BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         NATHANIAL McCLINTOCK,
 
         
 
              Claimant,                             File No. 830002
 
         
 
         vs.                                     A R B I T R A T I O N
 
         
 
         PAYNE & KELLER, INC.,                      D E C I S I O N
 
         
 
              Employer,
 
                                                       F I L E D
 
         and
 
                                                      JAN 20 1989
 
         NATIONAL UNION FIRE INSURANCE,
 
         COMPANY,                            IOWA INDUSTRIAL COMMISSIONER
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
                             STATEMENT OF THE CASE
 
         
 
              This is a proceeding in arbitration brought by Nathanial 
 
         McClintock, claimant, against Payne & Keller, Inc., employer, and 
 
         National Union Fire Insurance Company, insurance carrier, for 
 
         workers' compensation benefits as a result of an alleged injury 
 
         on July 21, 1986.  On November 28, 1988, a hearing was held in 
 
         Dubuque, Iowa.  The record in this case consists of joint 
 
         exhibits 1, 2, 3 and 5, and defendants' exhibits 3A, 4, 6, 7, 8 
 
         and 9.  Of the joint exhibits, exhibit 1 is the deposition of 
 
         Richard E. Chapman, exhibit 2 is the deposition of Sam McGinnis, 
 
         and exhibit 3 the deposition of Dr. Dennis Miller.  This case 
 
         originally listed the insurance carrier as American International 
 
         Adjustment, Inc., but the name of National Union Fire Insurance 
 
         Company was substituted by agreement as being in fact the actual 
 
         insurance carrier.
 
         
 
                                   ISSUES
 
         
 
              Pursuant to the prehearing report, the parties stipulated 
 
         that there was an employer-employee relationship.  The remaining 
 
         issues for resolution are:
 
         
 
              1.  Whether claimant's injury arose out of and in the course 
 
         of employment;
 
         
 
              2.  Whether there was a causal relationship between 
 
         claimant's injury and his employment;
 
         
 
              3.  The nature and extent of claimant's disability; and,
 
         
 
              4.  Whether claimant is entitled to medical benefits.
 
         
 
                                                       
 
                                                                
 
                              REVIEW OF THE EVIDENCE
 
         
 
              The claimant represented himself at the hearing and was 
 
         given full opportunity to present his evidence.  The claimant 
 
         attempted to offer the deposition of his prior personal testimony 
 
         as exhibit C.  Defendants objected to the offer for the reason 
 
         that it violated the hearing assignment order requiring the 
 
         exchange of exhibit lists within 15 days prior to the hearing.  
 
         Claimant was notified that notwithstanding the sustaining of 
 
         defendants' objection to this exhibit comprising his personal 
 
         testimony that he himself could still personally testify at the 
 
         hearing.
 
         
 
              The evidence of the claimant was joint exhibits 1, 2, 3 and 
 
         5, of which three exhibits were depositions of a doctor and two 
 
         co-workers.  The co-worker and foreman, Sam McGinnis, testified 
 
         that the claimant, Richard Chapman, and he were working together 
 
         on the day of the alleged injury, July 21, 1986.  They were 
 
         laying out cable and raising it up over head approximately ten 
 
         feet to the claimant who was on a ladder.  Claimant then would 
 
         push the cable through a hole in the wall to an adjoining room.  
 
         McGinnis said that claimant was considered an electrician's 
 
         helper and was considered inexperienced on the job.  Claimant was 
 
         under McGinnis' supervision for approximately two months.  At the 
 
         time of McGinnis' deposition, he was no longer employed with 
 
         defendant.
 
         
 
              McGinnis recalls the day of the alleged injury and testified 
 
         that he did not believe the claimant was injured.  McGinnis 
 
         indicated that he was present at all times and he would have 
 
         known if claimant had hurt himself.  McGinnis stated that Chapman 
 
         and he began working on this project about 8:30 a.m. on July 21, 
 
         1986 and around 9:00 or 9:30 a.m. claimant told McGinnis "this 
 
         could hurt a guy's back" jokingly.  These workers took a break at 
 
         10:00 a.m. and claimant came back and stated to McGinnis that he 
 
         was hurt. McGinnis indicated that he didn't take claimant 
 
         seriously as claimant" wasn't serious about it."  Claimant was on 
 
         the ladder again after the break and McGinnis further testified 
 
         that he didn't think it was possible for claimant to have lost 
 
         his balance without McGinnis noticing it that morning and there 
 
         was no time that he was out of the room when claimant was on the 
 
         ladder.  He did not believe that claimant could have gotten hurt 
 
         without McGinnis knowing it.  McGinnis testified that he again 
 
         asked claimant why claimant reported this injury if he was just 
 
         joking about it and claimant responded "just in case."  Claimant 
 
         finished working on July 21, 1986 but did not come to work the 
 
         next day.
 
         
 
              Mr. Richard Chapman testified that he was present when 
 
         McGinnis was feeding the cable to claimant who was on the ladder. 
 
         Chapman stated that he did not know claimant until approximately 
 
         two days before the alleged injury.  He basically supported the 
 
         testimony of McGinnis.  He did not recall claimant losing his 
 
         balance at all and did not believe it was possible for claimant 
 
         to lose his balance without him noticing it.  Chapman indicated 
 
                                                       
 
                                                                
 
         that he was in the room the entire morning that claimant was on 
 
         the ladder.  Claimant never said anything to him about an injury 
 
         before claimant reported that he had hurt himself to the 
 
         employer. Chapman testified that claimant said before he even 
 
         started pulling the cable that "this looked like a way a person 
 
         could hurt their back."  On July 23, 1986, two days after the 
 
         alleged injury, claimant returned to work and before beginning 
 
         work that day Chapman stated that claimant and he had a 
 
         conversation as they were walking together from the parking lot 
 
         to the defendant employer's office.  Chapman asked claimant how 
 
         his back was as he had heard claimant had hurt his back and 
 
         claimant said "okay now, I finally got a doctor and he gave me 
 
         some medicine."  Chapman indicated he and claimant kept on 
 
         walking and talking and claimant made a statement to him that "it 
 
         was time to try to make some easy money."  Chapman responded as 
 
         to what claimant meant by that and claimant responded "well, it's 
 
         time to pull a scam."  Chapman stated that claimant "said 
 
         something about he had worked in Colorado and that he had pulled 
 
         some kind of a scam, and he wouldn't elaborate much further on 
 
         it."  Chapman stated that no further conversation pursued as it 
 
         was time to punch the time clock and the two went their separate 
 
         ways.
 
         
 
              Dennis Miller, M.D., testified that his examination of 
 
         claimant on May 13, 1987 revealed that the cervical and thoracic 
 
         spine was well within normal limits although there was some 
 
         slight rotation of the spinous processes which would be 
 
         considered a normal finding.  An EMG that was ordered was done at 
 
         a later date, on May 15, 1987 by Fareeduddin Ahmed, M.D., and was 
 
         essentially normal.  Dr. Miller found no objective finding of 
 
         health impairment and found consistent tenderness over a 
 
         localized area which was based on claimant's report to him of 
 
         tenderness in that area.  Dr. Miller had an opportunity to review 
 
         x-rays from the office of Dr. Bonnie May, a chiropractor in 
 
         Clinton, Iowa.  Dr. Miller stated that he considered those x-rays 
 
         to represent a normal spine and within normal limits.  Dr. Miller 
 
         indicated that in reviewing Dr. May's records and the localized 
 
         area of complaints when she examined claimant versus the 
 
         localized area that Dr. Miller examined pursuant to the 
 
         claimant's complaints and history might be the same area, but he 
 
         was not at all sure.  Dr. Miller stated that the complaint of 
 
         claimant to Dr. May was to the thoracic spine and claimant's 
 
         complaint to Dr. Miller was somewhat higher on the back.
 
         
 
              Dr.  Miller testified that he also examined the records of 
 
         Dr. Michael Dehner of July 22, 1986 and Dr. Dehner had made a 
 
         diagnosis of lumbosacral strain.  As a result of his examination, 
 
         Dr. Miller opined that he did not believe Mr. McClintock had any 
 
         physical impairment.
 
         
 
              Dr. Miller stated that the examination histories of Dr. 
 
         Dehner were different than those of Dr. May and himself.
 
         
 
                        APPLICABLE LAW AND ANALYSIS
 
         
 
                                                       
 
                                                                
 
              Claimant has the burden of proving by a preponderance of the 
 
         evidence that he received an injury on September 20, 1986 which 
 
         arose out of and in the course of his employment.  McDowell v. 
 
         Town of Clarksville, 241 N.W.2d 904 (Iowa 1976); Musselman v. 
 
         Central Telephone Co., 261 Iowa 352, 154 N.W.2d 128 (1967).
 
         
 
              Claimant has not presented any evidence of an injury that 
 
         arose out of and in the course of his employment on July 21, 
 
         1986. Claimant did not give testimony contradicting the testimony 
 
         of his co-workers, McGinnis and Chapman.
 
         
 
              There is reliable evidence which indicates claimant brought 
 
         this case solely for the purpose of making money at the 
 
         defendants' expense without any injury occurring.
 
         
 
                               FINDINGS OF FACT
 
         
 
              1.  Claimant was not injured while working for defendant 
 
         employer on July 21, 1986.
 
         
 
                              CONCLUSIONS OF LAW
 
         
 
              THEREFORE, it is concluded:
 
         
 
              Claimant has failed to establish that he received an injury 
 
 
 
                              
 
                                                                
 
         arising out of and in the course of his employment on July 21, 
 
         1986.
 
         
 
              Claimant has not established a causal relationship between 
 
         his alleged injury of July 21, 1986 and his claimed disability.
 
         
 
              Claimant is not entitled to any benefits.
 
         
 
              Claimant is not entitled to payment of any medical bills.
 
         
 
                                    ORDER
 
         
 
              THEREFORE, it is ordered:
 
         
 
              That claimant take nothing from this proceeding.
 
         
 
              That claimant pay the costs of this proceeding pursuant to 
 
         Division of Industrial Services Rule 343-4.33, which shall 
 
         include but not limited to the depositions and the court reporter 
 
         at the time of hearing.
 
         
 
         
 
              Signed and filed this 20th day of January, 1989.
 
         
 
         
 
         
 
         
 
         
 
         
 
                                            BERNARD J. O'MALLEY
 
                                            DEPUTY INDUSTRIAL 
 
                                            COMMISSIONER
 
         
 
         Copies to:
 
         
 
         Mr. Nathanial McClintock
 
         2918 N. 2nd St
 
         Clinton, IA  52732
 
         CERTIFIED & REGULAR MAIL
 
         
 
         Mr. Roger L. Ferris
 
         Attorney at Law
 
         1900 Hub Tower
 
         699 Walnut
 
         Des Moines, IA  50309
 
         
 
         
 
         
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                       
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                                            1100; 1402.20
 
                                            Filed January 20, 1989
 
                                            Bernard J. O'Malley
 
         
 
                   BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         NATHANIAL McCLINTOCK,
 
         
 
              Claimant,
 
                                                  File No. 830002
 
         vs.
 
         
 
         PAYNE & KELLER,                       A R B I T R A T I 0 N
 
         
 
              Employer,
 
                                                  D E C I S I 0 N
 
         and
 
         
 
         NATIONAL UNION FIRE INSURANCE
 
         COMPANY,
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
         1100; 1402.20
 
         
 
              Claimant alleged back injury while laying cable for 
 
         defendant employer.  Co-worker testified claimant told him "this 
 
         could hurt a guy's back."  Shortly thereafter on same morning, 
 
         claimant reported an injury.
 
         
 
              Co-worker further testified that claimant told him while 
 
         walking from defendant employer's parking lot to office building 
 
         and discussing claimant's back complaint, "it was time to make 
 
         some easy money" and "it's time to pull a scam."
 
         
 
              No benefits awarded.  Claimant was pulling a scam.
 
         
 
         
 
         
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                      BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         _________________________________________________________________
 
         
 
         RUTH M. ZEARLEY,
 
         
 
              Claimant,
 
         
 
         VS.
 
         CEDAR RAPIDS MEAT d/b/a
 
         FARMSTEAD FOODS,
 
                                            File Nos. 830003, 830004
 
                                              787836, 701461, 834037
 
               Employer,
 
         
 
         and
 
                                                 A P P E A L
 
         SENTRY INSURANCE CO.,
 
                                                 R U L I N G
 
         
 
             Insurance Carrier,
 
         
 
         and
 
         
 
         SECOND INJURY FUND,
 
         
 
             Defendants.
 
         
 
         _________________________________________________________________
 
         
 
              Rule 500-4.27 states in part:
 
         
 
                   No appeal shall be separately taken under this or 4.25 
 
              (17A, 86) from an interlocutory decision, order or ruling of 
 
              a deputy industrial commissioner.  A decision, order or 
 
              ruling is interlocutory if it does not dispose of the 
 
              contested case unless the sole issue remaining for 
 
              determination is claimant's entitlement to additional 
 
              compensation for unreasonable denial or delay of payment 
 
              pursuant to section 86.13.
 
         
 
              The ruling filed June 12, 1987, which is the subject matter 
 
         of this appeal, is not dispositive of the contested case and 
 
         therefore interlocutory.
 
         
 
              THEREFORE, the appeal filed June 30, 1987 is hereby 
 
              dismissed.
 
         
 
         
 
              Signed and filed this 10th day of August, 1987.
 
         
 
         
 
         
 
        
 
                                                
 
         
 
         ZEARLEY V. CEDAR RAPIDS MEAT d/b/a FARMSTEAD FOODS                                                
 
         Page 2
 
         
 
         
 
         
 
                                          DAVID E. LINQUIST 
 
                                          ACTING INDUSTRIAL COMMISSIONER
 
         
 
         
 
         
 
         Copies To:
 
         
 
         Mr. James E. Shipman
 
         Attorney at Law
 
         1200 MNB Building
 
         Cedar Rapids, Iowa 52401
 
         
 
         Mr. Harry W. Dahl
 
         Attorney at Law
 
         974 73rd St., Suite 16
 
         Des Moines, Iowa 50312
 
         
 
         Mr. John M. Bickel
 
         Attorney at Law
 
         500 MNB Building
 
         P.O. Box 2107
 
         Cedar Rapids, Iowa 52406
 
 
 
         
 
 
         
 
 
 
 
 
 
 
 
 
 
 
                     BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         GILBERT WEILER,
 
         
 
              Claimant,
 
         
 
         VS.
 
                                         File No. 830013
 
         WELLS BLUE BUNNY,
 
                                         D E C I S I 0 N
 
              Employer,
 
                                           M E D I C A L
 
         KEMPER GROUP,
 
                                         B E N E F I T S
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
         
 
                              STATEMENT OF THE CASE
 
         
 
              This is a bifurcated proceeding in arbitration through which 
 
         claimant seeks payment of past medical expenses and alternate 
 
         care under Iowa Code section 85.27 and an independent medical 
 
         examination under Iowa Code section 85.39. This matter came on 
 
         for hearing before the undersigned deputy industrial commissioner 
 
         June 27, 1988 and was considered fully submitted at the close of 
 
         the proceeding.   The record in this case consists of the 
 
         testimony of claimant and Michael Ellis; joint exhibits 1 through 
 
         28, inclusive; and claimant's exhibits A through D, inclusive.
 
         
 
                                      ISSUES
 
         
 
              Pursuant to the prehearing report and order submitted and 
 
         approved June 27, 1988, the following issues are presented for 
 
         resolution:
 
         
 
              1. Claimant's entitlement to relief under Iowa Code section 
 
         85.27; and
 
         
 
              2. Claimant's entitlement to an independent medical 
 
         examination under Iowa Code section 85.39.
 
         
 
                                 FACTS PRESENTED
 
         
 
              Claimant testified that in June of 1985 he injured himself 
 
         at work when he spun around real fast to put a pail in the 
 
         machine on which he was working and felt a "pop" in his neck.  
 
         Claimant recalled he told his supervisor about the incident
 
         
 
         
 
         
 
         WEILER V. WELLS BLUE BUNNY 
 
         Page 2
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
         approximately one hour later, finished his shift and then went 
 
         home.  Claimant stated the next day he felt stiffness in his 
 
         neck, "could not hold onto a cup of coffee," and went to see a 
 
         Dr. Hiemstra at Medical Associates of Iowa at the direction of 
 
         his employer.  Claimant explained he went through physical 
 
         therapy but did not miss any work although he felt pain in his 
 
         neck, numbness in his fingers and left arm, and had recurring 
 
         headaches.  Claimant testified he returned to see Dr. Hiemstra 
 
         but wanted a second opinion and therefore went to see his family 
 
         doctor, R. J. Hassebroek, M.D., who initially treated him with 
 
         medication and physical therapy and who sent him to D. G. 
 
         Paulsrud, M.D., who recommended to claimant that he use a back 
 
         brace and refrain from lifting for six weeks.  Claimant stated 
 
         that Dr. Paulsrud later released him to return to work without 
 
         limitations.
 
         
 
              Claimant testified that he felt Dr. Paulsrud was not doing 
 
         justice to him, that he told defendant employer as much, and then 
 
         went to see Steven J. Parkin, D.C., at the direction of 
 
         defendants whom he continues to see approximately one time per 
 
         month.  Claimant stated that between December 1985 and July 1986, 
 
         he continued to experience headaches and returned to see Dr. 
 
         Hassebroek who recommended he go to the Mayo Clinic.  Claimant 
 
         recalled that approximately two weeks later he spoke with 
 
         defendants, who sent him back to Dr. Hiemstra.  Claimant stated 
 
         that on September 5, 1986, approximately one week after his 
 
         separation from employment, he went to the Mayo Clinic where a 
 
         series of tests were run after which claimant was given some 
 
         exercises to do.  Claimant stated that the doctors at the Mayo 
 
         Clinic found a lump which was not work related.  Claimant offered 
 
         that he did the exercises prescribed by the physicians at the 
 
         Mayo Clinic for a few months but was still experiencing headaches 
 
         and that in November of 1987 he went to see Horst G. Blume, M.D., 
 
         who recommended further testing.
 
         
 
              Claimant testified that since June of 1985 he has not been 
 
         pain-free., that he still experiences headaches, a stiffness in 
 
         his neck, and numbness in his fingers and arms while driving.  
 
         Claimant stated he injured his back while playing football in 
 
         high school in 1969-70, that he injured himself in a 1971 and 
 
         again in a 1982 auto accident, that he had a car accident in 1975 
 
         which did not involve any medical problems, and that while 
 
         working on a farm he burned his hands and feet when lighting a 
 
         furnace.
 
         
 
              On cross-examination, claimant acknowledged he has had a 
 
         long history of back and neck problems, that he was discharged 
 
         from the military service as a result of his back problems, and 
 
         that in 1970 he was diagnosed as having spondylolysis.  Claimant 
 
         could not recall if he had ever had a head injury or if he had 
 
         been treated for any neck problems prior to 1985. (See, however,
 
         
 
         
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         WEILER V. WELLS BLUE BUNNY 
 
         Page 3
 
         
 
         
 
         joint exhibit 5)  Claimant testified that sometime after June 
 
         1985, although he could not recall when, he fell at work and a 
 
         cart landed on top of him.  Claimant acknowledged he wore a back 
 
         brace while playing football and that he still uses a back brace 
 
         "off and on," "perhaps one time in the last six months" but that 
 
         it makes him uncomfortable.  Claimant stated he currently takes 
 
         no prescriptive.medication, that he has no current medical 
 
         appointments, and that he has not been denied any medical 
 
         treatment by defendants.
 
         
 
              Mike Ellis, who identified himself as defendant employer's 
 
         personnel director, testified claimant last worked on August 26, 
 
         1986 and that claimant never picked up the contents of his locker 
 
         which included a back brace.  Claimant later testified, however, 
 
         that the back brace found in his locker was replaced with another 
 
         one and therefore was no longer of any use to him.
 
         
 
                           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).
 
         
 
              Iowa Code section 85.27 provides:
 
         
 
                 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.
 
         
 
              Defendants do not dispute that on June 20, 1985, claimant 
 
         sustained an injury which arose out of and in the course of his 
 
         employment.  The question with regard to this injury may be 
 
         phrased as: Exactly what was that injury? The undersigned would 
 
         conclude that claimant's injury of June 20, 1985 is confined to 
 
         his neck and that it is for this injury that claimant is entitled 
 
         to treatment under Iowa Code section 85.27. The undersigned. 
 
         cannot conclude that claimant has established any causal 
 
         connection between the injury of June 20, 1985 and his asserted 
 
         back problems.
 
         
 
              Medical records and claimant's own testimony establish that 
 
         claimant has had a long history of back problems beginning as 
 
         early as 1969 when he was in high school and that he has been 
 
         diagnosed as suffering from spondylolysis, a congenital condition 
 
         in his back. claimant, at the time of his injury and fairly 
 
         consistently since, reported a pop in his neck on June 20, 1985.  
 
         The treatment rendered at Floyd Valley Hospital on June 29
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
         
 
         
 
         WEILER V. WELLS BLUE BUNNY 
 
         Page 4
 
         
 
         
 
         involved an x-ray of the cervical spine.  The treatment provided 
 
         by Dr. Hiemstra, Dr. Hassebroek and Dr. Parkin involved the 
 
         cervical spine.  In addition, Dr. Hiemstra reported on October 
 
         18, 1985 that while claimant was being treated for neck pain, 
 
         claimant complained of a back injury in July. (Joint Exhibit 12) 
 
         The undersigned has jurisdiction over the alleged injury date of 
 
         June 20, 1985 and will not expand that jurisdiction to include an 
 
         alleged injury occurring in July.  Further, physicians at the 
 
         Mayo Clinic report claimant was experiencing neck pain due to an 
 
         injury at work.  It was not until approximately July that 
 
         claimant first reported back pain.  Claimant gave no history of 
 
         the pail incident when associating this back pain.  The 
 
         undersigned cannot conclude that claimant has shown the injury of 
 
         June 20, 1985 extended beyond the neck and therefore any 
 
         treatment claimant has sought for a condition beyond the neck 
 
         would not be considered causally connected to the injury as 
 
         alleged in the petition for benefits.
 
         
 
              Consequently, the issue at this point is what medical 
 
         treatment claimant is entitled to as a result of this injury.  It 
 
         is interesting to first note that claimant has missed no time 
 
         from work as a result of this injury, that claimant was able to 
 
         perform his regular work (with the exception of a no lifting 
 
         restriction from Dr. Paulsrud which is not considered causally 
 
         connected to this injury), that claimant has gone for long 
 
         stretches of time without any medical treatment,and that claimant 
 
         has not been denied any medical treatment which is causally 
 
         connected to his injury.  Claimant was complaining of neck pain 
 
         and headaches long before his injury of June 20, 1985.  On 
 
         October 3, 1986, William F. Young, M.D., of the Mayo Clinic 
 
         reported to Dr. Hassebroek that:
 
         
 
                 We recently (September 5 through September 26, 1986) had 
 
              the pleasure of conducting a general medical examination on 
 
              your patient, Mr. Gilbert A. Weiler.  As you know, Mr. 
 
              Weiler's major medical concerns included neck and low back 
 
              discomforts.  The onset of the neck discomfort was 
 
              associated with an apparent injury at work....
 
              
 
                 ....
 
              
 
                 Mr. Weiler was seen in consultation by Dr. T. Yanagihara 
 
              from our Department of Neurology and his examination was 
 
              essentially within normal limits except for a muscle 
 
              tightness in the neck of a mild degree.  There was no 
 
              evidence of cervical or lumbar radiculopathy to explain his 
 
              neck or low back pain.  Doctor Yanagihara felt his neck 
 
              discomfort was consistent with tension myalgias.  In 
 
              addition, Doctor
 

 
              
 
 
 
 
 
 
 
 
 
 
 
         
 
         
 
         
 
         WEILER V. WELLS BLUE BUNNY
 
         Page 5
 
         
 
         
 
              Yanagihara felt the low back pain was mechanical in 
 
              nature....
 
              
 
                 Mr. Weiler was seen in consultation by Dr. L.F.A. 
 
              Peterson from our Department of orthopedic Surgery.  The 
 
              lumbar spine x-rays revealed spondylolysis at L5 
 
              bilaterally.  The next x-rays revealed slightly narrowed 
 
              fourth and fifth cervical interspaces.  Skull x-ray was 
 
              negative with possible old bilateral chronic mastoiditis.  
 
              Doctor Peterson felt Mr. Weiler had bilateral spondylolysis 
 
              of L5 without spondylolisthesis and also degenerative 
 
              arthritis of the lower cervical spine at C4 and C5 with 
 
              localized hypertrophic changes.  Doctor Peterson felt there 
 
              was no continuing aggravation of his degenerative arthritis 
 
              of the cervical spine at this time.  His examination was 
 
              essentially within normal limits.  Doctor Peterson felt 
 
              there was no continuing aggravation from the twisting which 
 
              occurred previously.
 
              
 
                 Mr. Weiler was seen in consultation by Dr. P. J. 
 
              McCreesch from our Department of Physical Medicine and 
 
              Rehabilitation and a program of exercise and modalities for 
 
              symptomatic relief of his discomfort was described in 
 
              detail.
 
         
 
         (Joint Exhibit 20)
 
         
 
              Based on the above, it is concluded that any injuries 
 
         suffered by claimant on June 20, 1985 have resolved and no 
 
         further treatment is warranted.. However, defendants shall 
 
         designate an authorized treating physician for claimant's 
 
         injuries and be liable for expenses therefor if claimant can 
 
         establish a causal connection between the injury to his neck on 
 
         June 20, 1985 and the future medical treatment.
 
         
 
              Claimant submits for payment by defendants an itemized 
 
         statement from the Mayo Clinic in the amount of $1,826.80.  In 
 
         light of the conclusions rendered above, only those portions of 
 
         the bill associated with claimant's neck injury are found to be 
 
         defendants' liability.  This deputy can find no reasonable basis 
 
         for allowing a "general medical examination" in this 
 
         circumstance.
 
         
 
              Claimant also submits an itemized statement from Dr. Parkin 
 
         totaling $337.  In a letter dated October 29, 1987 to claimant's 
 
         counsel, Dr. Parkin reported:
 
         
 
                 Mr. Weiler was originally seen in our office on December 
 
              21, 1985 as a result of a referral from Mr. David Calhoun of 
 
              Well's Dairy and Mr. David Halland,
 

 
              
 
 
 
 
 
 
 
 
 
 
 
         
 
         
 
         
 
         WEILER V. WELLS BLUE BUNNY 
 
         Page 6
 
         
 
         
 
              R.P.T. of Floyd Valley Hospital.  At the time his initial 
 
              complaints were of neck and lower back pain which according 
 
              to Mr. Weiler 11......    started about six months ago."
 
              
 
                 Examination performed December 21, 1985 demonstrated 
 
              foramina compression positive at C4 - C5 right.  Shoulder 
 
              depression was positive right.  Range of motion of the 
 
              cervical spine was reduced and there was bilateral 
 
              paracervical muscle splinting from Cl to T2.  Biceps, 
 
              tricepsreflexes [sic] were equal and active.  Left 
 
              brachioradialis reflex was non-active.  An acute active 
 
              trigger point was elicited at the insertion of the scalenus 
 
              anterior and scalenus posterior muscle groups bilaterally.  
 
              Pain was also elicited at the origins of both of these 
 
              muscle groups.
 
              
 
                 As these findings suggested injury to the cervical spine, 
 
              brachial plexus and supporting soft tissues of .the cervical 
 
              spine Mr. Michael Ellis - Personnel Manager of Well's Dairy 
 
              - was contacted by telephone and verbally informed of the 
 
              findings and asked to [sic] restrict Mr. Weiler's work, 
 
              allowing only light duties, those exclusive of repetitive 
 
              [sic] arm/shoulder movements.
 
              
 
                 On December 23, 1985 x-rays taken by Floyd Valley 
 
              Hospital were reviewed with Mr. Weiler.  Those x-rays showed 
 
              rotation of C2 to the right, C4 - C5 disc degeneration with 
 
              evidence of osteophytic changes in [sic] the adjacent region 
 
              of the cervical spine.  A lumbar scoliosis of approximately 
 
              10 degrees was also noted together with a deformity of the 
 
              Sacroiliac articulations - possibly congenital in etiology.
 
              
 
                 Mr. Weiler was commenced on a course of conservative 
 
              therapeusis aimed at restoring as much cervical spine 
 
              mobility as possible and minimizing his reported discomfort.  
 
              On December 30, 1985 his improvement was such that he was 
 
              allowed to return to careful work activities - those tasks 
 
              that did not produce discomfort.  This information was again 
 
              verbally communicated to Mr. David Calhoun of Well's Dairy.
 
              
 
                 From January 20, 1985 until July 9, 1985 Mr. Weiler was 
 
              seen in our office on a monthly basis during which time he 
 
              was able to perform average and customary employment with 
 
              little or no reported difficulty other than less than normal 
 
              cervical spine motion.
 
         
 
         
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         WEILER V. WELLS BLUE BUNNY
 
         Page 7
 
         
 
         
 
                 From July 9, 1985 until April 10, 1985 we had no contact 
 
              with Mr. Weiler.  On April 10, 1986 he presented at our 
 
              office reporting mid-thoracic pain as a result of lifting 
 
              while engaged in some farming activities.  This was a single 
 
              incident visit that required only one office call to 
 
              resolve.
 
              
 
                 Again Mr. Weiler was not seen in our office from April 
 
              10, 1986 until January 15, 1987.  At this time he reported 
 
              sharp pains in his neck.  He further stated that he had been 
 
              examined in Rochester, Minnesota and instructed in a course 
 
              of cervical spine exercises which he stated were of no help 
 
              in that they did not improve his condition.. Upon 
 
              examination it was noted that the original presenting 
 
              symptoms from December of 1985 were once again present.  Mr. 
 
              Weiler reported that the symptoms had been made worse by his 
 
              employment.  The patient was seen for a total of four times 
 
              between January 15, 1987 and August 28, 1987, each time with 
 
              mild recurrences of the original presenting complaints.
 
              
 
                 On October 15, 1987 he presented with the same original 
 
              complaints and a new examination with x-rays was scheduled 
 
              for October 26, 1987 
 
              
 
              
 
                 ....
 
              
 
                 Physical and radiographic findings in the cervical spine 
 
              are consistent with hyperextension/hyperflexion injuries..It 
 
              is my opinion that Mr. Weiler indeed suffered such an 
 
              injury, date unknown, and the results of that injury are 
 
              clearly evident and are in fact permanent in Mr. Weiler's 
 
              case.  It is therefore suggested that Mr. Weiler will 
 
              continue as in the past with subacute manifestations of the 
 
              original injury, gradually becoming [sic] worse as time and 
 
              his physical activity continues.
 
         
 
         (Jt. Ex. 21)
 
         
 
              As it was defendants who referred claimant to Dr. Parkin and 
 
         as it is Dr. Parkin's opinion that claimant's condition is as a 
 
         result of his employment, claimant is entitled to some payment 
 
         under Iowa Code section 85.27.  Clearly, the charge from April 
 
         10, 1986 is not as a result of the injury of June 20, 1985 and 
 
         therefore it shall be disallowed.  Further, it has been concluded 
 
         that claimant's condition as a result of the June 20, 1985 injury 
 
         resolved itself by October 1986 and therefore any treatment 
 
         thereafter would not be considered causally connected to his 
 
         employment.  Dr. Parkin refers to "injuries" and does not 
 
         restrict his findings to what occurred on June 20,.1985.
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
         
 
         WEILER V. WELLS BLUE BUNNY 
 
         Page 8
 
         
 
         
 
         Therefore, defendants are found liable for the treatment rendered 
 
         to claimant on December 21, 1985, December 23, 1985, December 30, 
 
         1985, January 20, 1986, January 23, 1986, and March 20, 1986.  
 
         Claimant has failed to establish a causal connection between the 
 
         charges of Dr. Parkin and his injury of June 20, 1985 subsequent 
 
         to March 20, 1986.
 
         
 
              The final issue presented for resolution is claimant's 
 
         entitlement to benefits under Iowa Code section 85.39. That 
 
         section of the law provides:
 
         
 
                 If an evaluation of permanent disability has been made by 
 
              a physician retained by the employer and the employee 
 
              believes this evaluation to be too low, the employee shall, 
 
              upon application to the commissioner and upon delivery of a 
 
              copy of the application to the employer and its insurance 
 
              carrier, be reimbursed by the employer the reasonable fee 
 
              for a subsequent examination by a physician of the 
 
              employee's own choice, and reasonably necessary 
 
              transportation expenses incurred for the examination.  The 
 
              physician chosen by the employee has the right to confer 
 
              with and obtain from the employer-retained physician 
 
              sufficient history of the injury to make a proper 
 
              examination.
 
         
 
              If one goes no further.than the opinion of Dr. Parkin, who 
 
         was clearly retained by defendant, or the opinion of Dr. Young at 
 
         the Mayo Clinic which the undersigned reads as a zero rating, 
 
         claimant has satisfied the necessary requirements of Iowa Code 
 
         section 85.39 entitling him to an independent medical 
 
         examination. claimant need not.have formally requested such an 
 
         examination pursuant to the industrial commissioner's decision in 
 
         Perozik v. Swift Independent Packing, filed on February 18, 1987.  
 
         Therefore, claimant's request for an examination by Dr. Blume 
 
         shall be granted and defendants shall pay the expense of $515.  
 
         Under Iowa Code section 85.39, claimant is entitled to an 
 
         examination only and while the testing requested by claimant may 
 
         be contemplated by the statute, claimant has failed to show it is 
 
         reasonable and necessary in this case.  Therefore, defendants 
 
         will not be ordered to pay the costs of a myelogram and CT scan.
 
         
 
                                 FINDINGS OF FACT
 
         
 
              Wherefore, based on all the evidence presented, the 
 
         following findings of fact are made:
 
         
 
              1. Claimant sustained an injury on June 20, 1985 which arose 
 
         out of and in the course of his employment.
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
         
 
         WEILER V. WELLS BLUE BUNNY
 
         Page 9
 
         
 
         
 
              2. Claimant's injury as a.result of the June 20, 1985 
 
         incident is confined to his neck and does not extend into his 
 
         back.
 
         
 
              3. Claimant has a long history of back problems and had been 
 
         diagnosed as having spondylolysis as early as approximately 1970.
 
         
 
              4. Claimant's back problems are not causally connected to 
 
         the injury of June 20, 1985.
 
         
 
              5. Subsequent to the injury of June 20, 1985, claimant was 
 
         able to perform his regular work, claimant lost no time from 
 
         work, claimant has gone for long stretches of time without any 
 
         medical treatment, and claimant has not been denied any medical 
 
         treatment which is causally connected to his injury.
 
         
 
              6. Any injuries suffered by claimant on June 20, 1985 have 
 
         resolved and no further treatment is warranted at this time.
 
         
 
              7. Defendants are liable for the treatment rendered to 
 
         claimant at the Mayo Clinic which is causally connected to the 
 
         neck injury of June 20, 1985.
 
         
 
              8. Defendants are liable for the expenses claimant incurred 
 
         in his treatment with Dr. Parkin, having referred claimant to Dr. 
 
         Parkin's care.
 
         
 
              9. A physician retained by the employer has rendered an 
 
         opinion on permanent disability with which claimant disagrees.
 
         
 
              10. Claimant is entitled to an independent medical 
 
         examination.
 
         
 
                                CONCLUSIONS OF LAW
 
         
 
              Therefore, based on the principles of law previously stated, 
 
         the following conclusions of law are made:
 
         
 
         ,    1. Claimant sustained an injury which arose out of And in 
 
         the course of his employment on June 20, 1985 and that injury is 
 
         confined to claimant's neck or cervical region.
 
         
 
              2. Claimant is entitled to the reasonable and necessary 
 
         medical expenses under Iowa Code section 85.27 which are causally 
 
         connected to that injury.
 
         
 
              3.  Claimant is entitled to an independent medical 
 
         examination under Iowa Code section 85.39.
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
         
 
         WEILER V. WELLS BLUE BUNNY
 
         Page 10
 
         
 
         
 
                                      ORDER.
 
         
 
              THEREFORE, it is ordered:
 
         
 
              Defendants shall pay the costs of medical treatment incurred 
 
         with Dr. Parkin for the medical appointments of December 21, 
 
         1985, December 23, 1985, December 30, 1985, January 20, 1986, 
 
         January 23, 1986, and March 20, 1986.
 
         
 
              Defendants shall be liable for the costs of the medical 
 
         examination at the Mayo Clinic which are causally connected to 
 
         the cervical injury,
 
         
 
              Defendants are liable for the costs of an independent 
 
         medical examination with Dr. Blume in the amount of five hundred 
 
         fifteen and no/l00 dollars ($515.00) but are not ordered to pay 
 
         for the examination of a CT scan or myelogram.
 
         
 
              Defendants shall designate an authorized treating physician 
 
         for claimant's injury within three (3) days from the date of this 
 
         decision and shall be liable for expenses for that treatment if 
 
         claimant can establish a causal connection between the injury and 
 
         the future treatment.
 
         
 
              Signed and filed this 11th day of December, 1989.
 
         
 
         
 
         
 
         
 
         
 
                                         DEBORAH A. DUBIK
 
                                         DEPUTY INDUSTRIAL COMMISSIONER
 
         
 
         Copies To:
 
         
 
         Mr. Harry Smith
 
         Attorney at Law
 
         P 0 Box 1194
 
         Sioux City IA 51102
 
         
 
         Ms. Judith Ann Higgs 
 
         Attorney at Law 
 
         701 Pierce St Ste 300 
 
         P 0 Box 3086
 
         Sioux City IA 51102
 
         
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
 
         
 
 
 
 
 
 
 
 
 
 
 
                                         51402. 60
 
                                         Filed December 11, 1989
 
                                         Deborah A. Dubik
 
         
 
                     BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         GILBERT WEILER,
 
         
 
              Claimant,
 
         
 
         VS.
 
                                               File No. 830013
 
         WELLS BLUE BUNNY,
 
                                              D E C I S I 0 N
 
              Employer,
 
                                              M E D I C A L
 
         and
 
                                                B E N E F I T S
 
         KEMPER GROUP,
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
         51402.60
 
         
 
              Claimant failed to show entitlement to additional medical 
 
         treatment where all doctors except one (Blume) stated claimant 
 
         needs no further treatment.
 
         
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
 
         
 
 
 
 
 
 
 
 
 
 
 
                     BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         TAMI M. HARTNESS,
 
         
 
              Claimant,                              File No. 830024
 
         
 
         vs.                                      A R B I T R A T I 0 N
 
         
 
         ESKA COMPANY,                               D E C I S I 0 N
 
         
 
              Employer,
 
                                                        F I L E D
 
         and
 
                                                       JUL 31 1989
 
         HOME INSURANCE COMPANY,
 
                                                   INDUSTRIAL SERVICES
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
                                   INTRODUCTION
 
         
 
              This is a proceeding in arbitration brought by Tami M. 
 
         Hartness, claimant, against Eska Company, employer, and Home 
 
         Insurance Company, insurance carrier, defendants, for benefits as 
 
         the result of an injury that occurred on December 4, 1984.  A 
 
         hearing was held in Dubuque, Iowa, on May 13, 1988 and the case 
 
         was fully submitted at the close of the hearing.  Claimant was 
 
         represented by Mr. Stephen J. Smalling and defendants were 
 
         represented by Mr. Michael Liebbe.  The record consists of the 
 
         testimony of Tami M. Hartness, claimant, joint exhibits 1 through 
 
         28, claimant's exhibit A, with pages 1 through 14 and defendants' 
 
         exhibit A (a diagram).  Both attorneys submitted excellent 
 
         briefs. Defendants ordered a transcript of the hearing and 
 
         supplied a copy to the industrial commissioner's file.
 
         
 
                                   STIPULATIONS
 
         
 
              The parties stipulated to the following matters.
 
         
 
              That an employer-employee relationship existed between 
 
         claimant and employer at the time of the injury.
 
         
 
              That claimant sustained an injury on December 4, 1984 which 
 
         arose out of and in the course of employment with employer.
 
         
 
              That the injury was the cause of temporary disability.
 
              
 
              That the time off work for which claimant now seeks either 
 
         temporary total disability or healing period disability benefits 
 
         are three separate periods:  (1) February 20, 1985 to February 
 
         25, 1985; (2) March 15, 1985 to February 11, 1986; and (3) May 8, 
 
         1986 to January 5, 1987.
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
              That the type of permanent disability, if the injury is 
 
         found to be a cause of permanent disability, is industrial 
 
         disability to the body as a whole.
 
         
 
              That the rate of compensation, in the event of an award, is 
 
         $198.52 per week.
 
         
 
              That the provider of medical services would testify that the 
 
         fees charged were reasonable and were for reasonable and 
 
         necessary medical treatment and defendants are not offering 
 
         contrary evidence.
 
         
 
              That defendants make no claim for benefits paid prior to 
 
         hearing under an employee nonoccupational group health plan.
 
         
 
              That defendants are entitled to a credit for workers' 
 
         compensation benefits paid prior to hearing at the rate of 
 
         $198.52 per week for 47 4/7 weeks.
 
         
 
              That there are no bifurcated claims.
 
         
 
                                      ISSUES
 
         
 
              The parties submitted the following issues for determination 
 
         at the time of the hearing.
 
         
 
              Whether claimant is entitled to temporary total disability 
 
         benefits or healing period disability benefits.
 
         
 
              Whether the injury was the cause of permanent disability.
 
         
 
              Whether claimant is entitled to permanent disability 
 
              benefits.
 
         
 
              Whether claimant is entitled to medical benefits.
 
                                        
 
                             SUMMARY OF THE EVIDENCE
 
         
 
              Of all of the evidence that was introduced, the following is 
 
         a summary of the evidence most pertinent to this decision.
 
         
 
              Claimant is 30 years old.  She completed high school.  
 
         Later, she completed a basic electronics course for employer.  
 
         She has also completed a computer course for Lotus 1, 2, 3 and 
 
         WordStar word processing.  Claimant's past employments have all 
 
         been assembly line jobs.  Claimant started to work for employer 
 
         in July of 1979 in the parts department as a clerk.  In December 
 
         of 1979, she went into the plant on the assembly line.  At first, 
 
         for a year and one-half, she mounted motors on outboards and 
 
         hung,them on the line.  Then she became a line inspector of 
 
         completed motors and put them on a conveyor belt to go to the 
 
         warehouse to be packaged (transcript pages 9-16).
 
         
 
              These outboard motors weighed from approximately 18 pounds 
 
         to 65 pounds.  Claimant testified that she processes 
 
         approximately 25 to 30 motors per hour.  With respect to the 
 
         trollers, she handled 40 or 50 motors per hour.  On the outboard 
 
         motors, she was required to pull the rope on every unit to make 
 
         sure the prop would turn.  Trollers were tested in a test tank.  
 
         Claimant denied any problems with her back, neck, shoulders or 
 
         arms prior to this injury (tr. pp. 16-18, 57-59).
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              On December 4, 1984, claimant was pounding one and one-half 
 
         inch metal bushings with a very heavy ball peen metal hammer.  
 
         She did this with her dominant right hand.  Claimant testified 
 
         that she hit the bushing approximately 10 to 15 times per motor 
 
         and that she was handling 25 to 30 motors per hour.  She said her 
 
         right arm became very tired.  It then felt like her shoulder 
 
         crackled in between her shoulder blades.  It was like a pop or 
 
         crack between her shoulder blades on her right side near her 
 
         spine (tr. pp. 64 & 65).  It seemed like it cracked and it felt 
 
         like hot water pouring and heat (tr. pp. 18-23, 64-67).  Claimant 
 
         said that she had used ball peen hammers like this ever since she 
 
         started with employer, but that they had never given her a 
 
         problem before (tr. p. 60).  Claimant finished working that day 
 
         and came to work the following day.
 
         
 
              On the night of December 4, 1984, claimant said it hurt to 
 
         breath and that she could hardly lift her arm.  Later, her right 
 
         leg began tingling and that is when she got concerned (tr. p. 
 
         24). Nevertheless, she came to work the following day.  Her 
 
         shoulder was still sore and it felt like her leg was going numb.  
 
         Claimant told other employees about the injury and the foreman 
 
         sent her to Acute Care which is operated by a firm of doctors 
 
         known as Medical Associates.She was examined by Craig Rose, M.D.  
 
         Dr. Rose told her it was strained muscles.  He prescribed 
 
         medication and told her to give it rest.  He did not take 
 
         claimant off work.  He told claimant that if her pain continued 
 
         that she should see an orthopedic doctor of her own choice.  
 
         Instead, claimant chose to see a chiropractor because she 
 
         believed that she would get instant relief from a chiropractor.  
 
         She saw a chiropractor three times. Claimant testified that she 
 
         lost no time from work for this injury in 1985 (tr. pp. 68 & 69).
 
         
 
              Claimant related that after the Christmas shutdown she 
 
         returned to work in the first week in January.  The leg was 
 
         better, but due to the pounding, pulling ropes and lifting, her 
 
         shoulder kept getting worse and worse.  Claimant said that she 
 
         kept on working and continued to see the chiropractor, Dave 
 
         Webber, D.C., in December, 1985.  Claimant informed that Dr. 
 
         Webber treated her with ultrasound.  She alleged that Dr. Webber 
 
         said that there was nothing that he could do for her as long as 
 
         she continued to work (tr. pp. 28-30 & 70).  There are.no medical 
 
         records from Dr. Webber introduced into evidence.
 
         
 
              Claimant said that she continued to work after Christmas 
 
         shutdown, but her work began to slow down in March of 1985.  At 
 
         that time, she was sent back to Medical Associates and saw Scott 
 
         C. McCuskey, M.D., an orthopedic surgeon.  He took claimant off 
 
         work on March 15, 1985.  Dr. McCuskey prescribed medications, 
 
         physical therapy at Finley Hospital, and gave her an injection of 
 
         cortisone.  Claimant testified that when she did not improve, he 
 
         referred her to Patrick R. Sterrett, M.D., a neurologist with 
 
         Medical Associates, in April of 1985.  Claimant testified that 
 
         Dr. Sterrett conducted nerve studies, took different x-rays, 
 
         performed a bone scan, ordered a TENS unit, ordered more physical 
 
         therapy and performed a myelogram, CT scan and EMG.  She said 
 
         that Dr. Sterrett's tests were all normal, but he continued to 
 
         keep her off work (tr. pp. 31-33 & 72).
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              At one point in her treatment by Dr. Sterrett, she developed 
 
         a high blood sedimentation rate and was referred to Dr. Pena of 
 
         Medical Associates, who is a rheumatologist (tr. pp. 34 & 35).  
 
         Dr. Sterrett also sent claimant to see Paulette Lynn, M.D., a 
 
         physiatrist with Medical Associates (tr. pp. 35 &.36).  Dr. Lynn 
 
         wanted to get claimant into a work hardening program, but instead 
 
         she was given more physical therapy.
 
         
 
              Claimant said that her workers' compensation checks 
 
         terminated in January of 1986.  She said that she was released to 
 
         return to work by Dr. Sterrett with a 15 to 20 pound weight 
 
         restriction in February of 1986 (February 10, 1986).  She did not 
 
         actually get to work until three weeks later in March of 1986.  
 
         She performed light duty because her shoulder was still sore and 
 
         it was difficult to use her arm in her work (tr. pp. 37 & 38).  
 
         Claimant said that she continued to see Drs. Sterrett and Lynn.  
 
         She requested to have her weight restrictions removed or 
 
         increased to 65 pounds so that she could perform her former job 
 
         of line inspector.  However, the weight restrictions were not 
 
         removed until January of, 1987 (tr. pp. 40 & 55).
 
         
 
              After claimant was returned to work in March of 1986, she 
 
         said that she was transferred to painting trollers in May of 
 
         1986. She added that trollers are very long and awkward and the 
 
         crackle, burning and hurting in her shoulder started all over 
 
         again.  She reported that she returned to Dr. Sterrett and that 
 
         he took her off work again.  He did permit her to work in July of 
 
         1986 with a 15 to 20 pound weight restriction, but there was no 
 
         work for her with those restrictions (tr. pp. 40 & 41).  In 
 
         January of 1987, she obtained a full release without restrictions 
 
         (tr. pp. 42 & 55).  Claimant testified that.she then worked as a 
 
         line inspector without restrictions from January of 1987 until 
 
         August of 1987 when all employees were terminated (tr. p. 43).
 
         
 
              Claimant said that she still takes Motrin and Darvocet.  She 
 
         maintained that she has lost strength in her right arm. Claimant 
 
         contended that if she reaches forward or overhead it hurts her to 
 
         breath.  She complained that she still has pain at the bottom of 
 
         her right shoulder blade (tr. pp. 43 & 44).
 
         
 
              Claimant said:  (1) she applied for jobs at several places; 
 
         (2) registered at the employment office; and (3) was assisted by 
 
         the dislocated workers program.  At the time of the hearing, she 
 
         was employed assembling medical supplies at $3.35 per hour. 
 
         Claimant testified that she was earning $8.63 per hour when 
 
         employer's plant was closed down.  Claimant related that she 
 
         operates a machine in her current job that requires her to reach 
 
         forward.  This causes her arm and shoulder to ache.  It is 
 
         similar to the pain she experienced at the time of this injury, 
 
         but it is not as bad as it was.  She no longer sees a doctor for 
 
         it (tr. pp. 45-48).
 
         
 
              Claimant admitted that she became ill with T.M.J. 
 
         (temporo-mandibular joint disease) in her right jaw in October of 
 
         1985 and had surgery for it in February of 1986 (tr. pp. 48-52).  
 
         Claimant conceded that she had her stomach stapled in September 
 
         of 1985 (tr. pp. 52 & 53).  She said that she weighed 290 pounds 
 
         at that time (tr. p. 74).  Claimant said that Dr. Sterrett told 
 
         her that the T.M.J. was not related to this injury.  Claimant 
 
         said that she lost weight from the stapling, but that it did not 
 
         help her shoulder (tr. pp. 53-55).  Claimant indicated that she 
 
         might weigh approximately 300 pounds at the time of the hearing 
 
         (tr. p. 75). She granted that she was also diagnosed as having a 
 
         high uric acid rate (tr. p. 75-77).  Claimant admitted that John 
 
         Whalen,,M.D., whom she chose as her own personal physician, 
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         examined her and all of her records and commented that no 
 
         permanent injury has been found (tr. pp. 81; jt. ex. 17).  She 
 
         also admitted that Dr. Whalen indicated that she could lift 65 
 
         pounds and that he has never lifted that weight restriction of 65 
 
         pounds (tr. p. 87; jt. ex. 17).
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              A summary of the medical evidence follows:
 
         
 
              There is no history of prior right shoulder pain in the 
 
         record.  The right upper quadrant pain referred to on April 30, 
 
         1984, appears to be the result of a cholecystectomy and an 
 
         appendectomy (ex. 22, p. 1).
 
         
 
              On December 6, 1984, Dr. Rose treated claimant for right 
 
         shoulder blade pain that began while pounding bushings on 
 
         December 4, 1984.  Twenty-four hours later, she noticed numbness 
 
         and tingling in her right thigh area.  His physical examination 
 
         revealed slight tenderness along the medial border of the 
 
         scapula. Range of motion and strength were normal.  Dr. Rose 
 
         diagnosed:  (1) subscapular myositis, traumatic and (2) 
 
         entrapment of the right lateral cutaneous nerve (meralgia).  Dr. 
 
         Rose urged weight loss to resolve the entrapment of the cutaneous 
 
         nerve (ex. 22, p. 2).
 
         
 
              There is no medical evidence from Dave Webber, D.C..
 
         
 
              Dr. McCuskey saw claimant on March 14, 1985, March 25, 1985 
 
         and April 8, 1985.  He recorded the history of pounding bushings 
 
         with a hammer.  Her neck and shoulder range of motion were 
 
         complete.  She had good symmetrical reflexes in her right 
 
         shoulder, biceps and triceps.  X-rays of the cervical spine and 
 
         shoulder were negative.  Dr. McCuskey diagnosed myofascitis of 
 
         the right parascapular muscles involving the neck and shoulder.  
 
         He took claimant off work, prescribed physical therapy, 
 
         medications and injected her shoulder with medications.  Dr. 
 
         McCuskey could not figure out why she did not respond and 
 
         referred her to Dr. Sterrett in his firm for a neurological 
 
         examination.  Claimant did not mention her right thigh area when 
 
         she talked to Dr. McCuskey (ex. 12, pp. 1-3).
 
         
 
              Dr. Sterrett, the neurologist, treated claimant from April 
 
         15, 1985 until July 1, 1986 (ex. 12, pp. 3-34).  Claimant told 
 
         Dr. Sterrett that she heard a crack in her right shoulder while 
 
         punching bushings.  Claimant also told Dr. Sterrett that she had 
 
         the same pain while wallpapering at home.  Claimant also 
 
         complained of severe headaches.  Dr. Sterrett diagnosed:  (1) 
 
         myofascitis around the medial right scapula and (2) paresthesias 
 
         in the right lateral thigh and pain in the right buttock 
 
         suggestive of sciatica.  He took x-rays, a bone scan and an EMG. 
 
         He prescribed a TENS unit and extensive physical therapy.  All of 
 
         the tests which he performed were negative and all of the 
 
         treatments which he administered were ineffective (ex. 12, pp. 
 
         3-7).
 
         
 
              On July 1, 1985, Dr. Sterrett found claimant refractory to 
 
         all conservative treatment modalities and ordered a lumbosacral 
 
         myelogram followed by a CT scan.  This resulted in a diagnosis 
 
         of: (1) right sciatica; (2) myofascitis of the tight parascapular 
 
         and lumbar paraspinal muscles; (3) morbid obesity; and (4) 
 
         osteoarthritis of the knees.  When claimant did not respond to 
 
         his treatment he referred claimant to Paulette Lynn, M.D., a 
 
         physiatrist, in his firm (ex. 12, pp. 10-12; ex. 23).
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              Dr. Lynn continued to keep claimant off work and saw her 
 
         from August 30, 1985 to January 13, 1986.  During this period, 
 
         claimant had her stomach stapled, developed T.M.J. and developed 
 
         a high uric acid level.  Dr. Lynn prescribed more physical 
 
         therapy and injections.  Claimant resisted certain physical 
 
         therapy modes such as spray and stretch.  On January 22, 1986, 
 
         Dr. Lynn said that she had nothing further to offer.  Dr. Lynn 
 
         concluded that claimant had nutritional problems and obesity 
 
         problems which were perpetuating factors in her muscle pain.  Dr. 
 
         Lynn referred claimant back to Dr. Sterrett for possible nerve 
 
         root impingement in her neck and concluded with these remarks:
 
         
 
              However, strictly from the Physical Medicine viewpoint, that 
 
              is insofar as her myofascial syndrome is concerned, I feel 
 
              that she is permanent and stationary at this point in time. 
 
              Pending further neurological work-up, should this be 
 
              negative, I would consider her to be permanent and 
 
              stationary and give her a 5% disability rating.
 
         
 
         (ex. 7)
 
         
 
              On July 25, 1986, when Dr. Lynn was accused of treating 
 
         claimant for conditions other than this injury, Dr. Lynn 
 
         responded as follows:
 
         
 
              Please note the following facts from the above record which 
 
              I am aware that you have in greater detail from my letters 
 
              that I sent you each time I saw the patient:
 
         
 
              1.  The first is that every time I have seen this lady it 
 
              has been for documented on-the-job injury for which she was 
 
              initially seen here in the Acute Care Department in December 
 
              of 1984.  It is entirely reasonable to think that her job 
 
              which entailed lifting heavy motors, particularly given her 
 
              obese body build, could have caused her problem.
 
         
 
              2.  Secondly, each time she saw me and had therapy ordered 
 
              after September 24, 1985, the patient was seen for the same 
 
              problem mentioned above.  And her other medical problems, 
 
              although they may have affected her general health and 
 
              ability to recover from any injury, were not followed by me 
 
              in any way other than to treat a perpetuating factor which 
 
              was the high uric acid.  Therefore, I feel that it is 
 
              unreasonable for you to assume that charges after September 
 
              24, 1985 were caused by conditions other than the 
 
              work-related injury.
 
         
 
         (ex. 9)
 
         
 
              When Dr. Lynn was asked whether a 60 pound weight 
 
         restriction would or would not be safe, Dr. Lynn recommended a 
 
         physical capacity evaluation and a work hardening program under 
 
         the supervision of a licensed practical therapist, but the 
 
         insurance company refused to do this (exs. 9, 10 & 28).  On 
 
         January 26, 1987, Dr. Lynn said that she was unable to document 
 
         that claimant could not lift 60 pound items from waist level and 
 
         carry them for a short distance, but she questioned whether this 
 
         activity might increase her discomfort if performed on a 
 
         repetitive basis.
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              On November 23, 1987, Dr. Lynn evaluated claimant again and 
 
         reported on November 25, 1987 as follows:
 
              
 
              IMPRESSION:  Myofascial pain syndrome involving 
 
         intrascapular
 
                           muscles paraspinal cervical/thoracic
 
                           muscles currently flared
 
         
 
              Based on the AMA's book on guidelines for impairment 
 
              ratings, I feel that she has a total body impairment of 5%.  
 
              I feel that her condition will be a permanent one which will 
 
              fluctuate in intensity depending upon her activities.
 
         
 
         (ex. 11)
 
         
 
              After Dr. Lynn referred claimant back to Dr. Sterrett in 
 
         January of 1986, to investigate nerve root impingement in her 
 
         neck, Dr. Sterrett on January 13, 1986 and January 23, 1986 
 
         recommended a complete myelogram from the foramen magnum to S-2 
 
         in order to rule out a cervical disc (ex. 12, pp. 18-22).  This 
 
         was done on January 27, 1986.  The result was that the cervical, 
 
         thoracic and lumbar levels were all normal (ex. 27).  Dr. 
 
         Sterrett then released claimant to return to work on February 10, 
 
         1986 with the 25 pound weight restriction (ex. 12, pp. 23 & 24).  
 
         It appears that Dr. Sterrett ordered a consulting opinion from 
 
         another doctor, Sun Hwan Chi, M.D.  Dr. Chi wrote to Dr. Sterrett 
 
         of February 20, 1986 and recommended that claimant be returned to 
 
         light duty only (ex. 20). Dr. Sterrett then reported on May 7, 
 
         1986 that claimant was complaining of severe pain and that he 
 
         took her off work again on May 8, 1986 (ex. 12, p. 31).  On June 
 
         24, 1986, Dr. Sterrett said that he had nothing further to offer 
 
         this patient.  He confirmed that she definitely had myofascial 
 
         pain syndrome with some functional overlay which made it 
 
         difficult to determine how much was myofascial and how much was 
 
         functional.  Dr. Sterrett concluded as follows:
 
         
 
              ...However, I do feel that she does not have any specific 
 
              neurologic deficit and that according to the American 
 
              Medical Association guideline for disabilities, I do feel 
 
              that she is probably a 5% for disability because of her 
 
              myofascial pain. I told her to talk to her employer about 
 
              future employment, but I had nothing further to offer her.
 
         
 
         (ex. 12, p. 32)
 
         
 
              Although Dr. Sterrett wrote lengthy and prolific office 
 
         notes, he never did indicate whether claimant's complaints were 
 
         caused by this injury or not.  Nor did he give any indication of 
 
         causal connection in his one letter report (ex. 8).
 
         
 
              On September 12, 1986, Charles R. Rothberg, M.D., a 
 
         neurosurgeon, refused to make an evaluation as to whether 
 
         claimant could go back to work without any weight restriction 
 
         unless claimant first received a functional capacity examination 
 
         (exs. 15 & 16).
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              John M. Whalen, M.D., examined all of claimant's medical 
 
         reports and examined claimant on August 13, 1986.  He said that 
 
         claimant had been very thoroughly examined by Dr. Sterrett and 
 
         "no evidence of permanent physical injury has been found".  In 
 
         addition, no structural abnormalities had been found as well.  He 
 
         said that the physical examination was within normal limits.  She 
 
         had a full range of motion.  He did not see any reason that she 
 
         can't return to work without restrictions (ex. 17).  On October 
 
         22, 1986, Dr. Whalen wrote a letter to Dr. Rothberg stating that 
 
         claimant had no significant injury.  The insurance company had 
 
         refused a functional capacity examination.  He suggested that Dr. 
 
         Rothberg authorize claimant to return to work (ex. 18).
 
         
 
              Claimant presented medical expenses totaling $5,873.95 
 
         (claimant ex. A).  All of this treatment appears to be by doctors 
 
         which were selected by defendants.
 
         
 
                           APPLICABLE LAW AND ANALYSIS
 
         
 
              The claimant has the burden of proving by a preponderance of 
 
         the evidence that the injury of December 4, 1984, is causally 
 
         related to the disability on which she now bases her claim.  
 
         Bodish v. Fischer, Inc., 257 Iowa 516, 133 N.W.2d 867 (1965).  
 
         Lindahl v. L.O. Boggs, 236 Iowa 296, 18 N.W.2d 607 (1945).  A 
 
         possibility is insufficient; a probability is necessary.  Burt v. 
 
         John Deere Waterloo Tractor Works, 247 Iowa 691, 73 N.W.2d 732 
 
         (1955).  The question of causal connection is essentially within 
 
         the domain of expert testimony.  Bradshaw v. Iowa Methodist 
 
         Hospital, 251 Iowa 375, 101 N.W.2d 167 (1960).
 
         
 
              However, expert medical evidence must be considered.with all 
 
         other evidence introduced bearing on the causal connection.  
 
         Burt, 247 Iowa 691, 73 N.W.2d 732.  The opinion of experts need 
 
         not be couched in definite, positive or unequivocal language.  
 
         Sondag v. Ferris Hardware, 220 N.W.2d 903 (Iowa 1974).  However, 
 
         the expert opinion may be accepted or rejected, in whole or in 
 
         part, by the trier of fact.  Id. at 907.  Further, the weight to 
 
         be given to such an opinion is for the finder of fact, and that 
 
         may be affected by the completeness of the premise given the 
 
         expert and other surrounding circumstances.  Bodish, 257 Iowa 
 
         516, 133 N.W.2d 867.  See also Musselman v. Central Telephone 
 
         Co., 261 Iowa 352, 154 N.W.2d 128 (1967).
 
         
 
              It was stipulated that claimant received an injury arising 
 
         out of and in the course of employment on December 4, 1984.  This 
 
         stipulation is accepted as to the right shoulder because a right 
 
         shoulder injury is supported by the evidence.  This stipulation 
 
         is not accepted as to the right thigh complaints because these 
 
         symptoms did not occur until 24 hours later.  Claimant did not 
 
         testify and there was no other evidence that any job activity 
 
         caused her right thigh complaints.
 
         
 
              It was stipulated that the injury was the cause of temporary 
 
         disability.  It was further stipulated that claimant was off work 
 
         for three different periods of time.
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              As to the first period of time, February 20, 1985 until 
 
         February 25, 1985, claimant did not testify that she was off work 
 
         for this period of time as a result of this injury and there is 
 
         no medical evidence to establish that claimant was off work 
 
         during this period of time as a result of this injury.  Claimant 
 
         saw Dr. Webber, but there is no evidence from Dr. Webber to 
 
         establish that claimant was off work during this period of time.  
 
         Therefore, claimant did not prove that she is entitled to 
 
         temporary disability benefits for this period of time, even 
 
         though the parties stipulated that claimant was off work because 
 
         there is no evidence in the record that this injury caused 
 
         claimant to be off work during that period of time.
 
         
 
              As to the period of time from March 15, 1985 until February 
 
         11, 1986, it was established that Dr. McCuskey took claimant off 
 
         work when he saw her on March 14, 1985 (ex. 12, p. l) and that 
 
         Dr. Sterrett returned her to work with a 25 pound weight 
 
         restriction on February 11, 1986 (ex. 12, pp. 23, 24 & 29).
 
         
 
              As to the period May 8, 1986 to January 5, 1987, claimant 
 
         did not prove entitlement for the entire period.  Claimant did 
 
         establish that Dr. Sterrett took her off work again on May 8, 
 
         1986 (ex. 12, p. 31).  No medical evidence can be found that 
 
         claimant returned to work on January 5, 1987, but the parties did 
 
         stipulate to that date.  There is evidence that Dr. Lynn 
 
         permitted her to return to work and try to lift 60 pounds after 
 
         she was seen on January 26, 1987 (ex. 10).  Claimant testified 
 
         under oath that she received a full release to return to work 
 
         without restrictions in January of 1987.  This testimony was not 
 
         disputed, controverted, contradicted, rebutted or refuted in any 
 
         manner.  Therefore, it is determined that claimant is entitled to 
 
         temporary disability benefits for the stipulated period from 
 
         March 8, 1986 to January 5, 1987.
 
         
 
              It is noted that this is an unusually long period of 
 
         recovery for simply myofascitis of the right medical scapula.  
 
         Nevertheless, Dr. Lynn commented several times that claimant had 
 
         a number of other problems which she considered perpetuating 
 
         factors. Furthermore, it is noted that these doctors were 
 
         selected by employer and the insurance carrier.  All of the 
 
         doctors are associated with Medical Associates.  Claimant's 
 
         supervisor sent her to see Dr. Rose is December of 1984; the 
 
         supervisor sent her to see Dr. McCuskey in March of 1985.  When 
 
         Dr. McCuskey had nothing further to offer he referred her to Dr. 
 
         Sterrett.  Dr. Sterrett referred her to Dr. Pena and Dr. Lynn.  
 
         Dr. Lynn referred her back to Dr. Sterrett.  When an authorized 
 
         physician refers claimant to another physician, the second 
 
         physician is also considered to be an authorized physician.  
 
         Limoges vs. Meier Auto Salvage, I Iowa Industrial Commissioner 
 
         Report 207 (1981).
 
         
 
              Claimant did not sustain the burden of proof by a 
 
         preponderance of the evidence that the injury was the cause of 
 
         permanent disability.  Although Dr. Sterrett wrote prolifically 
 
         in his lengthy office notes, he never once addressed whether the 
 
         injury was the cause of the condition he was treating or whether 
 
         it was the cause of the 5 percent "disability" he awarded because 
 
         of her myofascial strain (ex. 12, p. 33).  Nor did Dr. Lynn state 
 
         that the injury was the cause of claimant's 5 percent disability 
 
         rating which she awarded on January 22, 1986 or the 5 percent 
 
         total body impairment she awarded on November 25, 1987 (ex. 11).
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              Dr. Lynn's statement on July 25,.1986, that all of her 
 
         treatment was for the job injury, can be reasonably extended to 
 
         mean that claimant is also entitled to temporary disability 
 
         benefits for when claimant was off work as recommended by Drs. 
 
         McCuskey, Sterrett and Lynn.  This comment cannot be reasonably 
 
         extended to mean that claimant's permanent disability or 
 
         impairment was caused by this injury.
 
         
 
              Claimant did prove that the job was the cause of her injury. 
 
         Claimant did not prove that the injury was the cause of her 
 
         permanent disability.  If the injury was the cause of a 5 percent 
 
         permanent impairment or disability, then claimant should have 
 
         obtained a clear statement from one or more of the medical 
 
         doctors to that effect.  There is a super abundance of medical 
 
         information, but the crucial question of whether the disability 
 
         or impairment was caused by the injury is not answered by the. 
 
         medical reports.  Dr. McCuskey never addressed the issue of 
 
         causal connection.  Dr. Sterrett never addressed the issue of 
 
         causal connection.  Dr. Lynn stated that her treatment was for 
 
         the job-related injury and therefore, Dr. Lynn claimed that she 
 
         was entitled to be paid for her charges for that treatment.
 
         
 
              Since Drs. McCuskey, Sterrett and Lynn proceeded to treat 
 
         claimant on the history which claimant gave them, to wit, that 
 
         she injured her right shoulder while punching out bushings on 
 
         outboard motors, then it can be determined that claimant is 
 
         entitled to be paid for her time off work for the two periods of 
 
         time determined above.
 
         
 
              For the same reason it can be said that claimant is entitled 
 
         to recover all of her medical expenses in the amount of $5,873.95 
 
         as detailed in claimant's exhibit A.  All of this treatment 
 
         appears to be treatment ordered by doctors selected by the 
 
         employer and insurance carrier to treat claimant.
 
         
 
              However, as to claimant's permanent impairment, the doctors 
 
         did not say that this injury was the cause of her permanent 
 
         impairment.  Therefore, claimant did not sustain the burden of 
 
         proof by a preponderance of the evidence that the injury was the 
 
         cause of any permanent impairment or disability.  This 
 
         determination is supported by the fact that claimant, even though 
 
         a young woman, has suffered a myriad of health problems in her 
 
         relatively few years of life.  Claimant has had a tonsillectomy, 
 
         appendectomy, cholecystitis, gastro plasti and temporo-mandibular 
 
         joint surgery.  She demonstrated a high sedimentation blood rate 
 
         and a high uric acid level.  Claimant has knee problems, low back 
 
         problems and frequent, severe headaches.  Claimant has suffered 
 
         from abdominal problems and received a colonoscopic examination 
 
         and a sigmoidoscopic examination.  This is not a complete summary 
 
         of all of the health problems mentioned in the medical evidence. 
 
         This summary only the highlights.
 
         
 
              All of the doctors referred to claimant's morbid obesity. 
 
         Morbid means unhealthy.  Claimant is 5 feet 5 inches tall and 
 
         weighs approximately 300 pounds.  If a person who normally should 
 
         weigh approximately 125 pounds had an additional 175 pounds 
 
         attached to their body and were forced to carry this much 
 
         additional weight 24 hours a day for several years without any 
 
         relief from this burden, it is entirely possible if not probable 
 
         that the muscles (myo) and connecting tissue (fascia) would 
 
         become inflamed (itis) from such an enormous, continuous and 
 
         relentless heavy burden on the muscles and connecting tissues.
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              It should be noted that.claimant continued to have the same 
 
         symptoms on a chronic basis without much improvement even after 
 
         she was removed from the work place for most of two years after 
 
         the injury.  Muscle strains usually heal in time with or without 
 
         treatment.  Claimant received unusually extensive treatment, but 
 
         Drs. McCuskey, Sterrett and Lynn all found that her condition was 
 
         refractory.  Therefore, claimant's impairment of the right medial 
 
         scapula is at least as likely to be caused by her morbid 
 
         (unhealthy) obesity as it is from punching out bushings on 
 
         outboard motors.  It should be noted that claimant was able to 
 
         work immediately after the injury.  She worked before Christmas 
 
         break and she worked after Christmas break.  The injury occurred 
 
         on December 4, 1984 and claimant did not miss any work until 
 
         March 15, 1985 some three and one-half months later.  If 
 
         claimant's permanent impairment from myofascitis was due to this 
 
         injury, one or more of the doctors should have said so clearly.  
 
         The state of the record is that no doctor has stated that 
 
         claimant's 5 percent impairment from myofascitis was caused by 
 
         this shoulder injury. Consequently, it must be determined that 
 
         claimant did not sustain the burden of proof by a preponderance 
 
         of the evidence that the injury to her right medial scapula was 
 
         the cause of any permanent impairment or disability.  It is 
 
         further noted that claimant returned to work in January of 1987 
 
         to her position as a line inspector.  This job required claimant 
 
         to lift 60 pound motors. Claimant performed this job from January 
 
         of 1987 until the company closed down in September of 1987.  It 
 
         is further noted that claimant is presently employed doing 
 
         production line work again.
 
         
 
                                 FINDINGS OF FACT
 
         
 
              Wherefore, based upon the evidence presented the following 
 
         findings of fact are made.
 
         
 
              That claimant was employed by employer on December 4, 1984 
 
         as a line inspector of outboard motors.
 
         
 
              That on December 4, 1984, claimant was pounding bushings 
 
         with a ball peen hammer when she felt a crackle, crack or pop in 
 
         her right shoulder blade.
 
         
 
              That employer sent the employee to Dr. Rose of Medical 
 
         Associates for this injury on December 6, 1984.
 
         
 
              That claimant continued to work, when not on Christmas lay 
 
         off, and experienced continuing complaints with her right 
 
         shoulder.
 
         
 
              That employer sent claimant to see Dr. McCuskey on March 14, 
 
         1985 and that he took claimant off work on March 15, 1985.
 
         
 
              That claimant also saw Dr. Sterrett with Medical Associates 
 
         and he returned claimant to work on February 11, 1986.
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
              That Dr. Sterrett took claimant off work on May 8, 1986 and 
 
         by agreement of the parties, claimant returned to work again 
 
         light duty without restrictions on January 5, 1987.
 
         
 
              That Dr. Lynn with Medical Associates, stated that all of 
 
         her treatment of claimant was for claimant's on-the-job injury.  
 
         Dr. Lynn treated the same shoulder injury that Dr. McCuskey and 
 
         Dr. Sterrett treated.
 
         
 
              That claimant did not prove that her right thigh complaints, 
 
         which originated 24 hours after the right shoulder injury, were 
 
         connected with or related to any activities at work or the right 
 
         shoulder injury.
 
         
 
              That although Dr. Lynn and Dr. Sterrett opined that claimant 
 
         had a 5 percent disability or impairment, neither doctor said 
 
         that the disability or impairment was caused by the right 
 
         shoulder injury.
 
         
 
              That claimant incurred $5,873.95 in unpaid medical expenses 
 
         for this injury.
 
         
 
                               .CONCLUSIONS OF LAW
 
         
 
              WHEREFORE, based upon the evidence presented and the 
 
         foregoing principles of law, the following conclusions of law are 
 
         made.
 
         
 
              That claimant did sustain an injury to the right medial 
 
         scapula on December 4, 1984 that arose out of and in the course 
 
         of employment with employer.
 
         
 
              That claimant did not sustain the burden of proof by a 
 
         preponderance of the evidence that she sustained a right thigh 
 
         injury on December 4, 1984 which arose out of and in the course 
 
         of her employment with employer.
 
         
 
              That claimant did not sustain the burden of proof by a 
 
         preponderance of the evidence that the injury to her right 
 
         shoulder caused her to be off work from February 20, 1985 to 
 
         February 25, 1985.
 
         
 
              That claimant did sustain the burden of proof by a 
 
         preponderance of the evidence that the injury to the right medial 
 
         scapula caused her to be off work from March 15, 1985 to February 
 
         10, 1986 and again from May 8, 1986 to January 5, 1987.
 
         
 
              That claimant is entitled to temporary total disability 
 
         benefits for the periods of time specified in the foregoing 
 
         paragraph.
 
         
 
              That claimant did not sustain the burden of proof by a 
 
         preponderance of the evidence that the injury of December 4, 1984 
 
         to her right medial scapula was the cause of permanent 
 
         disability.
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              That claimant is not entitled to permanent disability 
 
         benefits.
 
         
 
              That claimant is entitled to medical benefits in the amount 
 
         of $5,873.95.
 
         
 
                                      ORDER
 
         
 
              THEREFORE, IT IS ORDERED:
 
         
 
              That defendants pay to claimant forty-seven point seven one 
 
         four (47.714) weeks of temporary total disability benefits for 
 
         the period from March 15, 1985 until February 11, 1986 at the 
 
         stipulated rate of one hundred ninety-eight and 52/100 dollars 
 
         ($198.52) per week in the total amount of nine thousand four 
 
         hundred seventy-two and 18/100 dollars ($9,472.18) commencing on 
 
         March 15, 1985.
 
         
 
              That defendants pay to claimant thirty point seven one four 
 
         (30.714) weeks of total temporary disability benefits for the 
 
         period from May 8, 1986 until January 5, 1987 at the stipulated 
 
         rate of one hundred ninety-eight and 52/100 ($198.52) per week in 
 
         the total amount of six thousand ninety-seven and 34/100 dollars 
 
         ($6,097.34) commencing on May 8, 1986.
 
         
 
              That defendants are entitled to a credit for forty-seven 
 
         point five one seven (47.517) weeks of workers' compensation 
 
         benefits paid prior to hearing at the rate of one hundred 
 
         ninety-eight and 52/100 dollars ($198.52) per week in the total 
 
         amount of nine thousand four hundred forty-three and 07/100 
 
         dollars ($9,443.07).
 
         
 
              That these benefits are to be paid in a lump sum.
 
         
 
              That interest will accrue pursuant to Iowa Code section 
 
         85.30.
 
         
 
              That defendants pay to claimant or the provider of medical 
 
         services five thousand eight hundred seventy-three and 95/100 
 
         dollars ($5,873.95) in medical benefits.
 
         
 
              That defendants are charged with the costs of this 
 
         proceeding pursuant to Division of Industrial Services Rule 
 
         343-4.33, including the cost of the transcript.
 
         
 
              That defendants file claim activity reports as requested by 
 
         this agency pursuant to Division of Industrial Services
 
         Rule 343-3.1
 
         
 
              Signed and filed this 31st day of July, 1989.
 
         
 
         
 
         
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
         
 
                                            WALTER R. McMANUS, JR.
 
                                            DEPUTY INDUSTRIAL COMMISSIONER
 
         
 
         Copies to:
 
         
 
         Mr. Nick Avgerinos
 
         Mr. Stephen Smalling
 
         Attorneys at Law
 
         101 N. Wacker Dr. STE 740
 
         Chicago, Illinois  60606
 
         
 
         Mr. Michael Liebbe
 
         Attorney at Law
 
         116 E. 6th St.
 
         PO Box 339
 
         Davenport, Iowa  52805
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
 
                                       
 
 
 
 
 
 
 
 
 
 
 
                                       51402.40; 51801; 51402.40; 51803 
 
                                       52501; 52602; 52700
 
                                       Filed July 31, 1989
 
                                       WALTER R. McMANUS, JR.
 
         
 
                     BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         TAMI M. HARTNESS,
 
         
 
              Claimant,                           File No. 830024
 
         
 
         vs.                                   A R B I T R A T I 0 N
 
         
 
         ESKA COMPANY,                            D E C I S I 0 N
 
         
 
              Employer,
 
         
 
         and
 
         
 
         HOME INSURANCE COMPANY,
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
         51402.40;  51801
 
         
 
              Claimant awarded temporary total disability for two lengthy 
 
         periods of time because the only medical evidence on this point 
 
         clearly proved that claimant's time off work was due to this 
 
         injury even though it might have been prolonged by a number of 
 
         other health factors claimant suffered from.
 
         
 
         51402.40; 51803
 
         
 
              Two of the doctors awarded 5 percent permanent functional 
 
         impairment, but neither one of them stated that it was due to the 
 
         injury.  Since claimant was 5 feet 5 inches tall and weighed 
 
         approximately 300 pounds and suffered from morbid obesity, it was 
 
         determined that it was quite possible, if not probable, that her 
 
         morbid obesity was the cause of her permanent impairment from 
 
         myofascitis.  No permanent partial disability benefits were 
 
         awarded.
 
         
 
         52501; 52602; 52700
 
         
 
              Claimant awarded $5,873.95 in unpaid medical expenses.
 
         
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
 
        
 
 
 
 
 
        
 
        
 
                    BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
        
 
        
 
        RUTH ANN (GAJESKI) CARTER,
 
        
 
            Claimant,
 
                                                            File No. 
 
        830031
 
        vs.
 
                                                            A R B I T R 
 
        A T I O N
 
        OSCAR MAYER COMPANY,
 
                                                            D E C I S I 
 
        O N
 
            Employer,
 
            Self-Insured,                               F I L E D
 
            Defendant.
 
                                                        APR 17 1989
 
        
 
                                                    INDUSTRIAL SERVICES
 
        
 
        
 
                                  INTRODUCTION
 
        
 
             This is a proceeding in arbitration brought by Ruth Ann 
 
             (Gajeski) Carter against Oscar Mayer Company, her self-insured 
 
             employer. The case was consolidated for hearing with file number 
 
             732627. The case was heard and fully submitted at Davenport, 
 
             Iowa on July 7, 1988. The record in the proceeding consists of 
 
             testimony from claimant, testimony from Monica Murphy, claimant's 
 
             exhibits 1 through 9 and defendant's exhibits A through DD.
 
        
 
                                      ISSUES
 
        
 
             Claimant seeks compensation for permanent partial disability 
 
             resulting from carpal tunnel syndrome. It was stipulated that 
 
             claimant contracted carpal tunnel syndrome and that such was an 
 
             injury which arose out of and in the course of employment. The 
 
             only issue is determination of claimant's entitlement to 
 
             compensation for permanent partial disability based upon the 
 
             condition.
 
        
 
                                 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.
 
        
 
            As stipulated by the parties, claimant developed carpal 
 
        tunnel syndrome and such constitutes an injury which arose out of 
 
        and in the course of employment. Claimant underwent left carpal 
 
        tunnel decompression surgery on July 24, 1986 and a similar 
 
        surgery on the right hand on August 21, 1986 (exhibit N, page 7). 
 
        Following the surgeries, claimant was placed in physical therapy 
 
        to increase the strength in her handS. Claimant returned to work 
 
        November 2, 1986. On March 30, 1987, John E. Sinning, Jr., M.D., 
 
        the treating physician and surgeon, indicated that claimant had 
 
        full range of motion, excellent resistant strength and 
 

 
        
 
 
 
 
 
        flexion-extension. He referred claimant to physical 
 
        rehabilitation for testing of her hand and wrist strength 
 
        (exhibit O, page 4). The results of that testing are not in 
 
        evidence.
 
        
 
             Claimant testified that she suffers from residual weakness 
 
             and pain in her hands and that her hands are not as mobile as 
 
             they were before she developed the disorder. She is not 
 
             undergoing further treatment for the condition. She has no known 
 
             medically imposed activity restrictions due to the condition. 
 
             Claimant testified that her wrists are so weak that she cannot 
 
             lift a skillet off the stove with one hand. She stated that the 
 
             right hand is much worse than the left.
 
        
 
                            APPLICABLE LAW AND ANALYSIS
 
        
 
             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).
 
        
 
            Claimant has the burden of proving the extent of any alleged 
 
        disability. Carpal tunnel syndrome is a scheduled member 
 
        disability which is compensated under the provisions of Iowa Code 
 
        section 85.34(2)(1) for one hand or Code section 85.34(2)(s) if 
 
        the injury affects both hands. Division of Industrial Services 
 
        Rule 343-2.4 makes the Guides to the Evaluation of Permanent 
 
        Impairment published by the American Medical Association prima 
 
        facie evidence of scheduled member disability.
 
        
 
            The evidence presented in this case does not contain any 
 
        rating of physical impairment or loss of use of either of 
 
        claimant's hands. The evidence does not contain any objective 
 
        showings of loss of range of motion or loss of grip strength. In 
 
        fact, the only indication in that regard which appears in the 
 
        record fails to demonstrate any abnormalities (exhibit 0, page 
 
        4).
 
        
 
            The only evidence of disability is claimant's testimony 
 
        regarding her complaints. Complaints of the type which claimant 
 
        voiced are not uncommon following carpal tunnel release surgery. 
 
        Such complaints, in the complete absence of any medical evidence 
 
        dealing with impairment or disability, could support an award. 
 
        In this case, however, the indications from Dr. Sinning are in 
 
        direct conflict with claimant's stated complaints. It is 
 
        therefore determined that claimant has failed to prove, by a 
 
        preponderance of the evidence, that she has any permanent 
 
        disability as a result of her carpal tunnel syndrome.
 
        
 
                                 FINDING OF FACT
 
        
 
             1. The evidence in this case fails to demonstrate that it 
 
             is more likely than not that claimant has any permanent loss of 
 
             use of either of her hands as a result of the carpal tunnel 
 
             syndrome which she developed as a result of her employment 
 
             activities with Oscar Mayer Company.
 
        
 
                                 CONCLUSIONS OF LAW
 
        
 
             1. This agency has jurisdiction of the subject matter of 
 
             this proceeding and its parties.
 
        
 
            2. Claimant has failed to prove, by a preponderance of the 
 

 
        
 
 
 
 
 
        evidence, that she is entitled to any compensation for permanent 
 
        partial disability based upon carpal tunnel syndrome.
 
        
 
                                      ORDER
 
        
 
             IT IS THEREFORE ORDERED that claimant take nothing from this 
 
             proceeding.
 
        
 
            IT IS FURTHER ORDERED that the costs of this proceeding are 
 
        assessed against claimant pursuant to Division of Industrial 
 
        Services Rule 343-4.33.
 
        
 
            Signed and filed this 17th day of April, 1989.
 
        
 
        
 
        
 
        
 
        
 
        
 
                                       MICHAEL G. TRIER 
 
                                       DEPUTY INDUSTRIAL COMMISSIONER
 
        
 
        Copies To:
 
        
 
        Mr. Albert J. Stafne, Jr.
 
        Mr. Thomas H. Preacher
 
        Attorneys at Law
 
        2535 Tech Drive, Suite 200
 
        Bettendorf, Iowa 52722
 
        
 
        Mr. Richard M. McMahon
 
        Ms. Vicki L. Seeck
 
        Attorneys at Law
 
        600 Union Arcade Building
 
        111 East Third Street
 
        Davenport, Iowa 52801-1550
 
        
 
        
 
 
        
 
 
 
 
 
        
 
                                            1402.40, 1803, 3700
 
                                            Filed April 17, 1989
 
                                            MICHAEL G. TRIER
 
        
 
                    BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
        
 
        
 
        RUTH ANN (GAJESKI) CARTER,
 
        
 
            Claimant,
 
                                          File No. 830031
 
        vs.
 
                                       A R B I T R A T I O N
 
        OSCAR MAYER COMPANY,
 
                                          D E C I S I O N
 
            Employer,
 
            Self-Insured,
 
             Defendant.
 
             
 
             
 
        1402.40, 1803, 3700
 
        
 
             Claimant's testimony, which was contradicted by medical 
 
             records, was held to be insufficient to prove the existence of 
 
             permanent partial disability resulting from carpal tunnel 
 
             syndrome. The evidence contained no rating of permanent 
 
             impairment and no medically-imposed activity restrictions.