citations of law in the arbitration and death benefits 
 
        decision are appropriate to the issues and evidence.
 
        
 
                                      ANALYSIS
 
        
 
        The analysis of the deputy in conjunction with the issues and 
 
        evidence presented is adopted.
 
        
 
        SCHULTZ v. DUNHAM-BUSH, INC.
 
        Page 2
 
        
 
        
 
        The findings of fact, conclusions of law, and order of the deputy 
 
        in the arbitration and death benefits decision dated November 23, 
 
        1987 are adopted herein.
 
        
 
                                 FINDINGS OF FACT
 
        
 
        1. Decedent experienced back pain on November 14, 1983 after he 
 
        had lifted a large impeller in the course of his duties as a 
 

 
        
 
 
 
 
 
        machine operator for employer, Dunham-Bush Company.
 
        
 
        2. Decedent had prior back complaints and had done Williams 
 
        exercises on a regular basis since 1971.
 
        
 
        3. Decedent sought no medical treatment in the immediate interval 
 
        following the November 14, 1983 incident.
 
        
 
        4. Decedent continued to have difficulties through December 6, 
 
        1983 for which decedent's spouse treated him-with back rubs. 
 
        Decedent also continued to do his Williams exercises.
 
        
 
        5. Decedent's spouse was a credible witness.
 
        
 
        6. An impeller weighs approximately 75-80 pounds and is 14 inches 
 
        in diameter and three inches thick.
 
        
 
        7. On December 6, 1983, decedent changed a chuck on a turret 
 
        lathe in the morning.
 
        
 
        8. A chuck weighs approximately 75 pounds. Lifting is
 
        required in changing a chuck.
 
        
 
        9. Decedent did not have symptoms immediately following lifting 
 
        the chuck. Little apparent significance was attached to the 
 
        lifting of the chuck.
 
        
 
        10. Upon rising from a seated position at the end of his work 
 
        break on the morning of December 6, 1983, decedent experienced 
 
        leg numbness and foot drop.
 
        
 
        11. Decedent subsequently sought medical treatment and was off 
 
        work from December 15, 1983 through February 13, 1984.
 
        
 
        12. Decedent returned to work until his May 3, 1985 retirement 
 
        without restriction and apparently at the same duties he had held 
 
        prior to the development of his back and leg condition.
 
        
 
        14. Decedent continued to experience numbness and foot drop while 
 
        myelographic studies and CT scan studies indicated a herniated 
 
        disc at L4-5.
 
        
 
        15. On August 21, 1985, decedent entered the hospital where Dr. 
 
        Brodersen performed a laminectomy on August 22, 1985.
 
        
 
        SCHULTZ v. DUNHAM-BUSH, INC.
 
        Page 3
 
        
 
        
 
        16. On September 5, 1985, decedent had fever, shortness of breath 
 
        and complaints of chest pain.
 
        
 
        17. On September 7, 1985, decedent died.
 
        
 
        18. An autopsy revealed clots in the pulmonary artery with one 
 
        clot representing a fusion of two smaller clots indicating that 
 
        the clot was from a small vein, probably in the upper leg or 
 
        pelvis.
 
        
 
        19. Blood clots are known complications of surgery in the leg or 
 
        pelvic area, especially in older persons.
 
        
 
        20. Decedent was born July 30, 1919.
 
        
 
        21. Dr. Summers is a board-certified neurologist with long-term 
 
        expertise in that field as well as experience in orthopaedics.
 

 
        
 
 
 
 
 
        
 
        22. Dr. Brodersen is a board-certified orthopaedic surgeon who 
 
        has substantially Less experience than has Dr. Summers.
 
        
 
        23. Decedent's disc herniation was proximately caused by his 
 
        November 14, 1983 work incident.
 
        
 
        24. Decedent's laminectomy was occasioned by his disc herniation.
 
        
 
        25. Decedent's death was caused by bilateral pulmonary emboli due 
 
        to his laminectomy.
 
        
 
        26. Decedent was off work and unable to seek other employment on 
 
        account of his work-related injury from August 21, 1985 until his 
 
        September 7, 1985 death.
 
        
 
        27. Lucille Schultz is the surviving spouse of decedent.
 
        
 
        28. Medical expenses to Glendon D. Button, M.D., Mach Ambulance 
 
        Service, Mary Greeley Medical Center and Marshalltown Medical 
 
        Center relate to decedent's work-related injury.
 
        
 
        29. Decedent's reasonable burial expenses exceeded $1,000.
 
        
 
                                 CONCLUSIONS OF LAW
 
        
 
        Decedent received an injury which arose out of and in the course 
 
        of decedent's employment on November 14, 1983.
 
        
 
        The injury of November 14, 1983 was a proximate cause of 
 
        decedent's disability and his ensuing death.
 
        
 
        SCHULTZ v. DUNHAM-BUSH, INC.
 
        Page 4
 
        
 
        
 
        Decedent's estate is entitled to payment of temporary total 
 
        disability benefits from August 21, 1985 through September 7, 
 
        1985.
 
        
 
        Decedent's surviving spouse is entitled to benefits as provided 
 
        in section 85.31(1)(a).
 
        
 
        Decedent's claimant is entitled to payment of medical costs as 
 
        enumerated in the order below.
 
        
 
        Decedent's claimant is entitled to payment of reasonable burial 
 
        expenses in the amount of $1,000.
 
        
 
        WHEREFORE, the decision of the deputy is affirmed.
 
        
 
                                      ORDER
 
        
 
        THEREFORE, it is ordered:
 
        
 
        That defendant pay claimant as surviving spouse of decedent Edwin 
 
        A. Schultz benefits as provided in section 85.31(1)(a) at the 
 
        rate of two hundred twenty-one and 42/100 dollars ($221.42) per 
 
        week.
 
        
 
        That defendant pay claimant as executor of the estate of Edwin A. 
 
        Schultz temporary total disability benefits from August 21, 1985 
 
        through September 7, 1985 at the rate cf two hundred twenty-one 
 
        and 42/100 dollars ($221.42).
 
        
 
        That defendant pay medical expenses as follows:
 

 
        
 
 
 
 
 
        
 
                  Glendon D. Button, M.D.       $257.50
 
                  Mach Ambulance Service         372.00
 
                  Mary Greeley Medical Center    286.00
 
                  Marshalltown Medical Center     35.00
 
        
 
        That defendant pay claimant reasonable burial expenses in the 
 
        amount of one thousand dollars ($1,000).
 
        
 
        That defendant pay accrued amounts in a lump sum.
 
        
 
        That defendant pay interest pursuant to section 85.30 as amended.
 
        
 
        That defendant pay costs of this proceeding including the cost of 
 
        transcription of the hearing pursuant to Division of Industrial 
 
        Services Rule 343-4.33.
 
        
 
        That defendant file claim activity reports as requested by the 
 
        agency.
 
        
 
        SCHULTZ v. DUNHAM-BUSH, INC.
 
        Page 5
 
        
 
        
 
        Signed and filed this 31st day of October, 1988.
 
        
 
        
 
        
 
                                         DAVID E. LINQUIST
 
                                      INDUSTRIAL COMMISSIONER
 
        
 
        
 
 
         
 
 
 
 
 
 
 
 
 
 
 
                     BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         LARRY VAN WINKLE,
 
         
 
              Claimant,
 
         
 
         VS.
 
         
 
                                         File No. 752893
 
         
 
         GROWMARK, INC.,
 
         
 
                                         A R B I T R A T I 0 N
 
         
 
              Employer,
 
         
 
                                         D E C I S I 0 N
 
         
 
         and
 
         
 
         AMERICAN MUTUAL INSURANCE
 
         COMPANY,
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
                                   INTRODUCTION
 
                                        
 
              This is a proceeding in arbitration brought by Larry Van 
 
         Winkel against Growmark, Inc., his employer, and American Mutual 
 
         Insurance Company.
 
         
 
              The case was heard and fully submitted at Des Moines, Iowa 
 
         on March 7, 1988.  The record in this proceeding consists of 
 
         testimony from Larry Van Winkel and Kevin Little.  Jointly 
 
         offered exhibits A through 0 were received into evidence.
 
         
 
                                      ISSUES
 
                                        
 
              The issues identified for determination at the time of 
 
         hearing are whether claimant sustained an injury on November 28, 
 
         1983 which arose out of and in the course of his employment; 
 
         whether the alleged injury is a cause of temporary or permanent 
 
         disability; and, determination of the claimant's entitlement to 
 
         compensation for permanent partial disability.  In their 
 
         post-hearing brief, however, defendants agreed that Van Winkel 
 
         was injured on November 28, 1983 in the manner in which he had 
 
         alleged.  It was stipulated that, in the event of an award, the 
 
         claimant's entitlement to healing period compensation was 74 1/7 
 
         weeks and that compensation for permanent partial disability 
 
         became payable commencing on July 1, 1985.  The rate of 
 
         compensation was stipulated to be $343.70 per week.  It was 
 
         stipulated that defendants had paid 74 1/7 weeks of compensation 
 
         for healing period and 50 weeks of compensation for permanent 
 
         partial disability prior to hearing.
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
         
 
         
 
         VAN WINKLE V. GROWMARK, INC.
 
         Page 2
 
         
 
         
 
                               SUMMARY OF EVIDENCE
 
         
 
              The following is a summary of evidence presented in this 
 
         case.  Of all the evidence received at the hearing, only that 
 
         considered most pertinent to this decision is discussed.  
 
         Conclusions about what the evidence showed are inevitable with 
 
         any summarization.  The conclusions in the following summary 
 
         should be considered to be preliminary findings of fact.
 
         
 
              Larry Van Winkel is a 45-year-old, married man who has three 
 
         dependent children.  Van Winkel ended his formal education during 
 
         the ninth grade.  Van Winkel served in the Navy as.a deck hand 
 
         and gunner's mate for three and one-half years.  Van Winkel's 
 
         work experience consists primarily of truck driving.
 
         
 
              Van Winkel initially could not recall experiencing any 
 
         injuries to his back prior to the injury of November 28, 1983.  
 
         Upon detailed questioning, Van Winkel did recall some other 
 
         incidents of injury, but stated that none of them caused any 
 
         permanent disability.
 
         
 
              Van Winkel testified that, on November 28, 1983, he slipped 
 
         on wet snow while making a delivery of fuel at Alden, Iowa.  Van 
 
         Winkel stated that he experienced the onset of a dull pain in his 
 
         back and reported the incident to his dispatcher when he returned 
 
         to Des Moines.
 
         
 
              Van Winkel consulted his physician, Gregory L. Ingle, D.O., 
 
         and was taken off work.  Claimant was seen by a number of 
 
         physicians.  Martin S. Rosenfeld, M.D., indicated in December, 
 
         1983 that claimant had resolving left sciatica (exhibit G).  In 
 
         February, 1984, David B. McClain, D.O., confirmed that diagnosis 
 
         (exhibit E).  Claimant was seen by Dante R. Toriello, D.O., 
 
         commencing in March, 1984.  A CT scan which was performed was 
 
         interpreted as being normal (exhibit F).  Dr. Toriello felt that 
 
         claimant had an L4 and L5 radiculopathy (exhibit D).
 
         
 
              Claimant commenced treatment with Kent M. Patrick, M.D., in 
 
         May, 1984.  Dr. Patrick reviewed the earlier CT scan and found it 
 
         to be of such a poor quality that it would not be reliable 
 
         (exhibit J, page 2).  Claimant continued to treat with Dr. 
 
         Patrick.  A second CT scan was performed which was interpreted as 
 
         showing a herniated L5-Sl intervertebral disc.  Dr. Patrick 
 
         indicated that claimant had a ten percent impairment of the body 
 
         as a whole due to the disc and that the impairment was the same 
 
         as what would exist if claimant had surgical excision of the disc 
 
         with a good result (exhibit J, report dated September 20, 1985).
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
              Claimant has been treated conservatively throughout this 
 
         matter.  Dr. Patrick has indicated that surgery would be 
 
         warranted if the frequency or duration of aggravations which Van 
 
         Winkel occasionally experiences were to increase substantially.
 
         
 
         
 
         
 
         VAN WINKLE V. GROWMARK, INC.
 
         Page 3
 
         
 
         
 
              Van Winkel continues to function as a truck driver for 
 
         Growmark, Inc.  Wages with the employer have been frozen since 
 
         the time of injury and claimant earns the same now as he earned 
 
         at the time of injury.  Claimant has been able to perform all the 
 
         duties of his employment, although he has had subsequent 
 
         aggravations which have caused him to miss work and seek medical 
 
         treatment.  Claimant drives a truck which has been equipped with 
 
         a special seat.  Claimant indicated that he would not be able to 
 
         function as a truck driver without the special seat.
 
         
 
              Claimant expressed concern regarding the security of his 
 
         position with Growmark, Inc.  Claimant complained of continuing 
 
         back pain.  He felt that he would be unable to perform several of 
 
         the jobs he had previously held with other employers due to his 
 
         limited bending and lifting abilities.  Claimant stated that he 
 
         would be unable to handle freight on a daily basis, although he 
 
         does so occasionally in his current job.
 
         
 
              Kevin Little, the regional dispatcher for Growmark, Inc., 
 
         stated that it is anticipated that Growmark will continue to use 
 
         employee drivers, such as claimant, rather than increase their 
 
         reliance upon owner-operators.  Little indicated that claimant 
 
         will likely have a job indefinitely into the future.  Little 
 
         testified that he would probably not hire a person with a 
 
         documented herniated disc if he were hiring new employees.
 
         
 
                           APPLICABLE LAW AND ANALYSIS
 
         
 
              By virtue of the agreement with regard to injury arising out 
 
         of and in the course of employment and liability for healing 
 
         period compensation as made in defendants' brief, it is 
 
         determined and established that Larry Van Winkel sustained an 
 
         injury to his back on November 28, 1983 which arose out of and in 
 
         the course of his employment with Growmark, Inc.  It is further 
 
         established that the injury is a proximate cause of a healing 
 
         period of 74 1/7 weeks' duration, which has been fully paid by 
 
         defendants.
 
         
 
              The only remaining issue is determination of the degree of 
 
         permanent partial disability that was proximately caused by the 
 
         injury of November 28, 1983.  The record contains evidence of 
 
         prior injuries, but no evidence which even suggests that any of 
 
         the prior incidents produced any degree of permanent disability.  
 
         Accordingly, all the disability currently found to exist is 
 
         determined to have resulted from the November 28, 1983 injury.
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              As 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
 
         
 
         
 
         
 
         VAN WINKLE V. GROWMARK, INC.
 
         Page 4
 
         
 
         
 
         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."
 
         
 
              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 
 
         v. Goodyear Service Stores, 255 Iowa 1112, 1121 125 N.W.2d 251, 
 
         257 (1963).
 
         
 
              Industrial disability or loss of earning capacity is a 
 
         concept that is quite similar to impairment of earning capacity, 
 
         an element of damage in a tort case.  Impairment of physical 
 
         capacity creates an inference of lessened earning capacity.  The 
 
         basic element to be determined, however, is the reduction in 
 
         value of the general earning capacity of the person, rather than 
 
         the loss of wages or earnings in a specific occupation.  
 
         Post-injury earnings create a presumption of earning capacity.  
 
         The earnings are not synonymous with earning capacity and the 
 
         presumption may be rebutted by evidence showing the earnings to 
 
         be an unreliable indicator.  Carradus v. Lange, 203 N.W.2d 565 
 
         (Iowa 1973); Holmquist v. Volkswagon of America, Inc., 261 N.W.2d 
 
         516 (Iowa App. 1977) A.L.R.3d 143; Michael v. Harrison County, 
 
         34th Biennial Report, 218 (1979): 2 Larson Workmen's Compensation 
 
         Law, sections 57.21 and 57.31.
 
         
 
              It is clear that if Larry Van Winkel were for any reason 
 
         compelled to seek reemployment in the competitive labor market, 
 
         it would be highly unlikely that he could obtain employment which 
 
         would in any way approach the level of earnings that he currently 
 
         experiences with Growmark, Inc.  The employer in this case, by 
 
         continuing Van Winkel's employment, insulated itself from what 
 
         would otherwise likely have been a large award.  Claimant is 
 
         currently working without any medically imposed specific activity 
 
         restrictions, but he is, nevertheless, limited.  He has been 
 
         rated as having a ten percent permanent impairment.  His 
 
         education is quite limited.  The evidence presents no reason to 
 
         suspect that claimant's current state of employment is insecure.  
 
         Industrial disability awards are not made upon speculation as to 
 
         what the future may hold. one thing about the future which is not 
 
         speculative is that the future holds uncertainty.  Industrial 
 
         disability is not precisely the same as wage loss, even though 
 
         wage loss is an important factor in determining the degree of 
 
         industrial disability.  When all the factors of industrial 
 
         disability are considered, it is determined that Larry Van Winkel 
 
         sustained a 20% permanent partial disability as a result of the 
 
         injuries he sustained on November 28, 1983.
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
         
 
         
 
         VAN WINKLE V. GROWMARK, INC.
 
         Page 5
 
         
 
         
 
                                 FINDINGS OF FACT
 
         
 
              1. On November 28, 1983, Larry Van Winkel was a resident of 
 
         the state of Iowa employed by Growmark, Inc., in the state of 
 
         Iowa.
 
         
 
              2. Van Winkel was injured on November 28, 1983 when he 
 
         slipped while unloading the truck that he operated for Growmark, 
 
         Inc.
 
         
 
              3. Following the injury, Van Winkel was medically incapable 
 
         of performing work in employment substantially similar to that he 
 
         performed at the time of injury until July 1, 1985 when he 
 
         returned to work.
 
         
 
              4. Van Winkel has a limited education, but appeared to be of 
 
         at least average intelligence.
 
         
 
              5. Van Winkel has a ten percent impairment of the body as a 
 
         whole as a result of the herniated disc he sustained on November 
 
         28, 1983.
 
              
 
              6. Van Winkel's work experience consists primarily of truck 
 
         driving.
 
         
 
              7. Larry Van Winkel has sustained a 20% permanent partial 
 
         loss of earning capacity as a result of the injuries he sustained 
 
         on November 28, 1983.
 
         
 
                                CONCLUSIONS OF LAW
 
                                        
 
              1.This agency has jurisdiction of the subject matter of this 
 
         proceeding and its parties.
 
         
 
              2. Larry Van Winkel has a 20% permanent partial disability 
 
         which entitles him to receive 100 weeks of compensation under the 
 
         provisions of Code section 85.34(2)(u).
 
         
 
                                      ORDER
 
         
 
              IT IS THEREFORE ORDERED that defendants pay claimant one 
 
         hundred (100) weeks of compensation for permanent partial 
 
         disability at the stipulated rate of three hundred forty-three 
 
         and 70/100 dollars ($343.70) per week payable commencing July 1, 
 
         1985.
 
         
 
              IT IS FURTHER ORDERED that defendants receive credit for the 
 
         fifty (50) weeks of compensation previously paid and that 
 
         remaining unpaid fifty (50) weeks be paid in a lump sum together 
 
         with interest pursuant to Iowa Code section 85.30.
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              IT IS FURTHER ORDERED that defendants.pay the costs of this 
 
         action pursuant to Division of Industrial Services Rule 343-4.33.
 
         
 
         
 
         
 
         VAN WINKLE V. GROWMARK, INC.
 
         Page 6
 
         
 
         
 
              IT IS FURTHER ORDERED that defendants file Claim Activity 
 
         Reports as requested by this agency pursuant to Division of 
 
         Industrial Services Rule 343-3.1.
 
         
 
              Signed and filed this 3rd day of January, 1989.
 
         
 
         
 
         
 
         
 
                                         MICHAEL G. TRIER
 
                                         DEPUTY INDUSTRIAL COMMISSIONER
 
         
 
         
 
         
 
         Copies To:
 
         
 
         Mr. Dennis L. Hanssen
 
         Attorney at Law
 
         Suite 111, Terrace Center
 
         2700 Grand Avenue
 
         Des Moines, Iowa 50312
 
         
 
         Mr. Ross H. Sidney
 
         Ms. Iris J. Post
 
         Attorneys at Law
 
         2222 Grand Avenue
 
         P.O. Box 10434
 
         Des Moines, Iowa 50306
 
         
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
 
         
 
 
 
 
 
 
 
 
 
 
 
                                         1803
 
                                         Filed January 3, 1989
 
                                         MICHAEL G. TRIER
 
         
 
                     BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         LARRY VAN WINKLE,
 
         
 
              Claimant,
 
         
 
         VS.
 
         
 
                                         File No.  752893
 
         GROWMARK, INC.,
 
                                         A R B I T R A T I 0 N
 
              Employer,
 
                                         D E C I S I 0 N
 
         and
 
         
 
         AMERICAN MUTUAL INSURANCE COMPANY,
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
         1803
 
         
 
              Claimant was a 45-year-old truck driver with a ten percent 
 
         permanent partial impairment of the body as a whole due to an 
 
         unoperated herniated lumbar disc.  Claimant was awarded 20% 
 
         permanent partial disability despite the fact that he had 
 
         suffered no actual wage loss due to the employer's action in 
 
         retaining his employment.
 
         
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                     BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         _________________________________________________________________
 
         
 
         ARCHIE ROZELL,
 
         
 
              Claimant,
 
                                                 File No. 753062
 
         VS.
 
                                                   A P P E A L
 
         SIOUX TOOLS, INC.,
 
                                                 D E C I S I 0 N
 
              Employer,
 
         
 
         and
 
         
 
         CNA INSURANCE COMPANIES,
 
              Insurance Carrier,
 
              Defendants.
 
         _________________________________________________________________
 
         
 
         
 
                              STATEMENT OF THE CASE
 
         
 
              Defendants appeal from an arbitration decision awarding 
 
         permanent total disability benefits.
 
         
 
              The record on appeal consists of the hearing transcript; 
 
         claimant's exhibits 1 through 6; and the briefs and filings of 
 
         all parties on appeal.  Defendants' exhibits A and B were 
 
         excluded from the record at the arbitration proceedings.
 
         
 
                                   ISSUES
 
         
 
              Defendants state the following issues on appeal.
 
         
 
              1.  Whether there is a causal relationship between 
 
         claimant's disability and his injury of November 28, 1983.
 
         
 
              2.  The extent of claimant's industrial disability.
 
         
 
              3.  Whether the deputy erred in excluding exhibits A and B.
 
         
 
                          REVIEW OF THE EVIDENCE
 
         
 
              The arbitration decision adequately and accurately reflects 
 
         the pertinent evidence and it will not be totally reiterated 
 
         herein.  Briefly stated, claimant was 64 years old at the time of 
 
         the hearing.  His education consists of completing the eighth 
 
         grade, and he stated that he found school to be "tough."  Since 
 
         the age of 18, claimant has worked at a series of physical labor 
 
         jobs such as farm work, factory work, and service station work, 
 
         all of which involved some degree of lifting, bending or 
 
         stooping.
 
         
 
              Claimant began work with defendant Sioux Tools, Inc., June 
 
         16, 1969, running a degreaser and a polisher.  This job required 
 
         him to lift pans weighing 40 to 50 pounds, as well as to stand, 
 
         stoop and bend.
 
         
 

 
              In 1975, claimant experienced an injury to his back while 
 
         lifting a 50 pound pan.  He underwent fusion surgery for this by 
 
         E.M. Mumford, M.D., and was off work for eight months.  It was 
 
         opined that claimant sustained an eight percent impairment of the 
 
         body as a whole as a result of the 1975 injury.
 
         
 
         He later returned to work and was able to perform his job tasks, 
 
         but was under medical restriction from Dr. Mumford not to lift 
 
         over 40 pounds.
 
         
 
              Claimant stated that he had no further injuries until 
 
         November 28, 1983.  On that date, he was engaged in shoveling 
 
         heavy packed snow.  He described the snow as hardened and icy, 
 
         and shoveling it "just like driving a shovel through cement." 
 
         Claimant shoveled snow for eight hours on November 28, 1983.  He 
 
         testified that he felt his back "catch" during the shoveling and 
 
         felt pain in the same area as the 1975 injury and surgery.
 
         
 
              Claimant also testified that when he returned home after 
 
         work on November 28, 1983, he was still in pain.  On November 29, 
 
         1983, he again shoveled snow for defendant employer.  At 10:00 
 
         a.m., he went home from work due to pain from the shoveling.  
 
         Claimant opined that each shovel of snow he lifted would weigh 
 
         about 25 pounds.
 
         
 
              Claimant made an appointment to see Dr. Mumford, but was not 
 
         seen until December 19, 1983.  He continued to work for Sioux 
 
         Tools until December 16, 1983, but avoided heavy duties and took 
 
         frequent rests.  He has not worked since that date.
 
         
 
              Claimant was hospitalized in January 1984.  At that time, he 
 
         underwent surgery by E.M. Howells, M.D., for a vascular 
 
         insufficiency in both legs and was also treated by Dr. Mumford 
 
         while in the hospital for his back, with a series of injections.  
 
         Claimant testified he had no problems with leg pain prior to 
 
         November 28, 1983.
 
         
 
              Claimant testified that since the injury of November 28, 
 
         1983, he is unable to lift or walk even a short distance without 
 
         pain and needing to rest.  He stated that he has a paralyzing 
 
         "Catch" in his back and has to wear a back brace eight hours 
 
         daily, and when his back catches, he experiences pain in his back 
 
         which also radiates into his legs.  He stated he cannot sit for a 
 
         long period of time or drive a car for more than a short 
 
         distance, experiences cramps, and has pain in the middle of his 
 
         bock without numbness in his hands or arms.  He cannot lift, 
 
         bend, stoop, or stand for over two or three hours.
 
         
 
              Claimant also indicated he knows of no work he can do, and 
 
         that he had contacted the Iowa Department of Job Service one 
 
         month prior to the hearing, but has had no indications of job 
 
         openings.  Claimant states he would prefer to work.  Dr. Mumford 
 
         has not released him to go back to work, and has told him there 
 
         is nothing more he can do for him.
 
         
 
              On July 30, 1984, Dr. Mumford stated:
 
         
 
              It is my impression this man aggravated a preexisting 
 
              degenerative spondylolisthesis and has increased 
 
              instability of the back.  He certainly does have 
 
              disability, some I think because of his vascular 
 
              insufficiency, and some because of the aggravation of 
 
              the low back area.
 
         
 

 
         
 
         
 
         
 
         ROZELL V. SIOUX TOOLS, INC.
 
         Page   3
 
         
 
         
 
              In my opinion he is disabled from doing any heavy work 
 
              and should retire.  As far as the percentage of 
 
              increased disability from the one episode of injury on 
 
              11/29/83, I would state that his impairment has 
 
              probably increased some 10-15% above and beyond his 
 
              previous disability.
 
         
 
              In distinguishing between the amount of impairment caused by 
 
         claimant's back condition as opposed to his vascular 
 
         insufficiency, Dr. Mumford opined on September 25, 1984:
 
         
 
              You asked if he would be able to return to gainful 
 
              employment if his condition were strictly the back.  He 
 
              could return to very sedentary employment at a sitting 
 
              position, but he would not be able to perform any kind 
 
              of activities requiring lifting, stooping or bending.  
 
              Certainly his legs, suffering from some vascular 
 
              insufficiency, do contribute to any activity that he 
 
              might do as far as prolonged walking.  However, his 
 
              back does preclude him from doing anything but a 
 
              sitting type of work.
 
         
 
              On January 4, 1985, Dr. Mumford concluded that claimant 
 
         "from a functional rating, would have 25-30% disability of his 
 
         body on the basis of his back.  This does not include the 
 
         disability due to his vascular insufficiency."
 
         
 
              In regard to the leg surgery of May 31, 1984, Dr. Howells 
 
         stated:
 
         
 
              I have treated Mr. Rozell for arterial insufficiency in 
 
              the lower extremities.  In January of 1984, he 
 
              underwent femoral popliteal bypass for arterial 
 
              insufficiency in the left lower extremity and underwent 
 
              dilatation of an iliac artery on the right side for 
 
              problems of the right lower extremity.  Both of these, 
 
              I think would be considered natural disease and not 
 
              result of accident or complicated by work.
 
         
 
              From the arterial point of view, I would consider his 
 
              disability partial at the present time.
 
         
 
              Testimony was also received from Calvin J. Rathel, an 
 
         interviewer for the Iowa Department of Job Service who 
 
         specializes in job placements for the handicapped.  Rathel 
 
         testified that due to claimant's age, lack of education, and 
 
         impairment, he cannot be "gainfully employed in the State of 
 
         Iowa."  He further opined that he could easier place a blind man 
 
         in a job than he could place claimant.
 
         
 
              Delores Rozell, claimant's wife, testified that since 
 
         November 28, 1983, claimant has frequent discomfort, has trouble 
 
         getting into and out of chairs, and can no longer do yard work or 
 
         help around the house.
 
         
 
              The parties stipulated that the injury arose out of and in 
 
         the course of claimant's employment with defendant employer, and 
 
         that his rate of compensation was $212.86.
 
         
 

 
         
 
         
 
         
 
         ROZELL V. SIOUX TOOLS, INC.
 
         Page   4
 
         
 
         
 
                                APPLICABLE LAW
 
         
 
              The claimant has the burden of proving by a preponderance of 
 
         the evidence that the injury of November 28, 1983 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).
 
         
 
              Under Blacksmith v. All-American, Inc., 290 N.W.2d 348, 354 
 
         (Iowa 1980), a cause is proximate if it-is a substantial factor 
 
         in bringing about the result.  It does not have to be the only 
 
         cause.
 
         
 
              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 Hosp. 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 v. Firestone Tire & Rubber Co., 253 
 
         Iowa 369, 112 N.W.2d 299 (1961); Ziegler v. United States Gypsum 
 
         Co., 252 Iowa 613, 106 N.W.2d 591 (1960).
 
         
 
              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.2d 760-761 (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, 815 (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, 252 Iowa 
 
         613, 620, 106 N.W.2d 591, 595.
 
         
 
              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, 253 Iowa 369, 112 N.W.2d 299; 100 
 

 
         
 
         
 
         
 
         ROZELL V. SIOUX TOOLS, INC.
 
         Page   5
 
         
 
         
 
         C.J.S. Workmen's Compensation 555 (17)a.
 
         
 
              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; Yeager 253 Iowa 369, 112 N.W.2d 
 
         299; Ziegler, 252 Iowa 613, 106 N.W.2d 591.  See also Barz v. 
 
         Oler, 257 Iowa 508, 133 N.W.2d 704 (1965); Almquist, 218 Iowa 
 
         724, 254 N.W. 35.
 
         
 
              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. * * * *
 
         
 
              Functional disability 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 
 
         v.Goodyear Service Stores, 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 later 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 
 

 
         
 
         
 
         
 
         ROZELL V. SIOUX TOOLS, INC.
 
         Page   6
 
         
 
         
 
         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 formula 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).
 
         
 
              An older worker with a relatively low functional disability, 
 
         little education, a history of former employment involving 
 
         physical labor, and restrictions on his present ability to 
 
         perform similar labor, may be totally disabled.  See Diederich, 
 
         219 Iowa 587, 258 N.W. 899.
 
         
 
              Division of Industrial Services Rule 343-4.17 (formerly 
 
         Industrial Commissioner Rule 500-4.17 (1986)) states:
 
         
 
              Each party to a contested case shall serve all medical 
 
              records and reports concerning the injured worker in 
 
              the possession of the party upon each opposing party 
 
              not later than twenty days following filing of an 
 
              answer, or if not then in possession of a party, within 
 
              ten days of receipt.  Medical records and reports are 
 
              records of medical practitioners and institutions 
 
              concerning the injured worker.  Medical practitioners 
 
              and institutions are medical doctors, osteopaths, 
 
              chiropractors, dentists, nurses, podiatrists, 
 
              psychiatrists, psychologists, counselors, hospitals, 
 
              clinics, persons engaged in physical or vocational 
 
              rehabilitation or evaluation for rehabilitation, all 
 
              other practitioners of the healing arts or sciences, 
 
              and all other institutions in which the healing arts or 
 
              sciences are practiced.  Each party shall serve a 
 
              notice accompanying the records and reports identifying 
 
              the records and reports served by the name of the 
 
              practitioner or institution and date of the records and 
 
              reports, and if served later than twenty days following 
 
              filing of the answer, stating the date when the records 
 
              and reports were received by the party serving them.  
 
              Pursuant to 4.14(86), the notice and records and 
 

 
         
 
         
 
         
 
         ROZELL V. SIOUX TOOLS, INC.
 
         Page   7
 
         
 
         
 
              reports shall not be filed with the industrial 
 
              commissioner.  A party failing to comply with the 
 
              provisions of this rule shall, if the failure is 
 
              prejudicial to an opposing party, be subject to the 
 
              provisions of 4.36(86).
 
         
 
              Division of Industrial Services Rule 343-4.36  (formerly 
 
         Industrial Commissioner Rule 500-4.36 (1986))  states:
 
         
 
              If any party to a contested case or an attorney 
 
              representing such party shall fail to comply with these 
 
              rules or any order of a deputy commissioner or the 
 
              industrial commissioner, the deputy commissioner or 
 
              industrial commissioner may dismiss the action.  Such 
 
              dismissal shall be without prejudice.  The deputy 
 
              commissioner or industrial commissioner may enter an 
 
              order closing the record to further activity or 
 
              evidence by any party for failure to comply with these 
 
              rules or an order of a deputy commissioner or the 
 
              industrial commissioner.
 
         
 
                                 ANALYSIS
 
         
 
              Defendants appeal the exclusion at the hearing of their 
 
         proffered exhibits A and B. The parties were required by Division 
 
         of Industrial Services Rule 343-4.17 to submit medical and 
 
         practitioners' reports to the opposing party.  At the pretrial 
 
         conference, defendants indicated to the prehearing deputy that 
 

 
         
 
         
 
         
 
         ROZELL V. SIOUX TOOLS, INC.
 
         Page   8
 
         
 
         
 
         they had received and exchanged all of their medical reports and 
 
         that Rule 343-4.17 was complied with.  An assignment order was 
 
         issued indicating that a list of exhibits to be offered at the 
 
         hearing shall be served on the opposing party.  Defendants 
 
         acknowledge noncompliance with both the rule and the order 
 
         through "inadvertence and oversight." Defendants offered exhibits 
 
         A and B at the hearing and they were objected to by claimant and 
 
         excluded by the deputy commissioner.  Defendants urge their 
 
         admission because some of claimant's exhibits allegedly similarly 
 
         failed to comply, yet the record shows defendants did not object 
 
         at hearing to claimant's exhibits.  The deputy properly excluded 
 
         defendants' exhibits for noncompliance with the rule and the 
 
         hearing order.
 
         
 
              Claimant's testimony indicates he had no back  pain  or
 
         "catch" prior to the date of injury, nor did he have any 
 
         difficulty bending, lifting, stooping, standing, walking or 
 
         driving prior to the date of injury, other than medical advice 
 
         not to lift more than 40 pounds.  After shoveling heavy snow for 
 
         his employer on November 28, 1983, claimant immediately 
 
         experienced a "catch" and pain in his back, and now has 
 
         difficulty lifting, bending or stooping, and cannot stand or 
 
         drive a car for any substantial period.of time.  He also now 
 
         wears a back brace.
 
         
 
              The testimony of Dr. Mumford that claimant aggravated his 
 
         preexisting spondylolisthesis on November 28, 1983 is 
 
         uncontroverted.  Claimant's restrictions on lifting, stooping or 
 
         bending all stem from his back condition.  Dr. Mumford based his 
 
         rating of impairment on the back condition alone, without regard 
 
         to the vascular insufficiency.  Claimant has established a causal 
 
         relationship between the November 28, 1983 injury and his 
 
         disability.
 
         
 
              The testimony of claimant and the reports of Dr. Mumford 
 
         indicate claimant has a 25 to 30 percent permanent-functional 
 
         impairment of his back.  Claimant previously was determined to 
 
         have an 8 percent functional impairment to the body as a whole 
 
         stemming from a 1975 injury to his back while working for the 
 
         same employer.  Defendants conceded at the bearing that 
 
         claimant's industrial disability is now greater than 30 percent 
 
         but less than 100 percent.
 
              
 
              Functional impairment is only one of the criteria.  Claimant 
 
         was 64 years old at the time of the hearing.  His education 
 
         limited to the eighth grade, and testified he found school 
 
         "tough."  His opportunity to retrain for other employment is 
 
         nonexistent.  His impairment makes him unable to perform the work 
 
         he has done all of his life and the testimony of Calvin Rathel 
 
         would indicate that claimant is not employable in the state of 
 
         Iowa.  Based on the fact that claimant has no earning capacity as 
 
         a result of his November 28, 1983 injury, he is permanently and 
 
         totally disabled.  Claimant's income from nonearned sources is 
 
         irrelevant to a determination of earning capacity.
 
         
 
                             FINDINGS OF FACT
 
         
 
              1.  Defendants failed to timely provide copies of medical 
 
         reports designated exhibits A and B.
 

 
         
 
         
 
         
 
         ROZELL V. SIOUX TOOLS, INC.
 
         Page   9
 
         
 
         
 
         
 
              2.  Claimant was 64 years old at the time of the hearing.
 
         
 
              3.  Claimant's education consists of completing the eighth 
 
         grade.
 
         
 
              4.  Claimant had difficulty with school.
 
         
 
              5.  Claimant worked in various labor jobs involving lifting, 
 
         bending, or stooping prior to working for defendant employer.
 
         
 
              6.  Claimant began work for defendant employer in June 1969 
 
         operating a degreaser and polisher.
 
         
 
              7.  Claimant's work for defendant employer required him to 
 
         bend, lift and stoop.
 
         
 
              8.  In 1975, claimant suffered a back injury while employed 
 
         by defendant employer which resulted in an 8 percent functional 
 
         impairment.
 
         
 
              9.  On November 28, 1983, while shoveling snow, claimant 
 
         suffered a back injury arising out of and in the course of his 
 
         employment.
 
         
 
              10.  Claimant did not have pain or experience difficulty 
 
         lifting, bending, stooping, standing, walking or driving prior to 
 
         the injury of November 28, 1983.
 
         
 
              11.  Claimant experiences pain  and a."catch" in his back, 
 
         wears a back brace, and can no longer lift, bend, stoop, walk or 
 
         drive more than short distances subsequent to his injury of 
 
         November 28, 1983.
 
         
 
              12.  Claimant can no longer perform the duties of his job.
 
         
 
              13.  Claimant's last day at work was December 18, 1983.
 
         
 
              14.  Claimant underwent surgery for a nonwork-related 
 
         vascular insufficiency of both legs in January 1984.
 
         
 
              15.  Claimant has 25-30 percent functional impairment of the 
 
         body because of back condition but separate and distinct from the 
 
         vascular insufficiency.
 
         
 
              16.  Claimant is motivated to work, and has utilized job 
 
         placement services without success.
 
         
 
              17.  Claimant's age, lack of education, his impairment and 
 
         job experience result in no jobs being available to claimant.
 
         
 
                            CONCLUSIONS OF LAW
 
         
 
              1.  The deputy properly excluded exhibits A and B.
 
         
 
              2.  Claimant's disability is causally related to his 
 
         November 28, 1983 injury.
 
         
 
              3.  Claimant is permanently and totally disabled as a result 
 

 
         
 
         
 
         
 
         ROZELL V. SIOUX TOOLS, INC.
 
         Page  10
 
         
 
         
 
         of his November 28, 1983 work-related injury.
 
         
 
              WHEREFORE, the decision of the deputy is affirmed.
 
         
 
                                      ORDER
 
         
 
              THEREFORE, defendants are to pay unto claimant permanent 
 
         total disability benefits at the stipulated rate of two hundred 
 
         twelve and 86/100 dollars ($212.86) per week for the period of 
 
         his disability.
 
         
 
              Defendants are to be given credit for benefits previously 
 
         paid.
 
         
 
              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 pay the costs of this action.
 
                                      
 
              Defendants shall file claim activity reports, pursuant to 
 
         Division of Industrial Services Rule 343-3.1(2), as requested by 
 
         this agency.
 
         
 
                Signed and filed this 18th day of December, 1987.
 
         
 
         
 
                                           DAVID E. LINQUIST
 
                                           INDUSTRIAL COMMISSIONER
 
         Copies To:
 
         
 
         Mr. P.D. Furlong
 
         Attorney at Law
 
         401 Commerce Building
 
         Sioux City, Iowa 51101
 
         
 
         Mr. Michael P. Jacobs
 
         Mr. William J. Rawlings
 
         Attorneys at Law
 
         300 Toy National Bank Bldg.
 
         Sioux City, Iowa 51101
 
         
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                                                 1108.50; 1804; 2601.20
 
                                                 Filed 12-18-87
 
                                                 David E. Linquist
 
         
 
                       BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         _________________________________________________________________
 
         
 
         
 
         ARCHIE ROZELL,
 
         
 
              Claimant,
 
                                                    File No. 753062
 
         VS.
 
                                                      A P P E A L
 
         SIOUX TOOLS, INC.,
 
                                                    D E C I S I 0 N
 
              Employer,
 
         
 
         and
 
         
 
         CNA INSURANCE COMPANIES,
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         _________________________________________________________________
 
         
 
         
 
         1108.50
 
         
 
              Where claimant's restrictions on bending and lifting were 
 
         shown by expert medical testimony to be caused by aggravation of 
 
         preexisting back condition and restrictions were not based on 
 
         claimant's vascular insufficiency, claimant's disability was 
 
         causally related to his injury.
 
         
 
         1804
 
         
 
              Affirmed deputy's finding that a 64 year old worker with 
 
         eighth grade education, a history of physical labor jobs 
 
         involving lifting and bending, a current rating of impairment of 
 
         25-30%, restrictions on lifting and bending, expert testimony 
 
         that claimant is unemployable, was permanently totally disabled.
 
         
 
         2601.1
 
         
 
              Deputy commissioner properly excluded defendants' medical 
 
         exhibits for failure to provide exhibits to claimant's counsel in 
 
         violation of rule and prehearing order.
 
         
 
 
 
 
 
 
 
 
 
 
 
                                                
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                      BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         JOYCE D'OSTILIO,                            File No. 753117
 
         
 
              Claimant,                               R E V I E W -
 
         
 
         vs.                                        R E O P E N I N G
 
         
 
         FEDERAL RESERVE BANK,                       D E C I S I O N
 
         
 
              Employer,
 
                                                        F I L E D
 
         and
 
                                                       MAR 09 1988
 
         THE HARTFORD INSURANCE GROUP,
 
                                              IOWA INDUSTRIAL COMMISSIONER
 
               Insurance Carrier,
 
               Defendants.
 
         
 
         
 
                                 INTRODUCTION
 
         
 
              This is a proceeding in review-reopening from a Memorandum 
 
         of Agreement brought by Joyce D'Ostilio against Federal Reserve 
 
         Bank, employer, and The Hartford Insurance Group, its insurance 
 
         carrier. Claimant seeks further benefits as a result of the 
 
         injury that she sustained on January 29, 1982 which arose out of 
 
         and in the course of her employment.
 
         
 
              The case was heard and fully submitted at Des Moines, Iowa 
 
         on August 6, 1987.
 
         
 
              The record in this proceeding consists of testimony from 
 
         Joyce D'Ostilio, Kim Rhoads and Bil Cooper.  Joint exhibits 1 
 
         through 20 were received into evidence.
 
         
 
                                     ISSUES
 
         
 
              The issues presented by the parties for determination are 
 
         whether the injury of January 29, 1982, which the employer 
 
         admitted, was a proximate cause of the permanent disability with 
 
         which claimant is afflicted; the extent of claimant's entitlement 
 
         to compensation for healing period; determination of claimant's 
 
         entitlement to compensation for permanent disability; and, 
 
         assessment of costs.  In particular, claimant urges that she is 
 
         permanently and totally disabled and relies upon the odd-lot 
 
         doctrine.  Defendants, at the time of hearing, sought credit for 
 
         the amount of claimant's salary that had been paid in addition to 
 
         workers' compensation benefits, but in their posthearing brief, 
 
         defendants acknowledged that they were not entitled to any credit 
 
         for the excess.  (Division of Industrial Services Rule 343-8.4). 
 
         Claimant had sought additional compensation under the fourth 
 
         unnumbered paragraph of Iowa Code section 86.13, but that claim 
 
                                                
 
                                                         
 
         was waived at the time of hearing.
 
         
 
              The parties stipulated that claimant's rate of compensation 
 
         is $169.68 per week, that benefits had been paid as set forth in 
 
         exhibit 19, which was received into evidence, and that the days 
 
         claimant was absent from work were as set forth in an attachment 
 
         to the pre-hearing report.
 
         
 
                            SUMMARY OF EVIDENCE
 
         
 
              The following is a summary of evidence presented in this 
 
         case.  Only the evidence most pertinent to this decision is 
 
         discussed, but all of the evidence received at the hearing was 
 
         considered in arriving at this decision.  Conclusions about what 
 
         the evidence offered may show are inevitable with any 
 
         summarization.  The conclusions in the following summary should 
 
         be considered to be preliminary findings of fact.  In the 
 
         post-hearing filings made by the parties, each party included a 
 
         summary of the evidence.  Those summaries were both quite 
 
         accurate and fairly summarize the pertinent evidence in the case.  
 
         The summarization by claimant is used as a basis for the 
 
         following statements, with some modifications as were deemed 
 
         appropriate by the undersigned.
 
         
 
              Claimant testified that she was 49 years old at the time of 
 
         hearing.  She resides at 902 SE Diehl, Des Moines, Iowa.  
 
         Claimant has been married for over 30 years to Patrick W. 
 
         D'Ostilio, a city of Des Moines police officer.  Their two 
 
         children are now grown and no longer reside in the family home.  
 
         Mr. D'Ostilio will be eligible for retirement in about three 
 
         years.  Claimant stated she and her husband then plan to move 
 
         their residence to a "place where it is warm."
 
         
 
              Claimant graduated from Roosevelt High School in 1955.  She 
 
         has had no further education or vocational training.  Following 
 
         high school, claimant worked for the phone company for 
 
         approximately two years; Central National Bank for five years; 
 
         and, Valley National Bank for one year.  All of these employment 
 
         positions were clerical in nature.  From 1966 until 1972 she 
 
         remained at home with her children as a housewife.  Claimant 
 
         returned to employment in 1972.  Initially, she worked in a 
 
         restaurant as a waitress and cashier.  Later in 1972, she gained 
 
         a position with the defendant, Federal Reserve Bank.  Initially, 
 
         her duties were limited to clerical typing and filing, but as she 
 
         gradually gained experience, her employment positions entailed 
 
         more responsibility and bookkeeping work.  At the time of her 
 
         injury in January, 1982, she worked in "check adjustment" 
 
         receiving "blocks" of tapes from commercial banks, reviewing and 
 
         researching the tapes, and trying to solve whatever bookkeeping 
 
         problem the banks had.  Claimant testified that, while employed 
 
         by the Federal Reserve Bank, she worked 40 hours per week and, at 
 
         the time of injury, was receiving an annual salary of $13,771.00.  
 
         Her job title at the time of injury was that of a "senior 
 
         difference clerk."  Claimant's duties included preparation of 
 
         routine correspondence, carrying blocks of checks, reviewing 
 
                                                
 
                                                         
 
         lists of figures for errors, movement of small file trays and 
 
         computer tapes, and other various clerical duties which included 
 
         both working at a desk as well as a lesser amount of walking and 
 
         climbing.  Claimant testified that she enjoyed her job duties 
 
         with the Federal Reserve Bank and received above average 
 
         performance ratings throughout the course of her employment.  
 
         This testimony is confirmed by exhibits 12 and 14, both of which 
 
         refer to above average performance ratings and an essentially 
 
         perfect attendance record prior to the January 29, 1982 work 
 
         incident.
 
         
 
              Claimant testified that, on January 29, 1982, (a Friday), 
 
         while walking to her car in a parking lot maintained by the 
 
         Federal Reserve Bank, she slipped on an icy surface with her feet 
 
         going out from under her.  She fell to the parking lot surface on 
 
         her buttocks and hands.  Claimant, not believing herself to be 
 
         seriously injured, went home, but, over the course of the 
 
         weekend, noticed that she began to feel poorly.  The following 
 
         Monday, February 1, 1982, claimant reported the fall to her 
 
         employer, but continued working (exhibit 13).  Claimant's 
 
         condition did not improve whereupon she was referred to the 
 
         company physician, Mangil G. Seo, M.D.  Claimant first saw Dr. 
 
         Seo on February 8, 1982 (exhibit 1).  Dr. Seo treated claimant in 
 
         a conservative fashion prescribing medication, heat, ultrasound 
 
         and massage.  He instructed claimant to stay off work.  One week 
 
         later, she again saw Dr. Seo who changed her medication and kept 
 
         her off work.  Dr. Seo saw claimant on February 22, 1982, at 
 
         which time claimant indicated that she was feeling better, but 
 
         that she was still experiencing pain at the center of her neck.  
 
         Dr. Seo was of the opinion that she had suffered a myofascial 
 
         strain of the neck. Claimant was authorized to return to her 
 
         preinjury employment duties on February 23, 1982 (exhibit 1).
 
         
 
              Claimant returned to and continued to perform her 
 
         occupational duties for approximately two months.  On April 28, 
 
         1982, she was examined by Dr. Seo who noted that her pain was 
 
         persisting both in her neck and right arm along with tingling and 
 
         numbness of the right fourth and fifth fingers.  The aspirin she 
 
         was taking for pain was giving her stomach problems.  On May 7, 
 
         Dr. Seo examined claimant noting pain intensification.  He 
 
         admitted her to Mercy Hospital Medical Center in Des Moines, Iowa 
 
         for purposes of administering physical therapy.
 
         
 
              On May 8, 1982, a consultation with John T. Bakody, M.D., a 
 
         board-certified neurosurgeon, was arranged by Dr. Seo.  Dr. 
 
         Bakody was initially of the impression that claimant was 
 
         suffering from traumatic spinal syndrome and suggested intensive 
 
         physical therapy and the administration of medication [exhibit 
 
         2(b)].  The physical therapy was performed without lasting 
 
         benefit [exhibit 2(i)].  On May 18, 1982, a cervical myelogram 
 
         was carried out which showed an anterior indentation of the dye 
 
         column at the C5-6 interspace [exhibit 2(i)].  On May 21, 1982, 
 
         Dr. Bakody carried out an anterior cervical interbody fusion at 
 
         the C5-6 interspace [exhibit 2(f), 2(i)].  Postoperatively, 
 
         claimant improved with regard to her discomfort, her wounds 
 
                                                
 
                                                         
 
         healed well and, upon x-ray, the cervical spine showed good 
 
         position and alignment of the fusion mass [exhibit 2(i)].  
 
         Claimant was allowed to return home on May 27, 1982 with a 
 
         prescription of Tylenol #3 for pain as needed [exhibit 2(i)].
 
         
 
              Claimant continued to follow up with Dr. Bakody as a patient 
 
         through the months of June and July.  Cervical x-rays again 
 
         showed excellent positioning of the fusion body although claimant 
 
         was experiencing discomfort with activity and also was suffering 
 
         from reduced range of motion of the head and neck [exhibit 2(a)].  
 
         Dr. Bakody recommended return to half-time duties beginning 
 
         August 23, 1982 [exhibit 2(a), 2(k)].
 
         
 
              Claimant testified that she felt she was ready to return to 
 
         work and did so on a half-time basis beginning August 23, 1982, 
 
         working approximately four hours per day.  On September 10, 1982, 
 
         she again saw Dr. Bakody.  Claimant reported that she was 
 
         continuing to suffer a lot of pain.  Her prescription for Tylenol 
 
         #3 was renewed and Dolobid and Elavil were also prescribed 
 
         [exhibit 2(a)].  On October 12, 1982, claimant was examined by 
 
         Dr. Bakody and related that "she was feeling a lot better" 
 
         (exhibit 18(d), page 9).  After discussion with Dr. Bakody, it 
 
         was agreed that she could try full-time work, which she did on 
 
         October 15, 1982 (exhibit 13).  Dr. Bakody related, in reference 
 
         to claimant's return to full-time duties in October, 1982:
 
                            
 
                                                         
 
         
 
              I think you could consider recovery, work return, at that 
 
              time, at least, representing a maximum recovery but not 
 
              knowing, again, what the future will bring.  (Exhibit 18(d), 
 
              page 12).
 
         
 
              Claimant testified that she did in fact return to her 
 
         preinjury employment duties on or about the October 15, 1982 date 
 
         and continued with these duties until approximately December 13, 
 
         1983.  In the interim, she testified to having experienced a lot 
 
         of pain in her neck, arms and head.  Exhibit 15 sets forth in 
 
         part the prescription medications that she was taking during this 
 
         interim.  In addition to the Dolobid, Tylenol #3 and Elavil, 
 
         claimant testified to taking lots of aspirin during this time 
 
         frame.  Claimant testified that the pulling of drawers and the 
 
         hanging of her head over her work area were two particular 
 
         factors that seemed to aggravate the discomfort in her neck, arms 
 
         and head.
 
         
 
              Dr. Bakody's office notes [exhibit 2(a)] also set out both 
 
         the quantity of pain medication that was being prescribed and her 
 
         reports of discomfort.  At the time of claimant's July 13, 1983 
 
         examination, the doctor resumed claimant's Dolobid and Elavil, 
 
         which apparently had been either reduced or discontinued during 
 
         January of 1983.
 
         
 
              Claimant testified that, on or about December 13, 1983, the 
 
         pain became so intense that it was to the point of becoming 
 
         disabling.  She testified that she could not function.  She 
 
         missed work on December 13, 14, 15, 16, 23 and 30.  On December 
 
         19, claimant consulted with Dr. Bakody reporting her distress.  
 
         Upon examination, Dr. Bakody found limitation in rotational 
 
         movements of claimant's head and neck, but neurological findings 
 
         were normal.  He advised continuing her medications and ordered 
 
         her to report for physical therapy (exhibit 18(d), page 15).  He 
 
         also ordered electromyography and nerve conduction studies, both 
 
         of which were reported as normal [exhibit 2(q)].  Dr. Bakody 
 
         reported that the symptoms claimant was suffering at this time 
 
         appeared to be a continuum of her problems relating to the fall 
 
         in the parking lot in 1982 [exhibit 2(t)].  Claimant testified 
 
         that she got no relief from the physical therapy and again sought 
 
         Dr. Bakody for further examination on January 24, 1984.  She had 
 
         not worked since December 29, 1983 (exhibit 2(t), page 18).  Dr. 
 
         Bakody obtained a progress x-ray and found, "the fusion position 
 
         from an x-ray standpoint, it was excellent."
 
         
 
              Claimant continued to see Dr. Bakody approximately every two 
 
         weeks during the months of January and February, 1984.  Dr. 
 
         Bakody continued the Tylenol #3, Elavil and Motrin, prescribed a 
 
         "wall-pil-o" and recommended the practice of biofeedback muscle 
 
         relaxation techniques [exhibit 2(a)].  On February 7, 1984, Dr. 
 
         Bakody recommended treatment at the Mercy Hospital Pain Clinic 
 
         under the care of James Blessman, M.D. [exhibits 2(a); 2(v)].
 
         
 
              Dr. Blessman was of the initial impression that claimant was 
 
                                                
 
                                                         
 
         suffering from chronic myofascial cervical strain [exhibit 5(a)]. 
 
         From mid-February to March 16, 1984, claimant was hospitalized at 
 
         the Mercy Hospital Medical Center Pain Clinic.  Claimant was seen 
 
         in consultation with staff psychologist, Dr. Todd Hines.  It was 
 
         reported that Dr. Hines found claimant to be significantly 
 
         depressed and noted a number of secondary gain factors that were 
 
         operating in this case [exhibit 5(b)].  However, Dr. Blessman 
 
         stressed that there were absolutely no signs of malingering 
 
         [exhibit 5(b)].  He felt the patient's pain to be on an 
 
         anatomical basis and did feel it was related to the traumatic 
 
         injury of 1982 [exhibit 5(b)].  While a patient at the Pain 
 
         Clinic, claimant's medication was modified, she was treated with 
 
         several different types of physical therapy.  A TENS unit was 
 
         recommended and utilized with some success [exhibit 5(b)].  
 
         Claimant participated in aquatic exercises, stretching and 
 
         flexing exercises and various aerobic exercises, specifically 
 
         including walking on a treadmill [exhibit 5(b)].  Dr. Blessman 
 
         was of the impression that claimant was very well motivated 
 
         [exhibit 5(b)].  Claimant was instructed in weight reduction, 
 
         restriction in the consumption of caffeine and refined sugars and 
 
         Dr. Blessman recommended that she work on her efforts to 
 
         discontinue smoking [exhibit 5(b)].  Dr. Blessman was of the 
 
         opinion that claimant had gained considerable improvement from 
 
         the pain management program and recommended that she continue an 
 
         active rehabilitation program through the use of an exercise 
 
         bicycle and swimming at the YMCA [exhibit 5(b)].  Her return to 
 
         work eight weeks following discharge from the Pain Center was 
 
         projected [exhibit 5(b)].
 
         
 
              Claimant testified that she returned to her home and 
 
         continued to practice the techniques learned at the Pain Clinic. 
 
         She also continued to consult with Dr. Bakody.  Dr. Bakody's 
 
         office notes of April 24, 1984 report that claimant was feeling a 
 
         lot better and that she was of the impression she had learned a 
 
         lot at the Pain Clinic [exhibit 2(a)].  At that time, it was Dr. 
 
         Bakody's plan that claimant return to employment duties during 
 
         early June, 1984 [exhibits 2(a); 2(z)].  Claimant returned to the 
 
         bank and worked the days of June 5 and June 6, 1984 (exhibit 13). 
 
         On June 5, 1984, she phoned Dr. Bakody with so many complaints 
 
         that he referred her to Theodore Rooney, D.O., who is head of the 
 
         rheumatology clinic at Mercy Hospital (exhibit 18(d), page 23). 
 
         Dr. Bakody has not seen claimant since then.
 
         
 
              In Dr. Bakody's opinion, claimant has sustained in the area 
 
         of a 15% to 20% permanent physical impairment to the body as a 
 
         whole "as a result of the change of the structure of her neck, 
 
         along with the surgery, and the fact that there are continuing 
 
         complaints" (exhibit 18(d), pages 13 and 34).
 
         
 
              Claimant first saw Dr. Rooney on or about June 19, 1984 
 
         [exhibit 3(a)].  The following are excerpts from exhibits 3(a) and 
 
         3(x).  Claimant reported to Dr. Rooney that she had been taking 
 
         between six and eight Tylenol #3 daily for the past three weeks, 
 
         but was barely able to deal with the pain.  She described symptoms 
 
         of achiness and discomfort of the posterior cervical area and the 
 
                                                
 
                                                         
 
         cervicothoracic area that was worse on the right as opposed to the 
 
         left.  She reported intermittent pain radiating down into her 
 
         hands. She reported swelling in her arms and fingers which came 
 
         and went, but was not associated with any definite joint stiffness 
 
         or swelling or was usually not limited to the joints.  She 
 
         reported that she generally felt best in the morning depending 
 
         upon how she felt before going to bed and that the symptoms became 
 
         worse as the day went on.  She reported significant disrupted 
 
         sleep.  Examination revealed restricted range of motion in the 
 
         cervical spine; evidence of multi-tender trigger points along the 
 
         posterior musculature of the upper neck and thoracic spine; and, 
 
         some tenderness in the lateral elbows.  She had no findings in the 
 
         lower extremity and her neurological exam was unrevealing (exhibit 
 
         18(c), pages 6 and 7). Dr. Rooney was under the initial impression 
 
         that claimant suffered from chronic pain syndrome secondary to 
 
         chronic cervical strain and significant fibromyalgia (exhibit 
 
         18(c), page 8).  He was also of the opinion that a portion of her 
 
         problems were tied to underlying depression and frustration which 
 
         would exacerbate the underlying condition.  Other aggravating 
 
         factors included her disrupted sleep pattern.  Testing was carried 
 
         out in order to rule out systemic rheumatologic manifestations.  
 
         Dr. Rooney prescribed Nalfon, Elavil and water exercises at Mercy 
 
         Hospital.  His plan for treatment was directed to controlling her 
 
         symptomatology through anti-inflammatory and anti-depression 
 
         medication (exhibit 18(c), page 11).
 
         
 
              Upon re-examination of claimant on July 28, 1984, Dr. Rooney 
 
         noted that she had less discomfort, was sleeping better and there 
 
         was no tenderness in her lower back area [exhibit 3(e)].  Dr. 
 
         Rooney reported that the Feldene he had prescribed in place of 
 
         the Nalfon was causing some stomach upset.  He also reported that 
 
         claimant tended to have symptoms of reflux without any other 
 
         medications on board.  Dr. Rooney recommended the continuation of 
 
         the Feldene, the use of liquid antacids and a trial basis of 
 
         return to half-time work approximately six weeks into the 
 
         future.
 
         
 
              On September 24, 1984, claimant returned to part-time 
 
         employment duties with the Federal Reserve Bank.  The half-time 
 
         duties were described as the same duties that she performed both 
 
         before her January 29, 1982 accident and the interims thereafter. 
 
         Claimant performed her half-time duties continuously until January 
 
         4, 1985 with the exception of December 14, 1984 and a vacation 
 
         taken from November 13 through December 7, 1984 (exhibit 13).  
 
         When claimant was next seen on November 25, 1984, Dr. Rooney found 
 
         her significantly improved and almost pain-free (exhibit 18(c), 
 
         page 17).  Apparently, claimant's medication had been changed from 
 
         Feldene to Naprosyn.  Claimant reported having occasional GI 
 
         upset, but on an irregular basis.  She was continuing to take 
 
         Elavil at night time.  Dr. Rooney reported his assessment as 
 
         moderate to severe fibromyalgia that was improved over the 
 
         episodes that had been previously reported.  He recommended 
 
         continuation of her present medications, a reduction in the 
 
         ingestation of Naprosyn, instruction in the use of stress and 
 
         relaxation techniques, continuation of a regular exercise program 
 
                                                
 
                                                         
 
         and an increase in her working day to a total of six hours with a 
 
         goal of an eventual increase to full-time duties (exhibit 13).  
 
         Claimant testified that, throughout this particular return to work 
 
         episode, she continued to suffer from pain and additional 
 
         frustration.
 
         
 
              Claimant testified that, on or about January 4, 1985, she 
 
         suffered from an exacerbation of the underlying condition.  She 
 
         reported that her pain and depression was much worse than during 
 
         the previous year, that she ached and that she had difficulty in 
 
         concentrating and thinking.  She was continuing with the 
 
         Naprosyn. She spoke with Dr. Rooney over the phone [exhibit 
 
         3(x)].  Claimant had apparently been taking Darvocet N100 for 
 
         pain, but the medication had caused her to be ill so she stopped 
 
         using this medication.  The doctor recommended she continue to 
 
         use the Naprosyn, Elavil, TENS unit, pool and warm heat [exhibit 
 
         3(x)]. Claimant returned to Dr. Rooney on January 27, 1985, 
 
         describing increased pain in her neck and shoulders radiating 
 
         down into both arms (exhibit 18(c), page 17).  Dr. Rooney 
 
         described his findings at the January 27, 1985 exam as indicating 
 
         a "flare-up" of symptoms which can be precipitated by a variety 
 
         of emotional or physical events (exhibit 18(c), page 20).  He was 
 
         of the impression that most of the manifestations were secondary 
 
         to rather significant muscle spasms [exhibit 3(x)].
 
         
 
              Dr. Rooney did not examine claimant again until September, 
 
         1985 (exhibit 18(c), page 23).  However, he received a phone call 
 
         from claimant in May, 1985, wherein she related feeling better, 
 
         but "she was freely admitting to some significant depression at 
 
         that time" (exhibit 18(c), page 24).
 
         
 
              In his report of April 14, 1985, Dr. Rooney indicated that 
 
         the natural history of conditions such as fibromyalgia, as well 
 
 
 
                            
 
                                                         
 
         as many different types of arthritis, is one of remissions and 
 
         exacerbations that do not necessarily have any predictable nature 
 
         to them [exhibit 3(h)].  He indicated that claimant's condition 
 
         had been precipitated by the original injury and that the injury 
 
         had probably predisposed her to some secondary osteoarthritis 
 
         which may have contributed to the difficulties she was suffering 
 
         [exhibit 3(h)].  Over the next four months, Dr. Rooney attempted 
 
         to adjust claimant's medication in order to accomplish maximum 
 
         relief which included the prescription of Tolectin, Darvocet N100 
 
         and Elavil.  During May, 1985, Dr. Rooney referred claimant to 
 
         Dr. Hines for consultation [exhibit 3(x)].
 
         
 
              Claimant began to consult with Dr. Hines on a weekly basis 
 
         beginning May 14, 1985 [exhibit 4(a)].  Dr. Hines reported that 
 
         claimant had experienced a reactive depression in response to the 
 
         pain and disability which had become of such magnitude as to be 
 
         disabling in and of itself [exhibit 4(a)].  The diagnostic 
 
         impression was that of Dysthymic Disorder (DSMIII/300.40).  Dr. 
 
         Hines was of the opinion that claimant expressed a strong 
 
         emotional investment in her work and derived much of her sense of 
 
         self worth from her productivity [exhibit 4(a)].  Claimant's 
 
         experience of pain had been so strong and so pervasive that she 
 
         had been unable to perform domestic tasks, to participate in 
 
         typical activity patterns and to be emotionally available to her 
 
         family as well as being unable to return to employment outside 
 
         the home [exhibit 4(a)].  She reported fears of rejection and 
 
         abandonment by everyone including family and employer as a result 
 
         of her decreased productivity and the fear of both tended to 
 
         drive her efforts toward recovery and to fuel her depression as 
 
         she found herself unable to perform [exhibit 4(a)].
 
         
 
              During approximately April, 1985, Bil Cooper (rehabilitation 
 
         counselor with North Central Rehabilitation) was employed by the 
 
         defendants to assist claimant in a possible return to employment 
 
         duties.  The effort to.return claimant to employment was 
 
         coordinated with Drs. Hines and Rooney, claimant and the 
 
         employer. Exhibit 9(c) is a job analysis form that was prepared 
 
         by Cooper specifically describing the nature of the employment 
 
         duties to which claimant would return.  The duties can be best 
 
         described as extremely light and primarily sedentary.  
 
         Approximately five percent of claimant's time would be spent 
 
         lifting weights between 3-12 pounds.  Approximately 75 percent of 
 
         her time would be spent sitting.  Cooper testified at hearing 
 
         that the job description was about as light as was possible with 
 
         the Federal Reserve Bank.
 
         
 
              Dr. Hines was in agreement that a third attempt to return to 
 
         work was needed [exhibit 4(a)].  The plan was for Dr. Hines, Dr. 
 
         Rooney, claimant, Bil Cooper and the employer to arrange for 
 
         claimant's return to work on a limited basis.
 
         
 
              On September 7, 1985, claimant returned to Dr. Rooney for 
 
         reevaluation.  The doctor noted improvement in pain and 
 
         discomfort although claimant appeared to be rather depressed.  
 
         She exhibited decreased motion in the neck and there was noted 
 
                                                
 
                                                         
 
         again tender muscles in the cervical and thoracic area (exhibit 
 
         18(c), page 25).  She also reported episodes of severe epigastric 
 
         pain that awakened her at night.  The medications of Nalfon, 
 
         Elavil and Tylenol #3 were continued.
 
         
 
              Claimant attempted a return to these employment duties 
 
         beginning September 9, 1985 and through October 22, 1985 with the 
 
         exception of September 18, 19, 20, 25, 26, 30, October 1, 2, 9, 
 
         and 10, 1985, when claimant missed entire work days.  Beginning 
 
         October 23, 1985 and continuing to the hearing date, claimant had 
 
         not resumed employment duties.  (From November 4, 1985 through 
 
         December 13, 1985, claimant was absent from work for a non-work 
 
         related condition.)
 
         
 
              On December 15, 1985, claimant was again evaluated by Dr. 
 
         Rooney.  She was continuing to complain of the same pain 
 
         including pain and stiffness in the muscles of the 
 
         cervical-thoracic region. Claimant, for the first time, related 
 
         to Dr. Rooney that she had developed discomfort in the outer hip 
 
         and low back (exhibit 18(c), pages 25, 48 and 49).  She was using 
 
         Elavil and Nalfon.  She was also complaining of migraine 
 
         headaches with visual symptoms.  She reported headaches of a 
 
         migraine variety as a young lady, but they had not reoccurred 
 
         until only recently.  Dr. Rooney recommended a prescription for a 
 
         Jackson cervical pillow, whirlpool and ultrasound treatments, 
 
         water exercises, neurologic consultation and a follow-up in 3-4 
 
         months.
 
         
 
              The neurologic consultation was carried out with Steven R. 
 
         Adelman, D.O.  Dr. Adelman was of the impression that claimant 
 
         was suffering from classic migraine headaches (exhibit 7).  Dr. 
 
         Adelman was of the opinion that stress and muscle tension can 
 
         precipitate the onset of migraine headaches, but that the same 
 
         could be controlled through the use of medication and lifestyle 
 
         modification [exhibits 7(c) and 7(d)].  Dr. Adelman was of the 
 
         opinion that there was a "loose" association at best between the 
 
         migraine headaches and the cervical fusion [exhibit 7(b)].
 
         
 
              During the course of both the return to work and the 
 
         subsequent discontinuing of her employment duties, claimant 
 
         continued to consult with Dr. Hines.  In his report of January 
 
         31, 1986 [exhibit 4(b)] he reported that, due to the intensity of 
 
         the pain experience, it was necessary for claimant to terminate 
 
         her recent efforts to return to work on a part-time basis.  Dr. 
 
         Hines continued in his opinion that claimant was strongly 
 
         motivated to return to work, but was realistic about the needs of 
 
         the employer to have someone on the job who is consistently 
 
         productive [exhibit 4(b)].  Dr. Hines indicated that the job had 
 
         become a source of continuing frustration to her and suggested 
 
         that it might well be therapeutic for the job and related legal 
 
         issues to be brought to a close [exhibit 4(b)].
 
         
 
              Claimant was examined by Dr. Rooney on June 22, 1986 
 
         [exhibit 3(x)].  A complete neurological examination was 
 
         unrevealing.  By this time, claimant was able to discontinue 
 
                                                
 
                                                         
 
         smoking.  Her pain was described as again in the 
 
         cervical-thoracic area with some intermittent numbness in the 
 
         shoulder and trapezius.  The pain seemed to be aggravated by most 
 
         kinds of activity.  Claimant reported suicidal ideations which 
 
         had improved recently.  Dr. Rooney was of the opinion that she 
 
         was continuing to suffer from chronic cervical muscular pain with 
 
         some secondary osteoarthritis and also depression.  He felt that 
 
         she should see a psychiatrist for a change in her antidepressant 
 
         medication with the prescription of either Orudis or Flexoril for 
 
         clinical relief once the depression medication had been regulated 
 
         (exhibit 18(c), pages 26 and 27).
 
         
 
              When seen on September 4, 1986, Dr. Rooney noted significant 
 
         improvement (exhibit 18(c), pages 27 and 28).
 
         
 
              Claimant was referred to Hector W. Cavallin, M.D., with Dr. 
 
         Cavallin first seeing claimant on June 30, 1986 [exhibit 8(b)]. 
 
         Dr. Cavallin began claimant on Tofranil PM with the amount of 
 
         medication being increased through the month of July.  Dr. 
 
         Cavallin did not feel claimant was able to return to work in the 
 
         near future [exhibit 8(b)].  Dr. Cavallin indicated that it was 
 
         difficult to know how well she would respond to the change in 
 
         medication and whether her depression would improve sufficiently 
 
         to allow her to return to work [exhibit 8(b)].
 
         
 
              On or about July 15, 1986, Jo Ann Bennett, manager of 
 
         operations of the Federal Reserve Bank, wrote to claimant 
 
         informing claimant that, effective February 20, 1986, all 
 
         benefits under the Workers' Compensation Act had ended (exhibit 
 
         4(c), page 2).  Bennett informed claimant that, from February 20 
 
         until July 7, 1986, claimant had received payments for accrued 
 
         sick leave. After July 7, 1986, claimant's status was changed to 
 
         "ill without pay."  Bennett asked for a commitment as to what 
 
         date claimant intended to return to work and required a response 
 
         by Friday, July 18, 1986, or claimant would be removed from the 
 
         company's records as of said date.  Dr. Hines [exhibit 4(d)], Dr. 
 
         Rooney [exhibit 3(u)], and Dr. Cavallin [exhibit 8(b)] were all 
 
         in agreement that, at that time, claimant was incapable of 
 
         returning to her previous employment duties with the Federal 
 
         Reserve Bank.
 
         
 
              Claimant testified that, at the present, she suffers from 
 
         limitations of neck movement and limitations in her ability to 
 
         use her hands above her head such as to wash her hair.  She is in 
 
         constant pain which interferes with her ability to concentrate. 
 
         She reports that the motion of her head and neck is severely 
 
         limited, both in her ability to rotate her head as well as to 
 
         flex and extend same.  She testified that a typical day would 
 
         involve her arising at approximately 6:00 a.m., having coffee and 
 
         breakfast with her husband, perhaps walking with a friend at her 
 
         own pace for approximately 45 minutes, listening to relaxation 
 
         tapes, performing light housework such as dusting and depositing 
 
         clothing in a washing machine.  All of the activities were 
 
         described as activities that she conducted at her own pace.  She 
 
         reported lying on a heating pad on a daily basis.  Pads were 
 
                                                
 
                                                         
 
         placed both on her recliner and davenport.  Claimant ate lunch 
 
         which she would prepare and then, in the afternoon, she would 
 
         rest and perhaps watch television or read while lying in the 
 
         recliner. Claimant usually prepared the evening meal for herself 
 
         and for her husband, limited her standing to less than 30 minutes 
 
         and was up and down as her tolerance for pain dictated.  After 
 
         the evening meal, claimant generally deposited her dishes in a 
 
         dishwasher, watched some television, was up and down as her pain 
 
         would tolerate, spent time lying on a heating pad and, on 
 
         occasion, took an evening shower.
 
         
 
              Claimant testified to having had various hobbies, including 
 
         toll painting, ceramics and sewing.  She participates in no 
 
         hobbies now.  She is able to operate a motor vehicle, although 
 
         she does have difficulty turning her head to observe traffic.
 
         
 
              Claimant reported that she feels herself to be a failure and 
 
         she has been unable to successfully return to work.  She reported 
 
         that work was something that she enjoyed in that she enjoyed the 
 
         sense of well-being and the sense of camaraderie that was shared 
 
         with her fellow employees.  She would like to return to work, but 
 
         she really does not know what she can do.  She cannot envision 
 
         any easier work than what was offered by her employer.  She feels 
 
         frustrated and disappointed.  She never thought she would end up 
 
         as she is now.  She is concerned about the future of her 
 
         relationship with her husband.  She feels she is not living up to 
 
         her end of her marital commitments.  She feels her goals of 
 
         working until retirement after her children are gone, of 
 
         traveling, of having security in the future and of developing and 
 
         maintaining friendships have all been affected by this injury.
 
         
 
              Dr. Rooney is the medical director of the Arthritis Center 
 
         and Rehabilitation Organization at Mercy Hospital Medical Center. 
 
 
 
                            
 
                                                         
 
         He is board certified and specializes in rheumatology, arthritis 
 
         and related disorders.  Dr. Rooney testified that, in his 
 
         opinion, there was a relationship between the January 29, 1982 
 
         incident and the initial diagnosis of chronic pain syndrome 
 
         secondary to chronic cervical strain and significant secondary 
 
         fibromyalgia (exhibit 18(c), page 9).  Dr. Rooney explained that 
 
         Nalfon was one of the medications prescribed which acts as an 
 
         anti-inflammatory medication similar to aspirin, Motrin and 
 
         Feldene.  All of these drugs are similar in that they are helpful 
 
         in reducing pain and/or inflammation depending upon the dosage 
 
         that is used.  He described Elavil as a tricyclic medication used 
 
         in very high doses to treat endogenous depression and other 
 
         associated disorders.  Dr. Rooney was of the opinion that 
 
         claimant's depression was related to her chronic pain syndrome 
 
         (exhibit 18(c), page 12).  He described fibromyalgia as a form of 
 
         nonarticular rheumatism meaning a discomfort in the muscles and 
 
         other soft tissues that surround the joints (exhibit 18(c), page 
 
         13).  As a part of its manifestation, fibromyalgia often disrupts 
 
         sleep, causes chronic pain with radiation into the arms or legs 
 
         and causes trigger points on palpation upon direct examination at 
 
         certain characteristic areas (exhibit 18(c), page 13).  At the 
 
         time of his initial assessment of claimant on June 19, 1984, he 
 
         did not feel she was capable of returning to her employment 
 
         duties with the Federal Reserve Bank and that such inability 
 
         continued up until the time of her eventual part-time return 
 
         during September, 1984 (exhibit 18(c), page 16).  At the time of 
 
         Dr. Rooney's examination of claimant during January, 1985, he 
 
         noted that she suffered a "flare" which can be precipitated by 
 
         over activity, stressful events or other emotional or physical 
 
         trauma (exhibit 18(c), page 20).  Dr. Rooney thought it would be 
 
         probable that the factors of returning to work, the underlying 
 
         depression and the presumed increased physical activity would all 
 
         contribute to the flare noted during January, 1985 (exhibit 
 
         18(c), page 21).
 
         
 
              In a report dated October 20, 1986 [exhibit 3(w)], Dr. 
 
         Rooney indicated that he reviewed all of claimant's cervical 
 
         spine films from 1982 up to and including x-rays taken in May, 
 
         1986, for purposes of seeing whether there had been any interval 
 
         change over that period of time.  The first x-rays taken in May, 
 
         1982, revealed mild changes of osteophyte formation (evidence of 
 
         osteoarthritis) at C5 and C6.  Repeat post-surgery films revealed 
 
         a stabilized cervical fusion without deterioration.  The fusion 
 
         remained stable over the four-year period.  The only change noted 
 
         was a little bit of osteophyte formation at C6 and C7 which had 
 
         not been present in 1982 (see also, exhibit 18(c), pages 29 and 
 
         30).  Dr. Rooney stated that claimant's initial film suggested 
 
         that she had osteoarthritis and that the change noted is 
 
         indicative of the natural history of the process of 
 
         osteoarthritis.  It was impossible for Dr. Rooney to state the 
 
         cause of the changes over the four-year period because 
 
         osteoarthritis is a slowly progressive disorder (exhibit 18(c), 
 
         page 31).  Nor could he state the effect of these changes upon 
 
         her symptoms (exhibit 18(c), page 33).  Since the disease is a 
 
         gradual process, it was impossible for him to tell how long the 
 
                                                
 
                                                         
 
         condition had existed prior to the initial May, 1982 x-rays 
 
         (exhibit 18(c), pages 46 and 47).
 
         
 
              Dr. Rooney has assigned a nine percent permanent partial 
 
         functional impairment rating to claimant's body as a whole 
 
         (exhibit 18(c), page 33).  In his opinion, claimant's prognosis 
 
         is fair.  Although he believes it is likely she will continue to 
 
         have exacerbations in the future, he thinks she would be able to 
 
         return to work and yet be able to control at least a comfortable 
 
         level of pain that was not disabling (exhibit 18(c), page 36).  
 
         Despite optimal, maximal measures, claimant has not progressed as 
 
         well as Dr. Rooney expected (exhibit 18(c), pages 36-38).  Dr. 
 
         Rooney did indicate that the opinions expressed in his deposition 
 
         as well as reports were restricted to musculoskeletal 
 
         manifestations and did not encompass the fields of psychiatry or 
 
         psychology (exhibit 18(c), page 60).
 
         
 
              Dr. Bakody is a board-certified neurosurgeon practicing in 
 
         Des Moines, Iowa.  Dr. Bakody was of the opinion that there was a 
 
         cause and effect relationship between falling at work and the 
 
         ensuing surgery of May, 1982 (exhibit 18(d), page 7).  Further, 
 
         the doctor was of the opinion that there was a permanent physical 
 
         impairment, both as a result of the change of the structure of 
 
         the neck along with the surgery and the fact that there are 
 
         continuing complaints (exhibit 18(d), page 13).  The doctor 
 
         referred to the Manual of Orthopedic Surgeons in Evaluating 
 
         Permanent Physical Impairment and offered the opinion that 
 
         claimant suffers from a 20% impairment of the body as a whole 
 
         from a functional standpoint.  Dr. Bakody indicated that he felt 
 
         there was a relationship between the exacerbation of December, 
 
         1983 and the original injury and that he felt the manifestations 
 
         of December, 1983 were a continuum of the earlier problem 
 
         (exhibit 18(d), page 20).  At the time of Dr. Bakody's January 9, 
 
         1984 evaluation of claimant, he related that claimant had not 
 
         been working since December 29, 1983 and that, based upon the 
 
         history as reported as well as his examination, he did not feel 
 
         claimant was able to return to her employment during that time.  
 
         Subsequent to the January 9, 1984 evaluation and continuing up to 
 
         his final evaluation of claimant, Dr. Bakody reported a gradual 
 
         improvement in her overall condition (exhibit 18(d), pages 22 and 
 
         23).  He was of the opinion that her discomfort could be expected 
 
         to continue for an indefinite amount of time into the future 
 
         (exhibit 18(d), page 23).
 
         
 
              Dr. Cavallin is a psychiatrist licensed to practice medicine 
 
         in the state of Iowa.  Dr. Cavallin testified that claimant was 
 
         suffering from a major depressive disorder and that she had been 
 
         suffering from this disorder for a significant amount of time 
 
         before he had first seen her (exhibit 18(e), page 4).  The doctor 
 
         indicated that the use of pain killing medication following 
 
         claimant's surgery both affects the intellectual functioning of 
 
         people who take the medication and also creates depression 
 
         (exhibit 18(e), page 5).  Dr. Cavallin described the function of 
 
         the medication Tofranil in that it helps sleep, reduces 
 
         depression and increases the tolerance for pain (exhibit 18(e), 
 
                                                
 
                                                         
 
         page 7).  He described the effect of chronic pain and/or 
 
         depression as creating chronic fatigue in that the patient loses 
 
         energy and suffers from a loss of motivation and a loss of 
 
         strength.  It tends to limit the amount of physical activity and 
 
         contributes to social withdrawal because a patient experiences 
 
         relief from being quiet and from spending a rather sizeable 
 
         amount of time resting, more than the usual person would (exhibit 
 
         18(e), page 7).
 
         
 
              Dr. Cavallin was of the opinion that the major depressive 
 
         disorder appeared to have been triggered by the chronic pain 
 
         syndrome which had been treated at the Mercy Pain Clinic during 
 
         1984 (exhibit 18(e), page 4).  He indicated that claimant would 
 
         be required to use Tofranil indefinitely.  Dr. Cavallin was of 
 
         the opinion that claimant was at the present unable to return to 
 
         gainful occupational duties because the degree of her depression 
 
         was so severe as to incapacitate her from any kind of gainful 
 
         employment (exhibit 18(e), page 11).  The doctor was also of the 
 
         opinion that, in view of the course of the illness up to the 
 
         present, her disability due to the depression is permanent and 
 
         that he does not anticipate any significant change in the 
 
         foreseeable future.  As a consequence of no anticipated 
 
         improvement in her depression, the doctor was of the opinion that 
 
         she would not be able to perform gainful occupational duties in 
 
         the future.  He indicated that his involvement would be necessary 
 
         into the indefinite future, but that it would be primarily 
 
         limited to monitoring claimant's medication.  Dr. Cavallin was of 
 
         the opinion that claimant's condition, from a psychiatric 
 
         standpoint, essentially stabilized since August 4, 1986 (exhibit 
 
         18(e), pages 16 and 17).
 
         
 
              Dr. Hines is a clinical psychologist licensed to practice 
 
         psychology in the state of Iowa.  He testified that claimant 
 
         suffers from a diagnosis called dysthymic disorder, which 
 
         basically means chronic depression.  Based upon the history given 
 
         and his examination of claimant, it was his clinical opinion that 
 
         there was a relationship between her diagnosis and the pain that 
 
         she suffered as a consequence of her work injury of January, 1982 
 
         (exhibit 18(f), page 6).  He testified:
 
         
 
              It's my opinion that the depression arises wholly out of the 
 
              injury and the pain experience.  I have seen Joyce on some 
 
              75 occasions, which is a rather extensive, at least in terms 
 
              of my practice, course of psychotherapy and have come to 
 
              know her, I think, and the conditions of her life relatively 
 
              well. As best I can discern, she was not depressed before 
 
              her injury.  There were no conditions or symptoms or 
 
              expressions of significant depressions that I am aware of, 
 
              and I know of no other factors in her life over the time 
 
              that I have been acquainted with her or information that I 
 
              have about other times that would indicate anything else as 
 
              the cause other than her injury and her pain.  (Exhibit 
 
              18(f), page 6).
 
         
 
              At the time claimant was first evaluated by Dr. Hines, Dr. 
 
                                                
 
                                                         
 
         Hines was of the opinion that she was incapable of performing or 
 
         returning to her full range of employment duties with the Federal 
 
         Reserve Bank (exhibit 18(f), page 6).
 
         
 
              Dr. Hines described depression as something that does not 
 
         occur overnight, but rather is a result of a gradual building 
 
         process (exhibit 18(f), page 8).  Dr. Hines expressed the opinion 
 
         that a particular episode is not necessary to cause depression, 
 
         but rather, in light of his knowledge of claimant, there would 
 
         either not be a particular event or else it would be difficult to 
 
         determine one particular event simply because claimant would have 
 
         a tendency to deny and suppress and try to work over or work 
 
         through any particular kind of event that would contribute to the 
 
         depression (exhibit 18(f), pages 9-10).
 
         
 
              Dr. Hines testified that he felt an attempt to return to 
 
         work would be therapeutic and thus he cooperated in the attempt 
 
         to return Joyce to employment duties during 1985 (exhibit 18(f), 
 
         pages 12-13).  Dr. Hines reported that claimant's motivation 
 
         continued at a very high level, but that her pain experience was 
 
         simply not going to allow her to do the work she wanted to do 
 
         (exhibit 18(f), page 14).  Following her efforts to return to her 
 
         employment duties during 1985, the doctor described that, when 
 
         she would come to his office, she would be dysfunctional (exhibit 
 
         18(f), page 14).
 
         
 
              She was a mess, which is to say she was in so much pain that 
 
              it was hard for her to get here.  It was hard for her to get 
 
              up out of a chair in the waiting room.  Once we got her down 
 
              in here, it was hard for her to get up and down.  She could 
 
              not sit still.  The pain experience was very strong.  She 
 
              was in tears all the time, just could not stop crying.  She 
 
              would literally cry from the moment she hit the door until 
 
     
 
                            
 
                                                         
 
              the moment she left.  She was then 60 minutes in tears.  
 
              (exhibit 18(f), page 14).
 
         
 
              Dr. Hines opined that emotional turmoil interferes with 
 
         concentration, memory, attention span, and can be so specific as 
 
         to disorient a person (exhibit 18(f), page 15).  Dr. Hines 
 
         indicated that the July 15, 1986 letter from the Federal Reserve 
 
         Bank directed to claimant informing her that she would be dropped 
 
         from the work roles had a very significant effect upon her 
 
         (exhibit 18(f), pages 17 and 18).  Dr. Hines explained that 
 
         claimant has carried a deep-seated fear of abandonment, that she 
 
         was strongly connected to her work and to the particular job and 
 
         that the letter emotionally carried her back into her fear of 
 
         abandonment (exhibit 18(f), page 18).  In Dr. Hines' opinion, 
 
         following the final attempt to return to occupational duties in 
 
         1985, claimant reached her psychological plateau at or about the 
 
         time of Dr. Hines' referral to Dr. Cavallin (exhibit 18(f), page 
 
         19).  Claimant's prognosis from a psychological standpoint is 
 
         that her condition will flare on occasion and, when it does, she 
 
         will need more therapeutic intervention (exhibit 18(f), page 21).  
 
         Dr. Hines is of the opinion that it is highly improbable that she 
 
         could carry on the necessary duties of employment (exhibit 18(f), 
 
         page 23).
 
         
 
              Dr. Hines confirmed the opinions expressed in his report of 
 
         January 20, 1987 [exhibit 4(e)] that claimant is totally and 
 
         permanently vocationally disabled and he does not anticipate that 
 
         this condition will improve in the foreseeable future.  Dr. Hines 
 
         indicated that psychotherapy will probably be necessary at least 
 
         one time per month for life (exhibit 18(f), page 21).  The 
 
         purpose of the continued therapeutic treatment is to keep 
 
         claimant from getting any worse as far as the depression is 
 
         concerned, particularly to ward off any need for mental health 
 
         unit hospitalization, and also to guard against any suicidal 
 
         impulses that might arise (exhibit 18(f), page 20).
 
         
 
              Scott B. Neff, D.O., is a board-certified orthopedic 
 
         surgeon. He examined claimant on one occasion during September, 
 
         1986.  Dr. Neff was of the opinion that claimant suffers from a 
 
         loss of motion and chronic achiness that occurs in the neck and 
 
         muscles of the neck as a consequence of her cervical fusion.  Dr. 
 
         Neff initially expressed the opinion that claimant suffered a 10% 
 
         functional impairment of the body as a whole because of the neck 
 
         injury, cervical fusion, resulting loss of motion and the 
 
         persistence of neck soreness and neck pain (exhibit 18(a), page 
 
         29).  Dr. Neff recommended that claimant not be asked to do heavy 
 
         manual labor and not be in a work place function whereby she has 
 
         to do repetitive side-to-side or flexion/extension activity of 
 
         the neck (exhibit 18(a), page 33).
 
         
 
              Dr. Neff felt claimant has one legitimate medical problem. 
 
         She has had a cervical fusion resulting in loss of motion and 
 
         chronic pain in the neck (exhibit 18(a), page 25).  He does not 
 
         know of any way anatomically that such a condition would result 
 
         in pain radiating down the legs and into the feet or cause 
 
                                                
 
                                                         
 
         headaches in the front part of her head (exhibit 18(a), page 25).  
 
         He further stated that he has examined numerous patients who 
 
         suffer from chronic pain syndrome and reactive depression and he 
 
         has never found any such individual to be permanently disabled 
 
         from gainful employment (exhibit 18(a), pages 27-28).  It is Dr. 
 
         Neff's opinion that claimant has a 10% impairment to the body as 
 
         a whole based on persistence of neck pain (exhibit 18(a), page 
 
         29), although he would have no difficulty in agreeing with Mr. 
 
         Bower's 15% rating (exhibit 18(a), page 34).  There is no 
 
         question in Dr. Neff's mind that claimant is physically capable 
 
         of gainful employment in an office-type environment (exhibit 
 
         18(a), page 33). Dr. Neff did confirm that there was more than 
 
         simply a musculoskeletal component to the injury which was in 
 
         part confirmed by the symptom magnification profile that was 
 
         completed (exhibit 18(a), page 40).  Dr. Neff conceded that 
 
         claimant has undergone significant deconditioning over the past 3 
 
         1/2 years since she last worked, that claimant does not fit 
 
         within the average parameters of strength for a person of her 
 
         size and age and that she could not be expected to do manual 
 
         labor at any point in the future (exhibit 18(a), page 42).  Dr. 
 
         Neff confirmed that the opinions he has expressed as far as 
 
         claimant's ability to perform office type sedentary work would be 
 
         from a musculoskeletal standpoint only (exhibit 18(a), page 34).
 
         
 
              Thomas W. Bower is a licensed physical therapist.  He 
 
         conducted a functional capacity evaluation of claimant in an 
 
         attempt to describe her overall abilities to function (exhibit 
 
         18(b), page 7).  Mr. Bower reported that her functional capacity 
 
         placed her within the light/medium category which means that she 
 
         could infrequently lift 35 pounds and frequently would be able to 
 
         lift 25 pounds or less (exhibit 18(b), page 16).  He expressed 
 
         the opinion that claimant was a borderline symptom magnifier 
 
         which means that the individual's behavior is out of proportion 
 
         to the organic findings (exhibit 18(b), page 19).  Mr. Bower was 
 
         of the opinion that claimant should be able to perform the 
 
         occupational duties that were attempted during the fall of 1985 
 
         (exhibit 18(b), pages 25-26).  However, Mr. Bower did confirm 
 
         that the opinions he expressed with regard to the job description 
 
         for the position created in the fall of 1985 would be from a 
 
         musculoskeletal standpoint only (exhibit 18(b), page 29).  He 
 
         confirmed that once deconditioning takes place, it makes it 
 
         extremely difficult to rehabilitate the person and get them back 
 
         to a functioning level. He indicated that a 3 1/2 year period of 
 
         time where an individual has been off work, such as claimant, 
 
         would make a work hardening process much more improbable (exhibit 
 
         18(b), page 30).  Mr. Bower confirmed that, from a 
 
         musculoskeletal standpoint, claimant suffers a 15% functional 
 
         impairment of the body as a whole (exhibit 18(b), page 32).  Mr. 
 
         Bower was not aware that claimant had been diagnosed as suffering 
 
         from chronic depression (exhibit 18(b), pages 36 and 37) and that 
 
         chronic depression could have an impact upon the findings he 
 
         noted (exhibit 18(b), page 37).  Mr. Bower confirmed that, if 
 
         claimant had attempted to return to the duties as described in 
 
         exhibit 9(c), and was unable to perform those duties, a question 
 
         would be posed as to why claimant could not function in a job 
 
                                                
 
                                                         
 
         placed within those restrictions (exhibit 18(b), page 40).  It 
 
         may mean that there would be other concerns such as psychological 
 
         or psychiatric concerns that would be beyond the area,of Mr. 
 
         Bower's admitted expertise which may in some fashion affect 
 
         claimant's ability to perform the occupational duties described 
 
         in exhibit 9(c), (exhibit 18(b), page 40).
 
         
 
              Exhibit 15 sets out claimant's prescription medication usage 
 
         and costs since February 8, 1982.  It shows that claimant has 
 
         advanced $178.00 from her own funds which has not been reimbursed 
 
         by the defendants.
 
         
 
              Exhibit 17 sets out claimant's mileage expenses.
 
         
 
              Exhibit 19 sets out the total amount of temporary partial 
 
         disability, temporary total disability/healing period, and 
 
         permanent partial disability benefits paid and the respective 
 
         dates thereof.
 
         
 
              Exhibit 20 reflects that the employer continued to pay 
 
         claimant's salary while absent from work until approximately the 
 
         second month of 1986 and that the total amount of salary paid 
 
         over and above workers' compensation benefits was $6,871.14.
 
         
 
              Kim Rhoads, testifying on behalf of the Bank, stated that 
 
         she is presently employed at the Bank as supervisor of the night 
 
         force, although most of her work experience with the Bank has 
 
         been in its human resources department.  She has been a Bank 
 
         employee since February, 1982.  Ms. Rhoads described the specific 
 
         duties of the "check processor" position to which claimant 
 
         returned in September, 1985.  The position entailed receiving and 
 
         comparing bookkeeping machine tapes for accuracy.  The duties 
 
         were performed while seated at a desk.  No machinery was required 
 
         other than an adding machine.  Other than carrying a "block" of 
 
         tapes from a cart to her desk, no lifting was required.  
 
         (Claimant testified these "blocks" weighed approximately one 
 
         pound.) Claimant was free to stand, walk or rest as she needed.
 
         
 
              Ms. Rhoads further testified that she researched and 
 
         prepared exhibit 20 which evidences the amount of salary paid to 
 
         claimant by the Bank over and above her weekly workers' 
 
         compensation benefits.  The Bank's policy is to pay employees on 
 
         workers' compensation full salary, less compensation benefits.
 
         
 
              Ms. Rhoads stated that the Bank is willing to return 
 
         claimant to employment.  Although the "check processor" position 
 
         is presently filled, she testified that there is a high rate of 
 
         turnover in the position, especially in the night force, and that 
 
         as soon as the position opened, claimant could return to work.
 
         
 
              Bil Cooper testified that he is owner of Cooper Consultants, 
 
         a vocational rehabilitation firm, and has been employed as a 
 
         rehabilitation consultant with his firm for one year.  Previously 
 
         he was a vocational rehabilitation counselor with North Central 
 
         Rehabilitation Services for three years.  While with North 
 
                                                
 
                                                         
 
         Central, he was retained by the Bank's insurance carrier on April 
 
         16, 1985 to evaluate claimant for vocational rehabilitation 
 
         purposes.  Thereafter, Cooper contacted claimant, her physicians 
 
         and Bank personnel and, in consultation with these individuals, 
 
         developed a "work hardening program" with a view towards 
 
         returning claimant to employment with the bank.  Cooper received 
 
         from Dr. Rooney a capacity evaluation concerning restrictions 
 
         upon claimant's physical activity [exhibit 9(d)].  He then 
 
         developed an employment position with the Bank which would meet 
 
         or be less taxing than the criteria set by Dr. Rooney.  The 
 
         position developed was that of "check processor."  Cooper then 
 
         set forth a description of the check processor's duties to both 
 
         Dr. Rooney and Dr. Hines for their approval on a "job analysis" 
 
         form [exhibit 9(c)].  Both Dr. Rooney and Dr. Hines approved 
 
         claimant's return to work as a check processor (exhibit 18(f), 
 
         page 30; exhibit 18(c), page 44).  The plan under the work 
 
         hardening program was to return claimant to work at the new 
 
         position on a part-time basis and gradually thereafter to 
 
         full-time.
 
         
 
              Claimant returned to work at the new position on September 
 
         9, 1985.  Cooper accompanied her to work and maintained close 
 
         contact with claimant as to her progress.  Cooper testified that 
 
         he could not think of a more sedentary job than that which 
 
         claimant performed as a check processor.  He did not recall 
 
         claimant complaining of any physical problems with the job.  The 
 
         Bank was very cooperative and allowed claimant to rest or take 
 
         breaks at will.  During the first 30 work days of the program, 
 
         claimant failed to report to work on 20 occasions (exhibit 13).  
 
         She absented herself from work on November 4, 1985 for gall 
 
         bladder surgery and has not returned to work since.  Cooper was 
 
         not satisfied with claimant's efforts toward the work hardening 
 
         program and did not feel claimant cooperated in the effort.
 
 
 
                            
 
                                                         
 
         
 
                        APPLICABLE LAW AND ANALYSIS
 
         
 
              The claimant has the burden of proving by a preponderance of 
 
         the evidence that the injury of January 29, 1982 is causally 
 
         related to the disability on which she now bases her 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).
 
         
 
              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).
 
         
 
              Defendants do not dispute that claimant sustained some 
 
         permanent impairment and permanent disability in the cervical 
 
         area of her spine as the result of the January 29, 1982 injury.  
 
         The real issue in the case is the relationship between the 
 
         January 29, 1982 injury and claimant's claimed inability to be 
 
         gainfully employed due to a major depressive disorder.
 
         
 
              The facts of this case as it began to unfold were relatively 
 
         unremarkable.  Claimant fell and then sought medical treatment 
 
         when her condition did not resolve promptly.  A trial of 
 
         conservative treatment was employed, but without success.  
 
         Surgery was eventually performed.  Following the surgery, 
 
         claimant returned to her work, which was sedentary in nature.  
 
         From the evidence presented, it appears that, as of October 16, 
 
         1982, when claimant resumed full-time duties, the expectation was 
 
         that she would make a relatively full recovery and continue with 
 
         her employment.  She, in fact, continued to work and perform the 
 
         duties of her employment in an apparently satisfactory manner, as 
 
         shown by her employee evaluations (exhibit 12).  However, in 
 
         December, 1983, she began missing work and again sought medical 
 
         care.  Although there have been two subsequent efforts for 
 
         claimant to resume her employment, both have met with failure. 
 
         Drs. Cavallin and Hines have both expressed the opinion that 
 
         claimant suffers from a major depressive disorder that was 
 
         induced by the pain which she experienced from the condition that 
 
         resulted from her January 29, 1982 fall.  There is some evidence 
 
         in the record that claimant may have had some problems in her 
 
         relationship with her husband, but that evidence appears to be 
 
                                                
 
                                                         
 
         quite remote and relatively less significant to claimant's 
 
         depressive disorder than is the pain resulting from the January 
 
         29, 1982 injury.
 
         
 
              From the evidence, it appears that the pain feeds the 
 
         depression and that the depression feeds the pain.  The symptom 
 
         magnification exhibited to Mr. Bower is as likely a symptom of 
 
         the depression as it is any indication of exaggeration of 
 
         complaints. The evidence does not contain a single opinion from a 
 
         medical professional which disputes the diagnosis of depression 
 
         that has been made.  It is therefore found that claimant is 
 
         afflicted with a major depressive disorder which was proximately 
 
         caused by the injuries she sustained in the fall that occurred on 
 
         January 29, 1982.
 
         
 
              Dr. Neff indicated that some degree of depression is not 
 
         uncommon following a relatively serious injury or surgery.  A 
 
         depression of the magnitude that has been diagnosed by Drs. 
 
         Cavallin and Hines is not, however, what normally occurs.  For 
 
         claimant to have developed the major depressive disorder, it 
 
         would seem likely that she was in some way predisposed or 
 
         susceptible to developing the disorder.
 
         
 
              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.2d 756, 760-761 
 
         (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, 815 (1962).
 
         
 
              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 v. United States Gypsum Co., 252 Iowa 
 
         613, 620, 106 N.W.2d 591 (1960), an 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 
 
         v. Goodyear Service Stores, 255 Iowa 1112, 125 N.W.2d 251 (1963); 
 
         Yeager v. Firestone Tire & Rubber, Co., 253 Iowa 369, 112 N.W.2d 
 
         299 (1961); Ziegler v. United States Gypsum Co., 252 Iowa 613, 
 
         106 N.W.2d 591 (1960).  See also Barz v. Oler, 257 Iowa 508, 133 
 
         N.W.2d 704 (1965); Almquist v. Shenandoah Nurseries, 218 Iowa 
 
         724, 254 N.W. 35 (1934).
 
         
 
              A cause is proximate if it is a substantial factor in 
 
         bringing about the result; it need not be the only cause. 
 
         Blacksmith v. All American, Inc., 290 N.W.2d 348, 354 (Iowa 
 
         1980). A disability of the magnitude claimant experiences does 
 
         not normally occur following an injury of the type which she 
 
         experienced.  The injury is, nevertheless, a proximate cause of 
 
                                                
 
                                                         
 
         the disability with which she is now afflicted.
 
         
 
              Claimant's injury was initially to her cervical spine and 
 
         she now has a major depressive disorder.  Neither condition is a 
 
         scheduled member and the parties correctly stipulated that her 
 
         disability should be evaluated industrially.
 
         
 
              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."
 
         
 
              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 
 
         v. Goodyear Service Stores, 255 Iowa 1112, 1121, 125 N.W.2d 251, 
 
         257 (1963).
 
         
 
              Claimant seeks to rely on the odd-lot doctrine.  Guyton v. 
 
         Irving Jensen Co., 373 N.W.2d 101 (Iowa 1985).  The Federal 
 
         Reserve Bank has treated claimant quite fairly throughout the 
 
         entire course of events that are the subject of this proceeding. 
 
         Claimant has been given fine medical treatment.  The employer 
 
         made good faith efforts to enable claimant to resume employment. 
 
         Unfortunately, the efforts were not successful.  Drs. Cavallin 
 
         and Hines have indicated that, in their opinions, claimant is not 
 
         capable of being gainfully employed due primarily to her 
 
         depressive disorder.  The physicians who have dealt with her 
 
         physical state, namely, Drs. Neff and Bakody, have found no 
 
         reason why claimant should not be able to be gainfully employed. 
 
          A cervical fusion does not normally make an individual unable to 
 
         perform sedentary employment.  If this case was typical, claimant 
 
         would have remained at work up to the present time and 
 
         indefinitely into the future following her return on October 16, 
 
         1982.  That is not, however, what occurred.  There is no expert 
 
         medical evidence in the record which indicates that claimant's 
 
         emotional disorder is not disabling.  There is no expert medical 
 
         evidence in the record which indicates that the emotional 
 
         disorder is not permanent.  To the contrary, the unrebutted 
 
         evidence from Drs. Cavallin and Hines shows claimant's emotional 
 
         disorder to be totally disabling and to be of indefinite and 
 
         indeterminable duration, if not permanent.  The only evidence in 
 
         the record which detracts from the opinions expressed by Drs. 
 
         Cavallin and Hines is:  (1) that a major depressive disorder does 
 
         not normally occur following an injury of the type claimant 
 
         sustained; (2) the fact that secondary gain may be a factor; and 
 
         (3) the physical impairment resulting from the cervical fusion 
 
         would not normally prevent a person from performing sedentary 
 
                                                
 
                                                         
 
         employment.  It is found that those factors are not sufficiently 
 
         strong to overcome the clear, unrebutted opinions of Drs. 
 
         Cavallin and Hines. Claimant is therefore found and determined to 
 
         be permanently and totally disabled within the meaning of Iowa 
 
         Code section 85.34(3).
 
         
 
              The date that claimant's healing period ended is not of any 
 
         particular importance in view of the finding of permanent total 
 
         disability.  It is clear that claimant was not permanently and 
 
         totally disabled when she resumed full-time work on October 16, 
 
         1982.  She did, however, have some degree of permanent partial 
 
         disability at that time and was entitled to receive compensation 
 
         for permanent partial disability.  It is determined that her 
 
         permanent partial disability, on October 16, 1982, based upon the 
 
         information that was available on that date, would have presented 
 
         a disability of approximately 15% permanent partial disability. 
 
         Such would have provided an entitlement of 75 weeks of benefits. 
 
         Claimant worked on a full-time basis for 60 5/7 weeks and then 
 
         began missing work again commencing December 13, 1983.  When she 
 
         began missing work, her entitlement to compensation for healing 
 
         period resumed.  That entitlement continued until the point that 
 
         it became medically indicated that further significant 
 
         improvement from the injury was not anticipated under the 
 
         provisions of Iowa Code section 85.34(1).  Teel v. McCord, 394 
 
         N.W.2d 405 (Iowa 1986); Thomas v. William Knudson & Son, Inc., 
 
         349 N.W.2d 124, 126 (Iowa App. 1984); Armstrong Tire & Rubber Co. 
 
         v. Kubli, 312 N.W.2d 60 (Iowa App. 1981).  It is therefore 
 
         determined that claimant's healing period ended on October 23, 
 
         1985, the last day of her last attempt to return to work.
 
         
 
              An injured worker is not entitled to receive both healing 
 
         period and compensation for permanent disability from the same 
 
         injury on any given day.  It must be one or the other.  In this 
 
 
 
                        
 
                                                         
 
         case, claimant was paid her full salary to supplement workers' 
 
         compensation benefits.  She was either receiving healing period, 
 
         permanent partial disability, temporary partial disability, her 
 
         regular salary or some combination.  Up to the date of October 
 
         23, 1985, claimant had clearly been paid all that was due to her 
 
         under the workers' compensation system through the combination of 
 
         workers' compensation benefits and the employer's salary 
 
         continuation policy.  While the excess of the salary continuation 
 
         over and above the workers' compensation benefits does not 
 
         constitute a credit towards future workers' compensation 
 
         liability, the amounts paid as salary do satisfy the workers' 
 
         compensation liability for the weeks for which the salary was 
 
         paid.  (Division of Industrial Services Rule 343-8.4).
 
         
 
              For purposes of the record, however, the healing period 
 
         should be specified.  Claimant's healing period, determined in 
 
         accordance with section 85.34(1), is as follows:
 
         
 
              February 9, 1982 through February 22, 1982 (2 1/7 weeks)
 
              May 6, 1982 through August 22, 1982 (15 4/7 weeks)
 
              December 13, 1983 through December 16, 1983 (4/7 week)
 
              December 23, 1983 (1/7 week)
 
              December 30, 1983 through September 23, 1984 (38 2/7 weeks)
 
              November 13, 1984 through December 9, 1984 (3 6/7 weeks)
 
              January 4, 1985 through September 8, 1985 (35 3/7 weeks)
 
              Total -- 96 weeks
 
         
 
              Claimant is also entitled to receive temporary partial 
 
         disability in accordance with Iowa Code section 85.33(2) for the 
 
         following periods:
 
         
 
              August 23, 1982 through October 15, 1982 (7 5/7 weeks)
 
              September 24, 1984 through November 12, 1984 (7 1/7 weeks)
 
              December 10, 1984 through January 3, 1985 (3 4/7 weeks)
 
              September 9, 1985 through October 22, 1985 (6 2/7 weeks)
 
              Total -- 24 5/7 weeks
 
         
 
              Claimant also seeks to recover costs.  Division of 
 
         Industrial Services Rule 343-4.33 controls costs in proceedings 
 
         before this agency.  The costs claimed are found in exhibit 13.  
 
         All of the depositions for which claimant seeks to recover costs 
 
         were received into evidence and reporting and transcription fees 
 
         incurred in obtaining depositions are recoverable under Iowa Rule 
 
         of Civil Procedure 157(a).  Woody v. Machin, 380 N.W.2d 727 (Iowa 
 
         1986).  Expert witness fees are limited, however, to $150.00 as 
 
         provided by Iowa Code section 622.72.  The costs recoverable by 
 
         claimant are therefore as follows:
 
         
 
                     Rooney report                         $100.00
 
                     Hines report                            90.00
 
                     Bakody expert witness fee              150.00
 
                     Cavallin expert witness fee            150.00
 
                     Rooney expert witness fee              150.00
 
                     Hines expert witness fee               150.00
 
                     Bakody deposition reporter fees        143.50
 
                                                
 
                                                         
 
                     Hines deposition reporter fees         157.00
 
                     Cavallin deposition reporter fees       83.25
 
                     Rooney deposition reporter fees        242.00
 
                     Total                               $1,415.75
 
                      
 
                                     FINDINGS OF FACT
 
         
 
              1.  On January 29, 1982, Joyce D'Ostilio was a resident of 
 
         the state of Iowa employed by Federal Reserve Bank in Des Moines, 
 
         Iowa.
 
         
 
              2.  Joyce D'Ostilio was injured when she fell in the parking 
 
         lot of the employer's place of business on January 29, 1982.
 
         
 
              3.  Following the injury, claimant continued to work through 
 
         February 8, 1982, but then sought medical treatment which took her 
 
         off work from February 9, 1982 through February 22, 1982.  
 
         Claimant was again absent from work from May 6, 1982 through 
 
         August 22, 1982 for purposes of medical treatment.  She returned 
 
         to Work part-time on August 23, 1982 and resumed full-time duties 
 
         on October 16, 1982.  Thereafter she continued to work full-time 
 
         until December 13, 1983.  Commencing on December 13, 1983, 
 
         claimant began missing work and has not since made a sustained, 
 
         long-term return to work, although she has attempted to return to 
 
         work on a part-time basis on three separate occasions.
 
         
 
              4.  During all of the times claimant was absent from work, 
 
         she was medically incapable of performing work in employment 
 
         substantially similar to that she performed at the time of 
 
         injury.
 
         
 
              5.  Claimant reached the point it was medically indicated 
 
         that further significant improvement from the injury was not 
 
         anticipated on October 23, 1985.  In all, claimant accumulated a 
 
         total of 96 weeks when she was in a healing period status and 24 
 
         5/7 weeks when she was temporarily partially disabled and working 
 
         part-time.  She has been paid all weekly benefits due prior to 
 
         October 23, 1985.
 
         
 
              6.  Claimant is a credible witness.
 
         
 
              7.  Claimant's injury was the herniation of cervical disc 
 
         for which cervical fusion surgery was performed.
 
         
 
              8.  Claimant initially made a relatively normal recovery, 
 
         but then developed a chronic pain syndrome which, in turn, 
 
         developed into a major depressive disorder which is currently her 
 
         primary medical problem.
 
         
 
              9.  The fall which claimant sustained on January 29, 1982 
 
         was a substantial factor in producing the depressive disorder 
 
         with which claimant is currently afflicted.
 
         
 
              10.  Drs. Cavallin and Hines are correct in their assessment 
 
         that claimant is presently totally disabled from performing 
 
                                                
 
                                                         
 
         gainful employment and that she is likely to remain so disabled 
 
         for an indefinite period of time.
 
         
 
                               CONCLUSIONS OF LAW
 
         
 
              1.  This agency has jurisdiction of the subject matter of 
 
         this proceeding and its parties.
 
         
 
              2.  Claimant's fall in the employer's parking lot on January 
 
         29, 1985 is a proximate cause of the physical impairment in her 
 
         cervical spine, the pain she experiences in the cervical spine, 
 
         the chronic pain syndrome which she has developed and the major 
 
         depressive disorder with which she is currently afflicted.
 
         
 
              3.  Claimant's depressive disorder is an injury which arose 
 
         out of and in the course of her employment with the Federal 
 
         Reserve Bank.
 
         
 
              4.  Claimant is permanently and totally disabled within the 
 
         meaning of Iowa Code section 85.34(3).
 
         
 
              5.  Claimant is entitled to receive 96 weeks of compensation 
 
         for healing period, all of which has previously been paid by the 
 
         employer and its insurance carrier.
 
         
 
              6.  Claimant is entitled to receive 24 5/7 weeks of 
 
         temporary partial disability compensation, all of which has 
 
         previously been paid by the employer and its insurance carrier.
 
         
 
              7.  Claimant is entitled to receive 60 5/7 weeks of 
 
         compensation for permanent total disability payable commencing 
 
         October 16, 1982, all of which has previously been paid by the 
 
         employer and its insurance carrier.
 
         
 
              8.  Claimant is entitled to receive compensation for 
 
         permanent total disability for so long as she remains permanently 
 
         and totally disabled commencing October 23, 1985.
 
         
 
              9.  Claimant is entitled to recover costs from the 
 
         defendants in accordance with Division of Industrial Services 
 
         Rule 343-4.33 in the amount of $1,415.75.
 
         
 
                                     ORDER
 
         
 
              IT IS THEREFORE ORDERED that defendants pay claimant 
 
         compensation for permanent total disability commencing October 
 
         23, 1985 at the rate of one hundred sixty-nine and 68/100 dollars 
 
         ($169.68) per week and continuing for so long as claimant remains 
 
         totally disabled from gainful employment.
 
         
 
              IT IS FURTHER ORDERED that defendants receive credit for all 
 
         amounts previously paid and, in the event any amounts are past 
 
         due and owing, such amounts shall be paid in a lump sum together 
 
         with interest pursuant to section 85.30 of The Code of Iowa.
 
         
 
                                                
 
                                                         
 
              IT IS FURTHER ORDERED that defendants pay the costs of this 
 
         action pursuant to Division of Industrial Services Rule 343-4.33 
 
         in the amount of one thousand four hundred fifteen and 75/100 
 
         dollars ($1,415.75).
 
         
 
              IT IS FURTHER ORDERED that defendants file Claim Activity 
 
         Reports as requested by this agency pursuant to Division of 
 
         Industrial Services Rule 343-3,1.
 
         
 
              Signed and filed this 9th day of March, 1988.
 
         
 
         
 
         
 
         
 
         
 
         
 
                                            MICHAEL G. TRIER
 
                                            DEPUTY INDUSTRIAL COMMISSIONER
 
         
 
         Copies To:
 
         
 
         Mr. Steven C. Jayne
 
         Attorney at Law
 
         5835 Grand Avenue
 
         Suite 201
 
         Des Moines, Iowa  50312
 
         
 
         Mr. George H. Capps
 
         Attorney at Law
 
         1332 Grand Avenue
 
         W. Des Moines, Iowa  50265
 
 
 
         
 
 
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                                            1108.20, 1402.30, 1402.40
 
                                            1701, 1804, 2907, 4100
 
                                            Filed March 9, 1988
 
                                            MICHAEL G. TRIER
 
         
 
                    BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         JOYCE D'OSTILIO,
 
         
 
              Claimant,
 
         
 
         vs.                                           File No. 753117
 
         
 
         FEDERAL RESERVE BANK,                          R E V I E W -
 
         
 
              Employer,                               R E 0 P E N I N G
 
         
 
         and                                           D E C I S I 0 N
 
         
 
         THE HARTFORD INSURANCE GROUP,
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         1108.20, 1402.30, 1402.40, 1701, 1804, 2907, 4100
 
         
 
              Claimant fell sustaining a herniated cervical disc.  Fusion 
 
         surgery was performed.  After relatively normal recovery, she 
 
         returned to work.  Approximately one year later, she began 
 
         missing work and seeking medical care due to complaints of severe 
 
         pain. Claimant's condition generally deteriorated and, at the 
 
         time of hearing, the only expert medical opinions in the record 
 
         indicated that she was permanently and totally disabled due to a 
 
         major depressive disorder which had arisen as a result of her 
 
         chronic pain.  Claimant urged that she was permanently and 
 
         totally disabled and sought assistance from the odd-lot doctrine.  
 
         The odd-lot doctrine was not discussed, but permanent total 
 
         disability was awarded based on the uncontroverted medical 
 
         opinions from a psychiatrist and a psychologist.  The employer 
 
         was granted a credit on a week-for-week basis for its salary 
 
         continuation program, but no credit was allowed for the excess of 
 
         salary over the workers' compensation liability as against future 
 
         workers' compensation benefits.  Costs in the nature of reports, 
 
         expert witness fees and report and transcription fees were 
 
         assessed.