Page   1
                     before the iowa industrial commissioner
            SANDY STOWE,                  :
                 Claimant,                :
            vs.                           :
                                          :      File No. 820910
            JOHN MORRELL & CO.,           :
                                          :    A R B I T R A T I O N
                 Employer,                :
                                          :      D E C I S I O N
            and                           :
            NATIONAL UNION FIRE           :
            INSURANCE COMPANY,            :
                 Insurance Carrier,       :
                 Defendants.              :
                 This is a proceeding in arbitration brought by Sandy 
            Stowe, claimant, against John Morrell & Co., employer, and 
            National Union Fire Insurance Company, insurance carrier, as 
                 Claimant alleges that she sustained a compensable 
            injury to her back on April 11, 1986, and seeks compensation 
            for an industrial disability.
                 The case was heard at Sioux City, Iowa on March 7, 
            1991.  The case was considered fully submitted upon 
            conclusion of the hearing, although leave was granted so 
            that the parties could file briefs.
                 The record in this proceeding consists of the testimony 
            of claimant, Cecil Cunningham, D.O., Dennis Howrey, Vicki 
            Witkowski, and Christine Huisman; and, joint exhibits 1-88, 
            and claimant's exhibits 1-6 and 9-12.
                 Claimant elicited live testimony from Cecil Cunningham, 
            D.O.  Dr. Cunningham was identified on claimant's witness 
            list, which was properly served on defendants fifteen (15) 
            days prior to the hearing, as required by the hearing 
            assignment order.
                 However, defendants raised an objection to that portion 
            of Dr. Cunningham's testimony which changed his original 
            opinion, based upon claimant's failure to supplement answers 
            to interrogatories thirty (30) days prior to the hearing.  
            Defendants argue that allowing claimant's medical expert to 
            change his opinion at the hearing is highly prejudicial.
                 Discovery requests in a workers' compensation case are 
            Page   2
            governed by rule 343 IAC 4.35 and Iowa Rules of Civil 
            Procedure 121-134.  As noted on the hearing assignment 
            order, under paragraph 7, "The service of witness lists 
            pursuant to this Order does not modify the requirements of 
            Iowa Rule of Civil Procedure 125(c) to supplement responses 
            to discovery as to experts not less than thirty (30) days 
            prior to the hearing."  
                 Claimant argues that Dr. Cunningham's testimony, which 
            does go beyond the scope of the reports and opinions 
            provided to defendants prior to the hearing, should be 
            admissible because to exclude said testimony would 
            "eliminate the testimony of a witness who could be helpful 
            to the claimant."
                 Claimant relies upon the Iowa Supreme Court case of 
            Lambert v. Sisters of Mercy Corporation, 369 N.W.2d 417 
            (Iowa 1985).  In Lambert the supreme court held that the 
            trial court abused its discretion by excluding the testimony 
            of defendants' expert because the defendants had failed to 
            supplement answers to interrogatories and identify the 
            expert and summarize his testimony.
                 Claimant's reliance on Lambert is misplaced.  In 
            Lambert, two defendant doctors originally designated an 
            expert witness, and limited the expert's testimony to review 
            of a fetal monitor strip.  At the trial, these two 
            defendants were dismissed from the case on a directed 
            verdict.  The remaining defendant hospital then attempted to 
            designate the same expert witness, and limit his testimony 
            to review of the fetal monitor strip.  
                 The plaintiffs objected, stating that to allow the 
            expert to testify violates the Rules of Civil Procedure, 
            which require the parties to supplement answers to 
            interrogatories.  In Lambert, the expert in question had 
            been properly designated by the defendant doctors and his 
            testimony regarding the fetal strip had been summarized.  
            Therefore, plaintiffs could claim no surprise, and they had 
            adequate opportunity to depose the expert prior to trial.  
            Lambert, 369 N.W.2d at 422.
                 In the instance case, claimant has attempted to 
            supplement the testimony to be provided by the expert 
            witness the day of the hearing.  Defendants have claimed 
            prejudice and surprise, in that they were given no 
            opportunity to formulate their position based on the 
            evidence available.  See, Kilker v. Mulry, 437 N.W.2d 1 
            (Iowa App. 1988).
                 Claimant urges that exclusion of Dr. Cunningham's 
            testimony is an abuse of discretion.  In Lambert, the court 
            stated that exclusion of an expert witness is justified only 
            when prejudice would result.  Other suggestions for 
            sanctions included continuation of the trial or limitation 
            of testimony.  Lambert, 369 N.W.2d at 421.
                 In the case at bar, at the hearing, Dr. Cunningham's 
            testimony was limited to his opinions formed prior to the 
            discovery deadline of January 2, 1990.  Claimant did not 
            Page   3
            supplement her answers to interrogatories, and did not ask 
            for an extension of the discovery deadline.  Furthermore, 
            claimant did not ask for a continuance of the hearing.  As a 
            result, Dr. Cunningham's testimony regarding any treatment 
            provided claimant after the discovery deadline (which is his 
            report dated August 3, 1989) was properly excluded.
                 In accordance with the hearing assignment order and the 
            prehearing report, the following issues were presented for 
                 1.  Whether claimant received an injury on April 11, 
            1986 which arose out of and in the course of her employment;
                 2.  Whether there is a causal relationship between the 
            alleged injury and the disabilities;
                 3.  Whether claimant is entitled to temporary total 
            disability or healing period benefits, or permanent partial 
            or permanent total disability benefits;
                 4.  Whether claimant is entitled to medical benefits 
            pursuant to Iowa Code section 85.27; and,
                 5.  The reasonableness of the medical expenses incurred 
            by the claimant.
                 The prehearing report also indicates that defendants 
            raise the affirmative defense of an untimely claim pursuant 
            to Iowa Code section 85.26.  However, a review of the file 
            shows that this issue was not preserved at the prehearing 
            conference, and as a result, the undersigned is without 
            authority to analyze and rule on this issue.  See, Joseph 
            Presswood v. Iowa Beef Processors, (appeal decision November 
            14, 1986).  (An issue not noted on the hearing assignment 
            order is waived).
            Page   4
            findings of fact
                 The undersigned deputy, having heard the testimony, and 
            having reviewed all of the evidence received, finds the 
            following facts:
                 Claimant, Sandy Stowe, was born on January 25, 1958.  
            She has worked for the defendant employer since January 12, 
                 Claimant has worked primarily on the production lines, 
            and filed claims for workers' compensation benefits for 
            injuries sustained on four separate occasions during 1981 
            through 1985.  Claimant settled these claims under Iowa Code 
            section 85.35.  It is noted that during this time, claimant 
            underwent several cervical and lumbar areas of the spine, as 
            well as the right upper extremity.  (Joint Exhibit 76)  
            Claimant was off of work between 1984 and 1985 due to 
            fusions at the lower lumbar spine and hips.  She remembers 
            that her medical restrictions were no repetitive bending or 
            stooping, and no lifting of greater than five pounds, 
            although at some time her lifting restriction was raised to 
            between 20 and 30 pounds.
                 In early 1986, claimant was placed on a job packing 
            ribs, which entailed filling a box weighing between 30-40 
            pounds and carrying the box to a pallet.  She also made the 
            cardboard boxes which was a repetitive job, constructing 
            boxes more than 100 times per day.
                 She bid for a pork chop loin line job which also 
            consisted of packing meat, stacking it in a basket, and 
            carrying the box to a pallet.
                 Claimant testified that on April 11, 1986, she fell 
            while carrying a box from one room to another room.  
            Claimant stated that as she fell she hit her low back, and 
            tried to break the fall with her left knee.  She reported to 
            the nurse.
                 She was referred to the company doctor, Joe Krigsteen, 
            M.D.  His notes indicate that she had sustained a contusion 
            and sprain of the left knee.  He treated with an Ace bandage 
            and ice packs, and prescribed Vicodin.  She was to return to 
            work on April 14, 1986.  (Jt. Ex. 39)
                 Claimant was re-examined by Dr. Krigsteen on April 15, 
            1986.  At that time, she was walking with a limp, and 
            requested to see a chiropractor for her hip.  Dr. Krigsteen 
            ordered x-rays of the pelvis which showed a defect of the 
            crest of the ilium on the right where previously bone had 
            been removed for the lumbar fusion performed several years 
            before.  Dr. Krigsteen was
            Page   5
            concerned about claimant's back, and made the following 
            assessment on April 21, 1986 in a letter to the defendant 
                    I think this patient could return to the work 
                 she has been doing prior to the present injury.  
                 However, it is my opinion that she presents a 
                 definite hazard with her 20% disability and back 
                 fusion.  She should either seek other work which 
                 does not require her to walk while at work because 
                 if she is re-injured, it will be difficult to 
                 treat her effectively.  Most employed people who 
                 have had back surgery as this patient has had do 
                 present a definite hazard to the employer.
            (Jt. Ex. 41, Page 2)
                 Prior to the April 11, 1986 incident, claimant had 
            sought treatment at St. Lukes Regional Medical Center in 
            Sioux City, Iowa for severe back pain.  She was examined by 
            C. Farrell, M.D., and was assessed as having right sciatica.  
            She was given various prescriptions, and was to follow-up 
            with Cecil Cunningham, M.D.  (Jt. Ex. 38, PP. 1-6)
                 Other records from the employer indicate that claimant 
            had constant complaints about physical problems during 1986.  
            (Jt. Ex. 44, PP. 1-3)
                 Eventually, claimant stopped work in January of 1987.  
            (Jt. Ex. 52)
                 The record is virtually silent as to any medical 
            treatment received by claimant during 1987.  However, there 
            are several exhibits which indicate claimant had sustained 
            an injury to her eye and was treated accordingly.  (Claimant 
            Exs. 9-12)  And, Dr. Cunningham performed some services on 
            February 6, 1987, which appear to be unrelated to claimant's 
            case.  (Jt. Ex. 73)  Additionally, on February 14, 1987, 
            claimant was treated for severe stomach pain.  (Jt. Ex. 46)
                 The next medical treatment claimant received was on 
            February 19, 1988, when she was treated at St. Lukes 
            Regional Medical Center in Sioux City, Iowa.  Claimant was 
            admitted to the emergency room, complaining of left leg 
            pain.  Those records indicate that she developed sciatica in 
            the left sciatic nerve "four weeks ago".  She was given 
            Dilaudid in the left arm.  She obtained complete relief from 
            the pain, but returned to the hospital several hours later, 
            requesting additional medication.  Again, she was given an 
            injection of Dilaudid, and was referred to Horst Blume, M.D.  
            (Jt. Ex. 47, PP. 1-7)
                 Claimant was again examined on February 22, 1988, and a 
            computed tomography test showed abnormalities of the lower 
            lumbar spine.  (Jt. Ex. 48)
                 Eventually, claimant underwent surgery on March 10, 
            1988.  Initial notes indicate that an MRI found a ruptured 
            disc at the L-5, S-1 level.  Interestingly, the hospital 
            records also state that, "up until 5 weeks ago she was 
            Page   6
            completely free of pain, no leg pain."  Claimant was 
            released from the hospital on March 18, 1988.  (Jt. Ex. 49, 
            PP. a-aa, P. 5).
                 Apparently claimant continued to have some physical 
            ailments, and received an epidural flooding at the L5 level 
            on September 12, 1988.  (Jt. Ex. 56, P. 1)
                 Claimant was evaluated by Joel Cotton, M.D., on June 2, 
            1989.  Upon examination, his impression was that claimant's 
            neurological examination was normal except for an absent 
            left ankle jerk and positive straight leg raising test on 
            the left.  He noted numbness in the entire left lower 
            extremity which he could not explain.  In Dr. Cotton's 
            opinion, she had no definite weakness in the muscles of 
            either lower extremity.  He gave her an additional five 
            percent permanent impairment of the body as a whole in 
            addition to her prior impairment of 28 percent.  He also 
            adhered to prior restrictions placed upon claimant.  (Jt. 
            Ex. 57, PP. 1-3)
                 Dr. Cunningham, the physical who has treated claimant 
            on an ongoing basis for the past several years, made the 
            following assessment on August 3, 1989:
                 Her condition remained quite stable through 1986 
                 and 1987, until she suffered a serious aggravation 
                 of her condition in approximately January of 1988.  
                 I am unaware of any injuries between 1986 and 
                 January of 1988, which would attribute to her 
                 problem.  During the period of 1986 and 1987, for 
                 the most part she had only a few and infrequent 
                 complaints and these were much less than she had 
                 in late 1985 and before.
                 She had surgery again on L5/S1 March 10, 1988, and 
                 this was probably ruptured sometime in January of 
                 1988, but the cause of the rupture at the time is 
                 unknown by me.
            (Jt. Ex. 59, P. 1)
                         analysis and conclusions of law
                 The first issue to be addressed is whether claimant 
            sustained an injury on April 11, 1986 which arose out of and 
            in the course of her employment.
                 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(1).
                 Claimant has the burden of proving by a preponderance 
            of the evidence that she received an injury on April 11, 
            1986 which arose out of and in the course of her employment. 
            McDowell v. Town of Clarksville, 241 N.W.2d 904 (Iowa 
            1976); Musselman v. Central Telephone Co., 261 Iowa 352, 154 
            N.W.2d 128 (1967). 
                 The injury must both arise out of and be in the course 
            Page   7
            of the employment.  Crowe v. DeSoto Consol. Sch. Dist., 246 
            Iowa 402, 68 N.W.2d 63 (1955) and cases cited at pp. 405-406 
            of the Iowa Report.  See also Sister Mary Benedict v. St. 
            Mary's Corp., 255 Iowa 847, 124 N.W.2d 548 (l963) and Hansen 
            v. State of Iowa, 249 Iowa 1147, 91 N.W.2d 555 (1958).
                 The words "out of" refer to the cause or source of the 
            injury.  Crowe, 246 Iowa 402, 68 N.W.2d 63. 
                 The words "in the course of" refer to the time and 
            place and circumstances of the injury.  McClure v. Union 
            et al. Counties, 188 N.W.2d 283 (Iowa 1971); Crowe, 246 Iowa 
            402, 68 N.W.2d 63.
                 Claimant's testimony and the evidence previously cited 
            to seem to indicate that she did sustain a fall while she 
            was working on April 11, 1986.  She was performing her 
            required job duties, during her regular shift hours, in a 
            manner consistent with the type of work performed at the 
            plant.  As a result, it is found that claimant did receive 
            an injury which was in the course of her employment with the 
            employer.  And, claimant has proven by a preponderance of 
            the evidence that there was a direct causal connection 
            between her injury and the requirements or duties 
            contemplated by the employer, which will translate into a 
            finding that her injury arose out of her employment.  
            However, there are two components to claimant's case, one 
            being the injury to the knee, and the other being the injury 
            to claimant's back.  It is found only that claimant's knee 
            injury arose out of and in the course of her employment.
                 To support a finding that claimant's subsequent back 
            problems and the third surgery she underwent in 1988 is 
            causally related to the fall she had on the employer's 
            premises would be contrary to the weight of the evidence 
            presented.  Claimant's own treating physician, Dr. 
            Cunningham, was unaware of any precipitating event which 
            caused the ruptured disc which was the basis for the 
            surgery.  She did not receive any treatment for her back 
            during 1987.  The evidence shows that claimant was pain free 
            until January of 1988.  There is nothing in the record which 
            would support a finding that claimant's back injury arose 
            out of and in the course of her employment due to the injury 
            she sustained on April 11, 1986.
                 As a result, defendants are obligated to pay only for 
            the medical treatment claimant receive to treat her knee.  
            There is no showing of permanency to the left lower 
            extremity, and claimant is entitled to no type of disability 
            benefits for this injury.
                 Claimant takes nothing from these proceedings as they 
            relate to her back condition.
                 THEREFORE, it is ordered:
                 That defendants are obligated to pay only for medical 
            treatment provided for the treatment of claimant's left 
            Page   8
                 That claimant take nothing from these proceedings with 
            respect to the back injuries.
                 That defendants shall file a claim activity report as 
            required by rule 343 IAC 3.1(2).
                 That defendants shall pay the costs of this proceeding.
                 Signed and filed this ____ day of July, 1991.
                                          PATRICIA J. LANTZ
                                          DEPUTY INDUSTRIAL COMMISSIONER
            Copies To:
            Mr Robert L Sikma
            Attorney at Law
            402 Benson Building
            Sioux City Iowa 51101
            Mr Thomas M Plaza
            Attorney at Law
            701 Pierce St Ste 200
            PO Box 3086
            Sioux City Iowa 51102
                      Filed July 11, 1991
                      PATRICIA J. LANTZ
            before the iowa industrial commissioner
            SANDY STOWE,   :
                 Claimant, :
            vs.       :
                      :      File No. 820910
            JOHN MORRELL & CO., :
                      :    A R B I T R A T I O N
                 Employer, :
                      :      D E C I S I O N
            and       :
            INSURANCE COMPANY,  :
                 Insurance Carrier,  :
                 Defendants.    :
            Claimant, who had a history of back problems and no prior 
            surgeries, sustained a fall at work.
            The greater weight of the evidence showed that claimant 
            sustained only a bruised knee from the fall, although she 
            argued that she reinjured her back when she fell.
            Claimant was not credible, and took nothing from these 
                                                 File No. 821055
         D & B AUTO RADIO, INC.,              A R B I T R A T I O N
              Employer,                          D E C I S I O N
              Insurance Carrier,
                              STATEMENT OF THE CASE
              This is a proceeding in arbitration brought by Scott 
         Erickson, claimant, against D & B Auto Radio, Inc., employer, and 
         Kemper Insurance, insurance carrier, to recover benefits under 
         the Iowa Workers' Compensation Act as a result of an alleged 
         injury sustained on February 26, 1985.  This matter came on for 
         hearing before the undersigned deputy industrial commissioner 
         April 26, 1988.  It was considered fully submitted at the close 
         of the hearing.  The record in this case consists of the 
         testimony of claimant, Carl Erickson, his father, Carolyn 
         Nordstrom, Dr. Kirk Witherspoon, Scott Swanson, Mike Robertson, 
         and Bob Aldin; joint exhibits 1 through 23, inclusive; and, 
         claimant's exhibits 24, 25 and 26 which were received without 
              Pursuant to the prehearing report and order submitted and 
         approved April 26, 1988, the following issues are presented for 
              1.  Whether claimant sustained an injury which arose out of 
         and in the course of his employment;
              2.  Whether the alleged injury is the cause of the 
         disability on which claimant now bases his claim;
              3.  The extent of claimant's entitlement to weekly 
         disability benefits, if any;
              4.  Claimant's entitlement, if any, to benefits provided 
         pursuant to Iowa Code section 85.27; and,
              5.  The applicability of the odd-lot doctrine.
         PAGE   2
                                 FACTS PRESENTED
              Claimant began working for defendant employer, an automotive 
         and electronics company that repairs automobile electrical 
         components, in February 1985 as a route driver whose 
         responsibilities were to pick up and deliver components from 
         various locations.  Claimant testified he was initially hired to 
         drive the Quad City route which consisted of six stops and took 
         about one-half day or less to complete but as the company grew 
         his route grew so that by February 1986, he was driving 250 to 
         300 miles on the Quad City route Monday, Wednesday and Friday, 
         plus driving the Tri-State route on Tuesday and Thursday which 
         consisted of 310 to 350 miles and approximately 28 stops.  
         Claimant stated he drove in all kinds of weather, that in order 
         to make all his stops he found it necessary to speed, and that he 
         was given a radar detector to avoid speed traps.  Claimant 
         acknowledged he was never told to exceed the speed limit but that 
         "driving faster was strongly inferred."  Claimant expressed a 
         strong dissatisfaction with the maintenance of his vehicle, with 
         some of the policies of the employer which he perceived to be 
         dishonest and with what he believed was the employer's dislike of 
         overtime.  Claimant had what was perceived to be a substantial 
         fear of breaking the law in any way because of the manner in 
         which he was raised, the fact his father is a law enforcement 
         officer and a desire to have a career in law enforcement 
              Claimant was involved in an accident November 13, 1985 when 
         another car pulled out in front of him and he tried to spin 
         sideways to avoid a collision.  Claimant stated that no one was 
         injured, that the accident was not his fault, and that following 
         this incident his feelings of being tired and "burned out" began 
         to get worse.  Claimant testified he took some time off from 
         driving after this accident but, because the employer could not 
         spare another driver, he began driving regularly again after 
         about a month.  Claimant testified that he began to perceive he 
         was striking pedestrians with his car or causing other vehicles 
         to run off the road, that his mind would wander so as to question 
         whether he had stopped at traffic lights or a stop sign and to 
         imagine that each time he hit a bump it was a body.  He stated he 
         would then go back to check the area but once there he would 
         forget why he had gone back or would be afraid to look because of 
         what he might see.  Claimant described his perception of constant 
         pressure that he was getting behind in his route which 
         intensified when he took so much longer to complete the route 
         after checking and rechecking where he had been.
              Claimant testified he believed he was speeding and that at 
         times he would go 70 or 80 miles per hour although he wondered if 
         perhaps he "dreamed everything" and admitted that towards the end 
         of his employment he did not know what he was doing.  Claimant 
         stated he thought he was told he was getting too much overtime 
         although at the time of his deposition he would acknowledge only 
         that excessive overtime was "hinted at" and that he was never 
         "sat down and scolded about it."
              Claimant recalled that on February 26, 1986, he was driving 
         the Quad City route, that he was "turning around and around, 
         going back and forth" convinced that he was killing people, 
         crying and that he stopped at a church where he called his 
         parents, totally distraught.  Claimant explained he believed he 
         was going "crazy," that he did not know what was happening to him 
         PAGE   3
         but that he had felt that day that something was going to happen 
         to him.  Claimant acknowledged that it is difficult for him to 
         remember what went on in November and December 1985 and January 
         and February 1986 and that he wonders if he made up the speeding 
         although he does recall rushing around.
              Claimant stated he left work then on February 26, 1986 and 
         eventually asked Dr. Kirk Witherspoon, with whom he was treating, 
         for a release to return to work on March 14, 1986.  Dr. 
         Witherspoon provided claimant with a release to return to work 
         with a restriction of no driving.  Claimant returned to work for 
         defendant employer in a position involving shipping and receiving 
         type work and offered that he did and redid the work he was 
         assigned and that he left again when he began to believe once 
         again he might hurt somebody.  Claimant recalled that he saw an 
         article by Dr. Dewat Chaudhry in the newspaper which described 
         some of the symptoms he was experiencing and from that article 
         set up an appointment with Dr. Chaudhry.  Although Dr. Chaudhry 
         suggested hospitalization for claimant, claimant rejected such a 
              Claimant stated that since his discharge from employment 
         with defendant employer May 23, 1986, he secured temporary 
         employment at Rink's Frozen Food Center where he marked "x's and 
         oOs" on livestock and where he was assigned to wrapping meat.  
         Claimant described wrapping and rewrapping the meat and an 
         inability to work in the slaughterhouse because of what went on 
         there.  Claimant also described part-time employment testing soil 
         which he was capable of doing some days but during which he 
         described feelings of paranoia.  Claimant opined he is not 
         capable of holding a regular job and finds this part-time 
         position appropriate because it does not require such things as 
         time records and he can do what he can as best he can.
              On cross-examination, claimant stated he could not recall 
         any offer from the employer to come in off the road outside of 
         when he first started and helped out a little on installation.  
         However, claimant felt work inside was also stressful to him.  
         Claimant admitted he was commonly paid for all hours reported, 
         that he was never suspended or disciplined and that at times his 
         job was boring although "mostly [he] was sick of it."
         When asked if there was any specific incident which may have 
         caused him to complain of stress, claimant responded that he 
         "imagined" he did so complain.  Claimant stated he had "checking" 
         tendencies in high school which did not affect his life but which 
         seemed to get worse as he got older and that when he was driving 
         a snowplow for the state of Illinois prior to his employment with 
         D & B Auto Radio, he was able to perform his job without doing 
         any checking.  Claimant explained he was used to driving in the 
         winter, that he was not bothered by snow and that when he was 
         plowing he had "all the time in the world" as he was not on any 
              Carolyn Nordstrom testified she has known claimant since May 
         1982 when they began dating and that she found claimant to have 
         normal behavior with normal habits, to be a well adjusted person 
         and a confident driver.  Ms. Nordstrom stated she began to notice 
         a change in claimant in the fall of 1985 because he seemed tired 
         all the time, upset about work and feeling "pushed" and burned 
         PAGE   4
         out.  Ms. Nordstrom described claimant as shaky, hardly able to 
         talk and crying when he became upset.  She stated claimant became 
         obsessed with his job and that he told her he was so tired when 
         he was driving that he would forget going through certain areas 
         and believed he was hitting people as he drove or making them 
         drive off the road.  Ms. Nordstrom relayed that claimant was 
         worried about the overtime hours he was working, that claimant 
         was concerned about what his supervisor said and their 
         satisfaction or dissatisfaction with his job performance, that 
         claimant believed he could think evil thoughts and cause people 
         harm including wishing people to hell and that claimant's 
         confidence waned during this period of time.
              Ms. Nordstrom testified that she and claimant had their "ups 
         and downs" in their relationship which were not always related to 
         his job explaining that his job might have brought them closer 
         together.  Ms. Nordstrom indicated she and claimant broke up on 
         February 10, 1988 as a result of claimant's problem because they 
         "could not have a relationship on top of" those problems.  Ms. 
         Nordstrom explained she always found claimant to be conscientious 
         but not to the extreme and that claimant was always rechecking 
         things, for example, not trusting himself to make sure everything 
         was off in the house before he would leave.
              On cross-examination, Ms. Nordstrom testified claimant has a 
         belief in God and lived under a fairly strict moral code, that 
         claimant never seemed to be bored with his job, that claimant 
         "loved driving a lot" and that claimant was a confident, "cocky" 
         driver who was "proud" of doing crazy things while driving.  Ms. 
         Nordstrom described a type of "ritual" claimant performed before 
         he would get up from the floor after watching television.  She 
         stated claimant would pat the floor, stand up and wave his arms 
         and that when she commented on this custom, he told her he did 
         not realize he was doing it.
              Carl Erickson, claimant's father, testified claimant has no 
         history of depression, panic attacks or obsessive disorders, that 
         claimant was a good student when he wanted to be, that prior to 
         claimant's illness he did not observe any compulsive behavior and 
         that when claimant got sick it was a complete shock to him.  Mr. 
         Erickson stated that when claimant went to work for defendant 
         employer he noticed no change in claimant's behavior and if he 
         thought claimant was sleeping less or having a little problem at 
         work he was not concerned because "everybody does."  Mr. Erickson 
         testified it was not until after claimant was hospitalized that 
         he became aware of claimant's concern over running people off the 
         road or causing accidents and that although he tried to convince 
         claimant otherwise and took every action to prove to claimant 
         that his fears were unfounded, claimant could not be easily 
         persuaded.  Mr. Erickson testified that when claimant eventually 
         returned to work he could tell something was wrong and that 
         claimant told him he had to re-read the numbers he was working on 
         numerous times to convince himself he was doing things correctly.  
         Mr. Erickson stated claimant seemed better when he was not 
         working and that claimant was discharged because he could not do 
         the job for defendant employer.  Mr. Erickson expressed his 
         belief that claimant feels "guilty about a lot of things" that 
         claimant is like a "yo-yo," that he doubts ail that he does, is 
         afraid of the unfamiliar, that he has problems driving, is afraid 
         of hurting people and that claimant cannot do anything around the 
         house without checking things over and over.  Mr. Erickson 
         PAGE   5
         described claimant as a perfectionist, that while claimant may 
         have gone around checking things before his hospitalization it 
         did not strike him as odd and that he did not know that claimant 
         had any obsessive traits before February 1986.
              Scott Swanson testified that he began employment with D & B 
         Auto Radio June 25, 1986 and that he drives five days per week on 
         the Quad City and Tri-State routes as claimant did at the time he 
         was employed with defendant employer.  Mr. Swanson stated he 
         drives the Quad City route Monday, Wednesday and Friday and that 
         it takes him eight and one-half to nine hours to complete the 50 
         stops and 300 miles and that he drives the 43 stops,400 mile 
         Tri-State run on Tuesday and Thursday.  Mr. Swanson explained he 
         feels no stress on the job, that he is paid for his overtime 
         hours without question and that the 1986 Cavalier station wagon 
         which he was given to drive is in good condition and is fixed as 
         boon as possible if there is a problem. on cross-examination, Mr. 
         Swanson stated he takes two or three minutes at each stop.that he 
         "runs" about 58 miles per hour and that in the two years he has 
         been employed he received five speeding tickets.  Mr. Swanson 
         denied that anyone ever encouraged him to speed and stated he 
         felt he had plenty of time to make the route.
              Mike Robertson testified that he has been employed by D & B 
         Auto Radio since June 1986 and that he drives the Muscatine run 
         of 400 miles and 40 stops on Tuesday and Thursday for a total of 
         9 to 9.5 hours and the Des Moines run on Monday, Wednesday and 
         Friday which takes from 10 to 10.5 hours to complete the 450 
         miles and 31 stops.  Mr. Robertson estimated he works 
         approximately 50 hours per week, that he is always paid his 
         overtime hours and that he was never told he had to get the 
         routes done within an eight hour day.  Mr. Robertson testified he 
         has received three traffic tickets, the last one in June 1987, 
         that he is not required to speed, that his vehicle is in good 
         condition and that it receives regular maintenance.  Mr. 
         Robertson denied feeling any stress from his job.
              Bob Aldin testified he has worked for D & B Auto Radio for 
         over three years as a technician for two different periods and as 
         a branch manager from April 1985 until November 1986.  Mr. Aldin 
         stated that he had little contact with claimant when claimant 
         first began his employment but that when he helped claimant he 
         found him to be "real conscientious," asking three or four times 
         what to do to make sure he got it right.  Mr. Aldin denied being 
         aware of any other drivers having any stress-related problems and 
         maintained that although claimant asked for more money, claimant 
         never complained to him that the job was stressful.  Mr. Aldin 
         testified to his awareness that claimant was taking longer to do 
         his job but denied claimant ever told him why.
              Mr. Aldin explained that radar detectors are in all company 
         vehicles (the company sells them), that no driver was ever told 
         to speed and that it was understood routes take longer than eight 
         hours to complete so there was no attempt to force a driver to 
         get done in eight hours.  Mr. Aldin testified claimant's car was 
         a new 1985 Cavalier wagon which was regularly maintained and that 
         claimant was never sent out in an unsafe car.  Mr. Aldin stated 
         claimant was offered a "driveway position" in installation which 
         claimant did not accept, that claimant was offered a sales job 
         and that when claimant wanted to return to work following the 
         PAGE   6
         diagnosis of his illness a position in shipping and receiving was 
         made available to him.  Mr. Aldin described claimant's actions in 
         counting and recounting things again, that claimant was taking 
         "an awful long time" to do the job and finally that he was not 
         involved in the decision to discharge claimant.
              Kirk Witherspoon, Ph.D., clinical psychologist, testified he 
         first saw claimant on February 27, 1986 with claimant giving a 
         list of symptoms including extreme depression, agitation, being 
         "full of considerable self doubt" and that he was having a great 
         deal of difficulty working.  Dr. Witherspoon advised he 
         administered the MMPI, on which, according to validity scales 
         configuration, claimant appeared to answer the questions 
         truthfully, and the Forer Structured Sentence Completion Test.  
         Dr. Witherspoon stated his initial diagnosis had to do with 
         judging that claimant was quite depressed with much agitation and 
                 As the depression eased a little bit as time went 
              on, the thinking, the obsessive-compulsive thinking and 
              behavior seemed to be the most problematic or 
              troublesome aspect of his functioning so that took a 
              little greater prominence, but that doesn't mean he 
              still didn't get depressed.  It is a question is it the 
              chicken or the egg, they go hand in hand.
         (Transcript, page 14)
              Dr. Witherspoon acknowledged there were some things in 
         claimant's background that could be described as obsessive or 
         compulsive but to a mild, not debilitating, degree and not to the 
         extent that claimant was more prone to the disorder than anyone 
         else.  Claimant described his symptoms to Dr. Witherspoon as:
              A.  He came to me saying in essence that he had --he 
              was extremely depressed, he was agitated, he was just 
              full of considerable self-doubt and complaining that he 
              was having a great deal of difficulty working.
                 He wanted very much to work, but he couldn't work 
              very well because he was having much trouble driving 
              and the trouble he was having was associated with his 
              fear that he may harm someone and he would go back and 
              double check and double check the route over and over 
              and he was having semi-delusional thoughts that he not 
              quite fully believing that these things were there, but 
              he talked about seeing what he thought were ghosts, 
              maybe there were these ghosts that he had run over and 
              did he run over somebody and what he was doing he was 
              obsessing and ruminating and worrying constantly about 
              what he had been doing or hadn't been doing such that 
              he was having tremendous difficulty even doing his job 
              and wanted very much to work, but at the same time was 
              just becoming completely debilitated, was losing 
              confidence in himself tremendously, and was very 
              conflicted about it.
         (Tr., pp. 7-8)
              Dr. Witherspoon testified:
         PAGE   7
              Q.  Doctor, based on your training, your education, 
              your experience, your diagnosis of Scott Erickson, the 
              history that you obtained from Scott Erickson, do you 
              have an opinion based upon a reasonable degree of 
              professional certainty as to whether Scott Erickson's 
              mental difficulties as you have described them stemmed 
              or were caused by I should say the stress that he had 
              at work?
              A.  Primarily, yes, I would say 80 to 90 percent of it 
              was caused by that.
         (Tr., pp. 19-20)
              Dr. Witherspoon relayed his current diagnosis of claimant as 
         suffering from obsessive-compulsive disorder from a psychokymic 
         disorder where he undergoes unipolar mood swings dipping down 
         into depression and back up to normal and, in addition, claimant 
         is suffering from an anxiety neurosis and perhaps a mixed 
         personality disorder with compulsive features, inadequate 
         features, and affective features.  Based on the fact claimant is 
         not now "doing tremendously better than he was" two years ago, 
         Dr. Witherspoon was not optimistic on claimant's prognosis.  Dr. 
         Witherspoon was unequivocal in his opinion that the cause of 
         claimant's current problems was his employment.
              When asked whether the depression from which Dr. Witherspoon 
         feels claimant is suffering is caused by the obsessive-compulsive 
         disorder, Dr. Witherspoon stated:
         PAGE   8
              So what I am trying to tell you is that I think there's 
              a very complex interplay between feelings and thoughts 
              and that they can affect one another, that the 
              depression affects the -- or causes the 
              obsessive-compulsive thinking or vice versa, I think 
              they tend to go hand in hand.
         (Tr., p. 44)
              Dr. Witherspoon went on to testify:
              Q.  ...Do you know of any single source of medical or 
              psychological literature that says anxiety or 
              depression can cause obsessive-compulsive disorder?  
              That is an organic problem with a patient, isn't it?
              A.  What is an organic problem?
              Q.  Obsessive-compulsive disorder, that isn't caused by 
              stress or it isn't caused by depression, is it?
              A.  What I am trying to say is that thoughts and 
              feelings co-exist.  To say one causes the other is 
              speculation.  I don't think I can speculate that.  I 
              think it can be either way.
              Q.  Do you have any single piece of medical literature 
              or psychological literature which states that stress 
              can cause obsessive-compulsive disorder?
              A.  Not offhand, no.
         (Tr. pp. 44-45)
              Dr. Witherspoon admitted he operated on the assumption 
              Q.  You are using this as an assumption and I think you 
              testified, Mr. Witherspoon, that it would be wrong for 
              virtually anyone to do the type of job that Scott was 
              asked to do at D and B Auto Radio, is that correct?
              A.  Under the circumstances that he was forced to 
              undergo.  Not that everybody would necessarily react 
              the way he did.  My understanding was other people 
              would get in that job for a period of time and the 
              particular route he was on and would quit after a short 
              period of time.
              Q.  Do you know why they quit?
              A.  No.
              Q.  Have you talked to any of those drivers?
              A.  No, I have not.
              Q.  Have you talked to anybody at D and B Auto Radio 
         PAGE   9
              that --
              A.  No, I have not.
              Q.  So again that's an assumption you have made in this 
              case and if that assumption is untrue, then again that 
              would seriously throw doubt upon your opinions in this 
              A.  Regarding my belief that it was caused by --
              Q.  By stress.
              A.  I honestly don't think it would.
              Q.  It doesn't matter how significant the stress is, 
              you are convinced that whatever stress he had at D and 
              B Auto Radio was the cause of this stress.
              A.  For him, yes, and the way he interpreted.
              Q.  What I am asking you does that opinion depend on 
              how significant objectively that stress was at work?
              A.  Well, yes and no.  I mean, you know, if it were 
              proven to be absolutely unfounded, you'd certainly have 
              to take a hard look at what the heck he was responding 
              to and I know that is a part of what you are going to 
              be taking a look at in addition to what I have.
         (Tr., pp. 49-50, 52)
              When asked whether he agreed with the statement "there is no 
         satisfactory etiologic explanation for the occurrence of 
         excessive compulsive neurosis," Dr. Witherspoon responded:
              A.  Well, that's a good question.  As a general 
              statement, yes.  It doesn't mean it can generalize from 
              the statement to each specific instance.  There's a big 
              difference there.  I don't think that necessarily would 
              apply to each specific instance.  I don't think it 
              applies to Scott's case, for example.
         (Tr., pp. 59-60)
              Dr. Witherspoon's testimony concluded:
              Q.  ...Is it your opinion in this case, Doctor, that 
              Scott has an obsessive-compulsive disorder or that he 
              has obsessive-compulsive underlying personality?
              A.  I guess both.
              Q.  I would like to read you a couple things again.  
              This is from a treatise, the chapter is written by 
              Thomas Insel who is Unit Chief, Clinical 
              Neuropharmacology Branch, National Institute of Mental 
              Health, Bethesda, Maryland.  The book is entitled 
              Psychiatric Clinics of North America.  It is volume 
              eight, number one.
         PAGE  10
                 Let me ask you, first of all, he describes what is a 
              second type of obsessive-compulsive disorder and ask 
              you if this agrees with your reading of Scott.
                 A second presentation for OCD involves pathologic 
              doubt with compulsive checking.  Typically the checker 
              fears the gas jets have been left on or that a bump in 
              the road was a body, doubts that reveal a concern with 
              violence.  Although some uncertainty about 
              carelessness, particularly carelessness that could lead 
              to catastrophic consequences is common in us all, for 
              the obsessional this uncertainty takes on a gnawing, 
              malignant quality.  Checking, which is enough to result 
              in normal uncertainty, often only contributes to the 
              obsessional's doubt.
                 "For instance, if after checking, a bump in the road 
              does not appear to be a body, then the obsessional 
              fears that the body may have been knocked into the 
              bushes.  Ultimately by some inscrutable means, the 
              patient resolves a particular doubt only to have it 
              replaced by a new obsessional preoccupation.
                 "Checkers live as if they are the guilty party 
              perpetually in search of a crime and unsurprisingly 
              they frequently describe a strict religious 
              upbringing."  Is that consistent with what you saw in 
              Scott Erickson in this case?
              A.  Yes, it is.
              Q.  Would you also agree with the following from that 
              treatise, "Finally, it needs to be emphasized that for 
              nearly all patients with OCD, pharmacologic management 
              is only one dimension of what must be a 
              multidimensional treatment approach.  As the symptoms 
              are likely to be chronic, the context in which they 
              have persisted needs careful attention.  Providing a 
              role for the family in the treatment may be critical to 
              ultimate outcome.
                 "In addition, these patients are likely to need 
              long-term support and directive interventions.  
              Encouraging obsessional patients to take risks and push 
              themselves into work or school may yield substantial 
                 "Whatever the ultimate etiology of this intriguing 
              disorder, the people who suffer with obsessions and 
              compulsions are usually guilt-ridden and socially 
              isolated.  As with any chronic illness, the 
              psychological complications are profound.  
              Pharmacotherapy is not a substitute for supportive 
              psychotherapy.  Ideally both should work together to 
              facilitate change." Would you agree with that?
              A.  Of course.
         (Tr., pp. 86-89)
         PAGE  11
              Medical records show claimant underwent an EEG on February 
         28, 1986 hie results of which show:
              CLINICAL INFORMATION:  Headaches for years, forehead 
              area with loss of memory.
              INTERPRETATION:  Normal 23 year old waking, drowsing 
              and light sleeping electroencephalogram.
         (Joint Exhibit 2)
              Dewat R. Chaudhry, M.D., child and adult psychiatrist, at 
         the Agoraphobia & Panic Treatment Center, opined after seeing 
         claimant on April 21 and 22, 1986, and being advised of a history 
         similar to that provided to Dr. Witherspoon by claimant, that 
         claimant has obsessive-compulsive disorder with panic attacks 
         which he could not substantiate were caused or aggravated by 
         claimant's employment.  On December 9, 1987, Dr. Chaudhry 
         reiterated his position to defendants' counsel:
              Although it is a fact that Mr. Ericson [sic] developed 
              very serious symptoms of psychiatric illness while 
              employed with D & D [sic] Auto Company, I do not feel 
              that the stresses of the job resulted in production of 
              his symptoms.  Depression and panic disorder as well as 
              obsessive/compulsive disorder are biological disorders.  
              Individuals are born with genetic vulnerability towards 
              these disorders and these disorders could emerge at any 
              stage in a persons [sic] life.  Most common age of 
              onset for panic disorder is late teens to mid thirties. 
               These disorders are responsive to 
              psychopharmacological and behavioral treatments.
         (Jt. Ex. 13)
              On December 10, 1987, claimant was seen by Russell Noyes, 
         M.D., of the University of Iowa Hospitals and Clinics, Department 
         of Psychiatry, Psychiatric Hospital, who reported:
              Prior to seeing Mr. Erickson I reviewed records of 
              contacts with a psychologist, Kurt [sic] Witherspoon, 
              Ph.D. and a psychiatrist, Dewat Chaudhry, M.D.  My 
              interview with Mr. Erickson lasted about an hour and 
              a.half.  He cooperated fully with the evaluation and 
              gave me what I believe was reliable information.
                 Mr. Erickson reported that he began to develop 
              symptoms of an emotional disturbance in the fall of 
              1985.  At that time he was a route driver for D & B 
              Auto Radio and began to experience tiredness along with 
              concern about his ability to operate a motor vehicle 
              safely.  In November of 1985 he was involved in a minor 
              automobile accident, and thereafter developed an 
              obsessional (repetitious and unrealistic) concern with 
              hitting pedestrians or other vehicles while driving.  
              That is, he became fearful that he might actually run 
              over someone or run other vehicles off the road.  As 
              this concern increased, he experienced mounting anxiety 
              and pictures began to come into his mind of accidents 
              that might have taken place.  As a result, he found 
         PAGE  12
              himself having to check and recheck to be sure that 
              accidents had not actually occurred.  He also began to 
              have trouble sleeping, getting only two or three hours 
              per night.  He frequently found himself shaking and had 
              the sensation of racing within his body.  He said that 
              he felt weaker and more tired and eventually stopped 
              work in February, 1986.  Thereafter he avoided driving 
              and social situations that brought him into contact 
              with others.  The latter was in response to another 
              obsessional concern, which was that he might become 
              angry and strike someone.  In early 1986 he also 
              experienced depressed mood, worry, loss of interest and 
              poor concentration, together with low self-esteem and 
              crying spells.  Panic attacks occurred in relation to 
              obsessional concerns.
                 Since the fall of 1985 Mr. Erickson has continued to 
              experience obsessions and compulsions (repetitious, 
              unrealistic thoughts and actions), however, the level 
              of these symptoms and the impairment related to them 
              has fluctuated.  His worst periods were between April 
              and July of both 1986 and 1987.  During these intervals 
              he suffered significant depressive symptoms and was 
              confined to his home on account of fears.  After 
              leaving employment with D & B Auto Radio in February, 
              1986, he was briefly employed in a slaughterhouse (five 
              weeks) but found the work disagreeable.  Currently he 
              is doing reasonably well, though he continues to have 
              obsessive and compulsive symptoms.  He continues to 
              have an obsessional concern with the possibility of 
              harming others, but on an average this occupies only 30 
              to 45 minutes daily.  Actual compulsive checking may 
              only involve five to ten minutes.  He has days of 
              feeling nervous, especially around people, where he may 
              have thoughts about hitting someone, something he has 
              never done.  Consequently, his impairment is rather 
              minimal and he appears capable of working.  He credits 
              his improvement to the treatment he has, received 
              through which he lilts learned about his illness and 
              found ways to gain control
                 Mr. Erickson reported that the circumstances of his 
              work as route driver with D & B Auto Radio were 
              stressful and may have been responsible for the 
              development of his symptoms in the fall of 1985.  He 
              stated that there was time pressure to complete runs, 
              that he was forced to drive in bad weather, and thus 
              expose himself to unsafe conditions.  He felt that 
              vehicles were sometimes unsafe and that he had to drive 
              faster than was prudent.  It occurred to him to seek 
              other employment, but he liked the work itself and did 
              not like to think of himself as a quitter.
                 My diagnosis is one of obsessive-compulsive 
         PAGE  13
              disorder.  Symptoms of anxiety and depression have also 
              been part of the picture.  This illness, which often 
              begins in the early twenties, tends to follow a chronic 
              course although remissions and exacerbations occur in 
              some patients.  Treatment consists of medication and 
              behavior therapy, both of which have been administered 
              with apparent success in Mr. Erickson's case.  With 
              successful treatment symptoms may be reduced but are 
              rarely eliminated.  Mr. Erickson appears capable of 
              working at this time, however it is likely that he will 
              continue to need treatment and, depending upon the 
              level of his symptoms, may wish to try clomipramine, a 
              medication of recognized value for obsessive-compulsive 
              disorder that is not yet available in the United 
                 Job stress may have been a precipitating factor in 
              Mr. Erickson's illness.  Many persons who develop 
              obsessive-compulsive disorder describe precipitating 
              events.  These are events, such as the death of a loved 
              one, divorce, financial loss, etc., that most people 
              find stressful.  However, most persons do not become 
              ill as a result of such events and they cannot be 
              regarded as a cause of obsessive-compulsive disorder.  
              The cause of this illness is, in fact, not known.  
              Consequently, the stress to which Mr. Erickson was 
              exposed probably did not play a large role in the 
              illness which he developed.  It should be noted that 
              this man had minor obsessive and compulsive symptoms 
              and obsessional personality traits prior to the onset 
         PAGE  14
              of his illness.  A vulnerability to 
              obsessive-compulsive disorder appears to have existed 
              prior to 1985.
         (Jt. Ex. 14)
              Dan Domingo, M.D., of Moline Psychiatric Associates, Ltd., 
         evaluated claimant and on February 22, 1988, rendered the opinion 
              [T]here is no doubt that he is suffering from 
              obsessive-compulsive disorder.  His obsessions at this 
              time are much more prominent than his compulsions.  
              Associated with his illness are symptoms of anxiety, 
              depression, low self-esteem and low self-confidence 
              ......The prognosis, of course, of this case is 
              considered cloudy as we do not know the cause of 
              obsessive-compulsive disorder and we don't have any 
              definite treatment for it.
         (Jt. Ex. 15)
              W. David McEchron, Ph.D., licensed psychologist, issued a 
         report to defendants' counsel on march 31, 1988, which stated:
                 Your latest documents from Dr. Chaudhry and the 
              University of Iowa were quite helpful concerning Mr. 
              Erickson's diagnosis and the cause of his problems.  I 
              firmly agree with the general content of these 
              documents and the points of view expressed by Dr. 
              Chaudhry and Dr. Noyes.
                 It seems clear to me, from reviewing these documents 
              and others, that Mr. Erickson has an 
              Obsessive-Compulsive Disorder which was well 
              established prior to his employment with D & B Auto.  
              It appears to me that during the course of his 
              employment, it is Mr. Erickson's own 
              obsessive-compulsive doubts and processes that are the 
              source of his stress rather than the stress of the job 
                 There is good research to suggest that there is a 
              biological component in obsessive-compulsive disorders 
              and anxiety attacks.  Psychology and psychiatry can 
              debate this issue in terms of the proportions of 
              genetic predispositions and other biological factors, 
              but there appears to be clear agreement that there is a 
              biological component and an environmental or learned 
              one .... Perhaps, one of the biggest stumbling blocks 
              in this situation was Dr. Witherspoon's suggestion to 
              Mr. Erickson that the causation of his anxiety attacks 
              was the stress on the job.  It appears to me that Dr. 
              Witherspoon did not look closely enough at the 
              predisposing personality and the dynamic interplay 
              between obsessive-compulsive disorder and his anxiety 
              attacks.  Once Mr. Erickson was given this explanation 
              for his difficulties, he probably latched onto it and 
         PAGE  15
              for Mr. Erickson, it became "the cause"....
                 On the Minnesota Multiphasic Personality Inventory 
              given by Dr. Kirk Witherspoon, the profile appears to 
              be an invalid one .... 
                 The EEG report from Dr. Robinson on February 28, 
              1986 indicates a history of headaches "for years" in 
              the forehead with accompanying loss of memory.  This 
              needs to also be clearly established.  The EEG was 
              normal, but the presence of these headaches for years 
              and the memory loss may be highly suggestive that this 
              problem actually was present, but was in a different 
              form prior to the onset of the panic attacks ....
                 Dr. Witherspoon's deposition is very interesting.  
              He states that he doesn't see any personality disorder 
              in the MMPI and that the MMPI only reflects stress 
              related symptoms.  I am sorry, but I disagree with this 
              very, very strongly.
                 I find it interesting that Scott relapsed when he 
              attempted to return to work and then was allowed to not 
              return to work because of this relapse in symptoms.  
              This may well have reinforced in his mind that the 
              cause of his problems were stress related difficulties.  
              It is also interesting that Dr. Witherspoon saw Scott 
              for 26 sessions and had very little success in treating 
              his disorder, and yet Mr. Erickson was quite successful 
              in moving around the community when he was not 
              attempting to return to work.  On Page 50 of the 
              Witherspoon deposition, he admits that the compliance 
              of Mr. Erickson to the treatment afforded to him was 
                 To summarize all of this, it is my thinking that the 
              pre-existence of an obsessive-compulsive personality, 
              with the evolving obsessive-compulsive disorder, prior 
              to D & B Auto employment is clearly established.  The 
              failure of the obsessive-compulsive defenses is tho 
              source of the anxiety and stress that precipitated the 
              onset of the panic attacks.
         (Jt. Ex. 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 must prove by a preponderance of the evidence 
         that his injury arose out of and in the course of his employment. 
         Musselman v. Central Telephone Co., 261 Iowa 352, 154 N.W.2d 128 
         PAGE  16
              In the course of employment means that the claimant must 
         prove his injury occurred at a place where he reasonably may be 
         performing his duties.  McClure v. Union, et al., Counties, 188 
         N.W.2d 283 (Iowa 1971).
              Arising out of suggests a causal relationship between the 
         employment and the injury.  Crowe v. DeSoto Consolidated School 
         District, 246 Iowa 402, 68 N.W.2d 63 (1955).
              The supreme court of Iowa in Almquist v. Shenandoah 
         Nurseries, 218 Iowa 724, 254 N.W. 35 (1934) at 731-32, discussed 
         the definition of personal injury in workers' compensation cases 
         as follows:
              While a personal injury does not include an 
              occupational disease under the workmen's Compensation 
              Act, yet an injury to the health may be a personal 
              injury [Citations omitted.] Likewise a personal injury 
              includes a disease resulting from an injury .... The 
              result of changes in the human body incident to the 
              general processes of nature do not amount to a personal 
              injury.  This must follow, even though such natural 
              change may come about because the life has been devoted 
              to labor and hard work.  Such result of those natural 
              changes does not constitute a personal injury even 
              though the same brings about impairment of health or 
              the total or partial incapacity of the functions of the 
              human body.
              A personal injury, contemplated by the Workmen's 
              Compensation Law, obviously means an injury to the 
              body, the impairment of health, or a disease, not 
              excluded by the act, which comes about, not through the 
              natural building up and tearing down of the human body, 
              but because of a traumatic or other hurt or damage to 
              the health or body of an employee. [Citations omitted.] 
              The injury to the human body here contemplated must be 
              something, whether an accident or not, that acts 
              extraneously to the natural processes of nature and 
              thereby impairs the health, overcomes, injures, 
              interrupts, or destroys some function of the body, or 
              otherwise damages or injures a part or all of the 
              As cited above in Crowe, there must be a causal relationship 
         between the employment and the alleged injury.
              The claimant has the burden of proving by a preponderance of 
         the evidence that the injury of February 26, 1986 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 
         PAGE  17
         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).
              As the question of causal connection is essentially within 
         the domain of expert testimony, review is first given to the 
         medical evidence submitted.  Five experts have provided opinions 
         on whether the stress claimant perceived in his employment with 
         defendant employer caused his mental condition.  All five agree 
         that claimant suffers from obsessive-compulsive disorder 
         compounded by symptoms of anxiety and depression.  The 
         undersigned does not doubt that claimant, in fact, suffers from 
         such a disorder.
              Dr. Dewat Chaudhry, a psychiatrist, stated in two different 
         reports that he could not substantiate claimant's problems were 
         caused or aggravated by his employment.  It is interesting to 
         note that claimant himself chose Dr. Chaudhry based on a 
         newspaper article and feeling that Dr. Chaudhry's specialty 
         coincided with his symptoms.  Yet, claimant gets no support for 
         his contention from Dr. Chaudhry's opinions.
              Dr. Dan Domingo, also a psychiatrist, saw claimant on 
         referral from Dr. Witherspoon, claimant's treating psychologist.  
         Dr. Domingo candidly admitted that the cause of 
         obsessive-compulsive disorder is not known and did not in any way 
         relate claimant's symptoms to his employment.
              Dr. W. David McEchron, who did not see claimant but reviewed 
         claimant's records on request of defendants, is firm in his 
         opinion that claimant's condition was caused by claimant's own 
         obsessive-compulsive doubts and processes rather than by any 
         stress of the job and suggests that good research exists that 
         there is a biological component to obsessive-compulsive disorders 
         and the anxiety attacks.
              To the undersigned the most interesting opinion rendered in 
         this case is that from Dr. Russell Noyes, of the University of 
         Iowa Hospitals and Clinics, Department of Psychiatry.  Dr. Noyes' 
         credentials, as found in his curriculum vitae, show he began his 
         teaching career at the University of Iowa in 1965 and became a 
         full professor of psychiatry in 1978, that he is a member of the 
         American Psychiatric Association, the past president of the Iowa 
         Psychiatric Society, a member of the American Psychopathological 
         Association, the Academy of Psychosomatic Medicine, and the 
         American Academy of Clinical Psychiatrists, in addition to being 
         a widely published author in the areas of personality disorders, 
         anxiety disorders, panic disorders, and obsessive-compulsive 
         disorder.  Dr. Noyes had the opportunity both to interview 
         PAGE  18
         claimant and to review claimant's previous medical records 
         particularly with regard to his contacts with Dr. Witherspoon and 
         with Dr. Chaudhry.  Dr. Noyes admits that the cause of 
         obsessive-compulsive disorder is not known and that "the stress 
         to which Mr. Erickson was exposed probably did not play a large 
         role in the illness which he developed."  While Dr. Noyes does 
         admit that "job stress may have been a precipitating factor" in 
         claimant's illness, the Iowa Supreme Court ruled in Burt, supra, 
         that a possibility of causal connection is insufficient; a 
         probability is necessary.  Dr. Noyes' opinion that job stress may 
         have been a precipitating factor falls far short of probability.  
         The opinions of Dr. Noyes are given greater weight.
              The most troubling opinion rendered in this case appears to 
         the undersigned to be that of Dr. Witherspoon, claimant's 
         treating psychologist.
              In Rockwell Graphic Systems, Inc. v. Prince, 366 N.W.2d 187 
         (Iowa 1985), the Iowa Supreme Court stated at 192:
                 We think a rule of law would be unwise that a 
              treating physician's testimony should be given greater 
              weight than that of a later physician who examines the 
              patient in anticipation of litigation.  The employer 
              should and does have the right to develop the facts as 
              to a latter physician's employment in connection with 
              litigation, his examination at a later date and not 
              when the injuries were fresh, his arrangement as to 
              compensation, the extent and nature of his examination, 
              his education, experience, training, and practice, and 
              all other factors which bear upon the weight and value 
              of his testimony.  The claimant may similarly develop 
              such information as to the treating physician.  Both 
              parties may press all of this information to the 
              attention of the fact finder, as either supporting or 
              weakening the physician's testimony and opinion.  All 
              these factors, however, go to the value of the 
              physician's testimony as a matter of fact, not as a 
              matter of law.  Musselman v. Central Telephone Co., 261 
              Iowa 352, 360, 154 N.W.2d 128 132 (Iowa 1967); Paulson 
              v. Central Idaho Forest Industries, 99 Idaho 896, 901, 
              591 P.2d 143, 148 (1979); Arcole Midwest Corp. v. 
              Industrial CommOr, 81 Ill.2d 11, 16, 39 Ill.Dec. 776, 
              779, 405 N.E.2d 755, 758 (1980); Yocum v. Emerson 
              Electric Co., 584 S.W.2d 744, 748 (Ky.App.1979); 
              Moscarelli v. Moscarelli Funeral Home, 55 A.D.2d 762, 
              390 N.Y.S.2d 223, 224 (1976); Dick's Delicatessen of 
              Paoli, Inc. v. W.C.A.B., 82 Pa.Cmwlth.1984).
              Dr. Witherspoon is a clinical psychologist who does not 
         appear to limit his practice to any specialty except that he does 
         not get "into too much" substance abuse.  Neither his Masters nor 
         his Doctor theses dealt with personality disorders.  His initial 
         diagnosis of claimant was not obsessive-compulsive disorder which 
         he now admits is claimant's primary problem.  Dr. Witherspoon was 
         not even aware of the medication available in Canada for the 
         treatment of obsessive-compulsive disorders until so told by 
         claimant who heard it from Dr. Noyes.  Dr. Witherspoon seemed 
         unfamiliar with and evasive in his answers about expert treatises 
         on the subject of obsessive-compulsive disorders.  Dr. 
         PAGE  19
         Witherspoon's testimony appears to the undersigned to be 
         inconsistent on a number of points.  Defendants' brief correctly 
         points out that when Dr. Witherspoon was asked if a single piece 
         of medical literature or psychological literature states that 
         stress can cause obsessive-compulsive disorder he knew of none.  
         When asked if the literature was overwhelming to the contrary, 
         Dr. Witherspoon gave a lengthy rambling explanation in which he 
         accused psychiatry of being the business of selling medication.  
         Yet, Dr. Witherspoon agrees that claimant should go to Canada and 
         obtain the medication that is available.  Dr. Witherspoon 
         concludes at one point that since medication did not work for 
         claimant that obsessive-compulsive disorder is not biological.  
         However, he then readily admits that the psychological treatments 
         which he had been giving claimant over the past two years had not 
         made claimant a lot better and that as a result his prognosis for 
         claimant was not optimistic.  The opinions of Dr. Witherspoon are 
         given less weight.
              While the undersigned is not unsympathetic to claimant's 
         condition as it is unfortunate such a thing should happen to a 
         young man, it must be concluded that the greater weight of 
         medical evidence fails to establish a causal connection between 
         claimant's diagnosed illness and his employment.  Expert medical 
         evidence must be considered, however, with all other evidence 
         introduced bearing on the issue of causal connection.  Burt, 
         supra.  Even absent the medical opinions in this case, the 
         undersigned must conclude that claimant failed to show a causal 
         connection between his employment and his illness.  While the 
         undersigned does not doubt claimant believes all to which he 
         testified, his reliability with regard to his memory clearly 
         PAGE  20
         plays an important part.  Claimant candidly acknowledges that he 
         simply cannot remember certain months of his life particularly 
         those when he felt he was most ill.  There is no dispute claimant 
         was paid for his overtime hours and that he never received any 
         warning or reprimand that he took too long to complete his job.  
         The employer admitted claimant's route could not be completed 
         within an eight hour day and expected to pay for extra hours.  
         There is no record that the employer expressed any 
         dissatisfaction with claimant's job performance.  The undersigned 
         must conclude that claimant's "stressors" were based on his own 
         perceptions, his own obsessive-compulsive doubts and that 
         claimant himself was the source of his own stress rather than his 
         employment.  As the supreme court stated in Newman v. John. Deere 
         Ottumwa Works, 372 N.W.2d 199 (Iowa 1985) at 203:  OWe find no 
         cases which permit recovery when employment merely provides a 
         stage for the nervous injury." (Emphasis original.)
              Finally, the Iowa Supreme Court has addressed the legal 
         standard which claimant must have met to sustain a workers' 
         compensation claim in a stress induced mental health claim.  In 
         Schreckengast v. Hammermills, Inc., 369 N.W.2d 809 (Iowa 1985), 
         the supreme court affirmed the industrial commissioner's finding 
         that a workers' compensation claimant failed to establish 
         causation in fact between his employment and either the onset of 
         his depressive disorder or exacerbation of existing depressive 
         disorder.  At page 810, footnote three of the decision, the court 
                 We have recognized that in both civil and criminal 
              actions causation in fact involves whether a particular 
              event in fact caused certain consequences to occur.  
              Legal causation presents a question of whether the 
              policy of the law will extend responsibility to those 
              consequences which have in fact been produced by that 
              event.  State v. Marti, 290 N.W.2d 570, 584-85 (Iowa 
              1980).  Causation in fact presents an issue of fact 
              while legal causation presents an issue of law. Id.
              As in Schreckengast, claimant has failed to meet his burden 
         of proof and will take nothing further from these proceedings.
                                 FINDINGS OF FACT
              Wherefore, based on all of the evidence presented, the 
         following findings of fact are made:
              1.  Claimant has been diagnosed as suffering from 
         obsessive-compulsive disorder.
              2.  Claimant's treating psychologist has opined his illness 
         is causally connected to stress claimant perceived in his 
              3.  The greater weight of medical evidence fails to 
         establish a causal connection between claimant's illness and his 
              4.  Claimant did not sustain an injury which arose out of 
         and in the course of his employment.
         PAGE  21
                                CONCLUSION OF LAW
              Therefore, based on the principles of law previously stated, 
         the following conclusion of law is made:
              Claimant failed to establish that he sustained an injury 
         which arose out of and in the course of his employment or that 
         the illness with which he has been diagnosed is causally related 
         to his employment.
              Claimant shall take nothing further from these proceedings.
              Costs are assessed against defendants pursuant to Division 
         of Industrial Services Rule 343-4.33.
              Signed and filed this 23rd day of December, 1988.
                                      DEBORAH A. DUBIK
                                      DEPUTY INDUSTRIAL COMMISSIONER
         Copies to:
         Mr. John D. Stonebraker
         Attorney at Law
         P.O. Box 2746
         Davenport, IA 52809
         Mr. Craig a. Levien
         Attorney at Law
         600 Union Arcade Bldg.
         Davenport, IA 52801
                                               1100; 1108
                                               Filed December 23, 1988
                                               Deborah A. Dubik
                                               File No. 821055
         D & B AUTO RADIO, INC.,            A R B I T R A T I O N
              Employer,                        D E C I S I O N
              Insurance Carrier,
         1100; 1108
         Claimant was a route driver for defendant employer who perceived 
         stress on the job to have caused his symptoms of 
         obsessive-compulsive disorder.  The greater weight of medical 
         evidence failed to show claimant's illness arose out of and in 
         the course of his employment.  Even absent any medical causation, 
         the evidence established it was claimant's own perceptions and 
         his own obsessive-compulsive doubts, not his employment, which 
         were the source of his symptom.