5180 3
 
                                            Filed August 15, 1989
 
                                            DAVID E. LINQUIST
 
         
 
                 BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         SCOTT C. MCKELVEY,
 
         
 
              Claimant,                              File No. 772870
 
         
 
         vs.
 
                                                       A P P E A L
 
         BURLINGTON MEDICAL CENTER,
 
         
 
              Employer,                              D E C I S I 0 N
 
         
 
         and
 
         
 
         ST. PAUL INSURANCE COMPANY,
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
         51803
 
         
 
              Deputy's award of 20 percent permanent partial disability of 
 
         the right arm affirmed on appeal.
 
         
 
         
 
         
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                
 
 
            
 
 
 
                
 
                 
 
                  BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         SCOTT C. MCKELVEY,
 
         
 
              Claimant,                              File No. 772870
 
         
 
         vs.                                      A R B I T R A T I O N
 
         
 
         BURLINGTON MEDICAL CENTER,                  D E C I S I O N
 
         
 
              Employer,                                 F I L E D
 
         
 
         and                                           FEB 21 1989
 
         
 
         ST. PAUL INSURANCE COMPANY,               INDUSTRIAL SERVICES
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
                                   INTRODUCTION
 
         
 
              This is a proceeding in arbitration brought by Scott C. 
 
         McKelvey against Burlington Medical Center, his former employer, 
 
         and its insurance carrier, St. Paul Insurance Company.  The case 
 
         was heard and fully submitted at Burlington, Iowa on July 6, 
 
         1988. The record in the proceeding consists of testimony from 
 
         Scott C. McKelvey and exhibits 1 through 15.
 
         
 
                                     ISSUES
 
         
 
              The only issue for determination is the extent of permanent 
 
         partial disability affecting McKelvey's right arm as a result of 
 
         the August 20, 1984 injury.
 
         
 
                             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.
 
         
 
              There is no material dispute with regard to the 
 
         circumstances of McKelvey's injury and its treatment.  The only 
 
         dispute is the extent of the resulting permanent partial 
 
         disability.
 
         
 
              Scott C. McKelvey was working as a maintenance person for 
 
         Burlington Medical Center during the summer of 1984.  On August 
 
         20, 1984, he was driving a dump truck.  When he tried to dump a 
 
         load of dirt, the bed would not raise high enough to dump the 
 
         dirt which it was carrying.  Claimant inspected, found a cable 
 
                                                      
 
                                                               
 
         which was binding, reached in, pulled the cable and the bed of 
 
         the truck came down on his arm.  He suffered a severe crush 
 
         injury to his arm with a comminuted fracture of his humerus.  The 
 
         posterior triceps muscle was severed.  The radial and ulnar 
 
         nerves were crushed (exhibit 15, pages 15-17).
 
         
 
              Exhibit 7, a report from Jerry L. Jochims, M.D., dated 
 
         September 4, 1984 adequately summarizes the first few days of 
 
         claimant's treatment and recovery and is hereafter set forth:
 
         
 
              As you are well aware, on August 20, 1984, Mr. Scott 
 
              McKelvey was brought to the Burlington Medical Center 
 
              emergency room after a traumatic incident while employed by 
 
              the Burlington Medical Center.  To the best of my 
 
              understanding, it appears as if he had his arm caught 
 
              between the I-beam support at the base of a truck box, and 
 
              the I-beam support of the truck chassis frame, when the 
 
              hydraulic mechanism somehow was tripped or failed, and the 
 
              truck box, which was hoisted up, collapsed down compressing 
 
              his right upper arm between the two pieces of metal.
 
         
 
              With the significant amount of compression force involved, 
 
              he sustained a complete loss of neural and arterial function 
 
              to the arm, as well as a very comminuted fracture of the 
 
              right humerus.  On his arrival at the Burlington Medical 
 
              Center, his condition was stabilized with intravenous fluids 
 
              and antibiotics, as well as pain medications.  While being 
 
              supported initially, we did place gentle manipulative 
 
              traction on his arm, and were able to get the pulses to 
 
              return in his right forearm.  Subsequent to this, I 
 
              indicated him for an open reduction internal fixation of the 
 
              humerus fracture and an exploration of the neural structures 
 
              so as to allow for debridement of this open fracture and 
 
              release of any of the neural tissue which might be 
 
              encompassed in the fracture.
 
         
 
              His surgery was undertaken the night of August 20, 1984, and 
 
              my partner Dr. Duane Nelson assisted on that surgery.  He 
 
              thereafter was followed in the Burlington Medical Center 
 
              emergency room until August 28, 1984, at which time he 
 
              appeared to have gone through his initial shock and primary 
 
              healing phase.  We did do a secondary surgical procedure 
 
              four days after his admission for the purpose of delayed 
 
              primary closure of his wound, which was too tight to close 
 
              the night of his surgery, and also to re-inspect the radial 
 
              nerve.
 
         
 
              His injury to date is as described above, and it should be 
 
              noted that although the nerves are intact to the best of our 
 
              ability to explore his arm through a posterior wound, we do 
 
              know that the radial nerve is in total continuity, not 
 
              having been transected as well as the ulnar nerve.  We did 
 
              not explore or dissect anteriorly to identify the median 
 
              nerve, but at about one month post injury, our plan is to 
 
              proceed with nerve conduction tests.  It would appear that 
 
                                                      
 
                                                               
 
                   he does have deep pain sensation in all nerve groups and 
 
              that although the nerve tissue itself was not transected, it 
 
              was merely severely contused in a type of injury called a 
 
              neuropraxia.
 
         
 
              I have no idea at this time as to the type of recovery we 
 
              will anticipate, nor the date upon which he might be able to 
 
              return to work.  Obviously, at this point his functional 
 
              impairment is with a complete loss of use of his right arm 
 
              from the shoulder distally, and I hope that return of 
 
              function will be progressive.  We have seen where the loss 
 
              of function in an extremity such as this takes as long as 
 
              3-4 months to recover, and I would not be surprised that he 
 
              will require at least 3-4 months for recovery.  It should be 
 
              noted that his triceps muscle on the radial border was also 
 
              totally transected by the compressive force, and loss of 
 
              muscle function is certainly a possibility as well.  
 
              Hopefully, because of his youth, his recuperative powers are 
 
              optimal.
 
         
 
         (Exhibit 7, pages 1 and 2)
 
         
 
              Dr. Jochims' office notes are found in exhibit 1.  The notes 
 
         show a gradual yet positive course of recuperation.  The note 
 
         dated March 29, 1985 indicates that claimant has had an almost 
 
         miraculous improvement with his radial nerve functioning at about 
 
         80% strength.  The ulnar and median nerves had previously 
 
         recovered much of their function.  On June 14, 1985, Dr. Jochims 
 
         evaluated claimant for the purpose of providing a permanent 
 
         partial impairment rating.  Dr. Jochims found claimant to have 
 
         triceps muscle weakness for which he assigned a ten percent 
 
         impairment rating.  Dr. Jochims also assigned a five percent 
 
         impairment rating to the radial nerve and to the median nerve 
 
         based upon hypesthesia.  The total rating provided by Dr. Jochims 
 
         was a 20% permanent partial impairment of the right upper 
 
         extremity.  At the time, Dr. Jochims had some reservations 
 
         regarding whether or not the fractured humerus was completely 
 
         united (exhibit 1, pages 5 and 6; exhibit 15, pages 5 and 6).
 
         
 
              Dr. Jochims last examined claimant on June 6, 1986.  At that 
 
         time, claimant displayed very minimal weakness in triceps 
 
         strength, but the neurological function was normal.  X-rays 
 
         demonstrated total consolidation of the humerus fracture (exhibit 
 
         1, page 7).  Dr. Jochims stated that the condition of claimant's 
 
         arm had actually improved between June of 1985 and June 1986 
 
         (exhibit 15, pages 6 and 7).
 
         
 
              Claimant's right upper arm exhibits quite marked notable 
 
         scars and pigment changes.  An indented portion is clearly 
 
         observable.
 
         
 
              Claimant was examined by Barry Lake Fischer, M.D., on 
 
         October 17, 1986.  Upon observing the deformities and performing 
 
         range of motion and strength testing, Dr. Fischer concluded that 
 
         claimant had a 41% permanent partial disability of his right arm 
 
                                                      
 
                                                               
 
         (exhibit 14, pages 19 and 20).
 
         
 
              Claimant testified at hearing that he has restricted range 
 
         of motion which causes him problems in movements such as 
 
         scratching his back.  He stated that the motion of his right hand 
 
         and fingers is impaired in comparison to his left.  Claimant 
 
         stated that he has a dull pain in his upper right arm at the area 
 
         of injury when he performs strenuous activities or when he 
 
         engages in movements such as throwing a ball or playing tennis.  
 
         Claimant is right-handed.
 
         
 
                        APPLICABLE LAW AND ANALYSIS
 
         
 
              Scott C. McKelvey suffered an extremely severe injury to his 
 
         right upper arm.  When the condition of the arm as it existed a 
 
         few days following the injury is compared to its present 
 
         condition, the amount of recuperation that occurred is nothing 
 
         short of miraculous.
 
         
 
              The workers' compensation system exists by virtue of 
 
         statute. The statute does not provide a recovery for matters such 
 
         as pain and suffering, or disfigurement which does not impair 
 
         function (except for disfigurement of the face).
 
         
 
              The right of a worker to receive compensation for injuries 
 
 
 
                
 
                                                               
 
         sustained which arose out of and in the course of employment is 
 
         statutory.  The statute conferring this right can also fix the 
 
         amount of compensation to be paid for different specific 
 
         injuries, and the employee is not entitled to compensation except 
 
         as provided by the statute.  Soukup v. Shores Co., 222 Iowa 272, 
 
         268 N.W. 598 (1936).
 
         
 
              Where an injury is limited to a scheduled member, the loss 
 
         is measured functionally, not industrially.  Graves v. Eagle Iron 
 
         Works, 331 N.W.2d 116 (Iowa 1983).
 
         
 
              The claimant has the burden of proving the degree of 
 
         disability that resulted from his injury.  The nature of the 
 
         injury that occurred could readily have left claimant with a very 
 
         severe disability.  While the current disability and impairment in 
 
         claimant's right arm is certainly not minimal or inconsequential, 
 
         it is far less than what might have occurred.  Dr. Jochims, 
 
         claimant's treating physician, rated a 20% impairment in 1985.  
 
         Dr. Jochims has indicated that the degree of impairment has 
 
         probably been reduced somewhat due to subsequent unanticipated 
 
         recovery.
 
         
 
              Dr. Fischer assigned a 41% disability.
 
         
 
              The testimony from claimant regarding his ability to engage 
 
         in activities such as throwing a ball:or playing tennis is 
 
         corroborative of Dr. Jochims' rating.  Individuals with a 40% 
 
         impairment of an arm are not commonly able to perform those types 
 
         of activities.  Further, Dr. Jochims is the treating physician 
 
         and is more familiar with this case than is Dr. Fischer.  For 
 
         these reasons, the assessment made by Dr. Jochims is accepted as 
 
         being correct.  Claimant is therefore entitled to receive 50 
 
         weeks of compensation for permanent partial disability 
 
         representing a 20% permanent partial disability of the right arm 
 
         under the provisions of Iowa Code section 85.34(2)(m).
 
         
 
              The entire amount of the award has been previously paid 
 
         voluntarily by the defendants.  In view of the fact that claimant 
 
         has been fully paid, the costs of this proceeding will be assessed 
 
         against claimant.  Costs are determined in accordance with 
 
         Division of Industrial Services Rule 343-4.33.  Costs related to 
 
         depositions can be assessed only if the deposition is introduced 
 
         into evidence at trial.  Woody v. Machin, 380 N.W.2d 727 (Iowa 
 
         1986).  Expert witness fees are limited to the statutory amount 
 
         provided by Code section 622.72 for expert witnesses.  
 
         Accordingly, defendants are entitled to recover costs in the 
 
         amount of $59.00 for the court reporter fees for Dr. Fischer's 
 
         deposition, $155.00 for reporter fees for Dr. Jochims' deposition 
 
         and $150.00 as an expert witness fee for Dr. Jochims at his 
 
         deposition.  The total is $364.00.
 
         
 
                                FINDING OF FACT
 
         
 
              1.  Scott C. McKelvey has a 20% permanent partial disability 
 
         of his right arm as a result of the injuries he sustained on 
 
                                                      
 
                                                               
 
         August 20, 1984.
 
         
 
                              CONCLUSIONS OF LAW
 
         
 
              1.  This agency has jurisdiction of the subject matter of 
 
         this proceeding and its parties.
 
         
 
              2.  Scott C. McKelvey is entitled to receive 50 weeks of 
 
         compensation for permanent partial disability representing a 20% 
 
         permanent partial disability of his right arm under the 
 
         provisions of Code section 85.34(2)(m).
 
         
 
              3.  Since defendants' liability has been fully satisfied by 
 
         voluntary payments made prior to the time of hearing, the costs 
 
         of this action should be assessed against claimant.
 
         
 
                                   ORDER
 
         
 
              IT IS THEREFORE ORDERED that claimant take nothing further 
 
         from this proceeding as his entitlement to compensation was fully 
 
         paid voluntarily by the defendants prior to hearing.
 
         
 
              IT IS FURTHER ORDERED that the costs of this action are 
 
         assessed against claimant pursuant to Division of Industrial 
 
         Services Rule 343-4.33 as follows:
 
         
 
              Cynthia Varelli, Dr. Fischer's deposition      $59.00
 
              Linda M. Flakne, Dr. Jochims' deposition       155.00
 
              Expert witness fee, Dr. Jochims                150.00
 
              Total                                         $364.00
 
               
 
              Signed and filed this 21st day of February, 1989.
 
         
 
                                   
 
                                   
 
                                            MICHAEL G. TRIER
 
                                            DEPUTY INDUSTRIAL 
 
                                            COMMISSIONER
 
         
 
         Copies To:
 
         
 
         Mr. Patrick A. Tallon
 
         Attorney at Law
 
         25 East Washington, Suite 835
 
         Chicago, Illinois  60602
 
         
 
         Mr. Greg A. Egbers
 
         Attorney at Law
 
         600 Union Arcade Building
 
         111 East Third Street
 
         Davenport, Iowa  52801-1550
 
         
 
                                                      
 
                                                               
 
         
 
         
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                      
 
 
            
 
 
 
             
 
                   
 
                                            1402.40, 1803, 2207
 
                                            Filed February 21, 1989
 
                                            MICHAEL G. TRIER
 
         
 
                   BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         SCOTT C. MCKELVEY,
 
         
 
              Claimant,
 
         
 
         vs.
 
                                                   File No. 772870
 
         BURLINGTON MEDICAL CENTER,
 
                                                A R B I T R A T I 0 N
 
              Employer,
 
                                                   D E C I S I 0 N
 
         and
 
         
 
         ST. PAUL INSURANCE COMPANY,
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
         1402.40, 1803, 2907
 
         
 
              Claimant awarded 20% permanent partial disability of the arm 
 
         consistent with the treating physician's rating, inspite of a 
 
         higher rating from an examining physician.  Defendants admitted 
 
         liability and had previously paid the full amount awarded.  Costs 
 
         were assessed against claimant.
 
         
 
         
 
         
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                
 
 
            
 
            
 
 
 
                  
 
                   BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         EARL LOWE,
 
         
 
              Claimant,
 
                                                   File No. 772890
 
         vs.
 
         
 
         LAS VEGAS CEMENT COMPANY,              A R B I T R A T I 0 N
 
         
 
              Employer,                            D E C I S I 0 N
 
         
 
         and                                          F I L E D
 
         
 
         MARYLAND CASUALTY COMPANY,                  MAR 24 1989
 
         
 
              Insurance Carrier,           IOWA INDUSTRIAL COMMISSIONER
 
              Defendants.
 
         
 
         
 
                              STATEMENT OF THE CASE
 
         
 
              This is a proceeding in arbitration brought by Earl Lowe, 
 
         claimant, against Las Vegas Cement Company, employer, and 
 
         Maryland Casualty Company, insurance carrier, to recover benefits 
 
         under the Iowa Workers' Compensation Act as a result of an injury 
 
         sustained on July 27, 1984.  This matter came on for hearing 
 
         before the undersigned deputy industrial commissioner May 5, 1988 
 
         and was considered fully submitted at the close of the hearing.  
 
         The record in this case consists of the testimony of claimant, 
 
         Delores Lowe, and joint exhibits 1 through 7, inclusive.
 
         
 
                                    ISSUES
 
         
 
              Pursuant to the prehearing report and order submitted and 
 
         approved May 5, 1988, the following issues are presented for 
 
         resolution.
 
         
 
              1.  Whether the injury of July 27, 1984 is the cause of the 
 
         disability on which claimant now bases his claim;
 
         
 
              2.  Claimant's entitlement to weekly benefits including 
 
         temporary total disability/healing period benefits and permanent 
 
         partial disability benefits;
 
         
 
              3.  The applicability of the odd-lot doctrine; and
 
         
 
              4.  Claimant's entitlement to certain benefits under Iowa 
 
         Code section 85.27.
 
         
 
                                FACTS PRESENTED
 
         
 
              Claimant sustained an injury on July 27, 1984 which arose 
 
         out of and in the course of his employment when, while loading 
 
                                                
 
                                                         
 
         trusses onto a flat bed truck on which steel beams had already 
 
         been loaded, the trusses slipped, claimant fell onto the ground 
 
         on his back and one of the trusses landed on claimant crushing 
 
         his pelvis.  Claimant testified he was hospitalized for two 
 
         weeks, that it was over a week before he could "get up and 
 
         around" and then only in a corset brace that "held [him] 
 
         together" and that he used a walker for about a month thereafter 
 
         until he began using a cane.  Claimant explained he underwent 
 
         physical therapy and did home exercises as prescribed by his 
 
         physician, Marvin Dubansky, M.D.  Claimant testified that in 
 
         approximately April 1986, Dr. Dubansky sent him to Iowa City 
 
         because he was having back pain (described as sometimes severe 
 
         and sometimes not) and trouble with his pelvis and bladder.  
 
         Claimant stated that Dr. Dubansky,, around the same time, 
 
         suggested he try to return to work and that he then went to work 
 
         for a contractor friend laying forms for sidewalks, doing drywall 
 
         and odd jobs.  Claimant stated that this venture proved 
 
         completely unsuccessful as the bending required resulted in 
 
         "terrible pains," that it was difficult for him to stretch, reach 
 
         out and twist and difficult for him to work above his head.  
 
         Claimant estimated he worked off and on for about a week and 
 
         during this week had worked only one full day.
 
         
 
              Claimant denied having any symptoms with reference to his 
 
         back prior to this injury although he acknowledged he had 
 
         suffered from some muscle soreness at times after a long day's 
 
         work. Claimant testified that currently he can stand anywhere 
 
         from 15 to 30 minutes, cannot bend over except for a "few 
 
         seconds," that he cannot walk over 15 minutes without pain and 
 
         that sitting, without frequently changing position, bothers him.  
 
         Claimant opined that his back has gotten worse since April 1986 
 
         and that since the injury he has never been pain-free, although 
 
         some days are worse than other.  Claimant does not believe he is 
 
         capable of working a 40 hour week or an 8 hour day because he 
 
         cannot move well enough to do a good job.  Claimant acknowledged 
 
         he did not do well when he went through vocational rehabilitation 
 
         programs because his pain made it difficult for him to 
 
         concentrate and he would not be able to set his own pace.  
 
         Claimant testified he has cooperated with vocational 
 
         rehabilitation counselors and sought work both through the 
 
         counselors and on his own but has been unsuccessful in that 
 
         endeavor.  Claimant opined that his age coupled with his injury 
 
         makes it particularly difficult for him to acquire work and that 
 
         even if he were in good health his age would be a barrier to 
 
         securing employment.  Claimant admitted he had one contract to 
 
         paint and repair a fence but that the job took so long to 
 
         complete he could not make any money on it and that his current 
 
         plans are to set up a woodworking shop at his home.
 
         
 
              On cross-examination, claimant testified he worked for 
 
         Delavan as a machine operator until the union was decertified, 
 
         but after this separation from employment he had trouble finding 
 
         other employment, and that during this time he worked on his own 
 
         doing remodeling/repair work until he was able to secure a series 
 
         of basically short-term labor positions.  Claimant estimated his 
 
                                                
 
                                                         
 
         earnings in 1981 as $2,100, in 1982 as $3,000, and in 1983 as 
 
         $7,000.  Claimant revealed he does do some housework and yard 
 
         work and that his wife retired in November 1987 on social 
 
         security disability.
 
         
 
              Delores Lowe testified claimant, prior to his injury, was a 
 
         robust, strong, healthy, hard working individual who could 
 
         provide a living for his family but that he is a different person 
 
         since the injury.  Mrs. Lowe stated claimant had a negligible 
 
         medical history prior to this injury and that he did not complain 
 
         of pain anytime after returning from work prior to the injury.  
 
         Mrs. Lowe described claimant as having to lean his arms on the 
 
         sink to wash dishes, to have to sit down to dry them, that he 
 
         cannot make a bed alone and that, although he tries, sometimes 
 
         cannot finish the house or lawn work.  Mrs. Lowe stated that 
 
         claimant does not complain and most generally keeps things to 
 
         himself.
 
         
 
              Marvin Dubansky, M.D., orthopedic surgeon, testified he 
 
         first saw claimant on July 27, 1984 at the request of Carlton N. 
 
         Vannatta, M.D., claimant's family physician, and that after 
 
         taking x-rays found claimant to have a fracture of the right 
 
         ilium and pubis and "some damage to the right sacroiliac joint."  
 
         Dr. Dubansky recommended bed rest and gradual ambulation, 
 
         physical therapy and referral to other physicians until December 
 
         1985 when he referred claimant to the University of Iowa 
 
         Hospitals and Clinics because of claimant's complaints with 
 
         reference to his back.  Dr. Dubansky concurred with the diagnosis 
 
         rendered at the University of Iowa of degenerative 
 
         spondylolisthesis and spinal stenosis and related those 
 
         conditions to the injury of July 24, 1984 stating:  "I think that 
 
         he had an injury and then he gradually developed this because I 
 
         don't think on our initial films we recognized a degenerative 
 
         spondylolisthesis as such." (Exhibit 2, Dubansky Deposition, page 
 
         22)  Dr. Dubansky went on to testify that:
 
         
 
                   So because on my December film I found no evidence of 
 
              degenerative spondylolisthesis or any kind of 
 
              spondylolisthesis and then in April they reported one and he 
 
              had a 500-pound steel girder or something hit him, has 
 
              trouble and he'd had continuing trouble, I would say that 
 
              there is a causal relationship between that girder and 
 
              eventually the presence of the degenerative 
 
              spondylolisthesis.
 
         
 
                   Now, one could say, yes, this could develop because 
 
              many people that we are -- the majority of the people we see 
 
              with degenerative spondylolisthesis have never had any 
 
              severe injury of this type, but on the other hand you have a 
 
              man who had this thing fall on him.
 
         
 
                   He's had continued trouble since that time and 
 
              eventually has shown up with a degenerative 
 
              spondylolisthesis.  So that I would say the chances are that 
 
              he had an injury.  Now, we -- it takes time for degeneration 
 
                                                
 
                                                         
 
                   to take place, and it would very well be he had the injury 
 
              and the full manifestation showed up.  I don't know. the 
 
              time of injury was in
 
         
 
                   Q.  July of '84.
 
         
 
                   A.  -- July of '84 and this is April.  So there were 
 
              nine months or so before -- no.  It was over nine months.  
 
              It was a year and a half or more that they found the 
 
              degenerative spondylolisthesis.  I have films that don't 
 
              show it, so that I would say that somebody who had an injury 
 
              and has had continued symptoms clear through that there's 
 
              probably a causal relationship between the two, although I 
 
              cannot stand here and say it would never have happened if he 
 
              didn't have something drop on him.
 
         
 
         (Ex. 2, Dubansky Dep., pp. 24-25)
 
         
 
              Dr. Dubansky's office notes of September 30., 1985 read:
 
         
 
                   I feel as a result of the fracture of the pelvis and 
 
              subsequent difficulties I think he's reach [sic] full 
 
              medical recovery as far as I can do and I have nothing more 
 
              I can recommend for him.  Circulation in his legs are all 
 
              right. He's been seen by a neurosurgeon who could not find 
 
     
 
                                
 
                                                         
 
              any neurosurgical changes and I think this is a result of 
 
              the severe compression fractures of the pelvis that he has 
 
              permanent pain, impairment and there is nothing more I can 
 
              do.
 
         
 
                   No future appointments have been given.
 
         
 
         (Ex. 1, p. 118)
 
         
 
              On October 11, 1985, Dr. Dubansky opined claimant "has 
 
         approximately 10% impairment of the body as a whole as a result 
 
         of the fracture of his pelvis" and explained this rating as "sort 
 
         of a guess because I don't know what 10 percent means really and 
 
         I don't know what any percent means either."  Dr. Dubansky 
 
         testified he expected claimant to fully or nearly fully recover 
 
         from the fractured pelvis and opined that claimants' present 
 
         inability to work is as a result of claimant's back problems.
 
         
 
              Dr. Dubansky referred claimant to C. A. Tom Foreman, M.D., 
 
         urologist, on August 24, 1984 because claimant's "complaints were 
 
         of voiding difficulty; including nocturia about every hour with 
 
         post voiding dribbling, urgency with urge incontinence."  Dr. 
 
         Foreman found claimant's condition had improved by November 14, 
 
         1984 and opined that claimant's voiding difficulties were 
 
         definitely caused by claimant's work accident.  However, on March 
 
         19, 1986, Hugh C. Dick, M.D., urologist, who practices with Dr. 
 
         Foreman, advised defendant insurance carrier:
 
         
 
              [T]he patient came to my office on 28 February 1986 with 
 
              complaints of post voiding dribbling and urinary urgency.  
 
              He underwent out-patient panendocystoscopy @ Mercy Hospital 
 
              on 5 March 1986 for urological evaluation to see if he 
 
              indeed had stricture due to his previous work injury.
 
         
 
                   However, no stricture was found, final diagnosis ,being 
 
              prostatic enlargement, which I feel is not related to his 
 
              injury.
 
         
 
         (Jt. Ex. 1, p. 6)
 
         
 
              Claimant was seen by Stuart R. Winston, M.D., on June 20 and 
 
         again on June 27, 1985 at the request of Dr. Dubansky.  On June 
 
         27, Dr. Winston opined:
 
         
 
                   His cranial nerves, on examination, are normal and the 
 
              remainder of the examination fails to show any weakness, 
 
              lack of strength, cerebellar signs.  His reflexes are 
 
              symmetric and perhaps the ankle jerk is reduced slightly on 
 
              the right. There is no Babinski sign.
 
         
 
                   Electrodiagnostic studies were performed which were 
 
              normal, and lumbosacral spine films show no evidence of any 
 
              recent or remote injury.  He does have some degenerative 
 
              diseases at L2-3.
 
         
 
                                                
 
                                                         
 
                   I sought to.reassure the patient since his numbness and 
 
              discomfort seem to be improving, that there still is room 
 
              for continued improvement.  I would certainly think with the 
 
              nature of the trauma to the pelvic floor that he probably 
 
              did have some involvement of the lumbosacral plexis, but we 
 
              cannot document any ongoing problem, and have reassure him 
 
              along these lines.
 
         
 
         (Ex. 1, p. 100)
 
         
 
              On April 8, 1986, claimant was admitted to the University of 
 
         Iowa Hospitals and Clinics on referral from Dr. Dubansky and 
 
         underwent a myelogram, CT, EMG, NCV, and urology evaluation.  The 
 
         orthopedic diagnosis was established as "degenerative 
 
         spondylolisthesis Lumbar 4-5 with spinal stenosis Lumbar 4-5." 
 
         (Ex. 1, p. 135)  Neurological evaluation showed no evidence of 
 
         neurogenic bladder.  Claimant had an epidural steroid injection 
 
         April 17, 1986 which he later advised the doctors "were of no 
 
         benefit."  Clinical notes dated July 10, 1986, state:
 
         
 
              IMPRESSION:  The patient suffers from low back pain with 
 
              impairment of his back aggravated by his injury.  It is 
 
              probable that the patient may in the future need a 
 
              decompression of the L5 nerve roots but we do not feel that 
 
              it is indicated at this time.  We feel that his back 
 
              impairment amounts to a 10 percent impairment of the body,as 
 
              a whole in addition to his impairment from the pelvic 
 
              fractures.  We will see the patient on a PRN basis.
 
         
 
         (Ex. 1, p. 141)
 
         
 
              In a report dated December 16, 1986, Jack E. Reynolds, M.D., 
 
         C.R.C., rehabilitation consultant with Resource Opportunities, 
 
         Inc., wrote:
 
         
 
                   On December 15, 1986, the consultant received a phone 
 
              call from Dr. Marvin Dubansky.  Dr. Dubansky stated that he 
 
              did not need to see Mr. Lowe at this time and that he felt 
 
              written work restrictions would not be appropriate.  It was 
 
              his opinion that the client's limitations are primarily up to 
 
              him and what he can handle.  Thy physician did state that he 
 
              would recommend no heavy manual labor including no climbing, 
 
              repetitive lifting, pushing or pulling and that Mr. Lowe 
 
              would need to change positions between sitting and standing 
 
              on an as needed basis.  The consultant discussed the 
 
              potential for a tool repair/assembly position with Ace Tool 
 
              and a desk clerk position or a light maintenance positions. 
 
              Dr. Dubansky stated that these types of occupations may be 
 
              appropriate for the client under the right circumstances.  
 
              Dr. Dubansky agreed that upon obtaining a job offer for the 
 
              client he would be willing to see Mr. Lowe at that time to 
 
              discuss the position and the appropriateness of that job.
 
         
 
         (Ex, 6, p. 3)
 
         
 
                                                
 
                                                         
 
              Claimant attended the Iowa State Vocational Rehabilitation 
 
         facility beginning January 5, 1987.  The final report of the 
 
         facility counselor states:
 
         
 
                   This evaluator does feel that the client put.forth good 
 
              efforts and attempted to meet competitive employment 
 
              expectations in regard to his work habits.  The disability 
 
              did seem to interfere with the evaluation.  The client did 
 
              make numerous complaints of discomfort, walked bent over 
 
              holding his back.  The client left the area early on two 
 
              occasions and had three additional days absent due to what 
 
              he stated was back problems.  The client, in my opinion, 
 
              does not appear to have physical tolerance for machine 
 
              operation tasks.  (It appears that bending to inspect the 
 
              tasks is the problem.)  The client tried two parts lists and 
 
              then declined further involvement.  In my opinion the best 
 
              performance can on low level (bench) electrical task.  The 
 
              client declined further interest in building inspection 
 
              tasks due to physical.  This evaluator questions if the 
 
              client's physical tolerance would be appropriate for an 
 
              8-hour day.  (Even if the task were bench repair oriented.)  
 
              The only area I can suggest (part-time) would be Electrical 
 
              Tool Repairer, 729.281-022, Repairer Hand tools, 
 
              701.381-010.  (Both jobs are classified as light physical in 
 
              the Dictionary of Occupational Titles.
 
         
 
         (Ex 5, p. 16)
 
         
 
                           APPLICABLE LAW AND ANALYSIS
 
         
 
              An employee is entitled to compensation for any and all 
 
         personal injuries which arise out of and in the course of the 
 
         employment.  Section 85.3(l).
 
         
 
              The claimant has the burden of proving by a preponderance of 
 
         the evidence that the injury of July 27, 1984 is causally related 
 
         to the disability on which he now bases his claim.  Bodish v. 
 
         Fischer, Inc., 257 Iowa 516, 133 N.W.2d 867 (1965).  Lindahl v. 
 
         L.O. Boggs, 236 Iowa 296, 18 N.W.2d 607 (1945).  A possibility is 
 
         insufficient; a probability is necessary.  Burt v. John Deere 
 
         Waterloo Tractor Works, 247 Iowa 691, 73 N.W.2d 732 (1955).  The 
 
         question of causal connection is essentially within the domain of 
 
         expert testimony.  Bradshaw v. Iowa Methodist Hospital, 251 Iowa 
 
         375, 101 N.W.2d 167 (1960.
 
         
 
              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).
 
         
 
              The parties do no dispute that on July 27, 1984 claimant 
 
         sustained an injury which arose out of and in the course of his 
 
         employment which, at a minimum, caused claimant to sustain a 
 
         fractured pelvis.  What appears to be principally an issue is 
 
         whether this injury was the cause of claimant's complaints 
 
         concerning his back and his urinary difficulties.  There does not 
 
         appear to be any question that it is claimant's back that is the 
 
         major cause of his disability and that the pain as the result 
 
         thereof is currently preventing claimant from gainful 
 
         employment.
 
         
 
              Dr. Dubansky has opined that there is a causal connection 
 
         between claimant's injury and the spinal stenosis and/or 
 
         spondylolisthesis with which claimant has been diagnosed.  Dr. 
 
         Dubansky was unequivocal in his testimony that "I would say that 
 
         there is a causal relationship between that girder and eventually 
 
         the presence of the degenerative spondylolisthesis."  (Jt. Ex. 2, 
 
         p. 24)  In addition, Dr. Lehmann, from the University of Iowa 
 
         Hospitals and Clinics, stated that claimant suffers from low back 
 
         problems with impairment of his back aggravated by his injury.
 
         
 
              While a claimant is not entitled to compensation for the 
 
         results of a preexisting injury or disease, the mere existence at 
 
         the time of a subsequent injury is not a defense.  Rose v. John 
 
         Deere Ottumwa Works, 247 Iowa 900, 908, 76 N.W.2nd 756, (1956).  
 
         If the claimant had a preexisting condition or disability that is 
 
         aggravated, accelerated, worsened or lighted up so that it results 
 
         in disability, claimant is entitled to recover.  Nicks v Davenport 
 
         Produce Co., 254 Iowa 130, 115 N.w.2d 812, (1962).
 
         
 
                                
 
                                                         
 
              When an aggravation occurs in the performance of an 
 
         employer's work and a causal connection is established, claimant 
 
         may recover to the extent of the impairment.  Ziegler v. United 
 
         States Gypsum Co., 252 Iowa 613, 620, 106 N.W.2d 591, (1960).
 
         
 
              Defendants argue that based on an admission note that 
 
         claimant had experienced "neck/back pains/stiffness/swelling with 
 
         heavy lifting" that claimant suffered from some preexisting back 
 
         problems.  Claimant did candidly acknowledge that at times he was 
 
         stiff and sore after a hard day's work.  However, the record, as 
 
         a whole, fails to,support defendants' position and, even if it 
 
         would be shown that claimant suffered from some sort of 
 
         preexisting back condition, claimant has established that the 
 
         injury of July 27, 1984 materially aggravated this condition so 
 
         as to bring claimant to the condition to which he now finds 
 
         himself.  Accordingly, the greater weight of medical evidence 
 
         would establish a causal connection between claimant's injury of 
 
         July 27, 1984 and claimant's underlying back problems.
 
         
 
              The undersigned must conclude that the same holds true with 
 
         regard to claimant's urinary problems.  The record is clear that 
 
         when claimant was first admitted to the hospital following the 
 
         injury there was concern over claimant's inability to void to the 
 
         point that a catheter was inserted.  Throughout claimant's 
 
         recuperation, he was treated by Dr. Foreman who "definitely" 
 
         found claimant's problems to be caused by the accident.  It was 
 
         not until almost two years after claimant's injuries that Dr. 
 
         Dick diagnosed claimant as having a prostatic enlargement, 
 
         unrelated to the injury.  Claimant received instructions from his 
 
         visit to the University of Iowa Hospitals and Clinics which 
 
         undoubtedly improved his condition.  In addition, Dr. Dubansky 
 
         has stated that the spinal stenosis, which has already been found 
 
         to be causally connected to the work injury, can result in 
 
         problems with bladder incontinence.  Therefore, the greater 
 
         weight of medical evidence would establish that claimant's injury 
 
         of July 27, 1984 was the precipitating factor in claimant's 
 
         bladder problems and accordingly was the proximate cause 
 
         thereof.
 
         
 
              The primary issue for resolution is the extent of claimant's 
 
         industrial disability.  Claimant asserts that he is permanently 
 
         and totally disabled either under Iowa Code section 85.34(3) or 
 
         under the applicability of the odd-lot doctrine as found in 
 
         Guyton v. Irving Jensen Co., 373 N.W.2d 101 (Iowa 1985).
 
         
 
              Under the odd-lot doctrine, which was formally adopted by the 
 
         Iowa Supreme Court in Guyton, supra, a worker becomes an odd-lot 
 
         employee when an injury makes the worker incapable of obtaining 
 
         employment in any well-known branch of the labor market.  An 
 
         odd-lot worker is thus totally disabled if the only services the 
 
         worker can perform are so limited in quality, dependability, or 
 
         quantity that a reasonably stable market for them does not exist. 
 
         Id., citing Lee v. Minneapolis Street Railway Company, 230 
 
         Minn.315, 320, 41 N.W.2d 433, 436 (1950).  The rule of odd-lot 
 
         allocates the burden of production of evidence.  If the evidence 
 
                                                
 
                                                         
 
         of degree of obvious.physical impairment, coupled with other facts 
 
         such as claimant's mental capacity, education, training or age, 
 
         places claimant prima facie in the odd-lot category, the burden 
 
         should be on the employer to show that some kind of suitable work 
 
         is regularly and continuously available to the claimant.  
 
         Certainly in such a case it should not be enough to show that 
 
         claimant is physically capable of performing light work and then 
 
         round out the case for non-compensable by adding a presumption 
 
         that light work is available.  Guyton, 373 N.W.2d at 105.
 
         
 
              When a worker makes a prima facie case of total disability 
 
         by producing substantial evidence that the worker is not 
 
         employable in the competitive labor market, the burden to produce 
 
         evidence of suitable employment shifts to the employer.  If the 
 
         employer fails to produce such evidence and the trier of fact 
 
         finds the worker falls in the odd-lot category, the worker is 
 
         entitled to a finding of total disability.  Even under the 
 
         odd-lot doctrine, the trier of fact is free to determine the 
 
         weight and credibility of the evidence in determining whether the 
 
         worker's burden of persuasion has been carried.  Only in an 
 
         exceptional case would evidence be sufficiently strong to compel 
 
         a finding of total disability as a matter of law.  Guyton, 373 
 
         N.W.2d at 106.  The court went on to state:
 
         
 
                   The commissioner did not in his analysis address any of 
 
              the other factors to be considered in determining industrial 
 
              disability.  Industrial disability means reduced earning 
 
              capacity.  Bodily impairment is merely one factor in a 
 
              gauging industrial disability.  Other factors include the 
 
              worker's age, intelligence, education, qualifications, 
 
              experience, and the effect of the injury on the worker's 
 
              ability to obtain suitable work.  See Doerfer Division of 
 
              CCA v. Nicol, 359 N.W.2d 428, 438 (Iowa 1984).  When the 
 
              combination of factors precludes the worker from obtaining 
 
              regular employment to earn a living, the worker with only a 
 
              partial functional disability has a total disability.  See 
 
              McSpadden v. Big Ben Coal Co., 288 N.W.2d 181, 192 (Iowa 
 
              1980.
 
         
 
              The undersigned would conclude that claimant's situation 
 
         falls far short of that presented in the Guyton case.  It cannot 
 
         be concluded that the evidence in this case would establish that 
 
         the only services that claimant can perform are so limited in 
 
         quality, dependability or quantity that a reasonably stable 
 
         market for them does not exist.  Claimant clearly has 
 
         transferable skills.  Dr. Dubansky has agreed that claimant is 
 
         capable of employment and claimant's search for employment does 
 
         not begin to compare to that done in Guyton.  Jack Reynolds has 
 
         identified jobs which are available in the job market which are 
 
         suited to claimant's capabilities even in light of his 
 
         restrictions. Therefore, claimant has failed to establish he is 
 
         an odd-lot employee.  Claimant has, however, suffered an 
 
         industrial disability as a result of the work injury of July 27, 
 
         1984.  Both Doctors Dubansky and Lehmann have rendered opinions 
 
         on claimant's impairment and the undersigned does not dispute 
 
                                                
 
                                                         
 
         that claimant has a permanent partial impairment as a result of 
 
         the injury.
 
         
 
              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,  125  N.W.2d 251 
 
         (1963).  Barton v. Nevada Poultry, 253 Iowa 285, 110 N.W.2d 660 
 
         (1961).
 
         
 
              A finding of impairment to the body as a whole found by a 
 
         medical evaluator does not equate to industrial disability.  This 
 
         is so as impairment and disability are not synonymous.  Degree of 
 
         industrial disability can in fact be much different than the 
 
         degree of impairment because in the first instance reference is 
 
         to loss of earning capacity and in the latter to anatomical or 
 
         functional abnormality or loss.  Although loss of function is to 
 
         be considered and disability can rarely be found without it, it 
 
         is not so that a degree of industrial disability is 
 
         proportionally related to a degree of impairment of bodily 
 
         function.
 
         
 
              Factors to be considered in determining industrial 
 
         disability include the employee's medical condition prior to the 
 
         injury, immediately after the injury, and presently; the situs of 
 
         the injury, its severity and the length of healing period; the 
 
         work experience of the employee prior to the injury, after the 
 
         injury and potential for rehabilitation; the employee's 
 
         qualifications intellectually, emotionally and physically; 
 
         earnings prior and subsequent to the injury; age; 
 
         education.motivation; functional impairment as a result of the 
 
         injury; and inability because of the injury to engage in 
 
         employment for which the employee is fitted. Loss of earnings 
 
         caused by a job transfer for reasons related to the injury is 
 
         also relevant.  These are matters which the finder of fact 
 
         considers collectively in arriving at the determination of the 
 
         degree of industrial.disability.
 
         
 
              There are no weighting guidelines that indicate how each of 
 
         the factors are to be considered.  There are no guidelines which 
 
         give, for example, age a weighted value of ten percent of the 
 
         total value, education a value of fifteen percent of total, 
 
         motivation - five percent; work experience - thirty percent, etc. 
 
         Neither does a rating of functional impairment directly correlate 
 
         to a degree of industrial disability to the body as a whole.  In 
 
         other words, there are no formulae which can be applied and then 
 
         added up to determine the degree of industrial disability.  It 
 
         therefore becomes necessary for the deputy 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).
 
         
 
                                                
 
                                                         
 
              Claimant is currently 60 years old with a high school 
 
         education and some education at the college level.  At age 60, it 
 
         cannot be the subject of much dispute that claimant has already 
 
         worked more years than he would anticipate working in the future. 
 
         In light of his age, claimant's loss of future earnings from 
 
         employment due to his disability is not as severe as would be the 
 
         case of a younger individual.  See Becke v. Turner-Busch, Inc., 
 
         34 Biennial Report, Iowa Industrial Commissioner 34 (1979). 
 
         Claimant identified himself as a machinist by trade who worked at 
 
         Delavan Manufacturing Company until a strike and decertification 
 
         of the union forced claimant to seek employment elsewhere.  
 
         Claimant candidly acknowledged that he had great difficulties 
 
         securing other employment after that and he was probably 
 
         unemployed more than he was employed after leaving Delavan. 
 
         Claimant has not had any regular steady employment since his 
 
         separation from employment with Delavan and had earnings over the 
 
         three years prior to his injury in the total amount of $12,100. 
 
         Claimant's position with defendant employer was again temporary 
 
         in nature.  Defendant cannot be held responsible for conditions 
 
         other than those related to the injury.  Claimant clearly has 
 
         transferable skills and although he may not now be capable of 
 
         performing all of the jobs for which he is fitted, he is not 
 
         excluded from that employment completely and has not lost all of 
 
         the knowledge gained from his years of working experience.  Dr. 
 
         Dubansky has not prohibited claimant from all employment and has 
 
         approved of certain positions recommended to claimant.  
 
         Claimant's restrictions on employability are essentially 
 
         self-imposed although Dr. Dubansky acknowledged claimant would 
 
         have difficulty bending, twisting and working over head.  
 
         Considering then all the elements of industrial disability, it is 
 
         determined that claimant has a permanent partial disability of 35 
 
         percent for industrial purposes entitling claimant to 175 weeks 
 
         of permanent partial disability benefits.
 
 
 
                                
 
                                                         
 
         
 
              Iowa Code section 85.34(1) provides that if an employee has 
 
         suffered a personal injury causing permanent partial disability, 
 
         the employer shall pay compensation for a healing period from the 
 
         day of the injury until (1) the employee returns to work; or (2) 
 
         it is medically indicated that significant improvement from the 
 
         injury is not anticipated; or (3) until the employee is medically 
 
         capable of returning to substantially similar employment.
 
         
 
              Based on the testimony of Dr. Dubansky, it is determined 
 
         that claimant's healing period ended on September 30, 1985.  
 
         Nothing in the record would indicate that claimant's condition 
 
         changed or that claimant improved subsequent to September 30, 
 
         1985 to lead the undersigned to conclude that claimant had not 
 
         reached his maximum medical recovery by this date.  Therefore" 
 
         claimant is entitled to 61.571 weeks of healing period benefits 
 
         for the period of July 27, 1984 through September 30, 1985, 
 
         inclusive.
 
         
 
              Iowa Code section 85.27 provides, in part:
 
         
 
                   The employer, for all injuries compensable under this 
 
              chapter or chapter 85A, shall furnish reasonable surgical, 
 
              medical, dental, osteopathic, chiropractic, podiatric, 
 
              physical rehabilitation, nursing, ambulance and hospital 
 
              services and supplies therefor and shall allow reasonably 
 
              necessary transportation expenses incurred for such 
 
              services. The employer shall also furnish reasonable and 
 
              necessary crutches, artificial members and appliances but 
 
              shall not be required to furnish more than one set of 
 
              permanent prosthetic devices.
 
         
 
              The final issue for resolution is claimant's entitlement to 
 
         medical expenses at the University of Iowa Hospitals and Clinics 
 
         as found in joint exhibit 7.  There is no dispute that Dr. 
 
         Dubansky is claimant's primary authorized treating physician and 
 
         further that claimant was referred to the University of Iowa by 
 
         Dr. Dubansky.  As it has been found that claimant's work injury 
 
         of July 27, 1984 was the proximate cause of claimant's urological 
 
         and orthopedic problems, it must be concluded that defendants are 
 
         liable for the costs of this treatment.  Therefore, defendants 
 
         shall bear the costs of the treatment at the University of Iowa 
 
         as found in joint exhibit 7.
 
         
 
                              FINDINGS OF FACT
 
         
 
              WHEREFORE, based on all of the evidence presented, the 
 
         following findings of fact are made:
 
         
 
              1.  Claimant sustained an injury which arose out of and in 
 
         the course of his employment on July 27, 1984 when, while loading 
 
         trusses onto a flat bed truck on which steel beams had already 
 
         been loaded, the trusses slipped with one of them landing on 
 
         claimant.
 
         
 
                                                
 
                                                         
 
              2.  Claimant was hospitalized and upon admission to the 
 
         hospital had difficulty voiding and a catheter was put in place.
 
         
 
              3.  Claimant had complaints of back pain upon admission to 
 
         the hospital and was found to have a fracture of the right ilium 
 
         and pubis and some damage to the right sacroiliac joint upon 
 
         taking x-rays.
 
         
 
              4.  Claimant was originally treated conservatively and 
 
         eventually referred by his primary treating physician to the 
 
         University of Iowa Hospitals and Clinics where claimant was 
 
         diagnosed as having.degenerative spondylolisthesis and spinal 
 
         stenosis which was aggravated by the injury.
 
         
 
              5.  Dr. Dubansky found claimant's spondylolisthesis and/or 
 
         spinal stenosis to be as a result of claimant's work injury of 
 
         July 27, 1984.
 
         
 
              6.  Claimant had been referred to a urologist because of 
 
         bladder incontinence which condition is causally connected to the 
 
         injury.
 
         
 
              7.  The services claimant can perform are not so limited in 
 
         quality, dependability or quantity that a reasonably stable 
 
         market for them does not exist.
 
         
 
              8.  Claimant is currently 60 years old with a high school 
 
         education and some education at the college level.
 
         
 
              9.  Claimant is a machinist by trade who had steady 
 
         employment with Delavan Manufacturing Company until a strike and 
 
         decertification of the union forced him to seek employment 
 
         elsewhere.
 
         
 
              10.  Claimant has been unable to secure regular steady 
 
         employment since his separation from employment with Delavan and 
 
         had earnings in 1981 of $2,100, 1982 of $3,000, and 1983 of 
 
         $7,000.
 
         
 
              11.  Claimant has transferable skills from previous 
 
         employment and although he may not now be capable of performing 
 
         all of the jobs for which he is fitted he is not excluded from 
 
         that employment completely and has not lost all of the knowledge 
 
         gained from his years of work and experience.
 
         
 
              12.  Claimant's restrictions on his employability are 
 
         essentially self-imposed.
 
         
 
              13.  Claimant does have difficulty bending, twisting and 
 
         working over head.
 
         
 
              14.  Claimant has a permanent partial disability of 35 
 
         percent for industrial purposes.
 
         
 
              15.  Claimant's healing period ended September 30, 1985.
 
                                                
 
                                                         
 
         
 
              16.  Claimant's treatment at the University of Iowa 
 
         Hospitals and Clinics were necessitated because of the work 
 
         injury.
 
         
 
                             CONCLUSIONS OF LAW
 
         
 
              THEREFORE, based on the principles of law previously stated, 
 
         the following conclusions of law are made:
 
         
 
              1.  Claimant's work injury of July 27, 1984 is the cause of 
 
         the disability on.which he now bases his claim.
 
         
 
              2.  Claimant has failed to establish he is an odd-lot 
 
         employee.
 
         
 
              3.  Claimant has established a permanent partial disability 
 
         of 35 percent for industrial purposes.
 
         
 
              4.  Claimant has established a healing period of July 27, 
 
         1984 through September 30, 1985, inclusive.
 
         
 
              5.  Claimant has established the medical expenses incurred 
 
         at the University of Iowa Hospitals and Clinics are causally 
 
         connected to the work injury of July 27, 1984.
 
         
 
                                   ORDER
 
         
 
              THEREFORE, it is ordered:
 
         
 
              Defendants' shall pay unto claimant sixty-one point five 
 
         seven one (61.571) weeks of healing period benefits at the 
 
         stipulated rate of two hundred six and 42/100 dollars ($206.42) 
 
         for the period from July 27, 1984 through September 30, 1985, 
 
         inclusive.
 
         
 
              Defendants shall pay unto claimant one hundred seventy-five 
 
         (175) weeks of permanent partial disability benefits at the 
 
         stipulated rate of two hundred six and 42/100 dollars ($206.42) 
 
         per week commencing October l, 1985.
 
         
 
              Defendants shall receive full credit for all disability 
 
         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 shall pay all disputed medical expenses as found 
 
         in joint exhibit 7.
 
         
 
              Defendants shall file a claimant activity report upon 
 
         payment of this award.
 
         
 
              Costs of this action are assessed against defendants 
 
                                                
 
                                                         
 
         pursuant to Division of Industrial Services Rule 343-4.33.
 
         
 
              Signed and filed this 24th day of March, 1989.
 
         
 
         
 
         
 
         
 
         
 
                                            DEBORAH A. DUBIK
 
                                            DEPUTY INDUSTRIAL 
 
                                            COMMISSIONER
 
         
 
         Copies to:
 
         
 
         Mr. James Waters
 
         Attorney at Law
 
         323 E. Fifth
 
         Des Moines, IA  50309
 
         
 
         Mr. Richard G. Book
 
         Attorney at Law
 
         500 Liberty Bldg
 
         Des Moines, IA  50309
 
         
 
         
 
         
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                
 
 
            
 
 
 
                    
 
                               
 
                                            1108; 1402.40; 1803; 4100 
 
                                            Filed March 24, 1989
 
                                            Deborah A. Dubik
 
         
 
                    BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         EARL LOWE,
 
         
 
              Claimant,
 
                                                   File No. 772890
 
         vs.
 
         
 
         LAS VEGAS CEMENT COMPANY,              A R B I T R A T I 0 N
 
         
 
              Employer,                            D E C I S I 0 N
 
         
 
         and
 
         
 
         MARYLAND CASUALTY COMPANY,
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
         1108; 1402.40; 1803
 
         
 
              Claimant sustained an injury which arose out of and in the 
 
         course of his employment when a steel beam from a truck fell on 
 
         top of him crushing his pelvis.  As a result of the injury, 
 
         claimant also experienced back problems and bladder incontinence 
 
         which were found to be causally connected to the original injury. 
 
         Claimant awarded permanent partial disability benefits of 35 
 
         percent.
 
         
 
         4100
 
         
 
              Claimant failed to establish he was an odd lot employee as 
 
         the services he can perform were not so limited in quality, 
 
         dependability or quantity that a reasonably stable labor market 
 
         for him did not exist.
 
         
 
         
 
         
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                
 
 
         
 
 
 
 
 
 
 
 
 
 
 
                                       5-2905;3102;2905
 
                                       Filed December 23, 1991
 
                                       BYRON K. ORTON
 
                                       WRM
 
         before the iowa industrial commissioner
 
         ____________________________________________________________
 
                                       :
 
         ORLA JANE SMITH,              :
 
                                       :
 
              Claimant,                :
 
                                       :
 
         vs.                           :
 
                                       :    File Nos. 853642/773001
 
         FLEETGUARD, INC.,             :
 
                                       :          A P P E A L
 
              Employer,                :
 
                                       :        D E C I S I O N
 
         and                           :
 
                                       :
 
         LIBERTY MUTUAL INSURANCE      :
 
         COMPANY,                      :
 
                                       :
 
              Insurance Carrier,       :
 
              Defendants.              :
 
         ___________________________________________________________
 
         
 
         5-2905
 
         At the time of the prior award, claimant was determined to be 
 
         able to perform clerical work.  Subsequent to the award, 
 
         claimant's physician determined that she was not able to perform 
 
         such work.  Held that a physical change of condition had 
 
         occurred, justifying a further award in review-reopening.
 
         
 
         3102, 2905
 
         A vocational rehabilitation expert's testimony was admitted.  
 
         Defendants objected because the expert could have testified prior 
 
         to the original award, but that evidence was not offered then.  
 
         Defendants argued it could not, therefore, be offered on 
 
         review-reopening.  Held that, especially here where the expert 
 
         did not conduct the evaluation of claimant until after the 
 
         original award, the evidence was admissible for the limited 
 
         purpose of showing a change of condition since the original 
 
         award, but could not be used to alter the assessment of 
 
         claimant's disability at the time of the original award as that 
 
         had already been legally determined.  The evidence was used only 
 
         as it related to events occurring subsequent to the original 
 
         award, and any portion purporting to assess claimant's condition 
 
         at the time of the prior award were disregarded.