BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         DANIEL E. SMITH,
 
         
 
              Claimant,
 
                                                   File No. 838605
 
         vs.
 
                                               A R B I T R A T I 0 N
 
         DOBBS HOUSE, INC.,
 
                                                   D E C I S I 0 N
 
              Employer,
 
         
 
         and
 
         
 
         LIBERTY MUTUAL INSURANCE CO.,
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
         
 
                              STATEMENT OF THE CASE
 
         
 
              This is a proceeding in arbitration brought by Daniel E. 
 
         Smith, claimant, against Dobbs House, Inc., employer, and Liberty 
 
         Mutual Insurance Company, insurance carrier, to recover benefits 
 
         under the Iowa Workers' Compensation Act as a result of an injury 
 
         sustained November 24, 1984.  This matter came on for hearing 
 
         before the undersigned deputy industrial commissioner March 8, 
 
         1988.  The record was considered fully submitted at the close of 
 
         the hearing.  The record in this case consists of the testimony 
 
         of the claimant and Robert Kenney; and joint exhibits A through 
 
         C, inclusive.  Claimant's answers to interrogatories were also 
 
         received into evidence although not marked as an exhibit.
 
         
 
                                      ISSUES
 
         
 
              Pursuant to the prehearing report and order submitted and 
 
         approved March 8, 1988, the following issues are presented for 
 
         determination:
 
         
 
              1.  Whether claimant's injury is causally connected to the 
 
         disability on which he now bases his claim; and
 
         
 
              2.  The nature and extent of claimant's entitlement, if any, 
 
         to disability benefits.
 
         
 
                                 FACTS PRESENTED
 
         
 
              Claimant sustained an injury which arose out of and in the 
 
         course of his employment November 24, 1984 when a safety 
 
         guardrail broke loose and landed on his left shoulder, neck, and 
 
         the back of his head.  After two weeks, claimant noticed he was 
 
         feeling a "tingling" in his shoulder and was dropping things with 
 
         his left hand and therefore sought medical attention for the 
 
         first time since the injury.  Claimant was initially treated with 
 
         warm compresses, "electricity" and a cortisone injection.  He 
 
         continued to work at his regular job with defendant employer 
 
         until defendant insurance carrier referred him to Scott B. Neff, 
 

 
         D.O., on March 6, 1985, who administered an injection.  Claimant 
 
         explained that none of this treatment provided any lasting 
 
         benefit and that Dr. Neff eventually "gave up" with no 
 
         recommendations for further treatment.  Claimant testified he 
 
         contacted the insurance company who told him they would find 
 
         another doctor.  However, two days later claimant presented 
 
         himself at Mercy Hospital complaining of neck pain and was 
 
         referred to Robert T. Brown, M.D., who prescribed medications and 
 
         ran another EMG which was negative.  Claimant explained he was 
 
         eventually referred to the University of Iowa Hospitals and 
 
         Clinics and that when he later returned to see Dr. Neff, Dr. Neff 
 
         again had no offer of additional treatment.
 
         
 
              Claimant explained that after the first time he was 
 
         released to return to work by Dr. Neff, he did return as 
 
         instructed.  He described the job to which he returned as 
 
         having lesser physical requirements than the job he held at the 
 
         time of his injury, but that it required him to lift and work 
 
         overhead.  Claimant stated he was taken off the job a second 
 
         time by a representative of defendant insurance carrier and 
 
         that he did not return to work after this period of 
 
         unemployment because of a dispute with the employer over 
 
         whether he quit or was discharged.  Claimant is currently 
 
         employed in a maintenance position with Villa of Patricia Park 
 
         earning approximately $5.50 per hour.  Claimant testified that 
 
         he was earning $6.35 per hour with defendant employer at the 
 
         time of his injury and $5.15 per hour when he left work on the 
 
         second occasion.  Claimant explained that he had previously 
 
         worked for Villa of Patricia Park on a part-time basis as a 
 
         painter but that he had to give that up because of the 
 
         requirement that he work over head.
 
         
 
              Claimant testified that his current symptoms are not 
 
         unlike those he has had all along:  He has pain on the top of 
 
         his shoulder, down into his arm and up across his neck which 
 
         swells on the left side when he attempts heavy lifting or 
 
         overhead work; he has numbness in his left shoulder and 
 
         sometimes in the tips of his fingers on the left hand; and pain 
 
         at the "trigger point" area of his back between the shoulder 
 

 
         
 
         
 
         
 
         SMITH V. DOBBS HOUSE, INC.
 
         Page   3
 
         
 
         blades.  Claimant testified that he is neither currently under 
 
         any medical care nor that he has any medical appointments for 
 
         further care.
 
         
 
              Robert Kenney, general manager for Dobbs Unit 716, 
 
         testified claimant was offered two positions subsequent to his 
 
         injury, but because the jobs involved evening hours and 
 
         claimant had been working days, claimant rejected each one as 
 
         the hours interfered with his other job.
 
              On December 21, 1984, claimant, on referral from the Dietz 
 
         Clinic, came under the care of Joshua Kimelman, D.O., of 
 
         Orthopedic Associates, P.C.  Dr. Kimelman noted claimant had 
 
         essentially full, "excellent" range of motion of the left arm 
 
         without evidence of atrophy and that the x-ray of the left 
 
         shoulder was within normal limits.  Dr. Kimelman ruled out 
 
         rotator cuff tear and the arthrogram performed was negative.  
 
         Dr. Kimelman gave claimant a 1:1:1/2 injection in the left A/C 
 
         joint, noting relief from discomfort on January 23, 1985.  
 
         Approximately one month later Dr. Kimelman noted claimant was 
 
         no longer getting the tingling and numbness that was previously 
 
         the subject of complaint.  Claimant discontinued treatment with 
 
         Dr. Kimelman in March 1985 when he was referred to Scott B. 
 
         Neff, D.O., by defendant insurance carrier.
 
         
 
              Claimant was first seen by Dr. Neff March 6, 1985 who, 
 
         after examination and injection to the subacromial bursa, 
 
         concluded:
 
         
 
                 In summary, I feel that this patient has two 
 
              problems.  I feel he has had a muscle contusion to the 
 
              posterior aspect of his left shoulder and neck, 
 
              secondary to his injury.  This is the result of the 
 
              muscle spasm and trigger point tenderness, and this 
 
              should be treated with trigger point injections, 
 
              physical therapy, and conservative treatment.  He does 
 
              have impingement syndrome, and the left subacromial 
 
              bursa and coracoacromial ligament area, but this is not 
 
              his area of primary complaints.
 

 
         
 
         
 
         
 
         SMITH V. DOBBS HOUSE, INC.
 
         Page   4
 
         
 
         
 
                 I would like him to remain off work for a period of 
 
              ten days and I would like to re-evaluate him again .... 
 
              The scapular syndrome is a situation with which I am 
 
              sure you are familiar.  It is frustrating to treat, and 
 
              can result in a pain/spasm/pain frustrating vicious 
 
              cycle.  It is generally associated with underlying 
 
              stress, or can be made worse with stress, and is called 
 
              the "cerviocothoracic tension state" by many 
 
              authorities.  It is generally not a disabling 
 
              condition, and it is generally not permanent.
 
         
 
         (Joint Exhibit A, part 5, page 1)
 
         
 
              EMG studies done April 10, 1985 were interpreted as totally 
 
         normal and claimant was released to return to work on May 8, 1985 
 
         with Dr. Neff stating:  "I do not believe there are any 
 
         significant abnormalities with reference to this patient, and I 
 
         see no reason to restrict him from work activity at this time."  
 
         (Jt. Ex. A, pt. 5, p. 3)  When claimant was again seen on July 1, 
 
         1985, Dr. Neff appears not to doubt claimant's subjective 
 
         symptoms of pain but admits "I don't have anything to offer him, 
 
         and don't have any idea why his neck is puffing up...."  (Jt. Ex. 
 
         A, pt. 5, p. 4) However, because of persistence of the symptoms, 
 
         Dr. Neff made arrangements for claimant to be seen at the 
 
         University of Iowa neurosurgery and the department of physical 
 
         medicine.  In October 1986, Dr. Neff noted claimant stated 
 
         nothing had changed in his condition and the functional capacity 
 
         evaluation, conducted in association with Thomas Bower, L.P.T., a 
 
         physical therapy consultant, resulted in an impairment rating of 
 
         one percent to the upper left extremity based on "a very slight 
 
         loss of abduction of approximately 15 degrees.O
 
         
 
              On July 15, 1985, claimant was evaluated by Thomas B. 
 
         Summers, M.D., who concluded:
 
         
 
                 I find no evidence of serious injury or residuals of 
 
              injury in the case of Mr. Smith.  Certainly, there is 
 
              no evidence of neurologic deficit or orthopedic deficit 
 
              on examination at this time.  I am inclined to feel 
 
              that the functional element here is sizeable in degree 
 
              and contributing to the symptomatology in whole or in 
 
              large part.
 
         
 
                 Copies of reports submitted by other examiners 
 
              concerned with care and treatment of Mr. Smith in the 
 
              recent past are reviewed at length and noted.  
 
              Appropriate diagnostic studies have been carried out, 
 
              including arthrography and electromyography.
 
         
 
                 I see no reason for any further studies or treatment 
 
              in the case of Mr. Smith at this time.  It is my 
 
              feeling that he is capable of regular and gainful 
 
              employment and without restriction, if he can be so 
 
              motivated.
 
         
 
         (Jt. Ex. A, pt. 8, pp. 3-4)
 
         
 
              Claimant was seen in the neurosurgery outpatient clinic of 
 
         the University of Iowa Hospitals and Clinics on July 28, 1986 and 
 

 
         
 
         
 
         
 
         SMITH V. DOBBS HOUSE, INC.
 
         Page   5
 
         
 
         was evaluated by David W. Beck, M.D., assistant professor of 
 
         neurosurgery.  Dr. Beck found claimant to be well muscled with no 
 
         evidence of atrophy; that his rhomboid, supraspinatus, and 
 
         infraspinatus muscles were within normal strength; that his 
 
         entire motor examination was normal; that sensory examination 
 
         revealed a subjective decreased pin sensation to the left side of 
 
         the neck; and that he had full range of motion of the cervical 
 
         spine.  Dr. Beck also reported that cervical spine x-rays were 
 
         obtained and were unremarkable.  Dr. Beck, in a report dated July 
 
         29, 1986, concluded:
 
         
 
                 It is my impression that Mr. Smith probably had a 
 
              soft tissue injury to the left side of his neck.  It is 
 
              curious that he has this numb feeling which would 
 
              really be in the distribution of either C2 or cutaneous 
 
              nerve.  Because of the lack of any muscle atrophy, I 
 
              doubt if he has injured any of his brachial plexus.
 
         
 
                 I have nothing really to offer Mr. Smith.  I know he 
 
              has been on TENS units and anti-inflammatory 
 
              medications without much relief.  I do think he does 
 
              not have a significant brachial plexus injury or 
 
              herniated disk, and therefore I am left with the 
 
              diagnosis of soft tissue injury.
 
         
 
         (Jt. Ex. A, pt. 11, p. 2)
 
         
 
              Thomas A. Carlstrom, M.D., neurological surgeon, evaluated 
 
         claimant November 19, 1987 and found claimant to have a good 
 
         range of motion of his neck and shoulder with no atrophy of the 
 
         muscles although he stated there was tenderness diffusely over 
 
         the shoulder and scapula.  On neurological examination, Dr. 
 
         Carlstrom noted no abnormalities except subjectively diminished 
 
         sensation over the apex of his shoulder.  On December 1, 1987, 
 
         Dr. Carlstrom stated:  "I think this patient experienced a 
 
         myofascial injury at the time of his altercation with the 
 
         guardrail in 1984.  I see no evidence for a permanent impairment 
 
         at the present time.O (Jt. Ex. A, pt. 13, p. 1)  Approximately 
 
         one month later, Dr. Carlstrom explained to claimant's counsel:
 
         
 
              Yes, I do believe that there is pain associated with a 
 
              myofascial injury; that really is the only symptom that 
 
              we can associate with it, in fact.  The length of time 
 
              into the future that this patient will experience these 
 
              symptoms is probably related to his physical activity.  
 
              If he continues to do heavy work, he can expect to 
 
              experience remissions and exacerbations more or less 
 
              permanently.  However, I believe it is more likely that 
 
              over the years, his symptoms will gradually resolve 
 
              completely.
 
         
 
              The last physician to see claimant was Jerome G. Bashara, 
 
         M.D., orthopedic surgeon, who conducted an evaluation and 
 
         examination on February 19, 1988.  Dr. Bashara found the motion 
 
         of claimant's cervical spine to be restricted and a full range of 
 
         motion of the left shoulder of approximately 10 to 15 degrees of 
 
         full abduction lacking.  Dr. Bashara appeared to have reviewed 
 
         previous x-rays and test results and concluded:
 
         
 
              DIAGNOSES: 1. Myofascial strain, cervical spine,
 

 
         
 
         
 
         
 
         SMITH V. DOBBS HOUSE, INC.
 
         Page   6
 
         
 
                            related to his injury; and
 
         
 
                         2. Soft tissue injury to the left shoulder,
 
                            specifically the supraspinatus and ratator 
 
              cuff
 
                            muscle group.
 
         
 
                            I would give the patient a 2% permanent 
 
              partial
 
                            physical impairment rating of his left upper
 
                            extremity related to the shoulder diagnosis.
 
         
 
                            I would give the patient a 3% permanent 
 
              partial
 
                            physical impairment of his body as a whole
 
                            related to the myofascial strain of the
 
                            cervical spine.
 
         
 
         (Jt. Ex. A, pt. 14, p. 4)
 
         
 
                                  APPLICABLE LAW
 
         
 
              An employee is entitled to compensation for any and all 
 
         personal injuries which arise out of and in the course of the 
 
         employment.  Section 85.3(l).
 
         
 
              The claimant has the burden of proving by a preponderance of 
 
         the evidence that the injury of November 24, 1984 is causally 
 
         related to the disability on which he now bases his claim.  
 
         Bodish v. Fischer, Inc., 257 Iowa 516, 133 N.W.2d 867 (1965).  
 
         Lindahl v. L. 0. Boggs, 236 Iowa 296, 18 N.W.2d 607 (1945).  A 
 
         possibility is insufficient; a probability is necessary.  Burt v. 
 
         John Deere Waterloo Tractor Works, 247 Iowa 691, 73 N.W.2d 732 
 
         (1955).  The question of causal connection is essentially within 
 
         the domain of expert testimony.  Bradshaw v. Iowa Methodist 
 
         Hospital, 251 Iowa 375, 101 N.W.2d 167 (1960).
 
         
 
              However, expert medical evidence must be considered with all 
 
         other evidence introduced bearing on the causal connection.  
 
         Burt 247 Iowa 691, 73 N.W.2d 732.  The opinion of experts need 
 
         not be couched in definite, positive or unequivocal language.  
 
         Sondag v. Ferris Hardware, 220 N.W.2d 903 (Iowa 1974).  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).
 
         
 
              Permanent partial disabilities are classified as either 
 
         scheduled or unscheduled.  A specific scheduled disability is 
 
         evaluated by the functional method; the industrial method is used 
 
         to evaluate an unscheduled disability.  Martin v. Skelly Oil Co., 
 
         252 Iowa 128, 133, 106 N.W.2d 95, 98 (1960); Graves v. Eagle 
 
         Iron Works, 331 N.W.2d 116 (Iowa 1983); Simbro v. DeLongOs 
 
         Sportswear, 332 N.W.2d 886, 887 (Iowa 1983).
 
         
 
              If a claimant contends he has industrial disability he has 
 
         the burden of proving his injury results in an ailment extending 
 

 
         
 
         
 
         
 
         SMITH V. DOBBS HOUSE, INC.
 
         Page   7
 
         
 
         beyond the scheduled loss.  Kellogg v. Shute and Lewis Coal Co., 
 
         256 Iowa 1257, 130 N.W.2d 667 (1964).  A shoulder injury, 
 
         however, is not scheduled, being an injury to the body as a 
 
         whole.  Alm v. Morris Barick Cattle Company, 240 Iowa 1174, 38 
 
         N.W.2d 161 (1949 .
 
         
 
              Iowa Code section 85.33(l) provides:
 
                 Except as provided in subsection 2 of this section, 
 
              the employer shall pay to an employee for injury 
 
              producing temporary total disability weekly 
 
              compensation benefits, as provided in section 85.32, 
 
              until the employee has returned to work or is medically 
 
              capable of returning to employment substantially 
 
              similar to the employment in which the employee was 
 
              engaged at the time of injury, whichever occurs first.
 
         
 
              Iowa Code section 85.34(2) provides, in part:
 
         
 
              Compensation for permanent partial disability shall 
 
              begin at the termination of the healing period ... For 
 
              all cases of permanent partial disability compensation 
 
              shall be paid as follows:
 
         
 
                 ....
 
         
 
                 (u)  In all cases of permanent partial disability 
 
              other than those hereinabove described or referred to 
 
              in paragraphs "all through "t" hereof, the compensation 
 
              shall be paid during the number of weeks in relation to 
 
              five hundred weeks as the disability bears to the body 
 
              of the injured employee as a whole.
 
         
 
                                    ANALYSIS
 
         
 
               The parties have stipulated that claimant sustained an 
 
         injury which arose out of and in the course of his employment and 
 
         that the extent of claimant's entitlement to weekly compensation 
 
         or temporary total disability/healing period benefits, if any, is 
 
         March 16, 1985 through April 1, 1985 and May 13, 1985 through 
 
         June 16, 1985.  What is first at issue is whether the disability 
 
         on which claimant now bases his claim is causally connected to 
 
         the work injury.
 
         
 
              As stated above, the question of causal connection is 
 
         essentially within the domain of expert testimony, although the 
 
         expert testimony must be considered with all other evidence 
 
         presented.  Initially, it is accepted claimant was asymptomatic 
 
         of shoulder and neck pain prior to the work injury of November 
 
         24, 1984.  The physicians from whom claimant received treatment 
 
         and by whom claimant was evaluated agree that the reason for 
 
         claimant's need of medical assistance in the first place and his 
 
         absences from work for the above mentioned periods was the work 
 
         injury of November 24, 1984.  Claimant has, therefore, met his 
 
         burden of establishing a causal connection between the work 
 
         injury and any resulting disability.
 
         
 
              Generally, a claim of permanent disability invokes an 
 
         initial determination of whether the work injury is the cause of 
 
         a permanent physical impairment or any permanent limitations in 
 
         his work activity.  By the very meaning of the phrase, a person 
 

 
         
 
         
 
         
 
         SMITH V. DOBBS HOUSE, INC.
 
         Page   8
 
         
 
         with a permanent impairment can never return to the same physical 
 
         condition he or she was in prior to the injury.  See, e.g., 
 
         Armstrong Tire & Rubber Company v. Kubli, 312 N.W.2d 60 (Iowa 
 
         1981) and 2 A. Larson, The Law of Workmen's Compensation, 
 
         SS67.12. Claimant testified he continues to experience pain in 
 
         his shoulder, down into his arm, and up across his neck which is 
 
         aggravated by "heavy" lifting or overhead work, pain which he did 
 
         not have and work which he could do prior to his injury.  Both 
 
         Dr. Neff, who treated claimant, and Dr. Bashara, who evaluated 
 
         him, find claimant to have some permanent impairment as a result 
 
         of the work injury.  Although Dr. Carlstrom saw no evidence of a 
 
         permanent impairment at the time of his examination of claimant, 
 
         he admits that if claimant continues to do heavy work, claimant 
 
         can expect to experience remissions and exacerbations more or 
 
         less permanently.  It is, therefore,.accepted claimant has 
 
         established that the work injury is the cause of a permanent 
 
         impairment.  This finding thus gives rise to the issue of whether 
 
         claimant's disability is to the upper extremity or extends to the 
 
         body as a whole.  Based upon the situs of the injury (claimant 
 
         testified the guardrail struck him on the shoulder, neck and back 
 
         of the head) as well claimant's objective symptoms of pain beyond 
 
         the upper extremity, it is found claimant sustained, under Alm, 
 
         an injury to the body as a whole.  See also Nazarenus v. Oscar 
 
         Mayer & Co., II Iowa Industrial Commissioner Reports 281 (Appeal 
 
         Decision 1982).  In Alm, claimant had a rating of 25-30 percent 
 
         impairment to the arm and the court, noting the anatomical 
 
         location of the injury extended from the arm into the shoulder, 
 
         ruled that the injury was not restricted to a schedule, thus, by 
 
         law, an injury to the shoulder which produces permanent 
 
         impairment entitles the claimant to an industrial disability.  
 
         See also Lauhoff Grain Company v. McIntosh, 395 N.W.2d 834 (Iowa 
 
         1986).
 
         
 
              The mere fact that the rating pertains to a scheduled member 
 
         does not mean the disability is restricted to a schedule.  
 
         Pullen v. Brown & Lambrecht Earthmoving, Incorporated, II Iowa 
 
         Industrial Commissioner Reports 308 (Appeal Decision 1982).
 
         
 
              Dr. Neff, along with Thomas Bower, L.P.T., found claimant to 
 
         have a one percent impairment to the upper left extremity.  Dr. 
 
         Bashara found claimant to have a two percent impairment to the 
 
         upper left extremity and a three percent impairment to the body 
 
         as a whole.
 
         
 
              Functional disability is an element to be considered in 
 
         determining industrial disability which is the reduction of 
 
         earning capacity, but consideration must also be given to the 
 
         injured employee's age, education, qualifications, experience and 
 
         inability to engage in employment for which he is fitted.  Olson 
 
         v. Goodyear Service Stores, 255 Iowa 1112, 125 N.W.2d 251 (1963).  
 
         Barton v. Nevada Poultry, 253 Iowa 285, 110 N.W.2d 660 (1961).
 
         
 
              A finding of impairment to the body as a whole by a medical 
 
         evaluator does not equate to industrial disability.  This is so 
 
         as impairment and disability are not synonymous.  The degree of 
 
         industrial disability can in fact be much different than the 
 
         degree of impairment because in the first instance reference is 
 
         to loss of earning capacity and in the later to anatomical or 
 
         functional abnormality or loss.  Although loss of function is to 
 
         be considered and disability can rarely be found without it, it 
 

 
         
 
         
 
         
 
         SMITH V. DOBBS HOUSE, INC.
 
         Page   9
 
         
 
         is not so that a degree of industrial disability is 
 
         proportionally related to a degree of impairment of bodily 
 
         function.
 
         
 
              Factors to be considered in determining industrial 
 
         disability include the employee's medical condition prior to the 
 
         injury, immediately after the injury, and presently; the situs of 
 
         the injury, its severity and the length of healing period; the 
 
         work experience of the employee prior to the injury, after the 
 
         injury and potential for rehabilitation; the employee's 
 
         qualifications intellectually, emotionally and physically; 
 
         earnings prior and subsequent to the injury; age; education; 
 
         motivation; functional impairment as a result of the injury; and 
 
         inability because of the injury to engage in employment for which 
 
         the employee is fitted.  Loss of earnings caused by a job 
 
         transfer for reasons related to the injury is also relevant.  
 
         These are matters which the finder of fact considers collectively 
 
         in arriving at the determination of the degree of industrial 
 
         disability.
 
         
 
              There are no weighting guidelines that indicate how each of 
 
         the factors are to be considered.  There are no guidelines which 
 
         give, for example, age a weighted value of ten percent of the 
 
         total value, education a value of fifteen percent of total, 
 
         motivation - five percent; work experience - thirty percent, etc.  
 
         Neither does a rating of functional impairment directly correlate 
 
         to a degree of industrial disability to the body as a whole.  In 
 
         other words, there are no formulae which can be applied and then 
 
         added up to determine the degree of industrial disability. it 
 
         therefore becomes necessary for the deputy to draw upon prior 
 

 
         
 
         
 
         
 
         SMITH V. DOBBS HOUSE, INC.
 
         Page  10
 
         
 
         experience, general and specialized knowledge to make the finding 
 
         with regard to degree of industrial disability.  See Christensen 
 
         v. Hagen, Inc., (Appeal Decision, March 26, 1985); Peterson v. 
 
         Truck Haven Cafe, Inc., (Appeal Decision, February 28, 1985).
 
         
 
              Claimant is 30 years old with a tenth grade education as an 
 
         average student.  He worked for seven years as a gas station 
 
         attendant and mechanic where he rebuilt carburetors, did tuneups, 
 
         oil changes, automobile electrical work and where he was able to 
 
         use the "high-tech" equipment provided by the Amoco Company.  
 
         Claimant has also rebuilt small engines such as those found in 
 
         lawnmowers, rototillers and go-carts and also has worked as a 
 
         laborer, truck and equipment operator and truck foreman for an 
 
         asphalt company.  It is interesting to note that none of the 
 
         health care providers who saw or treated claimant have placed any 
 
         restrictions on claimant's employability.  Although testifying he 
 
         could no longer do the "heavy" lifting required of an asphalt 
 
         laborer, claimant did not indicate he could no longer do any of 
 
         these other types of jobs.  Claimant continued to work for 
 
         defendant employer in his regular job after his injury and after 
 
         his return to work lifted as much as 55 pounds.  Claimant is 
 
         currently employed in a maintenance position for Villa of 
 
         Patricia Park earning approximately $5.50 per hour.  He was 
 
         earning approximately $6.35 per hour with defendant employer at 
 
         the time of his injury.  It is unclear from the testimony exactly 
 
         why claimant did not return to work for defendant employer when 
 
         work was offered.  If claimant did not want to work nights 
 
         because it interfered with his other employment, defendants 
 
         clearly cannot be held liable for any asserted loss of earnings 
 
         when the reason for claimant's failure to return to work was not 
 
         related to his injury.  While claimant also maintains he was not 
 
         capable of doing the work, he was under no medical restrictions 
 
         which would have kept him therefrom.  Because claimant now has 
 
         difficulty with lifting that he once did with relative ease as 
 
         well as problems with overhead work which were not problems 
 
         before the injury, it is accepted claimant's capacity to earn has 
 
         been hampered as a result of the work injury.  Considering then 
 
         all the elements of industrial disability in light of the medical 
 
         evidence as well as the testimony, it is found claimant sustained 
 
         a permanent partial disability of three percent for industrial 
 
         purposes.  As indicated above, and pursuant to Iowa Code section 
 
         85.33, claimant is entitled to healing period benefits for the 
 
         stipulated periods of March 16, 1985 through April 1, 1985, 
 
         inclusive, and May 13, 1985 through June 16, 1985, inclusive.
 
         
 
                                 FINDINGS OF FACT
 
         
 
              Wherefore, based on all of the evidence presented, the 
 
         following facts are found:
 
         
 
              1.  Claimant sustained an injury which arose out of and in 
 
         the course of his employment on November 24, 1984 when a 
 
         guardrail struck him on the left shoulder, neck and back of the 
 
         head.
 
         
 
              2.  During the next two weeks following his injury claimant 
 
         felt a Otingling" in his left shoulder and was dropping things 
 
         with his left hand and therefore sought medical attention.
 
         
 
              3.  Claimant has a permanent impairment as a result of the 
 

 
         
 
         
 
         
 
         SMITH V. DOBBS HOUSE, INC.
 
         Page  11
 
         
 
         work injury.
 
         
 
              4.  Claimant perceives persistent pain in his arm, across 
 
         his shoulder, into his neck which increases with heavy lifting 
 
         and overhead work.
 
         
 
              5.  Claimant is currently employed in a position which does 
 
         not require either heavy lifting or overhead work.
 
         
 
              6.  Claimant is 30 years old with a tenth grade education as 
 
         an average student.
 
         
 
              7.  Claimant has work experience for which he is still 
 
         qualified notwithstanding his injury.
 
         
 
              8.  Claimant is currently under no medical restrictions, no 
 
         medical care and has no appointments for medical care.
 
         
 
              9.  Claimant's capacity to earn has been hampered as a 
 
         result of the work injury.
 
         
 
             10.  Claimant has sustained a permanent partial disability to 
 
         the body as a whole as a result of the work injury.
 
         
 
             11.  Claimant has a three percent industrial disability as a 
 
         result of his injury.
 
         
 
                                CONCLUSIONS OF LAW
 
         
 
              Wherefore, based on the principles of law previously stated, 
 
         the following conclusions of law are made:
 
         
 
              1.  Claimant has established his injury is the cause of the 
 
         disability on which he now bases his claim.
 
         
 
              2.  Claimant has established he sustained an injury to the 
 
         body as a whole.
 
         
 
              3.  Claimant has met his burden of establishing an 
 
         industrial disability of three percent as a result of the injury 
 
         which arose out of and in the course of his employment on 
 
         November 24, 1984.
 
         
 
                                      ORDER
 
         
 
              THEREFORE, IT IS ORDERED:
 
         
 
              That defendants shall pay to claimant seven point four two 
 
         nine (7.429) weeks of healing period benefits for the stipulated 
 
         periods from March 16, 1985 through April 1, 1985, inclusive, and 
 
         May 13, 1985 through June 16, 1985, inclusive, at the stipulated 
 
         rate of one hundred fifty-seven and 79/100 dollars ($157.79) per 
 
         week.
 
         
 
              That defendants shall pay to claimant fifteen (15) weeks of 
 
         permanent partial disability benefits at the stipulated rate of 
 
         one hundred fifty-seven and 79/100 dollars ($157.79) per week 
 
         commencing June 17, 1985.
 
         
 
              That defendants shall receive full credit for all disability 
 

 
         
 
         
 
         
 
         SMITH V. DOBBS HOUSE, INC.
 
         Page  12
 
         
 
         benefits previously paid.
 
         
 
              That payments that have accrued shall be paid in a lump sum 
 
         together with statutory interest thereon pursuant to Iowa Code 
 
         section 85.30.
 
         
 
              That a claim activity report shall be filed upon payment of 
 
         this award.
 
         
 
              That the costs of this action are assessed against 
 
         defendants pursuant to Division of Industrial Services Rule 
 
         343-4.33.
 
         
 
         
 
              Signed and filed this 3rd day of May, 1988.
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 
                                            DEBORAH A. DUBIK
 
                                            DEPUTY INDUSTRIAL COMMISSIONER
 
         
 
         
 
         Copies to:
 
         
 
         Mr. Fredd J. Haas
 
         Attorney at Law
 
         5001 S.W. Ninth Street
 
         Des Monies, Iowa 50315
 
         
 
         Mr. W. C. Hoffmann
 
         Attorney at Law
 
         1000 Des Moines Building
 
         Des Moines, Iowa 50309
 
         
 
         
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                                                          1803; 1803.1
 
                                                          Filed 5-3-88
 
                                                          Deborah A. Dubik
 
         
 
                     BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         DANIEL E. SMITH,
 
         
 
              Claimant,
 
                                                      File No. 838605
 
         vs.
 
         
 
         DOBBS HOUSE, INC.,                       A R B I T R A T I 0 N
 
         
 
              Employer,                              D E C I S I 0 N
 
         
 
         and
 
         
 
         LIBERTY MUTUAL INSURANCE CO.,
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
         
 
         1803; 1803.1
 
         
 
              Claimant was injured when a safety guardrail broke loose and 
 
         landed on his left shoulder, neck, and the back of his head.  The 
 
         residuals of the injuries extended beyond the upper extremities 
 
         and therefore under Lauhoff Grain Company, it was found claimant 
 
         sustained an injury to the body as a whole entitling him to an 
 
         industrial disability.  Claimant's injury was found to have 
 
         caused a permanent partial impairment although none of the health 
 
         care providers who either saw or treated claimant placed any 
 
         restrictions on his employability.  Claimant maintained he was 
 
         precluded from doing "heavy" labor but was not precluded from 
 
         employment for which he was suited by education and previous 
 
         experience.  Claimant is found to have sustained a permanent 
 
         partial disability of three percent for industrial purposes.
 
 
 
         
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                      BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         JACK C. MILLER,                               File Nos. 838614
 
                                                                 826388
 
              Claimant,
 
                                                   A R B I T R A T I O N
 
         vs.
 
                                                       D E C I S I O N
 
         ROADWAY EXPRESS, INC.,
 
                                                          F I L E D
 
              Employer,
 
              Self-Insured,                              AUG 07 1989
 
              Defendant.
 
                                                     INDUSTRIAL SERVICES
 
         
 
         
 
                                   INTRODUCTION
 
         
 
              This is a proceeding in arbitration brought by claimant Jack 
 
         C. Miller against defendant self-insured employer Roadway Express, 
 
         Inc. to recover benefits under the Iowa Workers' Compensation Act 
 
         for alleged injuries on July 25, 1986 and September 15, 1986.  
 
         This matter was scheduled to come on for hearing at 8:30 a.m. on 
 
         August 7, 1989, at,the industrial commissioner's office in Des 
 
         Moines, Iowa.
 
         
 
              The undersigned was present.  Neither claimant nor defendant 
 
         appeared.
 
         
 
                            SUMMARY OF THE EVIDENCE
 
         
 
              Claimant failed to present any evidence in support of the 
 
         allegations found in his original notice and petition.  At the 
 
         time of hearing, neither an agreement for settlement nor a 
 
         request for continuance was on file.
 
         
 
              Claimant has the burden of proving by a preponderance of the 
 
         evidence that he sustained an injury which arose out of and in 
 
         the course of his employment.  McDowell v. Town of Clarksville, 
 
         241 N.W.2d 904 (Iowa 1976).
 
         
 
                             FINDINGS OF FACT
 
         
 
              WHEREFORE, it is found:
 
         
 
              1.  Neither claimant nor defendant appeared at the scheduled 
 
         time and place of hearing.
 
         
 
              2.  The undersigned deputy industrial commissioner was 
 
         present and prepared to proceed to hearing.
 
         
 
              3.  At the time of the hearing, neither an agreement for 
 
         settlement nor a request for continuance was on file with the 
 
         industrial commissioner.
 
                                                
 
                                                         
 
         
 
              4.  Claimant failed to present any evidence to support 
 
         allegations of a compensable work injury.
 
         
 
                                   ORDER
 
         
 
              THEREFORE, IT IS ORDERED:
 
         
 
              Claimant has failed to meet his burden of proof that he 
 
         sustained an injury which arose out of and in the course of his 
 
         employment.
 
         
 
              Claimant take nothing from this hearing.
 
         
 
              Costs are taxed to the claimant pursuant to Division of 
 
         Industrial Services Rule 343-4.33.
 
         
 
              Signed and filed this 7th day of August, 1989.
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 
                                            WALTER R. McMANUS,
 
                                            DEPUTY INDUSTRIAL 
 
                                            COMMISSIONER
 
         
 
         Copies To:
 
         
 
         Mr. Robert E. McKinney
 
         Attorney at Law
 
         480 6th St.
 
         PO Box 209
 
         Waukee, Iowa  50263
 
         
 
         Mr. Cecil Goettsch
 
         Mr. Brian L. Campbell
 
         Attorneys at Law
 
         1100 Des Moines Building
 
         Des Moines, Iowa  50309
 
 
 
         
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                                            51400; 51402
 
                                            Filed August 7, 1989
 
                                            Walter R. McManus, Jr.
 
         
 
                  BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         JACK C. MILLER,
 
         
 
              Claimant,
 
                                                    File Nos. 838614
 
         vs.                                                  826388
 
         
 
         ROADWAY EXPRESS, INC.,                  A R B I T R A T I 0 N
 
         
 
              Employer,                             D E C I S I 0 N
 
              Self-Insured,
 
              Defendant.
 
         
 
         
 
         51400; 51402
 
         
 
              Neither claimant nor counsel appeared at the hearing.  No 
 
         evidence in support of allegations of a compensable work injury 
 
         was presented and claimant therefore failed to meet his burden of 
 
         proof.
 
 
 
         
 
 
            
 
            Page   1
 
            
 
            
 
            
 
            
 
            
 
                     before the iowa industrial commissioner
 
            ____________________________________________________________
 
                                          :
 
            DONALD M. BOGGS,              :
 
                                          :
 
                 Claimant,                :    File Nos. 846119 & 838618
 
                                          :
 
            vs.                           :      A R B I T R A T I O N
 
                                          :
 
            NUTRENA FEEDS,                :         D E C I S I O N
 
                                          :
 
                 Employer,                :
 
                 Self-Insured,            :
 
                 Defendant.               :
 
            ___________________________________________________________
 
            
 
            
 
                                   introduction
 
            
 
                 These are  arbitration proceedings brought by Donald M. 
 
            Boggs, claimant, against Nutrena Feeds, self-insured 
 
            employer, defendant.  The cases were heard by the 
 
            undersigned in Sioux City, Iowa on May 1, 1990.  The record 
 
            in the proceeding consists of the testimony of claimant and 
 
            the testimony of his ex-wife, Cynthia Boggs.  The record 
 
            also consists of joint exhibits A-P.
 
            
 
                               issues/stipulations
 
            
 
                 As a result of the prehearing report and order 
 
            submitted and approved on May 1, 1990, the issues and 
 
            stipulations presented by the parties are:
 
            
 
                                      issues
 
            
 
                 1.  Whether claimant received injuries on September 15, 
 
            1986 and April 20, 1987 which arose out of and in the course 
 
            of claimant's employment;
 
            
 
                 2.  Whether there are causal relationships between the 
 
            alleged injuries and the disability;
 
            
 
                 3.  Whether claimant is entitled to temporary 
 
            disability/ healing period benefits or permanent partial 
 
            disability benefits;
 
            
 
                 4.  Whether claimant is entitled to medical benefits 
 
            under section 85.27;
 
            
 
                 5.  Whether claimant is entitled to a medical 
 
            evaluation under section 85.39; and,
 
            
 
                 6.  Whether claimant is entitled to penalty benefits 
 
            under section 86.13.
 
            
 
                                   stipulations
 
            
 
                 1.  The existence of an employer-employee relationship 
 
            between claimant and employer at the time of the alleged 
 

 
            
 
            Page   2
 
            
 
            
 
            
 
            
 
            injury;
 
            
 
                 2.  In the event of an award of weekly benefits, the 
 
            rate of weekly compensation is stipulated to be for 
 
            September 15, 1986:  $382.44 and for April 20, 1987:  
 
            $366.47 per week; and,
 
            
 
                 3.  Defendant paid claimant zero weeks of compensation.
 
            
 
                                 facts presented
 
            
 
                 Claimant is 45 years old.  He commenced his employment 
 
            with defendant in 1967.  Several years later claimant was 
 
            laid off from his employment.  He then worked for a 
 
            different employer.  Claimant returned to his employment 
 
            around 1970.  He worked as a bulk unloader/operator for 
 
            eight years.  He worked as a short mix operator for seven or 
 
            eight years.  For the past two years, claimant had worked in 
 
            the maintenance department.
 
            
 
                 Claimant described a work injury which he maintained 
 
            occurred in January of 1985.  He stated this was the first 
 
            time where he had ever injured his head or neck.  He 
 
            testified he had rammed his head against a tractor cab while 
 
            driving.  Claimant stated he reported the 1985 incident to 
 
            his supervisor.
 
            
 
                 Claimant testified that on September 15, 1986, he was 
 
            working in rail receiving where he was assigned the duty of 
 
            unloading rail tanker cars.  Claimant related he injured 
 
            himself because he was required to stand underneath a tanker 
 
            and swing a 36 inch hammer against the underside of a car.  
 
            Claimant indicated he was forced to stand hunched over and 
 
            swing a hammer weighing eight to ten pounds.
 
            
 
                 Claimant testified he reinjured himself on April 20, 
 
            1987.  He stated he had been swinging the sledge hammer 
 
            again and he felt pain on the lower right side of his neck.  
 
            He also stated he experienced a headache.
 
            
 
                 In 1987, claimant bid on a housekeeping position.  He 
 
            held that job for approximately one year but he stated he 
 
            had pain everyday in the neck area.  Claimant indicated he 
 
            obtained his present job in maintenance 20 months prior to 
 
            the date of the hearing.  Claimant described his job duties.  
 
            He reported he was required to inspect equipment, maintain 
 
            equipment, grease equipment and lift gear boxes.
 
            
 
                 Medical records were admitted as evidence.  Claimant 
 
            received chiropractic care for a portion of his care.
 
            
 
                 Mark Hagen, D.C., wrote in his report of February 22, 
 
            1990:
 
            
 
                 DIAGNOSIS
 
            
 
                 ICD-9-CM   718.88   Hyperflexion/extension injury 
 
                 to                            the neck
 
                       723.1    Cervicalgia (pain in the neck)
 
                       723.2    Cerviocranial syndrome
 

 
            
 
            Page   3
 
            
 
            
 
            
 
            
 
                       848.9    Cervical sprain
 
                       724.1    Pain in thoracic spine
 
                       848.9    Thoracic sprain
 
                       784.0    Vascular pain in the head,                                  
 
            lightheadedness, loss of balance
 
                       307.81   Tension headaches
 
                       346.9    Migraine headaches
 
                       719.40   Pain in shoulder joint
 
                       729.5    Numbness and pain in arms, 
 
            hands,                        and fingers
 
                       854.0    Carpal Tunnel syndrome
 
            
 
                 TREATMENT
 
            
 
                 Treatment in the care of this patient has been of 
 
                 a conservative nature consisting of gentle spinal 
 
                 adjustments and physio-therapy [sic] in the forms 
 
                 of traction, ultrasound, and electrical 
 
                 stimulation.
 
            
 
                 COMMENTS
 
            
 
                 Due to the nature of Mr. Boggs [sic] injuries, he 
 
                 has a sprain injury to his neck, upper back and 
 
                 middle back.  With a sprain injury you will have 
 
                 tearing and overstretching of the ligaments which 
 
                 are part of the soft tissue that holds the bones 
 
                 together.  The areas of the ligaments which are 
 
                 torn and overstretched will fill in with scar 
 
                 tissue.  Scar tissue is a cheap tissue of the body 
 
                 in which there is no nerve or blood suppply [sic], 
 
                 this tissue does not have the elacicity [sic] of 
 
                 normal ligaments.  Since the ligaments are the 
 
                 structures that hold the bones to bones, there 
 
                 will be instability of the spine.  Normal everyday 
 
                 activity can cause misalignments of the bones.  If 
 
                 this is not corrected, the degenerating process of 
 
                 the bones and its surrounding tissue will be 
 
                 accelerated.  Chiropractic care is essential in 
 
                 relieving pain and restoring the structure and 
 
                 function of the body, and also in delaying the 
 
                 degenerating processes that are inevitable.
 
            
 
                 PROGNOSIS
 
            
 
                 Due to the nature of these conditions, and 
 
                 supported by the findings upon examination and 
 
                 evaluation, the patient's prognosis is considered 
 
                 poor.
 
            
 
                 It should be noted that the patient's response to 
 
                 conservative treatment has been consistent and 
 
                 encouraging despite the severity of his condition.
 
            
 
                 RECOMMENDATIONS
 
            
 
                 The patient should receive care and supportive 
 
                 therapy to reduce his symptomatology as needed.  
 
                 It should be noted that Mr. Boggs needs care in 
 
                 every one to two weeks.  If Mr. Boggs waits over 
 

 
            
 
            Page   4
 
            
 
            
 
            
 
            
 
                 two weeks he develops severe spasms and many 
 
                 headaches from not getting adjusted.
 
            
 
                 It is my opinion at this time that there is no 
 
                 reason to expect any major changes in Mr. Bogg's 
 
                 clinical picture in the immediate future.
 
            
 
                 It is my professional opinion that the patient has 
 
                 reached a point of maximum medical improvement 
 
                 (MMI) under my conservative care.
 
            
 
                 Guides to the Evaluation of Permanent Impairment, 
 
                 AMA, 1988.  Manual for Orthopaedic Surgeons in 
 
                 Evaluating Permanent Physical Impairment American 
 
                 Academy of Orthopaedic Surgeons, a standard has 
 
                 been set forth in the rateable impairments for 
 
                 this patient in which he has been assigned these 
 
                 values:
 
            
 
                 Percent whole body permanent physical impariment 
 
                 [sic] and loss of physical function.
 
            
 
                 Cervical Spine
 
            
 
                 Healed sprain, contusion.  Persistent
 
            muscle spasm, rigidity and pain sub-
 
            stantiated by loss of anterior curve
 
            revealed by x-ray, consisting of narrowing
 
            of intervertebral spaces and some osseous
 
            arthritic development.                     = 20 
 
            percent
 
            
 
     
 
            
 
            
 
            Page   5
 
            
 
            
 
            
 
            
 
            Low Lumbar Spine
 
            
 
                 Healed sprain, contusion.  No involuntary
 
            muscle spasm, subjective symptoms of pain
 
            not substantiated by demonstrable path-
 
            ology.                                =  0 
 
            percent
 
            
 
                      TOTAL WHOLE MAN IMPAIRMENT            = 20 
 
                 percent
 
            
 
                 It is my professional opinion based on the history 
 
                 as presented by the patient and the above-noted 
 
                 objective findings from examinations that the 
 
                 above noted injuries were sustained in the 
 
                 accident of January 5, 1985.
 
            
 
                 Claimant was also examined on several occasions by Joel 
 
            T. Cotton, M.D.  Dr. Cotton prepared a report dated May 24, 
 
            1989.  In the report he wrote:
 
            
 
                    Clinical Impression:  This individual's 
 
                 neurological examination at this time remains 
 
                 normal.  The examination performed today is 
 
                 identical to that performed on May 5, 1987.  There 
 
                 is nothing to indicate that his condition has 
 
                 changed in any way from the previous examination 
 
                 except for the fact that movement of the neck can 
 
                 now be accomplished without any subjective 
 
                 complaint of pain while the patient complained of 
 
                 mild subjective discomfort with turning his neck 
 
                 90 degrees to the right during the May 5, 1987 
 
                 examination.  According to the history given by 
 
                 the patient, he is suffering from chronic 
 
                 headaches which sound to be of a vascular type 
 
                 related to migraine.  These migraine headaches 
 
                 specifically cannot be attributed to a head or 
 
                 neck injury in my experience.  He does state that 
 
                 the headaches came on within several weeks of the 
 
                 tractor injury in December, 1984, or January, 
 
                 1985.  In this regard, they appear to be 
 
                 temporally related though I am unable to state 
 
                 that a causual [sic] relationship exists between 
 
                 the migraine headaches and the head trauma.  There 
 
                 is furthermore no evidence that any additional 
 
                 injury has occurred which would aggravate these 
 
                 migraine headaches.
 
            
 
                 Mr. Boggs also describes a chronic neck pain which 
 
                 appears to be on a musculoskeletal basis.  This 
 
                 the patient also states followed the tractor 
 
                 injury of December, 1984, or January, 1985.  This 
 
                 again appears to be temporally related to that 
 
                 injury and according to the history obtained from 
 
                 the patient on May 5, 1987, this complaint of neck 
 
                 pain followed the tractor injury within several 
 
                 months.  According to the history obtained from 
 
                 the patient on May 5, 1987, there was no 
 
                 additional injury described by the patient as 
 
                 having occurred in 1986.  He did report to me an 
 

 
            
 
            Page   6
 
            
 
            
 
            
 
            
 
                 aggravation of his complaints two weeks before the 
 
                 May 5, 1987, evaluation when he used the hammer to 
 
                 strike beneath the grain bins.  According to the 
 
                 patient May 5, 1987, this exacerbation of his 
 
                 symptoms was resolving by the time I saw him on 
 
                 May 5, 1987, and according to the history obtained 
 
                 from the patient today, he continues to state that 
 
                 that temporary exacerbation of his symptoms 
 
                 resolved.  I am personally unable on review of 
 
                 medical records or my previous neurological 
 
                 evaluation of May 5, 1987, to document any 
 
                 particular reinjury occurring in 1986.  The 
 
                 patient continues to have chronic complaints which 
 
                 appear to be uneffected by physical activity, time 
 
                 of day, occurring at home, at rest, on weekends, 
 
                 and during vacation.  There is nothing from the 
 
                 history I obtained from this patient to indicate 
 
                 that his continued employment has aggravated his 
 
                 underlying condition.  This is also confirmed on 
 
                 his neurological examination which continues to be 
 
                 normal at this time and in fact is improved over 
 
                 the May 5, 1987 evaluation when he complained of 
 
                 pain in the neck with movement which is no longer 
 
                 the case.
 
            
 
                    Mr. Boggs at this time has no neurological 
 
                 impairment in the right upper or both lower 
 
                 extremities.  He continues to have a pre-existing 
 
                 injury to the left hand.  In the presence of an 
 
                 otherwise entirely normal neurological 
 
                 examination, this individual in my opinion is 
 
                 without neurological impairment.  In the absence 
 
                 of neurological impairment, there can be no 
 
                 permanent partial disability from a neurological 
 
                 standpoint.  In addition, he has recently had a 
 
                 number of radiological studies which are normal.  
 
                 According to Dr. Miller's report, x-rays of the 
 
                 cervical spine are "basically normal with a 
 
                 minimal osteophyte at C6-7, but nothing 
 
                 significant".  Also reported according to Dr. 
 
                 Miller were normal flexion and extension films of 
 
                 the neck.  An MRI scan of the neck was described 
 
                 as "completely negative".  In the presence of 
 
                 those normal tests, I do not feel that additional 
 
                 medical evaluation or treatment would be necessary 
 
                 for his chronic complaints of subjective pain in 
 
                 the neck and migraine headaches.  In addition, I 
 
                 can see no justification for continued chi
 
                 ropractic manipulation for this man's chronic com
 
                 plaint.  Though the patient continues to complain 
 
                 of subjective complaints of chronic migraine 
 
                 headaches and neck pain, he is at this time 
 
                 without any objective evidence of neurological 
 
                 injury.  In the presence of normal neurological 
 
                 examination, there is no reason in my opinion this 
 
     
 
            
 
            
 
            Page   7
 
            
 
            
 
            
 
            
 
                 individual could not pursue all usual and 
 
                 customary activity without restrictions.  I find 
 
                 nothing to indicate from his history or subsequent 
 
                 examinations that his continued employment has in 
 
                 any way produced either subjective worsening of 
 
                 his complaints or objective changes in his 
 
                 examination.
 
            
 
                 Medical records also indicate claimant was examined by 
 
            Daniel J. Miller, M.D., a neurological surgeon.  Dr. Miller 
 
            prescribed nerve blocks.  He opined the following relative 
 
            to claimant's condition:
 
            
 
                 ...Otherwise throughout, motor was normal and the 
 
                 remainder of the Neurological examination was 
 
                 normal.  Range of motion in the neck appeared to 
 
                 be normal also.  He did demonstrated [sic] wasting 
 
                 in the First Dorsal Interosseous Muscle on the 
 
                 left.  The patient's plain Cervical Spine films 
 
                 were basically normal with a minimal Osteophyte at 
 
                 C67, but nothing significant.  The 
 
                 flexion-extension films were normal and I referred 
 
                 the patient for an MRI Scan.  This Scan was 
 
                 completely negative and on a return visit I 
 
                 recommended that the patient undergo Physical 
 
                 Therapy of the Cervical Spine region with ultra 
 
                 sound, heat and massage.  I also recommended 
 
                 Motrin, and as he was describing a solitary spot 
 
                 in the mid-line of the Posterior, approximately, 
 
                 C6 Region, being the location of his chronic pain 
 
                 and being tender to palpation, I recommended that 
 
                 he undergo a Trigger Point Injection.  He was also 
 
                 describing headaches in the Suboccipital Region, 
 
                 which pass over the right side of his head, and I 
 
                 felt that for this he should undergo a right 
 
                 Occipital Nerve Block.  It is my impression, 
 
                 overall, that the patient has chronic pain 
 
                 secondary to a Cervical Sprain with a chronic 
 
                 Myofascial type pain syndrome.  Also, perhaps, a 
 
                 right Occipital Neuralgia.  I plan on seeing him 
 
                 again after these blocks, and I will try to keep 
 
                 you informed as to how we proceed.  Once again, 
 
                 thank you for his referral.
 
            
 
                 The medical evidence also shows claimant was examined 
 
            on several occasions by John J. Dougherty, M.D., an 
 
            orthopaedic physician.  Dr. Dougherty, according to his 
 
            letter of April 20, 1987, took a medical history from 
 
            claimant.  The physician stated:
 
            
 
                 ...He first presented himself on 1-11-85.  He gave 
 
                 a history that he was injured at work on 12-15-84 
 
                 while removing snow in a tractor.  The tractor 
 
                 came to a sudden stop and jarred the patient 
 
                 inside the cab.  Patient at that time told me he 
 
                 didn't fly off the tractor, did not hit his head 
 
                 and he had no pain initially, merely tightness in 
 
                 his neck.  Said at that time he had a stiff neck 
 
     
 
            
 
            
 
            Page   8
 
            
 
            
 
            
 
            
 
                 for 5-6 days, but he hadn't missed any work.  Said 
 
                 at that time he had a headache, although he's had 
 
                 headaches occasionally for years, but now he wakes 
 
                 up in the morning with a stiff neck and he gets a 
 
                 headache....Then I did not see him again until 
 
                 1-21-87, approximately two years later.  At that 
 
                 time, he complained of his neck.  He also dated it 
 
                 back to the time of the incident of 12-84.  At 
 
                 this time, he told the girls he struck his head on 
 
                 a cab, but in 1985, he told me he did not hit his 
 
                 head.
 
            
 
                     ...
 
            
 
                 With regard to whether he's reached maximum 
 
                 medical recovery, my only other suggestion along 
 
                 this line might be that he be seen by a 
 
                 neurologist.  However, the neurologist in Sioux 
 
                 City doesn't want to get involved in these types 
 
                 of problems.
 
            
 
                 What is the cause of his current complaints?  On 
 
                 reviewing his x-rays and comparing them with 
 
                 previous films, they don't appear to be much 
 
                 different.  He does have a minimal straightening 
 
                 of the cervical spine, but disc spaces appear to 
 
                 be maintained.  He does have a mild scoliosis to 
 
                 the right in the cervical spine, but I think this 
 
                 is probably secondary to a scoliosis to the left 
 
                 in the dorsal spine.  According to him, he 
 
                 apparently didnt' [sic] do too bad from 1-85 until 
 
                 9-86.  I'm not sure exactly what precipitated 
 
                 recurrence of his problems and complaints in 
 
                 September of 1986.  Based on the fact that he 
 
                 continued to work every day and the fact that, 
 
                 according to his deposition, he does seem to have 
 
                 problems whether he's working or not, I'm not sure 
 
                 we can definitely asociate [sic] this with 
 
                 working.  It certainly does not appear that any 
 
                 further diagnostic studies are indicated.  I just 
 
                 would question if a myelogram would show us much.  
 
                 He did get some relief from the injection.  I 
 
                 think he should be seen by a neurologist who 
 
                 probably should evalute [sic] him and possibly 
 
                 treat him more vigorously from a migraine type of 
 
                 headache diagnosis and see if he got relief.
 
            
 
                 There is a suggestion that his scoliosis may be a 
 
                 little more in the dorsal spine than it was two 
 
                 years ago, which is probably just a normal 
 
                 progressive thing.  It would appear to me that his 
 
                 complaints are probably more now than they were in 
 
                 1985.  However, I'm not sure that I can explain 
 
                 why that be [sic] the case.  I would really 
 
                 question if this is associated with his work.  The 
 
                 fact that he did not seem to have any significant 
 
                 problems from 1985 until September of 1986, 
 
                 certainly makes one question the severity of the 
 
     
 
            
 
            
 
            Page   9
 
            
 
            
 
            
 
            
 
                 intial [sic] injury and whether this could still 
 
                 be giving him problems.
 
            
 
                 Basically, I guess my feeling would be that he did 
 
                 not sustain any significant injury to his neck at 
 
                 the time of the original injury of January of 
 
                 1985.  I'm not sure we can adequately explain his 
 
                 present complaint.  I would not feel that further 
 
                 chiropractic treatments are indicated.  I don't 
 
                 understand the mechanism of using a gun which the 
 
                 chiropractors do.  It would certainly appear to me 
 
                 that, if anything, that would only aggravate the 
 
                 situation.  Based on the fact that he's been 
 
                 working every day since the incident, I just can't 
 
                 conceive that his work would have caused any 
 
                 aggravation of his complaints.  I can only 
 
                 reiterate again that I'm not sure here whether 
 
                 diagnostic studies are going to be significant.
 
            
 
                 My only other suggestion, as I mentioned above, 
 
                 would be to have him seen by a neurologist with 
 
                 the idea of possibly further investigation from a 
 
                 headache evaluation.  Possibly switching drugs 
 
                 around to see if it might not help, would be a 
 
                 consideration.  Possibly his headaches and 
 
                 complaints of pain in the neck are more on some 
 
                 type of a vascular problem, like a migraine 
 
                 headache, than actually related to his injury of 
 
                 December of 1984 or the work he does.  As you can 
 
                 see from my office notes, I think it just does not 
 
                 present a clear case of one over the other and I'm 
 
                 not sure, based on the findings, that I can 
 
                 explain his continued complaint.  Admittedly, he 
 
                 does have the scoliosis which could be increasing 
 
                 just with every day living or the onset of 
 
                 headaches not really related to his work.
 
            
 
                 Medical records also demonstrate claimant was seen by 
 
            A. Kleider, M.D., on February 10, 1987.  Dr. Kleider opined 
 
            in his medical note for that date:
 
            
 
                 This is a 41-year-old, right-handed man who came 
 
                 because of a sore spot on the right side of his 
 
                 neck, some neck stiffness and recurrent headaches.
 
            
 
                 On or about 1-4-85 he was thrown forward when the 
 
                 forklift truck that he was driving came abruptly 
 
                 to a halt.  He was not knocked out.  He really 
 
                 hasn't missed any work to speak of as a result of 
 
                 that injury.  Nevertheless, since that time he has 
 
                 had stiffness of his neck and that sore spot 
 
                 mentioned and then typically that sore spot would 
 
                 from time to time get worse and develop into a 
 
                 whole right-sided headache.  He used to get up to 
 
                 three a day, now he gets about three to four a 
 
                 week.  Typically, the headaches last 3-4 hours and 
 
                 often they are associated with vomiting.  They typ
 
                 ically are throbbing headaches.  He has never had 
 
                 it on the left side.  In spite of this frequency, 
 
     
 
            
 
            
 
            Page  10
 
            
 
            
 
            
 
            
 
                 he has hardly ever lost work because of the 
 
                 problem.
 
            
 
                 He claims that his health is otherwise good but in 
 
                 1971 he had a wrist fracture which required 
 
                 surgery on the right and in 1977 he got shot in 
 
                 the left arm and has had some left hand disability 
 
                 (mainly an ulnar nerve deficit) ever since.
 
            
 
                 EXAMINATION:
 
            Revealed a man whose range of cervical spine 
 
            movement was near normal.  There was no weakness 
 
            in any of the upper extremity muscle groups except 
 
            for the hand intrinsics on the left which were 
 
            atrophied and he had the typical claw deformity of 
 
            an ulnar paresis.
 
            Fundoscopy was unremarkable and extraocular 
 
            movements were full.  No bruits could be heard 
 
            about the head or neck or over the orbits.
 
            
 
                 IMPRESSION:
 
            This man has clearly had some sort of a flexion 
 
            extension injury to his neck.  I suspect that his 
 
            headaches may well be the result of migraine with 
 
            questionable relationship to his actual injury.
 
            
 
                 My recommendation is that he be treated as a 
 
                 migraine patient to see if that would help.  Dr. 
 
                 Kissel might want to do that or he might want to 
 
                 refer the patient on to one of the neurologists.
 
            
 
                 From the neck injury point of view, I just think 
 
                 we need to offer him reassurance and not much 
 
                 else.
 
            
 
                                  applicable law
 
            
 
                 Claimant has the burden of proving by a preponderance 
 
            of the evidence that he received injuries on April 20, 1987 
 
            and September 15, 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). 
 
            
 
                 An employee is entitled to compensation for any and all 
 
            personal injuries which arise out of and in the course of 
 
            the employment.  Section 85.3(1).
 
            
 
                 The injury must both arise out of and be in the course 
 
            of the employment.  Crowe v. DeSoto Consol. Sch. Dist., 246 
 
            Iowa 402, 68 N.W.2d 63 (1955) and cases cited at pp. 405-406 
 
            of the Iowa Report.  See also Sister Mary Benedict v. St. 
 
            Mary's Corp., 255 Iowa 847, 124 N.W.2d 548 (l963) and Hansen 
 
            v. State of Iowa, 249 Iowa 1147, 91 N.W.2d 555 (1958).
 
            
 
                 The words "out of" refer to the cause or source of the 
 
            injury.  Crowe, 246 Iowa 402, 68 N.W.2d 63 (1955). 
 
            
 
                 The words "in the course of" refer to the time and 
 
            place and circumstances of the injury.  McClure v. Union 
 

 
            
 
            Page  11
 
            
 
            
 
            
 
            
 
            et al. Counties, 188 N.W.2d 283 (Iowa 1971); Crowe, 246 Iowa 
 
            402, 68 N.W.2d 63 (1955).
 
            
 
                 "An injury occurs in the course of the employment when 
 
            it is within the period of employment at a place the 
 
            employee may reasonably be, and while he is doing his work 
 
            or something incidental to it."  Cedar Rapids Comm. Sch. 
 
            Dist. v. Cady, 278 N.W.2d 298 (Iowa 1979), McClure, 188 
 
            N.W.2d 283 (Iowa 1971); Musselman, 261 Iowa 352, 154 N.W.2d 
 
            128 (1967). 
 
            
 
                 The claimant has the burden of proving by a 
 
            preponderance of the evidence that the injuries of April 20, 
 
            1987 and September 15, 1986 are causally related to the 
 
            disability on which he now bases his claim.  Bodish v. 
 
            Fischer, Inc., 257 Iowa 516, 133 N.W.2d 867 (1965).  Lindahl 
 
            v. L. O. Boggs, 236 Iowa 296, 18 N.W.2d 607 (1945).  A 
 
            possibility is insufficient; a probability is necessary.  
 
            Burt v. John Deere Waterloo Tractor Works, 247 Iowa 691, 
 
            73 N.W.2d 732 (1955).  The question of causal connection is 
 
            essentially within the domain of expert testimony.  Bradshaw 
 
            v. Iowa Methodist Hospital, 251 Iowa 375, 101 N.W.2d 167 
 
            (1960). 
 
            
 
                 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, 261 Iowa 352, 154 
 
            N.W.2d 128 (1967).
 
            
 
                 While a claimant is not entitled to compensation for 
 
            the results of a preexisting injury or disease, the mere 
 
            existence at the time of a subsequent injury is not a 
 
            defense.  Rose v. John Deere Ottumwa Works, 247 Iowa 900, 
 
            908, 76 N.W.2d 756, 760-61 (1956).  If the claimant had a 
 
            preexisting condition or disability that is aggravated, 
 
            accelerated, worsened or lighted up so that it results in 
 
            disability, claimant is entitled to recover.  Nicks v. 
 
            Davenport Produce Co., 254 Iowa 130, 115 N.W.2d 812, 815 
 
            (1962).
 
            
 
                 When an aggravation occurs in the performance of an 
 
            employer's work and a causal connection is established, 
 
            claimant may recover to the extent of the impairment.  
 
            Ziegler v. United States Gypsum Co., 252 Iowa 613, 620, 106 
 
            N.W.2d 591, 595 (1960).
 
            
 
                 The Iowa Supreme Court cites, apparently with approval, 
 
            the C.J.S. statement that the aggravation should be material 
 
            if it is to be compensable.  Yeager v. Firestone Tire & 
 
            Rubber Co., 253 Iowa 369, 112 N.W.2d 299 (1961); 100 C.J.S. 
 
            Workmen's Compensation sec. 555(17)a.
 

 
            
 
            Page  12
 
            
 
            
 
            
 
            
 
            
 
                 Our supreme court has stated many times that a claimant 
 
            may recover for a work connected aggravation of a 
 
            preexisting condition.  Almquist v. Shenandoah Nurseries, 
 
            218 Iowa 724, 254 N.W. 35 (1934).  See also Auxier v. 
 
            Woodward State Hosp. Sch., 266 N.W.2d 139 (Iowa 1978); Gosek 
 
            v. Garmer and Stiles Co., 158 N.W.2d 731 (Iowa 1968); Barz 
 
            v. Oler, 257 Iowa 508, 133 N.W.2d 704 (1965); Olson v. 
 
            Goodyear Service Stores, 255 Iowa 1112, 125 N.W.2d 251 
 
            (1963); Yeager, 253 Iowa 369, 112 N.W.2d 299 (1961); 
 
            Ziegler, 252 Iowa 613, 106 N.W.2d 591 (1960).
 
            
 
                 An employer takes an employee subject to any active or 
 
            dormant health impairments, and a work connected injury 
 
            which more than slightly aggravates the condition is 
 
            considered to be a personal injury.  Ziegler, 252 Iowa 613, 
 
            620, 106 N.W.2d 591 (1960), and cases cited.
 
            
 
                                     analysis
 
            
 
                 Claimant has not proven by a preponderance of the 
 
            evidence that his claimed disability is casually related to 
 
            either the alleged injury on September 15, 1986 or to the 
 
            alleged injury on April 20, 1987.  There is a wide disparity 
 
            of opinions.  Dr. Hagen, claimant's treating chiropractor, 
 
            casually relates claimant's condition to a work injury date 
 
            of January 5, 1985.  This appears to be the same incident 
 
            described by claimant where he rammed his head inside a 
 
            tractor cab while clearing snow from some railroad tracks.  
 
            The January 1985 date, however, is not in issue before the 
 
            undersigned.
 
            
 
                 Dr. Dougherty does not relate claimant's claimed 
 
            condition to an injury date of either September 15, 1986 or 
 
            to an injury date of April 20, 1987.  Dr. Dougherty opines 
 
            the claimant's condition is a vascular problem, like a 
 
            migraine headache.  The physician does not casually connect 
 
            claimant's condition to any work condition, even the 
 
            incident occurring in December of 1984.
 
            
 
                 Dr. Cotton is unable to find a causal relationship 
 
            between claimant's migraine headaches and the alleged 
 
            injuries of September 15, 1986 or April 20, 1987 and between 
 
            the headaches and the head trauma work incident of December 
 
            1984.  Dr. Cotton does not find claimant's employment to 
 
            have caused or to have aggravated claimant's reported 
 
            condition, in any respect.
 
            
 
                 Only Dr. Hagen, a chiropractor, has found causation and 
 
            that is between an injury date which is not under 
 
            consideration before this division.  None of the medical 
 
            doctors have found the requisite causal connection.  The 
 
            undersigned has determined the greater weight of the 
 
            evidence is with the medical doctors relative to the issue 
 
            of causation.  See Reiland v. Palco, Inc., Thirty-Second 
 
            Biennial Report of the Industrial Commissioner 56 (1975).  
 
            Claimant has not established the necessary causal connection 
 
            to prevail.
 
            
 
                     findings of fact and conclusions of law
 

 
            
 
            Page  13
 
            
 
            
 
            
 
            
 
            
 
                 WHEREFORE, based on the evidence presented and the 
 
            principles of law previously stated, the following findings 
 
            of fact and conclusions of law are made:
 
            
 
                 Finding 1.  Claimant sustained a work incident in 
 
            December of 1984 which resulted in claimant banging his head 
 
            against the inside of a tractor cab.
 
            
 
                 Finding 2.  The work incident which occurred in 
 
            December of 1984 is not an issue before the Division of 
 
            Industrial Services.
 
            
 
                 Finding 3.  Claimant sustained neck pain and headaches 
 
            several months after the work incident which occurred in 
 
            December of 1984.
 
            
 
                 Finding 4.  No medical practitioner has attributed 
 
            claimant's neck pain and headaches to injury dates of 
 
            September 15, 1986 and/or April 20, 1987.
 
            
 
                 Conclusion A.  Claimant has failed to prove by a 
 
            preponderance of the evidence that his neck pain and 
 
            headaches were caused by alleged work injuries on September 
 
            15, 1986 and/or April 20, l987.
 
            
 
                           
 
            
 
            
 
            Page  14
 
            
 
            
 
            
 
            
 
            order
 
            
 
                 Claimant takes nothing from these proceedings.
 
            
 
                 Each party shall bear its own costs.
 
            
 
            
 
            
 
                 Signed and filed this ____ day of May, 1990.
 
            
 
            
 
            
 
            
 
            
 
                                          ______________________________               
 
            MICHELLE A. McGOVERN
 
                                          DEPUTY INDUSTRIAL COMMISSIONER
 
            
 
            Copies To:
 
            
 
            Mr. Harry H. Smith
 
            Mr. Dennis McElwain
 
            Attorneys at Law
 
            632-640 Badgerow Bldg
 
            P O Box 1194
 
            Sioux City  IA  51102
 
            
 
            Mr. Thomas M. Plaza
 
            Attorney at Law
 
            200 Home Federal Bldg
 
            P O Box 3086
 
            Sioux City  IA  51102
 
            
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                                               1100; 5-1108
 
                                               Filed May 17, 1990
 
                                               MICHELLE A. McGOVERN
 
            
 
                     before the iowa industrial commissioner
 
            ____________________________________________________________
 
                                          :
 
            DONALD M. BOGGS,              :
 
                                          :
 
                 Claimant,                :    File Nos. 846119 & 838618
 
                                          :
 
            vs.                           :      A R B I T R A T I O N
 
                                          :
 
            NUTRENA FEEDS,                :         D E C I S I O N
 
                                          :
 
                 Employer,                :
 
                 Self-Insured,            :
 
                 Defendant.               :
 
            ___________________________________________________________
 
            
 
            
 
            1100; 5-1108
 
            Claimant did not prove by a preponderance of the evidence 
 
            that his neck pain and headaches were causally related to 
 
            his alleged injuries of September 15, 1986 and April 20, 
 
            1987.  Claimant's treating chiropractor causally related 
 
            claimant's condition to an alleged work injury in December 
 
            of 1984.  The December 1984 incident was not a date where a 
 
            petition had been filed.
 
            
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                   BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         JEAN WASHBURN
 
         
 
              Claimant,
 
         
 
         vs.                                     File No.  838620
 
         
 
         WACKENHUT CORPORATION,               A R B I T R A T I O N
 
         
 
              Employer,                          D E C I S I O N
 
         
 
         and
 
         
 
         HOME INSURANCE COMPANY,
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
                                   INTRODUCTION
 
         
 
              This is a proceeding in arbitration brought by Jean 
 
         Washburn, claimant, against Wackenhut Corporation, employer, and 
 
         Home Insurance Company, insurance carrier, defendants, for 
 
         benefits as the result of an injury that occurred on July 8, 
 
         1985.  The hearing was held in Burlington, Iowa, on October 16, 
 
         1987, and the case was fully submitted as the close of the 
 
         hearing.  The record consists of the testimony of Jean Washburn, 
 
         claimant, Glen Washburn, claimant's husband, Claimant's Exhibits 
 
         1 through 39 (with pages numbered 1 through 63) and Defendants' 
 
         Exhibits A through N.  Claimant's attorney filed an excellent 
 
         brief.. No brief was received from defendants' attorney.  
 
         Defendants did voluntarily provide the agency with a transcript 
 
         of the hearing.
 
         
 
                                   STIPULATIONS
 
         
 
              The parties stipulated to the following matters at the 
 
         hearing.
 
         
 
              That an employer-employee relationship existed between 
 
         claimant and employer at the time of the injury.
 
         
 
              That claimant sustained an injury on July 8, 1985, which 
 
         arose out of and in the course of employment with employer.
 
         
 
              That tHe injury was the cause of temporary disability; that 
 
         claimant is entitled to and has been paid temporary disability 
 
         benefits from July 9, 1985 to July 12, 1985, and that temporary 
 
         disability benefits are not an issue in this case at this time.
 
         
 
              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 claimant's gross weekly earnings from employer for the 
 
         13 weeks prior to hearing is $828.93; claimant is married and is 
 

 
         
 
         
 
         
 
         WASHBURN V. WACKENHUT CORPORATION
 
         PAGE   2
 
         
 
         
 
         entitled to two exemptions.
 
         
 
              That the provider of medical services would testify that the 
 
         fees charged are reasonable for the services and supplies 
 
         delivered and that defendants are not offering contrary 
 
         evidence.
 
         
 
              That defendants claimant no credit for nonoccupational group 
 
         health plan benefits or workers' compensation benefits paid prior 
 
         to hearing.
 
         
 
              That there are no bifurcated claims.
 
         
 
                                      ISSUES
 
         
 
              The parties stipulated to the following issues at the time 
 
         of the hearing.
 
         
 
              Whether the injury was the cause of any permanent 
 
         disability.
 
         
 
              Whether claimant is entitled to permanent disability 
 
         benefits, and if so, the nature and extent of benefits.
 
         
 
              Whether claimant is entitled to medical benefits.
 
         
 
              Whether claimant is an odd-lot employee.
 
         
 
              The parties requested a determination of the proper rate of 
 
         weekly compensation.
 
         
 
                             SUMMARY OF THE EVIDENCE
 
         
 
              All of the evidence was examined and considered.  The 
 
         following is a summary of the evidence most pertinent to this 
 
         decision.
 
         
 
              Claimant was 49 years old at the time of the injury and 51 
 
         years old at the time of the hearing.  She attended school 
 
         through the eighth grade.  Past employments include:  nurse's 
 
         aide jobs, private sitting jobs, custodial work and maintenance 
 
         work.
 
         
 
              Claimant was employed by employer from May 23, 1985, until 
 
         she terminated her employment on August 10, 1985, in order to 
 
         take a full-time job (Exhibit 11, page 22).  Claimant was a 
 
         part-time employee for this employer.  She testified that she 
 
         normally worked one or two days a week.
 
         
 
              Claimant admitted to prior problems with her shoulder and 
 
         back and had received workers' compensation benefits; however, 
 
         she testified that these problems had been resolved prior to the 
 
         instant injury.  Claimant testified that she was pain free and 
 
         could do whatever she wanted to do when she started to work for 
 
         this employer.  She did not take a preemployment physical 
 
         examination.
 
         
 
              Claimant worked as a security guard for employer.  She was 
 
         assigned to work at the Sheller-Globe Company.  Claimant carried 
 
         a time clock and punched approximately 40 time clock stations.  
 
         She stated that it took two hours to make rounds.  She walked 
 
         possibly two miles in making rounds.  Her duties involved 
 
         checking heavy metal doors that weighed possibly 200 pounds.
 

 
         
 
         
 
         
 
         WASHBURN V. WACKENHUT CORPORATION
 
         PAGE   3
 
         
 
         
 
         
 
              On July 8, 1985, claimant was pulling down an overhead door 
 
         with a chain.  It came down about 18 inches and then it jerked 
 
         back up and she went up with it.  She had a hold of the chain 
 
         with both arms, but it was her left arm that was jerked and this 
 
         jerk lifted her off of the floor (Transcript pages 13 & 14).  
 
         Claimant reported the injury to her supervisor, Laura (full name 
 
         unknown), who told her not to pull down any more doors.
 
         
 
              Claimant sought medical attention on her own authority from 
 
         a doctor of her own choosing.  She saw William A. Vance, D.C.  
 
         She said that Dr. Vance took an x-ray and gave her an adjustment. 
 
          Claimant stated that she was off work from July 9, 1985 to July 
 
         12, 1985.  Then she worked until August 10, 1985, when she quit 
 
         to take a full-time job sitting with a lady who was recovering 
 
         from surgery.
 
         
 
              Dr. Vance reported that claimant hurt her neck, left 
 
         shoulder and lower back.  He added that claimant has a great deal 
 
         of nervous tension and her symptoms tend to recur under stress 
 
         (Ex. 2, p. 4).  His office records show that he treated claimant 
 
         prior to this injury for generally the same complaints that she 
 
         had after the injury.
 
         
 
              On February 17, 1984, he reported a neck injury and that 
 
         claimant could not turn her head without pain.  On May 21, 1984, 
 
         he treated claimant for headache, pain in the neck, shoulder and 
 
         low back which occurred when she helped her husband lift the lawn 
 
         mower from a truck.  On May 14, 1985, she reported tingling to 
 
         her left hand, left leg and foot.  On May 23, 1985, she reported 
 
         that she lifted a box at home to put it on a shelf and suffered 
 
         leg pain at L-5 and right S-1.  Records of Dr. Vance showed that 
 
         he continued to treat claimant for these and various other 
 
         complaints through December 15, 1985 (Ex. 4, pp. 5-7).
 
         
 
              Claimant said that she next saw Robert R. Kemp,  M.D., a 
 
         general practitioner and general surgeon, who was a doctor of her 
 
         own choice.  Dr. Kemp referred claimant to Rouben Mirbegian, 
 
         M.D., an orthopedic surgeon.  Dr. Kemp's records show that he did 
 
         not see claimant until October 17, 1986 (Ex. 1, pp. 1 & 2).  The 
 
         evidence shows that claimant saw Dr. Mirbegian on October 21, 
 
         1986 (Ex. 15, p. 26).  Dr. Mirbegian referred claimant to Julio 
 
         del Castillo, M.D., a neurosurgeon in Quincy, Illinois (Ex. 18, 
 
         P. 31).
 
         
 
              Dr. del Castillo saw claimant on December 10, 1986 (Ex. 3, 
 
         p. 11; Ex. 21, p. 35) for a very complex and wide-spread history 
 
         of trouble that originated on December 8, 1980, when two doors 
 
         fell on her and injured her neck, left shoulder and back with 
 
         pain radiating down into her left hip.  He said that claimant was 
 
         discharged but continued to hurt.  He added that when claimant 
 
         could not get social security disability, she took a second job 
 
         as a security guard.  Then on July 8, 1985, the overhead door 
 
         reinjured her left shoulder and her old pains, which had been 
 
         improving, became aggravated.  Claimant described pains to Dr. 
 
         del Castillo in her left neck, left shoulder blade and left arm 
 
         radiating to her left hand.
 
         
 
              Dr. del Castillo found that the reports of two previous EMG 
 
         tests, taken on two previous occasions, showed quite normal 
 
         results.  He related that claimant's symptoms were ill defined 
 
         and diffuse and offered a multitude of possibilities.  He found 
 
         nothing to indicate thoracic outlet syndrome.  Dr. del Castillo 
 

 
         
 
         
 
         
 
         WASHBURN V. WACKENHUT CORPORATION
 
         PAGE   4
 
         
 
         
 
         said that his primary diagnosis was conversion and anxiety, but 
 
         that this has been going on for six years.  He recommended a 
 
         cervical and lumbar myelogram and an arthrogram of her left 
 
         shoulder.  Claimant related to Dr. del Castillo that she had 
 
         already seen a psychiatrist (Ex. 21, pp. 35-37).
 
         
 
              Dr. Mirbegian reported that his attempt to do an arthrogram 
 
         was not successful (Ex. 18, p. 31).  This is explained by the 
 
         report of R. C. Kimmell, M.D., who reported on December 22, 1986, 
 
         that his attempt to perform a left shoulder arthrogram was not 
 
         successful.  He said that claimant was apprehensive and 
 
         complained during the administration of anesthesia.  She could 
 
         only tolerate lcc of contrast injection despite generous amounts 
 
         of local anesthesia.  Therefore, the examination was terminated 
 
         without satisfactory imaging (Ex. J, p. 11).  Dr. del Castillo 
 
         noted that claimant told him that J. A. Gwaltney, Jr., M.D., 
 
         examined claimant's shoulder for the possibility of a rotator 
 
         cuff tear.  Claimant said that Gwaltney felt that her shoulder 
 
         was quite normal and that she did not have one (Ex. 22, p. 40; 
 
         Ex. I, p. 3; Ex J, p. 9).
 
         
 
              Dr. del Castillo did perform the cervical and lumbar 
 
         myelogram on December 18, 1986 (Ex. 22, pp. 38-42; Ex. 24, p. 
 
         42).  The cervical myelogram was normal.  The lumbar myelogram 
 
         disclosed a ruptured disc between the fourth arid fifth lumbar 
 
         vertebra that was fairly large in size.  It also disclosed a 
 
         small indentation between L-5 and S-1.  The doctor said that it 
 
         was not possible to tell how long it had been there.  X-rays of 
 
         the lumbar spine demonstrated chronic degenerative arthritis, 
 
         moderate scoliosis and some straightening of the dorsolumbar 
 
         curve.  He said he also performed an MRI of her neck and it, too, 
 
         was normal (Ex. 38, pp. 27-30; Ex. 24, p. 42).  The doctor 
 
         testified that he never did reach a decision as to the exact 
 
         reason for this hernia (Ex. 38, p. 34).  The doctor said he was 
 
         aware of the injury of December 8, 1980, when the doors fell on 
 
         claimant, but there were numerous other prior injuries that he 
 
         was not aware of and that she did not tell him about.  The doctor 
 
         said that claimant would not need surgery for this herniated 
 
         nucleus pulposus unless the pain got so bad that she could no 
 
         longer stand it.  He said that her injury of July 8, 1985, could 
 
         have aggravated a preexisting herniated nucleus pulposus (Ex. 38, 
 
         p. 37). However, it was his medical opinion that the injury of 
 
         July 8, 1985, sprained her neck and sprained her ligaments and 
 
         that the diagnosis of chronic strain is medically a good 
 
         diagnosis (Ex. 38, p. 41).  The doctor believed that claimant had 
 
         suffered a permanent functional impairment of 20 percent of the 
 
         body as a whole, five percent of which was attributable to 
 
         subjective neck pain (Ex. 38, pp. 41 & 42).
 
         
 
              When claimant reapplied for a job with employer, on October 
 
         10, 1986, she completed and signed an employment application in 
 
         which she stated that she had never been treated for any bone or 
 
         joint disorder or arthritis or for back injury, back problems or 
 
         backache (Ex. L).
 
         
 
              At the time claimant resigned from employer she wrote a 
 
         letter on August 13, 1985.  In this letter she stated that she 
 
         was resigned to take full-time employment.  She did not give any 
 
         indication that she was suffering any pain or disability from the 
 
         injury of July 8, 1985, at that time (Ex.M).
 
         
 
              Defense counsel pointed out to claimant that she had 
 
         suffered a large number of prior injuries, many of which affected 
 

 
         
 
         
 
         
 
         WASHBURN V. WACKENHUT CORPORATION
 
         PAGE   5
 
         
 
         
 
         her neck, left shoulder and back.  She also suffered a number of 
 
         other injuries affecting other parts or areas of her body.  Some 
 
         of the prior injuries, which appear to be pertinent, are as 
 
         follows:
 
         
 
              08-05-76     Left side of shoulder and left side     Ex.  0
 
                           of back.
 
         
 
              09-15-76     Upper left leg and pelvis               Ex.  P
 
         
 
              01-10-77     Tail bone and low back and lower leg    Ex.  Q
 
                           muscles.
 
         
 
              06-28-77     Middle of back, neck & head             Ex.  R
 
         
 
              02-16-78     Hip hurting                             Ex.  T
 
         
 
              11-16-78     Neck hurt and lower stomach             Ex.  U
 
         
 
              03-15-79     Neck, back and left hip                 Ex.  W
 
         
 
              03-22-79     Left arm and stomach                    Ex.  X
 
         
 
              04-05-79     Neck, back and headache                 Ex.  Y
 
         
 
              09-13-79     Left thigh                              Ex. BB
 
         
 
              12-06-79     Left side of neck, shoulder and back    Ex. CC
 
         
 
              12-20-79     Left rib and shoulder blade             Ex. CC
 
         
 
              04-21-80     Left side of back                       Ex. FF
 
         
 
              04-22-80     Left side of back                      Ex. GG
 
         
 
              09-30-80     Neck, back and hip                     Ex. II
 
         
 
              10-02-80     Ribs and left side                     Ex. JJ
 
         
 
              10-22-80     Left leg and back                      Ex. KK
 
         
 
              12-08-80     Left shoulder, neck and back           Exs. 
 
                                                                   B,C,
 
                                                                    I,LL
 
         
 
              Claimant settled the injury of December 8, 1980, with the 
 
         workers' compensation carrier for a substantial amount of money 
 
         on or about February 18, 1982 (Ex. MM).  Claimant has at least 
 
         one other workers' compensation settlement for other injuries 
 
         (Ex. NN).
 
         
 
              Claimant saw two other doctors one time each.  Raymond 
 
         Hanks, Jr., D.C., reported in December of 1986, that he treated 
 
         claimant for the injury of July 2, 1985.  He did not make a 
 
         professional medical statement that the injury of July 2, 1985, 
 
         was the cause of her complaints, nor did he find any permanent 
 
         impairment (Ex. 16, pp. 27-29).  Claimant also consulted Lowell 
 
         D. Barrowes, M.D., one time, on February 27, 1987 (Ex. 5, p. 13; 
 
         Ex. 12, p. 23).  Claimant testified that Dr. Barrowes said that 
 
         he could not do anything for her.
 
         
 
              The x-rays of claimant's lumbar spine for the injury of 
 

 
         
 
         
 
         
 
         WASHBURN V. WACKENHUT CORPORATION
 
         PAGE   6
 
         
 
         
 
         December 8, 1980, were normal (Ex. 35, p. 57).
 
         
 
              Claimant testified that there are a number of things that 
 
         she can no longer do.  She cannot stand, sit, walk, vacuum, walk 
 
         down steps, do dishes, make the bed, paint, remodel, ride a 
 
         bicycle, mow the grass, drive the car, carry groceries, scrub 
 
         floors, wash and wax windows, do laundry, pick up her new 
 
         granddaughter, cook very much or wash her own feet.  She cannot 
 
         sleep and she uses a heating pad most of the time.
 
         
 
              Claimant admitted that she saw Dr. Vance, the chiropractor, 
 
         as her own choice of physician on July 8, 1985.  He returned her 
 
         to work the following day on July 9, 1985 (Ex. 2, p. 4; Ex. 14, 
 
         p. 25).  Claimant acknowledged that she had seen Dr. Vance prior 
 
         to this injury for headaches, pain in her neck, left shoulder, 
 
         back and left leg.  Dr. Vance recorded L-5 and right S-1 leg 
 
         pain.  Defense counsel pointed out that claimant had not admitted 
 
         this treatment in her earlier deposition; but claimant 
 
         distinguished that these were different pains and that they were 
 
         gone at the time of the deposition (Tr. pp. 29-31).
 
         
 
              Claimant admitted that after the injury on December 8, 1980, 
 
         to her neck, left shoulder and left hip, that she was off work 
 
         for several weeks, was given a disability rating by Koert Smith, 
 
         M.D., and received a workers' compensation settlement for that 
 
         injury.
 
         
 
              Glen Washburn, claimant's husband of 34 years, testified 
 

 
         
 
         
 
         
 
         WASHBURN V. WACKENHUT CORPORATION
 
         PAGE   7
 
         
 
         
 
         that claimant can no longer wash clothes, do the dishes, vacuum, 
 
         make her bed or do her housework.
 
         
 
                           APPLICABLE LAW AND ANALYSIS
 
         
 
              The claimant has the burden of proving by a preponderance of 
 
         the evidence that the injury of July 8, 1985, 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).
 
         
 
              Claimant did not sustain the burden of proof by a 
 
         preponderance of the evidence that the injury of July 8, 1985, 
 
         was the cause of permanent disability.  Defendants very 
 
         definitively proved that claimant has sustained numerous injuries 
 
         to her neck, left shoulder, back and hips.  Claimant sustained at 
 
         least 18 prior injuries to one or more of these body areas, 
 
         dating back to 1976.  Claimant sustained a serious injury on 
 
         December 8, 1980, lost several weeks from work and received a 
 
         substantial workers' compensation settlement for this injury.  
 
         The injury of July 8, 1985, also affects the same general 
 
         areas--the neck, left shoulder, back and hip.
 
         
 
              In February and May of 1984, and again in March and May of 
 
         1985, claimant was treating with Dr. Vance for the same general 
 
         complaints to the neck, left shoulder and hip.  On May 23, 1985, 
 
         Dr. Vance said in his notes it was L-5 and right S-1 leg pain 
 
         (Ex. 2, p. 5).  Claimant continued to see Dr. Vance for the same 
 
         general complaints through December 15, 1986.  Dr. Vance reported 
 
         that claimant could return to work on the following day after 
 
         this injury.  He also stated on the surgeon's report that a 
 
         permanent defect was not indicated.  He gratuitously added that 
 
         claimant has a great deal of nervous tension and her symptoms 
 
         tend to recur under stress.  Claimant was not hospitalized and no 
 
         x-rays were taken (Ex. 2, p. 4).  Dr. Kemp, the general 
 
         practitioner and general surgeon, and Dr. Mirbegian, the 
 
         orthopedic surgeon, did not make any statement on whether 
 
         claimant had or had not sustained a permanent impairment.
 
         
 
              Dr. Mirbegian and Dr. Kimmell attempted a left shoulder 
 
         arthrogram but it was unsuccessful due to claimant's intolerance 
 
         for the procedure.  Claimant then reported to Dr. del Castillo 
 
         that Dr Gwaltney told her that her shoulder was quite normal.
 
         
 
              Dr. del Castillo said that the EMG reports he looked at, 
 

 
         
 
         
 
         
 
         WASHBURN V. WACKENHUT CORPORATION
 
         PAGE   8
 
         
 
         
 
         that were taken on two different occasions, were normal.  He said 
 
         claimant's symptoms were diffuse and ill defined.  His primary 
 
         diagnosis was conversion and anxiety but that this had been going 
 
         on for six years already.  Claimant told Dr. del Castillo that 
 
         she had already seen a psychiatrist at the time that she applied 
 
         for social security disability.
 
         
 
              Dr. del Castillo did perform a cervical and lumbar myelogram 
 
         and a cervical MRI.  The cervical tests were normal.  A lumbar 
 
         myelogram showed a large herniated nucleus pulposus.  The doctor 
 
         could not tell how long it had been there.  It did not show up on 
 
         the lumbar x-ray in December of 1980 at the time of the earlier 
 
         injury, and it did not show up on the lumbar x-ray at the time of 
 
         the myelogram either.  Apparently, this herniation was detectable 
 
         only by the lumbar myelogram.  Claimant testified that she never 
 
         did have a CT scan and could not take an MRI while she was 
 
         conscious because she had claustrophobia.  Dr. del Castillo did 
 
         not say that the herniated nucleus pulposus at L-4, L-5 or the 
 
         indentation at L-5, S-1 were caused by the injury of July 8, 
 
         1985.  He did not know how it was caused or when it was caused.  
 
         He said it was possible that it could have been aggravated by the 
 
         injury of July 8, 1985, but he did not say that it was in fact 
 
         caused or aggravated by that injury, nor did he say that it was 
 
         probably caused or aggravated by that injury.  Dr. del Castillo's 
 
         x-rays did reveal chronic degeneration of the spine, arthritis, 
 
         moderate scoliosis and some straightening of the dorsolumbar 
 
         curve.  The doctor said that claimant did not tell him about her 
 
         many other injuries prior to July 8, 1985.  She only described 
 
         the one injury on December 8, 1980.  Dr. del Castillo did not say 
 
         what caused the 20 percent permanent functional impairment, of 
 
         which, five percent was attributable to the neck.
 
         
 
              Dr. Hanks, the chiropractor, who saw claimant for a social 
 
         security examination, did not give a formal medical opinion on 
 
         the cause of claimant's complaints, but he did record the 
 
         description of the injury that claimant gave to hint.  Dr. Hanks 
 
         did not find that claimant was permanently impaired (Ex. 16, pp. 
 
         27-30).
 
         
 
              Claimant saw Dr. Vance, Dr.  Kemp, Dr. Barrowes, Dr. 
 
         Mirbegian, Dr. Hanks, and Dr. del Castillo.  All of these doctors 
 
         were chosen by claimant.  The first five doctors did not give a 
 
         statement to indicate that claimant sustained any permanent 
 
         impairment.  Dr. del Castillo found permanent impairment but he 
 
         could not say what caused it.  Considering the large number of 
 
         injuries., that claimant had sustained to her neck, left 
 
         shoulder, back and hip prior to July 8, 1985, in particular, the 
 
         treatment that she received from Dr. Vance in May of 1984 and May 
 
         of 1985, and considering that claimant settled the workers' 
 
         compensation claim for the injury of December 8, 1980, which 
 
         affected the same general areas, then claimant has not sustained 
 
         the burden of proof by a preponderance of the evidence that the 
 
         injury of July 8, 1985, was the cause of any permanent impairment 
 
         or disability.  Complaints to the neck, left shoulder, back and 
 
         hip preexist and continue after this injury.  The same must be 
 
         concluded as to claimant's anxiety and conversion.  Dr. del 
 
         Castillo said that it had been ongoing for at least six years 
 
         when he saw claimant in December of 1986.  In conclusion, 
 
         claimant has not proven that the injury of July 8, 1985, was the 
 
         cause of any permanent impairment or disability and therefore, is 
 
         not entitled to any permanent disability benefits for this 
 
         injury,
 
         
 

 
         
 
         
 
         
 
         WASHBURN V. WACKENHUT CORPORATION
 
         PAGE   9
 
         
 
         
 
              Claimant did not sustain the burden of proof by a 
 
         preponderance of the evidence that she is entitled to medical 
 
         benefits other than the initial treatment with Dr. Vance in July 
 
         of 1985.  Claimant testified that she chose all of the doctors on 
 
         her own.  She was not sent to them by the employer or the 
 
         insurance carrier or any physician chosen by the employer or 
 
         insurance carrier.  The treatment performed by Dr. Vance in 
 
         August and September of 1986 cannot be determined to be work 
 
         related by any of the evidence in the record.  It appears to be a 
 
         continuation of claimant's normal chiropractic.maintenance care 
 
         or a chronic condition.  Dr. del Castillo was not an authorized 
 
         physician.  Even though he did find a herniated nucleus pulposus 
 
         that had not previously been discovered, he could not say that it 
 
         was caused by the injury that occurred on July 8, 1985.  There 
 
         was no evidence that Dr. Barrowes was an authorized physician, 
 
         nor did he state that he treated a work-related injury.
 
         
 
              The question of whether claimant is an odd-lot employee is, 
 
         therefore, moot as well as the issue of the proper rate of 
 
         compensation.
 
         
 
                                 FINDINGS OF FACT
 
         
 
              Wherefore, based upon the evidence presented the following 
 
         findings of fact are made.
 
         
 
              That claimant sustained an injury on July 8, 1985, while 
 
         employed by employer when she pulled down on the chain of an 
 
         overhead door and it recoiled on her and injured her neck, left 
 
         shoulder and hip.
 
         
 
              That Dr. del Castillo stated that in his opinion she 
 
         received a shoulder sprain and ligament sprain from which she 
 
         should have recovered in a few weeks.
 
         
 
              That Dr. Vance,.her own physician, indicated this was a 
 
         minor injury and returned claimant to work the following day.  He 
 
         further indicated that claimant suffered from nervous tension and 
 
         stress factors that caused these complaints to recur.
 
         
 
              That Dr. Vance, Dr. Kemp, Dr. Barrowes, Dr. Mirbegian, and 
 
         Dr. Hanks did not find that claimant had sustained any permanent 
 
         impairment or disability.
 
         
 
              That Dr. del Castillo did find that claimant had a herniated 
 
         nucleus pulposus but that he could not state when or how it 
 
         happened.
 
         
 
               That Dr. del Castillo found that claimant had a 20 percent 
 
         permanent functional impairment of the body as a whole, but he 
 
         did not say how or when it was caused.
 
         
 
              That Dr. del Castillo said that claimant had anxiety and 
 
         conversion, but that it predated this injury for about five or 
 
         six years.
 
         
 
              That claimant received a workers' compensation settlement 
 
         for the injury of December 8, 1980, which affected the same areas 
 
         of the body.
 
         
 
              That claimant chose all of the treating physicians herself 
 
         without any prior authority from the employer, the insurance 
 
         carrier or any doctor selected by them.
 

 
         
 
         
 
         
 
         WASHBURN V. WACKENHUT CORPORATION
 
         PAGE  10
 
         
 
         
 
         
 
                                CONCLUSIONS OF LAW
 
         
 
              Wherefore, based upon the evidence presented and the 
 
         principles of law previously discussed, the following conclusions 
 
         of law are made.
 
         
 
              That claimant did not sustain the burden of proof by a 
 
         preponderance of the evidence that the injury of July 8, 1985, 
 
         was the cause of any permanent impairment or disability.
 
         
 
              That claimant did not sustain the burden of proof by a 
 
         preponderance of the evidence that she is entitled to the payment 
 
         of medical expenses.
 
         
 
                                      ORDER
 
         
 
              THEREFORE, IT IS ORDERED:
 
         
 
              That no amounts are owed by defendants to claimant for the 
 
         injury of July 8, 1985.
 
         
 
              That defendants are to pay for the transcript of the 
 
         hearing, which they volunteered to pay for at the time of the 
 
         hearing.  That all of the other costs of this proceeding are to 
 
         be paid for by claimant pursuant to Division of Industrial 
 
         Services Rule 343-4.33.
 
         
 
              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 27th day of October, 1988.
 
         
 
         
 
         
 
         
 
                                          WALTER R. McMANUS, JR.
 
                                          DEPUTY INDUSTRIAL COMMISSIONER
 
         
 
         Copies to:
 
         
 
         Mr. James Hoffman
 
         Attorney at Law
 
         Middle Road
 
         Keokuk, IA 52632
 
         
 
         Mr. Michael Liebbe
 
         Attorney at Law
 
         116 E 6th St.
 
         P.O. Box 339
 
         Davenport, IA 52805-0339
 
         
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                                                1402.40; 1402.60
 
                                                Filed October 27, 1988
 
                                                WALTER R. McMANUS, JR.
 
         
 
                     BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         JEAN WASHBURN,
 
         
 
              Claimant,
 
         
 
         vs.                                    File No.  838620
 
         
 
         WACKENHUT CORPORATION,               A R B I T R A T I O N
 
         
 
              Employer,                          D E C I S I O N
 
         
 
         and
 
         
 
         HOME INSURANCE COMPANY,
 
         
 
              Insurance Carrier,
 
              Defendants.
 
         
 
         
 
         1402.40; 1402.60
 
         
 
              Claimant with chronic long term neck, back, left shoulder 
 
         and left hip problems, with numerous prior repeated injuries to 
 
         the same areas, did not sustain the burden of proof by a 
 
         preponderance of the evidence that this injury, a sprain injury, 
 
         was the cause of permanent disability.
 
         
 
              Claimant was denied permanent partial disability and medical 
 
         expenses.
 
         
 
 
            
 
            Page   1
 
            
 
            
 
            
 
            
 
                      2401
 
                      Filed April 15, 1991
 
                      Walter R. McManus, Jr.
 
            
 
                     before the iowa industrial commissioner
 
            ____________________________________________________________
 
                                          :
 
            JOHN E STANGL,                :
 
                                          :
 
                 Claimant,                :
 
                                          :
 
            vs.                           :
 
                                          :      File No.  838622
 
            FISHER CONTROLS,              :
 
                                          :  A R B I T R A T I O N
 
                 Employer,                :
 
                                          :      D E C I S I O N
 
            and                           :
 
                                          :
 
            CIGNA,                        :
 
                                          :
 
                 Insurance Carrier,       :
 
                 Defendants.              :
 
            ___________________________________________________________
 
            
 
            2401
 
            Claimant failed to give timely notice and defendants did not 
 
            have actual notice of injury.  Decision contains several 
 
            cites.