BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
            ____________________________________________________________
 
            LINDA GORDON,  
 
                      
 
                 Claimant, 
 
                      
 
            vs.       
 
                                                   File No. 846902
 
            HILLS BANK AND TRUST CO.,     
 
                                                    A P P E A L
 
                 Employer, 
 
                                                  D E C I S I O N
 
            and       
 
                      
 
            CONTINENTAL INSURANCE CO.,    
 
                      
 
                 Insurance Carrier,  
 
                 Defendants.    
 
            ____________________________________________________________
 
            The record, including the transcript of the hearing before 
 
            the deputy and all exhibits admitted into the record, has 
 
            been reviewed de novo on appeal.  The decision of the deputy 
 
            filed April 16, 1991 is affirmed and is adopted as the final 
 
            agency action in this case with the following additional 
 
            analysis:
 
            The decedent died of acute cardiac dysrhythmia with arrest.  
 
            There is insufficient evidence in the record to find that 
 
            the decedent had a preexisting circulatory or heart 
 
            condition.  Dr. From stated that the decedent had no 
 
            coronary atherosclerosis.  Dr. Davia indicated that there 
 
            was insufficient data to establish a definite diagnosis of 
 
            organic heart disease.  Therefore, the line of cases in 
 
            which an employee had a preexisting condition are not 
 
            directly applicable.  See, Sondag v. Ferris Hardware, 220 
 
            N.W.2d 903 (Iowa 1974).  Even if the line of cases dealing 
 
            with heart attacks with a preexisting conditions were 
 
            applicable, the claimant has not proved the decedent's heart 
 
            attack was compensable.  Claimant has met neither the legal 
 
            nor the medical test.  See, Bailey v. Moorhead Construction 
 
            Co., Appeal Decision, July 27, 1992, File no. 872710.
 
            Claimant has not proved that the decedent's work environment 
 
            was stressful for him.  Even if claimant had proved a 
 
            stressful work environment, claimant has not met her burden 
 
            of proving a causal connection between the work and the 
 
            heart attack.  The medical evidence is insufficient to meet 
 
            claimant's burden of proving the causal connection.
 
            Claimant shall pay the costs of the appeal, including the 
 
            preparation of the hearing transcript.
 
            Signed and filed this ____ day of September, 1992.
 

 
            
 
            Page   2
 
            
 
            
 
            
 
            
 
            
 
            
 
            
 
            
 
                                   ________________________________
 
                                           BYRON K. ORTON
 
                                      INDUSTRIAL COMMISSIONER
 
            
 
            Copies To:
 
            
 
            Mr. John L. Riccolo
 
            Attorney at Law
 
            Suite 1140, The Center
 
            425 Second St., SE
 
            Cedar Rapids, Iowa 52401
 
            
 
            Ms. Dorothy L. Kelley
 
            Attorney at Law
 
            500 Liberty Bldg.
 
            Des Moines, Iowa 50309
 
            
 
 
            
 
 
 
 
 
 
 
 
 
                                          1107; 1108.10; 1402.30; 2202
 
                                          Filed September 16, 1992
 
                                          Byron K. Orton
 
            
 
                   BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
            ____________________________________________________________
 
            LINDA GORDON,  
 
                      
 
                 Claimant, 
 
                      
 
            vs.        
 
                                                  File No. 846902
 
            HILLS BANK AND TRUST CO.,     
 
                                                   A P P E A L
 
                 Employer, 
 
                                                  D E C I S I O N
 
            and       
 
                      
 
            CONTINENTAL INSURANCE CO.,    
 
                      
 
                 Insurance Carrier,  
 
                 Defendants.    
 
            ____________________________________________________________
 
            
 
            1107; 1108.10; 1402.30; 2202
 
            Claimant failed to prove that decedent's sudden cardiac 
 
            dysrhythmia that resulted in immediate death, while watching 
 
            an exciting basketball game at home with friends, was caused 
 
            by job stress even though there was evidence of a number of 
 
            factors that could have caused stress from his job; i.e. (1) 
 
            the bank president was shot to death in his office; (2) the 
 
            bank lost its liability insurance coverage for officers and 
 
            directors; (3) decedent and the bank were sued for 
 
            mishandling a trust account; and (4) decedent worked long 
 
            hours and spent a lot of time at the bank.  Four heart 
 
            specialists gave interesting expert testimony on the cause 
 
            of sudden cardiac death.  Claimant did not prove that the 
 
            decedent's work environment was stressful to him.  This was 
 
            not a case where decedent had a preexisting heart condition 
 
            so Sondag v. Ferris Hardware, 220 N.W.2d 903 (Iowa 1974) was 
 
            not directly applicable.
 
            
 
 
            
 
            Page   1
 
            
 
            
 
            
 
            
 
            
 
                     before the iowa industrial commissioner
 
            ____________________________________________________________
 
                                          :
 
            LINDA GORDON,                 :
 
                                          :
 
                 Claimant,                :
 
                                          :
 
            vs.                           :
 
                                          :      File No. 846902
 
            HILLS BANK AND TRUST CO.,     :
 
                                          :  A R B I T R A T I O N
 
                 Employer,                :
 
                                          :      D E C I S I O N
 
            and                           :
 
                                          :
 
            CONTINENTAL INSURANCE CO.,    :
 
                                          :
 
                 Insurance Carrier,       :
 
                 Defendants.              :
 
            ___________________________________________________________
 
            
 
                                   introduction
 
            
 
                 This is a proceeding in arbitration brought by Linda 
 
            Gordon, claimant, the surviving spouse of James R. Gordon, 
 
            against Hills Bank and Trust Company, employer, and 
 
            Continental Insurance Company, insurance carrier, 
 
            defendants, for benefits as the result of the alleged injury 
 
            and death of James R. Gordon on March 14, 1986.  A hearing 
 
            was held in Cedar Rapids, Iowa, on November 16, 1989, and 
 
            the case was fully submitted at the close of the hearing.  
 
            Claimant was represented by John L. Riccolo.  Defendants 
 
            were represented by Dorothy L. Kelley.  The record consists 
 
            of the testimony of Tom Hobart, an attorney; John Keen, 
 
            claimant's friend; Cindy Mills, decedent's secretary; 
 
            Patricia Keen, claimant's friend and former wife of John 
 
            Keen; Linda Gordon, claimant; James Pratt, employer's 
 
            controller; Richard See, a business acquaintance of 
 
            decedent; Roy Justis, decedent's work associate; Barbara J. 
 
            Mahanna, employer's receptionist; Dwight Seegmiller, 
 
            employer's president and chief executive office; claimant's 
 
            exhibits 1 through 29 and defendants exhibits 1 through 20.  
 
            Claimant presented a prehearing brief and defendants 
 
            presented a description of disputes at the time of the 
 
            hearing.  The deputy ordered a transcript of the hearing.  
 
            Both attorneys submitted outstanding posthearing briefs.  
 
            
 
                                      issues
 
            
 
                 The parties presented the following issues for 
 
            determination at the time of the hearing
 
            
 
                 Whether claimant's decedent sustained an injury which 
 
            arose out of and in the course of employment with employer 
 
            on March 14, 1986.
 
            
 
                 Whether the alleged injury was the cause of permanent 
 
            disability, more specifically, death of claimant's decedent.
 

 
            
 
            Page   2
 
            
 
            
 
            
 
            
 
            
 
                 Whether claimant is entitled to permanent disability 
 
            benefits as the surviving spouse of her decedent.
 
            
 
                 Whether claimant is entitled to funeral expenses of her 
 
            decedent.
 
            
 
                                 findings of fact
 
            
 
                                      injury
 
            
 
                 It is determined that claimant did not sustain an 
 
            injury on or about March 14, 1986, which arose out of and in 
 
            the course of employment with employer.
 
            
 
                 It is further determined that claimant's death was not 
 
            caused by his employment.
 
            
 
                 Claimant's decedent, James R. Gordon, was a graduate of 
 
            the University of Iowa Law School who practiced law for a 
 
            short period of time and was employed as the vice-president 
 
            and trust officer of employer bank at the time of his death.  
 
            He was born on March 2, 1948, and was 37 years old at the 
 
            time of his death on March 14, 1986.  The death certificate 
 
            states, "No anatomical cause of death; commensurate with 
 
            cardiac death." (claimant's exhibit 11; defendants' exhibit 
 
            1).  A summary of pertinent information from the autopsy 
 
            report states, "No anatomic cause of death found, clinical 
 
            history consistent with acute cardiac arrest." (cl. ex. 10, 
 
            p. 35; def. ex. 1, p. 10).  W.J. Powers, M.D., pathologist, 
 
            reported on March 24, 1986:
 
            
 
                 Enclosed is the final report of the autopsy 
 
                 examination performed on the body of James Gordon 
 
                 on March 15, 1986 (MXA-86-1).  The completion of 
 
                 the microscopic portion of the examination 
 
                 confirmed our initial impression, that death is 
 
                 due to a well witnessed episode of acute cardiac 
 
                 dysrhythmia with arrest as there were no gross or 
 
                 microscopic anatomic changes explaining the sudden 
 
                 death.
 
            
 
            (claimant's exhibit 10, page 34; defendants' exhibit 1, page 
 
            11)
 
            
 
                 Some pertinent details from the autopsy report are as 
 
            follows: 
 
            
 
                 The clinical summary shows that claimant collapsed at 
 
            home while watching a basketball game.  Claimant was in 
 
            previous good health except for a history of hypertension 
 
            for which treatment was unknown.  Claimant's heart weighed 
 
            425 grams.  His coronary arteries were small in caliber, but 
 
            totally lacking of any atheromatous or calcific change and 
 
            there was no significant narrowing in any area nor any 
 
            occlusions or thromboses.  There were some small and 
 
            insignificant patches of myocardial fibrosis widely 
 
            scattered and generally in the subepicardial zones.  There 
 
            was no extensive infarction, ischemic damage or fibrosis 
 
            found.  The pathologic summary stated there were no gross or 
 

 
            
 
            Page   3
 
            
 
            
 
            
 
            
 
            microscopic anatomic findings to explain this individual's 
 
            sudden death.  The pathologist concluded that death was due 
 
            to a sudden cardiac rhythm disturbance with fatal and 
 
            irreversible cardiac arrest (cl. ex. 10, pp. 36-40; def. ex. 
 
            1, pp. 5-9).
 
            
 
                 Peter J. Schwartz, M.D., professor of medicine at the 
 
            University of Milan, Italy, an internationally known 
 
            cardiologist and prolific author (cl. ex. 13), examined 
 
            medical documents, depositions and deposition summaries 
 
            prepared by claimant's attorney and wrote a letter on 
 
            December 28, 1988.  Dr. Schwartz concluded as follows:  
 
            
 
                    I can say, to a reasonable degree of medical 
 
                 certainty, that the job-related stress probably 
 
                 caused the development of cardiac electrical 
 
                 instability which in turn favoured the onset of 
 
                 ventricular fibrillation that resulted in sudden 
 
                 death.  The ultimate trigger for the lethal 
 
                 arrhythmia could have been virtually any external 
 
                 event, more probably a condition associated with 
 
                 some increase in sympathetic activity as it 
 
                 happens with emotions of any origin.  The negative 
 
                 findings at post-mortem examination and the 
 
                 negative clinical history suggest that, except for 
 
                 the work-related stress-induced cardiac electrical 
 
                 instability, the lethal arrhythmia would probably 
 
                 not have occurred.
 
            
 
            (claimant's exhibit 12)
 
            
 
                 Thomas B. Graboys, M.D., board certified in internal 
 
            medicine and cardial vascular disease, a professor of 
 
            medicine, a treating physician, a cardiac research physician 
 
            and also a prolific writer (cl. ex. 15), examined the same 
 
            background material and made a written report on October 19, 
 
            1988 (cl. ex. 14).  His particular specific area of research 
 
            is in the area of sudden cardiac death and heart rhythm 
 
            disturbances (ex. 25, p. 176).  Dr. Graboys stated on 
 
            October 19, 1988, 
 
            
 
                 Assuming in Mr. Gordon's case we can eliminate 
 
                 such variables such as illicit drug or diuretic 
 
                 use, sudden prolonged changes in diet, or the use 
 
                 of certain dietary supplements, known obvious 
 
                 chest trauma, acute and chronic alcoholism, or the 
 
                 use of cocaine, then it would be my opinion from a 
 
                 review of the material and deposition summaries 
 
                 that this man's heart was "primed" due to a period 
 
                 of chronic, intolerable stress which would have 
 
                 resulted in chronically elevated levels of 
 
                 adrenaline-like substances and altered the level 
 
                 of his serum potassium.
 
            
 
            (claimant's exhibit 14)
 
            
 
                 Dr. Graboys further elaborated on his theory by 
 
            testifying in his deposition:
 
            
 
                 A.  ...What I'm saying is that our hypothesis is 
 

 
            
 
            Page   4
 
            
 
            
 
            
 
            
 
                 that their death is the culmination of prolonged 
 
                 period of change.  This doesn't occur simply 
 
                 within a few minutes, again, in people without 
 
                 heart disease.
 
            
 
                 Q.  Would you explain how this occurs over time?
 
            
 
                 A.  For example, a given individual who's 
 
                 susceptible to stress, and knowing that stress is 
 
                 very difficult to quantitate, but that 
 
                 individual's response to stress is manifest by a 
 
                 release of adrenaline-like substances in the body, 
 
                 and we see many of these patients.
 
            
 
                    When an individual is under chronic release of 
 
                 adrenaline induced by stress, the chemical effect 
 
                 of adrenaline is to shift potassium from outside 
 
                 the cell into the cell.   When that occurs, the 
 
                 normal potassium, the normal potassium blood level 
 
                 may then lower, and that is a known and fully 
 
                 documented association between that event, i.e., 
 
                 low serum potassium and abnormalities in the heart 
 
                 rhythm.
 
            
 
                    In fact, if you look at patients having cardiac 
 
                 arrest in the hospital, there's a very strong 
 
                 relationship between the low potassium and that 
 
                 event.
 
            
 
            (claimant's exhibit 25, pages 181 & 181)
 
            
 
                 Dr. Graboys stated:
 
            
 
                    It's my impression from the review of the 
 
                 material that I have available that Mr. Gordon's 
 
                 sudden cardiac death was a direct result to 
 
                 work-induced stress.
 
            
 
                 ***
 
            
 
                    The basis for that is that individuals with 
 
                 normal hearts don't die suddenly unless their 
 
                 heart is primed in some way.  Our experience has 
 
                 indicated that such individuals may have their 
 
                 heart primed for a fatal event by high levels of 
 
                 adrenaline induced by stress over a longer period 
 
                 of time which results in the shifting of potassium 
 
                 from outside the cell to inside the heart cells 
 
                 resulting in an abnormal heart rhythm.
 
            
 
            (claimant's exhibit 25, p. 191).
 
            
 
                 At another point, Dr. Graboys testified, "...In my 
 
                 estimate the long-term stress that he was under 
 
                 was in fact the inciting event for his premature 
 
                 demise." (clmt. ex. 25, p. 202).  Dr. Graboys 
 
                 stated:
 
            
 
                 A.  I think he was under a specific level of 
 
                 stress that began with the homicide of the bank 
 

 
            
 
            Page   5
 
            
 
            
 
            
 
            
 
                 president.
 
            
 
                 Q.  How long a period was that before his sudden 
 
                 death?
 
            
 
                 A.  I don't recall precisely, a year, year and a 
 
                 half.  I don't know the exact figure.  
 
            
 
            (claimant's exhibit 25, pages 236 & 237).
 
            
 
                 The bank president, John Hughes, was murdered in the 
 
            bank by a disgruntled customer on December 9, 1985, and 
 
            claimant's heart attack occurred on March 14, 1986, a period 
 
            of approximately three months later.
 
            
 
                 Paul From, M.D., a board certified internal medicine 
 
            doctor and originator and director of the coronary care unit 
 
            at Mercy Hospital in Des Moines (def. ex. 10, pp. 4-7), 
 
            examined essentially the same background documents and gave 
 
            a written report on June 22, 1988.  He concluded as follows
 
            
 
                 Dysrhythmia occurs at a moment in time.  There 
 
                 were no findings in the autopsy to suggest that if 
 
                 he had been truly subjected to stress, he had 
 
                 reacted unfavorably in his body in any way to that 
 
                 stress.  He was stressed at the moment of death 
 
                 but this was in relationship to an athletic event 
 
                 and occurred sometime after he had left his job.  
 
                 There was no suggestion in any material I did 
 
                 review that he thought his job was truly stressful 
 
                 to him to the point of complaining about it to 
 
                 other people.
 
            
 
                 Mr. Gordon did not sustain a myocardial infarction 
 
                 and, in fact, had no coronary atherosclerosis.  
 
                 His sudden cardiac death must, therefore, have 
 
                 been due to dysrhythmia, which all authorities 
 
                 conceed [sic] is due to occurences at a moment in 
 
                 time.  I cannot relate this moment in time to 
 
                 anything he had been subjected to at work, and 
 
                 therefore, would not consider his death, in any 
 
                 way, causally related to his work.
 
            
 
            (defendants' exhibit 6, page 5)
 
            
 
                 Dr. From gave a deposition on August 30, 1989, in which 
 
            he stated that the cause of death was arrhythmia and 
 
            ventricular fibrillation (def. ex. 10, p. 49).  After his 
 
            examination of the depositions and deposition summaries 
 
            prepared by claimant's counsel he concluded there was no 
 
            psychological or physical stress at work which in any way 
 
            hastened, lighted up or aggravated Mr. Gordon to sustain a 
 
            cardiac death (def. ex. 10, pp. 49 & 50).  More 
 
            particularly, Dr. From believed he died from the excitement 
 
            of watching the basketball game.  He phrased his opinion as 
 
            follows:  
 
            
 
                 A.  He was known to be a very avid Hawkeye fan, 
 
                 University of Iowa fan.  He wanted to work in Iowa 
 
                 City, because he wanted to be near the Hawkeyes.
 

 
            
 
            Page   6
 
            
 
            
 
            
 
            
 
            
 
                    He was watching a home game at home during a 
 
                 party on the night that he died.  It was a very 
 
                 exciting game.  It was in the last minutes of the 
 
                 game.  There was some dispute among the people 
 
                 watching the television game at that point and the 
 
                 referee's calls as to what was going on at the 
 
                 game during which he collapsed, and I think that 
 
                 with the sudden outpouring of adrenaline that he 
 
                 would have in a situation such as that, that he 
 
                 developed the cardiac arrhythmia ventricular 
 
                 fibrillation and died almost instantaneously with 
 
                 it.
 
            
 
            (defendants' exhibit 10, pages 50 & 51).
 
            
 
                 Dr. From further elaborated:
 
            
 
                 A.  Dysrhythmia means an irregularity of the 
 
                 rhythm of the heart.  It's not normal rhythm.  
 
                 It's dysrhythmic.  This will occur at a moment in 
 
                 time, and usually it's related to the events that 
 
                 are occurring at that moment in time, as far as we 
 
                 can tell....
 
            
 
                 ***
 
            
 
                    So that it you have dysrhythmia, which is a 
 
                 cardiac irregularity, it's often related to what's 
 
                 going on at that moment in time versus, for 
 
                 example, a myocardial infarction, which may be the 
 
                 culmination of events taking place over a great 
 
                 number of years and also culminate at a moment in 
 
                 time but would have no relationship to what's 
 
                 going on at the time, because it's going to happen 
 
                 some time, and it just picks a particular moment 
 
                 and happens.  That's what I was trying to say with 
 
                 dysrhythmia occurs at a moment in time.
 
            
 
            (defendants' exhibit 10, pages 51 & 52)
 
            
 
                 All of the medical professionals, including Dr. From, 
 
            referred to a letter to the editor that Dr. Graboys wrote to 
 
            the New England Journal of Medicine which describes a 
 
            54-year old avid Celtics fan who was observed with a 24-hour 
 
            electrocardiographic ambulatory recording which showed the 
 
            patient had more complex arrythmias while watching a game 
 
            which correlated to what he was watching (def. ex. 10, pp. 
 
            59 & 60).  This colloquy then transpired with Dr. From:
 
            
 
                 Doctor, do you have an opinion as to whether or 
 
                 not watching a game, watching the playoff game of 
 
                 your favorite team in an individual who had not 
 
                 had a myocardial infarction, what effect would it 
 
                 have on such an individual, if any?
 
            
 
                 A.  If the pathways are correct and right for 
 
                 brain to the adrenal medulla, to release of 
 
                 adrenaline, to the elaboration of the 
 
                 catecholamines, which are the breakdown products 
 

 
            
 
            Page   7
 
            
 
            
 
            
 
            
 
                 of adrenaline that actually affect the heart rate, 
 
                 those things can affect the heart rate and make it 
 
                 go faster.  The adrenaline getting in there can 
 
                 certainly drop the blood potassium immediately, 
 
                 put the potassium into the cells of the heart and 
 
                 other cells of the body--not just the heart but 
 
                 all over the body--drop the potassium, bring about 
 
                 other arrhythmias which can be fatal, and that 
 
                 must be the mechanism that we have in 
 
                 instantaneous death that we've been discussing in 
 
                 which there has to be some explanation for it.  
 
            
 
                 Q.  And does this apply to Mr. Gordon's case?
 
            
 
                 A.  I think so..
 
            
 
            (defendants' exhibit 10, pages 62 & 63)
 
            
 
                 Dr. From did not think that the claimant was suffering 
 
            from stress.  He stated:
 
            
 
                 A.  Well, I didn't get anything in the extremely 
 
                 voluminous material that I went over that Mr. 
 
                 Gordon had anything that I would consider 
 
                 stress....
 
            
 
                    There was no time anyplace in which he ever 
 
                 complained to anybody that stress was getting to 
 
                 him, either by saying those actual words or by 
 
                 implying it, that "I don't feel well" or "My chest 
 
                 hurts" or "My stomach is killing me," or something 
 
                 like that, or "I can't take this anymore; I've got 
 
                 to get away for a while."  I mean I didn't get any 
 
                 statements like that.
 
            
 
                    It's that kind of stress which leads to the 
 
                 outpouring of cortisol over a long period of time 
 
                 which brings about these changes in the body.  I 
 
                 found nothing like that.  I, therefore, thought 
 
                 that anything that had to happen to him had to be 
 
                 instantaneous and in adrenal mechanisms and were 
 
                 not related to the job in any way.
 
            
 
            (defendants' exhibit 10, pp. 65 & 66)
 
            
 
                 James E. Davia, M.D., a cardiologist, board certified 
 
            in internal medicine and cardiovascular disease, with a 
 
            background as a professor of medicine, prolific writer and 
 
            former chief of cardiology service at Walter Reed Army 
 
            Medical Center, examined the same documents as the other 
 
            doctors essentially and made a written report on May 18, 
 
            1989 (def. ex. 11, deposition exs. 1 & 2).  Dr. Davia wrote 
 
            as follows:
 
            
 
                 In the following paragraphs I will submit my 
 
                 comments on the cause of Mr. Gordon's death and 
 
                 whether there is sufficient evidence to support 
 
                 the claim that his death was related to job 
 
                 stress.
 
            
 

 
            
 
            Page   8
 
            
 
            
 
            
 
            
 
                 The initial consideration that must be addressed 
 
                 is the degree to which Mr. Gordon suffered from 
 
                 job related emotional stress.  The claimants 
 
                 indicate that Mr. Gordon's long hours on the job, 
 
                 the shooting death of Mr. Hughes, and the lawsuit 
 
                 against the bank and Mr. Gordon were stress 
 
                 factors that were responsible for his sudden 
 
                 death.  However, when the testimonies of a large 
 
                 number of people who worked with Mr. Gordon or 
 
                 knew him very well as a person are carefully 
 
                 examined, the picture emerges of an individual who 
 
                 was a dedicated, conscientious worker but who also 
 
                 was a relaxed, laid-back type of person who 
 
                 handled the stresses and strains of his employment 
 
                 very well.  This conclusion may be supported from 
 
                 the statements made in the depositions of his 
 
                 coworkers, friends, and wife:  1) Coworker Dwight 
 
                 Seegmiller stated on two occasions that Mr. Gordon 
 
                 was relaxed at the bank and that even though he 
 
                 spent many hours at the bank he was not working 
 
                 all of the time but rather spent time relaxing and 
 
                 pursing such leisure activities as watching 
 
                 television and reading a large variety of 
 
                 newspapers.  On the weekends while at work he 
 
                 would watch athletic events on television.  His 
 
                 attitude toward the lawsuit was only described as 
 
                 "positive".  2) Coworker James Miller stated that 
 
                 Mr. Gordon would often sit back, light his pipe, 
 
                 and read the newspapers on the job.  He also 
 
                 stated that none of the other bank officers ever 
 
                 claimed that Mr. Gordon was working excessively 
 
                 hard.  3) Coworker James Pratt did not believe 
 
                 that Mr. Gordon had been working too hard or that 
 
                 he had been under excessive stress or pressure.  
 
                 4)  Friend Mark Jennings stated that Mr. Gordon 
 
                 never complained of working long hours.  5)  
 
                 Friend Vicki Jennings stated that Mr. Gordon never 
 
                 complained of being overworked or that he was 
 
                 under any stress or pressure on the job.  6)  
 
                 Friend, nurse, and stress manager Patricia Keen 
 
                 stated that Mr. Gordon never complained of stress, 
 
                 pressure, fatigue, or long hours on the job.  7)  
 
                 Wife Linda Gordon stated that her husband did not 
 
                 complain of his work activities or any unhappiness 
 
                 after the death of Mr. Hughes.  Furthermore, she 
 
                 stated that he enjoyed his work and never 
 
                 mentioned wanting to terminate his employment at 
 
                 the bank.
 
            
 
                 On the basis of the foregoing testimonies of the 
 
                 very individuals who knew Mr. Gordon the best, it 
 
                 must be concluded that there is no evidence that 
 
                 he perceived himself as one who was fatigued, 
 
                 harrassed, or pressured as a result of his job 
 
                 activities.  On the contrary, he was an easy-going 
 
                 person who handled the stresses and strains of his 
 
                 job remarkably well and even found time to pursue 
 
                 leisurely activities in his own office.  It would 
 
                 seem that if Mr. Gordon was as fatigued and 
 
                 stressed out to the point of death as the 
 

 
            
 
            Page   9
 
            
 
            
 
            
 
            
 
                 claimants allege, someone someplace along the way 
 
                 would have detected that he was having problems in 
 
                 this regard, but this was not the case.
 
            
 
            (defendants' exhibit 11, deposition exhibit 2, pages 1 & 2).
 
            
 
                 In the medical realm, Dr. Davia testified:
 
            
 
                 Some researchers claim that patients whose hearts 
 
                 are "primed" by ongoing psychological stress are 
 
                 especially vulnerable to sudden cardiac death, but 
 
                 this suggestion is based upon animal experiments 
 
                 and anecdotal evidence and has never been 
 
                 adequately tested in human beings with results 
 
                 published in a recognized scientific journal.  
 
                 Furthermore, there has never been a well 
 
                 documented case in a refereed medical journal of 
 
                 an individual without organic heart disease in 
 
                 whom it could be unequivocally proved that sudden 
 
                 cardiac death resulted from chronic job 
 
                 stress....It may thus be concluded that adequate 
 
                 scientific information that supports the 
 
                 allegations of the claimants is not available and 
 
                 their position in a legal setting would be very 
 
                 week.
 
            
 
            (defendants' exhibit 11, deposition exhibit 2, pages 2 & 3).
 
            
 
                 Dr. Davia goes on to give his own opinion, "The cause 
 
            of death in this case remains unknown.  There are a variety 
 
            of etiologies of sudden cardiac death that have not been 
 
            excluded in Mr. Gordon's case."  (def. ex. 11, dep. ex. 2, 
 
            p. 3).  At this point he mentions certain microscopic 
 
            abnormalities and certain electrophysiologic abnormalities.
 
            
 
                 Dr. Davia adds the following insight:
 
            
 
                 In the autopsy data there are some findings that 
 
                 deserve mention because they provide a possible 
 
                 explanation for the sudden fatal outcome in this 
 
                 case.  While there is insufficient data to 
 
                 establish a definite diagnosis of organic heart 
 
                 disease in the usual sense of the word, there were 
 
                 three abnormalities described by the pathologist 
 
                 that may have played a significant role in Mr. 
 
                 Gordon's demise.  First of all, the heart was 
 
                 heavy, a finding that implies an overabundance of 
 
                 heart muscle.  It is well known that hypertrophied 
 
                 (thickened) heart muscle is very susceptible to 
 
                 sudden heart rhythm abnormalities.  Secondly, the 
 
                 coronary arteries were described as "small".  
 
                 Unfortunately, the pathologist did not provide 
 
                 quantitative date in this regard, but the fact 
 
                 that he mentioned their small size is very 
 
                 significant.  There was also a degree of 
 
                 subintimal thickening of the coronary arteries 
 
                 which is a pathologic abnormality that can narrow 
 
                 the inside diameter of blood vessels and thus 
 
                 reduce blood flow.  Small coronary arteries, and 
 
                 especially those with narrowing, translate into 
 

 
            
 
            Page  10
 
            
 
            
 
            
 
            
 
                 less blood flow to the heart and therefore greater 
 
                 vulnerability to the genesis of heart rhythm 
 
                 abnormalities that may be fatal....The third 
 
                 autopsy finding of possible significance is the 
 
                 description of widely scattered fibrosis in the 
 
                 heart muscle which means that some of the muscle 
 
                 had been replaced by scar tissue.  The pathologist 
 
                 did not provide quantitative data on the amount of 
 
                 fibrosis except to state that it was 
 
                 insignificant.  However, even a small degree of 
 
                 fibrotic replacement of heart tissue has the 
 
                 potential for generating abnormal electrical 
 
                 circuits that result in fatal heart rhythm 
 
                 abnormalities, especially in the setting of a 
 
                 thickened heart muscle that may be undersupplied 
 
                 with oxygen because of small coronary arteries.  
 
                 It is therefore reasonable to postulate that the 
 
                 combined effects of these three abnormalities 
 
                 could have provided the pathophysiologic substrate 
 
                 for the heart rhythm abnormality that resulted in 
 
                 Mr. Gordon's sudden demise.
 
            
 
                 It is also important to emphasize that Mr. 
 
                 Gordon's sudden death occurred in the setting of 
 
                 intense emotional excitement of an athletic event.  
 
                 As opposed to the problem of chronic emotional 
 
                 stress which has no significant scientific support 
 
                 as a cause of sudden cardiac death, there is at 
 
                 lease [sic] some degree of support in the medical 
 
                 literature for the concept of acute emotionally 
 
                 traumatic events serving as a trigger mechanism 
 
                 for the initiation of fatal heart rhythm 
 
                 abnormalities.  It is therefore reasonable to 
 
                 suggest that the emotionally traumatic event of 
 
                 the poor call by the referee against the favored 
 
                 home team was the trigger event that precipitated 
 
                 a serious heart rhythm disturbance in a heart 
 
                 muscle that had been rendered vulnerable as a 
 
                 result of the aforementioned abnormalities.  
 
                 Another possible contributing trigger mechanism in 
 
                 this case was Mr. Gordon's alcohol consumption 
 
                 immediately prior to death as this substance is 
 
                 known to have the potential for causing heart 
 
                 rhythm abnormalities.
 
            
 
                 In summary, it is evident to me that there is 
 
                 insufficient data to support the claimants' 
 
                 position that Mr. Gordon's death can be ascribed 
 
                 to job related stress, pressure, and fatigue.  
 
                 While the precise mechanism of death will never be 
 
                 known with certainty, there are several reasonable 
 
                 alternative explanations that have a firm 
 
                 scientific basis.
 
            
 
            (defendants' exhibit 11, deposition exhibit 2, pages 3 & 4)
 
            
 
                 Dr. Davia gave a deposition on October 21, 1989, in 
 
            which he basically reiterated the data from his letter just 
 
            quoted (def. ex. 11).  Most importantly he stated that 
 
            claimant's decedent died from a sudden heart rhythm 
 

 
            
 
            Page  11
 
            
 
            
 
            
 
            
 
            abnormality called an arrhythmia which rendered his heart 
 
            incapable of pumping blood and therefore, caused his death 
 
            (def. ex. 11, p. 11).  He added, "My opinion is that the 
 
            cardiac death that Mr. Gordon experienced was not in any 
 
            related-- in any way related to his job situation." (def. 
 
            ex. 11, p. 13).  Moreover, "I believe that there is no 
 
            indication in the record that Mr. Gordon perceived himself 
 
            to be under any undue amount of stress." (def. ex. 11, p. 
 
            13).  Dr. Davia added:
 
            
 
                    I see no indication that he ever saught [sic] 
 
                 any type of help in that regard, and as a matter 
 
                 of fact, on the contrary.  The picture emerges 
 
                 here when you read all of these depositions that 
 
                 he was a fairly easygoing person who was laid back 
 
                 and he had time to relax on the job.  That's not 
 
                 to say he wasn't a hard worker, but he certainly 
 
                 had time to relax and pursue some leisurely 
 
                 activities on the job, and this type of existence 
 
                 never led him to seek any type of counseling or 
 
                 medical help related to stress on the job.
 
            
 
            (defendants' exhibit 11, pages 15 & 16)
 
            
 
                 There was evidence of nonwork stress because decedent's 
 
            father died in 1984 allegedly from hypertension.  His mother 
 
            became mentally ill and decedent became responsible for her 
 
            care and managing her affairs (def. ex. 11, pp. 19 & 20).  
 
            
 
                 Dr. Davia said there was no body of accepted medical 
 
            evidence that people who have chronic long-term stress 
 
            suffer from low potassium levels and magnesium levels.  If 
 
            this was an accepted medical fact, then the medical 
 
            community would be recommending that people who perceive 
 
            themselves to be under stress should be taking supplemental 
 
            potassium and magnesium pills (def. ex. 11, pp. 32 & 33).  
 
            
 
                 Like Dr. From, Dr. Davia was shown an article in the 
 
            New England Journal of Medicine, authored by Dr. Graboys 
 
            entitled, "Stress and the Aching Heart", in which Dr. 
 
            Graboys wrote:
 
            
 
                    Although a wealth of evidence has linked 
 
                 central and peripheral sympathetic mechanisms to 
 
                 changes in cardiac electrophysiology, an 
 
                 independent relation between psychosocial stress 
 
                 and cardiac mortality has yet to be defined, owing 
 
                 to the difficulty inherent in the quantification 
 
                 of higher neural activity.
 
            
 
            (defendants' exhibit 11, deposition exhibit 3, page 1)
 
            
 
                 Dr. Davia commented:
 
            
 
                 A.   First of all, he does not discuss his 
 
                 hypothesis that chronic stress causes hypokalemia 
 
                 that primes the heart for sudden death.  Second of 
 
                 all, he admits that causality, that is, a 
 
                 causative relationship between psychosocial stress 
 
                 and cardiac mortality has yet to be defined, and I 
 

 
            
 
            Page  12
 
            
 
            
 
            
 
            
 
                 would like to quote, if you'll allow me to do so.
 
            
 
            (defendants' exhibit 11, page 34)
 
            
 
                 At this point Dr. Davia quoted the above quoted 
 
            statement of Dr. Graboys.  
 
            
 
                 Dr. Davia said that one of the most common causes of an 
 
            enlarged heart is high blood pressure and noted that 
 
            claimant was rejected for ROTC at age 21 because he was 
 
            determined to be borderline hypertensive at that time.  
 
            Subsequently, claimant had very few blood pressure readings 
 
            and those were recorded as generally normal.  The bottom 
 
            line conclusion of Dr. Davia is as follows: 
 
            
 
                 A.  I don't think that there is any cause, 
 
                 specific cause that we can identify in this case 
 
                 that we could say was responsible for his sudden 
 
                 fatal heart rhythm abnormality with any real 
 
                 degree of medical certainty.
 
                 
 
            
 
            (defendants' exhibit 11, page 91)
 
            
 
                 Claimant's decedent was classified as 4-F with the 
 
            selective service system (def. ex. 15, p. 3).  The notes of 
 
            the decedent's personal physician on July 2, 1969, when 
 
            claimant's decedent was 21 years old, show that he failed 
 
            the ROTC physical examination due to an elevated blood 
 
            pressure of 140/90 on several repeated tests (def. ex. 5, 
 
            pp. 1-3).  Also, claimant saw his personal physician on 
 
            April 17, 1980, for chest pain with numbness to his fingers 
 
            on the right hand.  It was noted that he had increased blood 
 
            pressure and the notation states 120-122/88.  No heart or 
 
            blood pressure workup was done and there are no blood 
 
            pressure readings between April of 1980 and the time of 
 
            claimant's death, nor did he have any cardiograms or stress 
 
            tests.  In February, before his death, claimant's decedent 
 
            told her that he had a pain in his chest.  He pounded his 
 
            chest at that time.  His wife recommended that he have it 
 
            checked out, but he refused to do so stating it was just a 
 
            cramp (tr. p. 214). 
 
            
 
                 From the foregoing evidence it is the determination of 
 
            this deputy that the cause of claimant's decedent's cardiac 
 
            dysrhythmia which resulted in his death is unknown and 
 
            cannot be determined.  It is further determined that even 
 
            though a number of unusual circumstances occurred at work 
 
            prior to decedent's sudden and unexpected death that he 
 
            exhibited no manifestation of stress to his coemployees, nor 
 
            did he complain of stress, nor did he seek any treatment for 
 
            stress.  A photograph of decedent with other bank employees 
 
            taken just a few hours before his death on March 14, 1986, 
 
            shows a smiling individual who from all appearances is 
 
            relaxed, happy and healthy (def. ex. 14).  He considered the 
 
            lawsuit against himself and the bank to be groundless and he 
 
            was well prepared to counter it.  Decedent and the bank 
 
            later won the suit.
 
            
 
                 The opinions of Dr. From and Dr. Davia are preferred 
 

 
            
 
            Page  13
 
            
 
            
 
            
 
            
 
            over the opinions of Dr. Schwartz and Dr. Graboys because 
 
            they comport best with all of the other evidence in this 
 
            case both of a medical nature and from the lay witnesses.  
 
            The most likely precipitating cause of decedent's 
 
            dysrhythmia that caused his instant death is probably the 
 
            excitement of the basketball game.  
 
            
 
                 John Keen testified, "There had been a call in the 
 
            basketball game.  The ref made a call that we objected to, 
 
            and Mark and I were yelling, and Jim just fell over face 
 
            front onto the floor." (transcript p. 98).  Patricia Keen 
 
            testified, "He uttered something, and I remember it being, 
 
            `Oh, my God, what's happening?'  He stood up halfway and 
 
            then collapsed on the floor." (tr. p. 170).  The bulk of the 
 
            evidence did not support the conclusion that decedent was 
 
            suffering from job-related stress either actual or 
 
            perceived, even though John Hughes had been shot to death at 
 
            the bank three months earlier, the bank's liability 
 
            insurance carrier had withdrawn officer and directors 
 
            liability coverage and another patron of the bank sued the 
 
            bank and decedent personally for mismanagement of a trust.  
 
            Decedent demonstrated no stress from these situations to his 
 
            coworkers and coemployees at the bank.  He did not complain 
 
            to his wife.  He did not seek any medical or stress relief 
 
            of any kind. 
 
            
 
                 In conclusion, it must be determined that claimant's 
 
            decedent did not sustain an injury arising out of and in the 
 
            course of employment with employer on March 14, 1986, nor 
 
            did his employment substantially cause or contribute to his 
 
            death.
 
            
 
                                conclusions of law
 
            
 
                 Wherefore, based upon the foregoing and following 
 
            principles of law, these conclusions of law are made:
 
            
 
                 That claimant did not sustain the burden of proof by a 
 
            preponderance of the evidence that her decedent sustained an 
 
            injury which arose out of and in the course of employment 
 
            with employer.  Iowa Code section 85.3(1); 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); 
 
            Almquist v. Shenandoah Nurseries, 218 Iowa 724, 254 N.W. 35 
 
            (1934). 
 
            
 
                 Claimant did not sustain the burden of proof by a 
 
            preponderance of the evidence that a preexisting condition 
 
            or disability was aggravated, accelerated, worsened or 
 
            lighted up by decedent's employment.  Nicks v. Davenport 
 
            Produce Co., 254 Iowa 130, 115 N.W.2d 812, 815 (1962).
 
            
 
                 Claimant did not sustain the burden of proof by a 
 
            preponderance of the evidence that decedent's death was 
 
            caused by work-related stress or any other employment 
 
            related cause.  Bodish v. Fischer, Inc., 257 Iowa 516, 133 
 
            N.W.2d 867 (1965); Lindahl v. L.O. Boggs Co., 236 Iowa 296 
 
            18 N.W.2d 607 (1945).
 
            
 
                 In view of the foregoing findings of fact and 
 

 
            
 
            Page  14
 
            
 
            
 
            
 
            
 
            conclusions of law, all other issues of the case become 
 
            moot.
 
            
 
                                      order
 
            
 
                 THEREFORE, IT IS ORDERED:
 
            
 
                 That no amounts are due from defendants to claimant.
 
            
 
                 That the costs of this action, including the cost of 
 
            the attendance of the court reporter at hearing and the cost 
 
            of the transcript are charged to claimant pursuant to rule 
 
            343 IAC 4.33.
 
            
 
                 Signed and filed this ____ day of April, 1991.
 
            
 
            
 
            
 
            
 
                                          ______________________________
 
                                          WALTER R. McMANUS, JR.
 
                                          DEPUTY INDUSTRIAL COMMISSIONER    
 
            
 
            Copies to:
 
            
 
            Mr. John L. Riccolo
 
            Attorney at Law
 
            STE 1140, The Center
 
            425 2nd St. SE
 
            Cedar Rapids, Iowa  52401
 
            
 
            Ms. Dorothy Kelley
 
            Attorney at Law
 
            500 Liberty Bldg
 
            Des Moines, Iowa  50309
 
            
 
 
            
 
            Page   1
 
            
 
            
 
            
 
            
 
                                          1100 1107 1108.10 1401 1402.20 
 
                                          1402.30 1402.40 2202 2206 2902 
 
                                          2907
 
                                          Filed April 16, 1991
 
                                          Walter R. McManus, Jr.
 
            
 
                           before the iowa industrial 
 
                                   commissioner
 
            ____________________________________________________________
 
                                          :
 
            LINDA GORDON,                 :
 
                                          :
 
                 Claimant,                :
 
                                          :
 
            vs.                           :
 
                                          :      File No. 846902
 
            HILLS BANK AND TRUST CO.,     :
 
                                          :  A R B I T R A T I O N
 
                 Employer,                :
 
                                          :      D E C I S I O N
 
            and                           :
 
                                          :
 
            CONTINENTAL INSURANCE CO.,    :
 
                                          :
 
                 Insurance Carrier,       :
 
                 Defendants.              :
 
            ___________________________________________________________
 
            
 
            1100 1107 1108.10 1401 1402.20 1402.30 1402.40 2202 2206 
 
            2902
 
            Claimant failed to prove that decedent's sudden cardiac 
 
            dysrhythmia that resulted in immediate death, while watching 
 
            an exciting basketball game at home with friends, was caused 
 
            by job stress even though there was evidence of a number of 
 
            factors that could have caused stress from his job; i.e. (1) 
 
            the bank president was shot to death in his office; (2) the 
 
            bank lost its liability insurance coverage for officers and 
 
            directors; (3) decedent and the bank were sued for 
 
            mishandling a trust account; and (4) claimant worked long 
 
            hours and spent a lot of time at the bank.  Four heart 
 
            specialists gave interesting expert testimony on the cause 
 
            of sudden cardiac death.
 
            
 
            2907
 
            Costs charged to claimant.
 
            
 
 
            
 
            Page   1
 
            
 
            
 
            
 
            
 
            before the iowa industrial commissioner
 
            ____________________________________________________________
 
                      :
 
            DONNA GRAHAM,  :
 
                      :
 
                 Claimant, :      File No. 846903
 
                      :
 
            vs.       :        A P P E A L
 
                      :
 
            SHELLER-GLOBE CORPORATION,    :      D E C I S I O N
 
                      :
 
                 Employer, :
 
                 Self-Insured,  :
 
                 Defendant.     :
 
            ___________________________________________________________
 
             The record, including the transcript of the hearing before 
 
            the deputy and all exhibits admitted into the record, has 
 
            been reviewed de novo on appeal.  The decision of the 
 
            deputy, filed July 19, 1990, is affirmed and is adopted as 
 
            the final agency action in this case with the following 
 
            additional analysis and except as specified below:
 
            Defendant urges on appeal that claimant's prior compromise 
 
            special case settlements bar recovery.  The injury involved 
 
            in this case is a new injury, in the form of an aggravation 
 
            of a preexisting condition.  A new injury is not barred by a 
 
            prior compromise special case settlement.  However, 
 
            claimant's recovery is limited to the extent of disability 
 
            caused by the aggravation of the condition that was the 
 
            subject of the special case settlement.  
 
            ORDER
 
            THEREFORE, it is ordered:
 
            That defendant pay the claimant temporary total disability 
 
            benefits from June 4, 1987 through October 31, 1987 at the 
 
            rate of two hundred twenty-nine and 95/100 dollars ($229.95) 
 
            per week.
 
            That defendant pay the medical expenses listed in the 
 
            prehearing report; namely, three hundred ten dollars ($310) 
 
            for Dr. Crenshaw, and five hundred sixty-seven and 15/100 
 
            dollars ($567.15) for prescriptions.  Claimant shall be 
 
            reimbursed for any of these expenses actually paid by her.  
 
            Otherwise, defendant shall pay the provider directly.
 
            That defendant pay accrued weekly benefits in a lump sum and 
 
            shall receive credit against this award for all benefits 
 
            previously paid.
 
            That defendant receive credit for previous payment of 
 
            benefits under a nonoccupational group insurance plan, under 
 
            Iowa Code section 85.38(2) as set forth in the prehearing 
 
            report.
 
            That defendant pay interest on weekly benefits awarded 
 
            herein as set forth in Iowa Code section 85.30.
 
            That defendant pay the costs of this action including the 
 
            costs of transcribing the hearing.
 

 
            
 
            Page   2
 
            
 
            
 
            
 
            
 
            
 
                 That defendant file claim activity reports as requested 
 
            by this agency pursuant to rule 343 IAC 3.1.
 
            Signed and filed this ____ day of April, 1991.
 
            
 
            
 
            
 
            
 
                      ________________________________
 
                               CLAIR R. CRAMER
 
                       ACTING INDUSTRIAL COMMISSIONER
 
            
 
            Copies To:
 
            
 
            Mr. James P. Hoffman
 
            Attorney at Law
 
            Middle Road
 
            Keokuk, Iowa 52632-1066
 
            
 
            Mr. Harry W. Dahl
 
            Attorney at Law
 
            974 73rd St., Suite 16
 
            Des Moines, Iowa 503l2
 
            
 
 
            
 
 
 
 
 
 
 
 
 
 
 
            1600
 
            LPW
 
            Filed April 22, 1991
 
            Clair R. Cramer
 
            before the iowa industrial commissioner
 
            ____________________________________________________________
 
                      :
 
            DONNA GRAHAM,  :
 
                      :
 
                 Claimant, :      File No. 846903
 
                      :
 
            vs.       :        A P P E A L
 
                      :
 
            SHELLER-GLOBE CORPORATION,    :      D E C I S I O N
 
                      :
 
                 Employer, :
 
                 Self-Insured,  :
 
                 Defendant.     :
 
            ___________________________________________________________
 
            
 
            1600
 
            Defendants urged that claimant's petition was barred by a 
 
            prior special case settlement.  Held that claimant's injury 
 
            was in the form of an aggravation of the injury that was the 
 
            subject of the special case settlement, and constituted a 
 
            separate injury and was therefore not barred by the 
 
            settlement.  However, claimant's recovery is limited to the 
 
            extent of the aggravation.
 
            
 
 
         
 
         Page   1
 
         
 
         
 
         
 
         
 
                     before the iowa industrial commissioner
 
         ____________________________________________________________
 
                                       :
 
         DONNA GRAHAM,                 :
 
                                       :
 
              Claimant,                :
 
                                       :        File No. 846903
 
         vs.                           :
 
                                       :
 
         SHELLER-GLOBE CORPORATION,    :     A R B I T R A T I O N
 
                                       :
 
              Employer,                :        D E C I S I O N
 
              Self-Insured             :
 
              Defendant.               :
 
         ___________________________________________________________
 
         
 
         
 
                                  statement of the case
 
         
 
              This is a proceeding in arbitration brought by Donna Graham, 
 
         claimant, against Sheller-Globe Corporation, a self-insured 
 
         employer, hereinafter referred to as SG, defendant, for workers' 
 
         compensation benefits as a result of an alleged injury on January 
 
         8, 1987.  On April 17, 1990, a hearing was held on claimant's 
 
         petition and the matter was considered fully submitted at the 
 
         close of this hearing.
 
         
 
              The parties have submitted a prehearing report of contested 
 
         issues and stipulation which was approved and accepted as a part 
 
         of the record of this case at the time of hearing.  Oral 
 
         testimony and written exhibits were received during the hearing 
 
         from the parties.  The exhibits offered into evidence are listed 
 
         in the prehearing report.
 
         
 
              According to the prehearing report, the parties have 
 
         stipulated to the following matters:
 
         
 
              1.  An employer-employee relationship existed between 
 
         claimant and SG at the time of the injury.
 
         
 
              2.  Claimant is seeking temporary total disability or 
 
         healing period benefits in this proceeding from June 4, 1987 
 
         through October 31, 1987, and defendant agrees that she was not 
 
         working during this period of time.
 
         
 
              3.  Claimant's rate of weekly compensation in the event of 
 
         an award of weekly benefits from this proceeding shall be 
 
         $229.95.
 
         
 
              4.  The medical bills submitted by claimant at hearing were 
 
         fair and reasonable and causally connected to the medical 
 
         condition upon which the claim is based but that the causal 
 
         connection to any work injury remains an issue.
 
         
 
                                      issues
 
         
 
              The parties submitted the following issues for determination 
 
         in this proceeding:
 
         
 
                I.  Whether claimant received an injury arising out of and 
 

 
         
 
         Page   2
 
         
 
         
 
         
 
         in the course of her employment;
 
         
 
         
 
               II.  The extent of claimant's entitlement to disability 
 
         benefits; and,
 
         
 
         
 
              III.  The extent of claimant's entitlement to medical 
 
         benefits.
 
         
 
                                 findings of fact
 
         
 
              Having heard the testimony and considered all the evidence, 
 
         the undersigned deputy industrial commissioner finds as follows:
 
         
 
              A credibility finding is necessary to this decision as 
 
         defendant places credibility at issue during cross-examination as 
 
         to the nature and extent of the injury and disability.  From her 
 
         demeanor while testifying, claimant is found credible.
 
         
 
              Claimant has worked for SG for 22 years and continues to do 
 
         so at the present time.  At the time of the alleged injury, 
 
         claimant was trimming covers and was required to carry two eight 
 
         pound bundles 40 to 50 feet, approximately 250 to 300 times each 
 
         day.  Since her return to work in November 1987, claimant has 
 
         been assigned to flocking or the process of gluing weather 
 
         stripping used on motor vehicles.  The change in jobs was due to 
 
         the imposition of a  five pound lifting restriction by claimant's 
 
         family physician, Neville Q. Crenshaw, D.O., in October 1987.  A 
 
         40 hour per week work restriction also imposed at the time has 
 
         been lifted by Dr. Crenshaw and claimant frequently works in 
 
         excess of 40 hours per week in her current job.  Claimant's 
 
         testimony with reference to these matters was uncontroverted.
 
         
 
              On or about January 8, 1987, while performing and lifting 
 
         and carrying duties in the trimming job, claimant injured her 
 
         cervical and thoracic spine and she began to experience severe 
 
         pain from the mid and upper back across the shoulder and down to 
 
         the elbow.  The injury was due to aggravation of a preexisting 
 
         degenerative disc disease of the thoracic and cervical spine.  
 
         The injury was not an aggravation of a prior right shoulder 
 
         problem stemming from two prior injuries - a nonwork-related 
 
         injury in 1974 and a work injury in 1984.  Claimant had 
 
         previously settled a claim involving the 1984 work injury of the 
 
         right shoulder in October 1986 wherein she received weekly 
 
         benefits for a 10 percent permanent partial disability to the 
 
         body as a whole.
 
         
 
              The above finding that the January 8, 1987 injury was not 
 
         related to the prior right shoulder problems, even though some of 
 
         the pain radiated across the shoulder, is based upon the views of 
 
         a board certified orthopedic surgeon, James A. Gwaltney, M.D.  
 
         Dr. Gwaltney treated claimant for both the 1984 and 1987 
 
         injuries.  It was felt that as a treating physician, Dr. Gwaltney 
 
         had more clinical knowledge of claimant's condition than Peter 
 
         Wirtz, M.D., another orthopedic surgeon, who expressed views 
 
         contrary to those of Dr. Gwaltney.
 
         
 
              As a result of the injury of January 8, 1987, claimant was 
 
         absent from her job at SG from June 4, 1987 until October 31, 
 
         1987, upon the advice of her family physician.  Following the 
 

 
         
 
         Page   3
 
         
 
         
 
         
 
         injury, claimant was initially treated by several physicians and 
 
         chiropractors retained by SG who prescribed pain medication but 
 
         did not recommend a temporary absence from work.  Claimant then 
 
         continued to experience pain from not only her prior chronic 
 
         right shoulder problems from prior injuries but the problems 
 
         stemming from the recent injury to the mid and upper back.  
 
         Finally, claimant sought treatment from her family physician, Dr. 
 
         Crenshaw, who took her off work and sent her into physical 
 
         therapy at a pain clinic.  The pain clinic treated both the 
 
         ongoing right shoulder and the back pain in conjunction with 
 
         chronic headaches.  This treatment reduced the need for pain 
 
         medication and reduced the headaches.  Claimant was then released 
 
         by Dr. Crenshaw to return to work in November 1987 with the 
 
         restrictions previously discussed.  Although the treatment by Dr. 
 
         Crenshaw also involved pain from the prior right shoulder injury, 
 
         the aggravation injury of January 8, 1987 remained a substantial 
 
         factor which precipitated the need for treatment and the absence 
 
         from work activity during the summer and fall of 1987.
 
         
 
              The claimant failed to show that the work injury of January 
 
         1987 was a cause of permanent impairment to the body as a whole 
 
         or a loss of earning capacity.  No physician in this case has 
 
         opined that the aggravation injury caused permanent partial 
 
         impairment.  Although the five pound lifting restriction was 
 
         first imposed after the January 1987 injury, Dr. Crenshaw did not 
 
         opine that it was due to the January 1987 injury.  Without such 
 
         an opinion, it is just as likely that the five pound restriction 
 
         was due to the prior right shoulder injury or due to the prior 
 
         degenerative disc disease and that the January 1987 injury was 
 
         only a temporary aggravation of prior existing problems.  
 
         Claimant had mild thoracic mid and upper back problems in 1983 
 
         and again in 1984.  It is clear from the written report of Dr. 
 
         Crenshaw that he felt that such a lifting restriction was 
 
         necessary to prevent further reinjury.  Again, it is likely that 
 
         Dr. Crenshaw felt that this restriction should have been imposed 
 
         earlier which could have possibly avoided the January 1987 injury 
 
         and resulting loss of work.  Claimant is now back to work and has 
 
         not suffered any loss of income as a result of the new work 
 
         restriction or job transfer.  Claimant's current employment 
 
         appears stable and she expressed no difficulty with performing 
 
         her current work.  Her only difficulty expressed at the time of 
 
         the hearing was with her nonwork-related activities.
 
         
 
              The medical expenses requested by claimant in the prehearing 
 
         report are found causally connected to the work injury of January 
 
         8, 1987.
 
         
 
                                conclusions of law
 
         
 
              I.  Claimant has the burden of proving by a preponderance of 
 
         the evidence that claimant received an injury which arose out of 
 
         and in the course of employment.  The words "out of" refer to the 
 
         cause or source of the injury.  The words "in the course of" 
 
         refer to the time and place and circumstances of the injury.  See 
 
         Cedar Rapids Community Sch. v. Cady, 278 N.W.2d 298 (Iowa 1979); 
 
         Crowe v. DeSoto Consol. Sch. Dist., 246 Iowa 402, 68 N.W.2d 63 
 
         (1955).  An employer takes an employee subject to any active or 
 
         dormant health impairments, and a work connected injury which 
 
         more than slightly aggravates the condition is considered to be a 
 
         personal injury.  Ziegler v. United States Gypsum Co., 252 Iowa 
 
         613, 620, 106 N.W.2d 591 (1960) and cases cited therein.
 

 
         
 
         Page   4
 
         
 
         
 
         
 
         
 
              In the case sub judice, claimant stated that she experienced 
 
         pain symptoms after performing her work duties.  The failure to 
 
         identify an exact and the specific task she was doing did not 
 
         defeat her claim as the onset of symptoms simply occurred 
 
         gradually over time.  A sudden traumatic event need not be shown 
 
         to establish compensable injury.  McKeever Custom Cabinets v. 
 
         Smith, 379 N.W.2d 368 (Iowa 1985).
 
         
 
         
 
                II.  The claimant has the burden of proving by a 
 
         preponderance of the evidence that the work injury is a cause of 
 
         the claimed disability.  A disability may be either temporary or 
 
         permanent.  In the case of a claim for temporary disability, the 
 
         claimant must establish that the work injury was a cause of 
 
         absence from work and lost earnings during a period of recovery 
 
         from the injury.  Generally, a claim of permanent disability 
 
         invokes an initial determination of whether the work injury was a 
 
         cause of permanent physical impairment or permanent limitation in 
 
         work activity.  However, in some instances, such as a job 
 
         transfer caused by a work injury, permanent disability benefits 
 
         can be awarded without a showing of a causal connection to a 
 
         physical change of condition.  Blacksmith v. All-American, Inc., 
 
         290 N.W.2d 348, 354 (Iowa 1980); McSpadden v. Big Ben Coal Co., 
 
         288 N.W.2d 181 (Iowa 1980).
 
         
 
              The question of causal connection is essentially within the 
 
         domain of expert medical opinion. To establish compensability, 
 
         the injury need only be a significant factor, not be the only 
 
         factor causing the claimed disability.  Blacksmith, 290 N.W.2d 
 
         348, 354.  In the case of a preexisting condition, an employee is 
 
         not entitled to recover for the results of a preexisting injury 
 
         or disease but can recover for an aggravation thereof which 
 
         resulted in the disability found to exist.  Olson v. Goodyear 
 
         Service Stores, 255 Iowa 1112, 125 N.W.2d 251 (1963).
 
         
 
              In the case sub judice, claimant failed to show a causal 
 
         connection by a preponderance of the evidence between the work 
 
         injury and permanent partial impairment or loss of earning 
 
         capacity.  Although it was clear that the five pound work 
 
         restriction is very limiting in the number of jobs she can 
 
         perform, there has been no showing by claimant that the 
 
         aggravation injury of January 8, 1987 was a cause of the 
 
         restriction.  It would appear likely that the claimant's prior 
 
         existing shoulder and degenerative disc disease was more than 
 
         likely the cause of the restriction.
 
         
 
              Although claimant failed to establish entitlement to 
 
         permanent partial disability benefits, it was found that the 
 
         injury of January 8, 1987 was a cause of a temporary absence from 
 
         work.  Under Iowa Code section 85.33(1), claimant is entitled to 
 
         temporary total disability benefits from the first day of 
 
         disability until claimant returns to work.  Temporary total 
 
         disability benefits will therefore be awarded accordingly.
 
         
 
              III.  Pursuant to Iowa Code section 85.27, claimant is 
 
         entitled to payment of reasonable medical expenses incurred for 
 
         treatment of a work injury.  However, claimant is entitled to an 
 
         order of reimbursement only if claimant has paid those expenses.  
 
         Otherwise, claimant is entitled to only an order directing the 
 
         responsible defendant to make such payments.  See Krohn v. State, 
 

 
         
 
         Page   5
 
         
 
         
 
         
 
         420 N.W.2d 463 (Iowa 1988).
 
         
 
              In the case at bar, it was found that the requested expenses 
 
         were causally connected to the work injury involved in this case.  
 
         Therefore, these expenses will be awarded.
 
         
 
                                      order
 
         
 
              1.  Defendant shall pay the claimant temporary total 
 
         disability benefits from June 4, 1987 through October 31, 1987 at 
 
         the rate of two hundred twenty-nine and 95/100 dollars ($229.95) 
 
         per week.
 
         
 
              2.  Defendant shall pay the medical expenses listed in the 
 
         prehearing report; namely, three hundred ten dollars ($310) for 
 
         Dr. Crenshaw, and five hundred sixty-seven and 15/100 dollars 
 
         ($567.15) for prescriptions.  Claimant shall be reimbursed for 
 
         any of these expenses paid by her.  Otherwise, defendant shall 
 
         pay the provider directly along with any lawful late payment 
 
         penalties imposed upon the account by the provider.
 
         
 
              3.  Defendant shall pay accrued weekly benefits in a lump 
 
         sum and shall receive credit against this award for all benefits 
 
         previously paid.
 
         
 
              4.  Defendant shall receive credit for previous payment of 
 
         benefits under a nonoccupational group insurance plan, under Iowa 
 
         Code section 85.38(2) as set forth in the prehearing report, less 
 
         tax deductions, if any, from those payments.
 
         
 
              5.  Defendant shall pay interest on weekly benefits awarded 
 
         herein as set forth in Iowa Code section 85.30.
 
         
 
              6.  Defendant shall pay the costs of this action pursuant to 
 
         Division of Industrial Services Rule 343-4.33.
 
         
 
              7.  Defendant shall file activity reports upon payment of 
 
         this award as requested by this agency pursuant to Division of 
 
         Industrial Services Rule 343-3.1.
 
         
 
         
 
              Signed and filed this ____ day of July, 1990.
 
         
 
         
 
         
 
         
 
         
 
                                       ______________________________
 
                                       LARRY P. WALSHIRE
 
                                       DEPUTY INDUSTRIAL COMMISSIONER
 
         
 
         Copies To:
 
         
 
         Mr James P Hoffman
 
         Attorney at Law
 
         Middle Rd
 
         P O Box 1066
 
         Keokuk IA 52632
 
         
 
         Mr Harry W Dahl
 
         Attorney at Law
 

 
         
 
         Page   6
 
         
 
         
 
         
 
         974 73rd St Ste 16
 
         Des Moines IA 50312
 
         
 
         
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                                          5-1803
 
                                          Filed July 19, 1990
 
                                          Larry P. Walshire
 
            
 
                     before the iowa industrial commissioner
 
            ____________________________________________________________
 
                                          :
 
            DONNA GRAHAM,                 :
 
                                          :
 
                 Claimant,                :
 
                                          :        File No. 846903
 
            vs.                           :
 
                                          :
 
            SHELLER-G
 
            LOBE CORPORATION,   :     A R B I T R A T I O N
 
                                          :
 
                 Employer,                :        D E C I S I O N
 
                 Self-Insured             :
 
                 Defendant.               :
 
            ___________________________________________________________
 
            
 
            5-1803
 
            Casual connection and extent of disability issue 
 
            nonprecedential.
 
            
 
            
 
 
         
 
         Page   1
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 
         before the iowa industrial commissioner
 
         ____________________________________________________________
 
                   :
 
         LEWIS HALL,    :
 
                   :
 
              Claimant, :
 
                   :      File No. 846905
 
         vs.       :
 
                   :        A P P E A L
 
         DR. DARYL LARSON, d/b/a  :
 
         HILL TOP PORK, :      D E C I S I O N
 
                   :
 
              Employer, :
 
              Uninsured,     :
 
              Defendant.     :
 
         ___________________________________________________________
 
          The record, including the transcript of the hearing before the 
 
         deputy and all exhibits admitted into the record, has been 
 
         reviewed de novo on appeal.  The decision of the deputy filed 
 
         October 19, 1989 is affirmed and is adopted as the final agency 
 
         action in this case. 
 
         Defendant shall pay the costs of the appeal, including the 
 
         preparation of the hearing transcript.
 
         Defendant is again ordered to file a first report of injury as 
 
         required by Iowa Code section 86.11 within twenty (20) days of 
 
         the date of this decision.
 
         Signed and filed this ____ day of April, 1991.
 
         
 
         
 
         
 
         
 
                   ________________________________
 
                            CLAIR R. CRAMER
 
                    ACTING INDUSTRIAL COMMISSIONER
 
         
 
         Copies To:
 
         
 
         Mr. Brian Anderson
 
         Attorney at Law
 
         405 Tracy Street
 
         Audubon, Iowa 50025
 
         
 
         Hill Top Pork
 
         c/o Dr. Daryl Larson
 
         Hwy 71 North
 
         P.O. Box 163
 
         Audubon, Iowa 50025
 
         CERTIFIED AND REGULAR MAIL
 
         
 
 
            
 
 
 
 
 
 
 
 
 
 
 
            9998
 
            WRM
 
            Filed April 22, 1991
 
            Clair R. Cramer
 
            before the iowa industrial commissioner
 
            ____________________________________________________________
 
                      :
 
            LEWIS HALL,    :
 
                      :
 
                 Claimant, :
 
                      :      File No. 846905
 
            vs.       :
 
                      :        A P P E A L
 
            DR. DARYL LARSON, d/b/a  :
 
            HILL TOP PORK, :      D E C I S I O N
 
                      :
 
                 Employer, :
 
                 Uninsured,     :
 
                 Defendant.     :
 
            ___________________________________________________________
 
            
 
            9998
 
            
 
                 Summary affirmance of deputy's decision filed October 
 
            19, 1989.
 
            
 
 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
                     BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         LEWIS HALL,
 
         
 
              Claimant,                              File No. 846905
 
         
 
         DR. DARYL LARSON, d/b/a                  A R B I T R A T I O N
 
         HILL TOP PORK,
 
                                                     D E C I S I O N
 
              Employer,
 
              Uninsured,                                F I L E D
 
              Defendant.
 
                                                       OCT 19 1989
 
         
 
                                                   INDUSTRIAL SERVICES
 
         
 
         
 
                                   INTRODUCTION
 
         
 
              This is a proceeding in arbitration brought by Lewis Hill, 
 
         claimant, against Dr. Daryl Larson, d/b/a/ Hill Top Pork, 
 
         employer and uninsured defendant, for benefits as the result of 
 
         an alleged injury which occurred on July 8, 1986.  A hearing was 
 
         held in Council Bluffs, Iowa, on July 7, 1988, and the case was 
 
         fully submitted at the close of the hearing.  The record consists 
 
         of the testimony of Lewis Hall, claimant, Dan Murtaugh, 
 
         claimant's former attorney, Dr. Daryl Larson, defendant employer, 
 
         Timothy Van Cleve, supervisor, claimant's exhibits 1 through 4 
 
         and defendant's exhibits A and B.  Defendant filed an attachment 
 
         to the prehearing report which is in the nature of a prehearing 
 
         brief.  Claimant also filed an attachment to the prehearing 
 
         report which is in the nature of a prehearing brief.  Both 
 
         parties filed posthearing briefs.  The deputy ordered a 
 
         transcript of the hearing.
 
         
 
                                PREHEARING MATTER
 
                                        
 
              The prehearing report indicated that employer-employee 
 
         relationship, failure to bring a timely claim under Iowa Code 
 
         section 85.26 and failure to give timely notice under Iowa Code 
 
         section 85.23 were to be issues in this case.  These issues were 
 
         not designated as hearing issues on the hearing assignment order 
 
         that was prepared as a result of the prehearing conference. 
 
         Defendant stated that he was not present for the prehearing 
 
         conference, but defendant did admit that he had notice of the 
 
         time and date of the prehearing conference and made no request 
 
         for an alternate time and date.  Therefore, it is determined that 
 
         the foregoing issues are not hearing issues and determination of 
 
         these issues will not be made in this decision.  Issues not 
 
         asserted at the time of the prehearing conference are waived.  
 
         Presswood vs. Iowa Beef Processors, Inc., file number 735442 
 
         (Appeal Decision November 14, 1986).
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
                                   STIPULATIONS
 
         
 
              The parties stipulated to the following matters:
 
         
 
              That claimant's gross weekly earnings at the time of the 
 
         injury were $175 per week, that claimant was single and entitled 
 
         to one exemption at that time.
 
         
 
              That the provider of medical services or supplies would 
 
         testify that the fees charged are fair and reasonable and that 
 
         the treatment was for reasonable and necessary treatment for the 
 
         alleged injury and defendant is not offering contrary evidence.
 
         
 
              That there is a causal connection of the expenses to 
 
         treatment for the medical condition on which claimant bases his 
 
         claim, but the causal connection of this condition to a work 
 
         injury remains an issue to be decided in these proceedings.
 
         
 
              That defendant claims no credit for benefits paid prior to 
 
         hearing under either:  (1) an employee nonoccupational group 
 
         health plan or (2) as workers' compensation benefits.
 
         
 
              That there are no bifurcated claims.
 
         
 
                                      ISSUES
 
         
 
              The parties submitted that following issues for 
 
         determination at the time of the hearing.
 
         
 
              Whether claimant sustained an injury on July 8, 1986, that 
 
         arose out of and in the course of employment with employer.
 
         
 
              Whether the alleged injury was the cause of either temporary 
 
         or permanent disability.
 
         
 
              Whether claimant is entitled to either temporary or 
 
         permanent disability benefits.
 
         
 
              Whether claimant is entitled to the payment of medical 
 
         expenses.
 
         
 
              What is the proper rate of compensation in the event of an 
 
         award of weekly benefits.
 
         
 
                             SUMMARY OF THE EVIDENCE
 
         
 
              Claimant, age 45, started to work for employer on or about 
 
         June 4, 1986, performing whatever needed to be done in a hog 
 
         confinement unit.  The last day of employment was on June 9, 
 
         1986, the day after the alleged injury.  Claimant cared for the 
 
         pigs.  He cleaned and maintained the confinement facility.  On 
 
         July 8, 1986, claimant was washing out the farrowing units with 
 
         formaldehyde mixed with water in a pressure washing unit.  The 
 
         coupling came lose and the solution struck claimant in the right 
 
         side of his face.  Claimant did not know how the coupling came 
 
         loose (transcript page 45).  He could not see, but found his way 
 
         to where he could wash his eyes out with water.  He then found 
 
         and reported what happened to his foreman, Tim Van Cleve, who 
 
         washed his eyes out some more.  He finished out that day.  His 
 
         eyes hurt that night.  On the following day, June 9, 1986, both 
 
         eyes were still burning and he was experiencing difficulties in 
 
         breathing, like shortness of breath.  He couldn't get enough air.  
 
         He asked Van Cleve to take him to the doctor at about 2:00 p.m.  
 
         He had experienced shortness of breath in the past, after 
 
         exertion like running, but on this day he experienced it without 
 
         exertion. Claimant conceded that he smoked cigarettes.  Van Cleve 
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         made two phone calls to employer and then elected to take 
 
         claimant to see David G. Stilley, M.D. (tr. p. 70).  Claimant did 
 
         not have a doctor of his own (defendant's exhibit A, tr. pp. 
 
         23-32).
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              Claimant testified that he reported both his eye and 
 
         breathing problems to Dr. Stilley.  The doctor medicated and 
 
         patched his eyes and sent him home.  That night claimant's 
 
         breathing got worse.  He called Dr. Stilley who put him in the 
 
         hospital for two days for x-rays and tests.  Claimant testified 
 
         that he was told he had chemical pneumonia from formaldehyde. 
 
         Employer denied claimant had chemical pneumonia, a disease, but 
 
         asserted instead claimant only had chemical pneumonitis, and 
 
         inflammation (ex. 3, p. 1; tr. pp. 46-50, 120, 122).  Claimant 
 
         said he was administered oxygen and something else at the 
 
         hospital.  When he left the hospital his breathing was alright. 
 
         He has not experienced any shortness of breath since then.  He 
 
         serves as a volunteer fireman, which requires exertion, without 
 
         difficulty.  His vision cleared up in about a month, but his eyes 
 
         were still bloodshot for a while.  His eyes still matter.  
 
         Claimant denied his eyes mattered prior to this injury.  Dr. 
 
         Stilley had claimant examined by an eye specialist. The eye 
 
         specialist did nothing.  Claimant assumed that he would just have 
 
         to live with the mattering of the eyes (tr. pp. 47 & 90). 
 
         Claimant is now employed by another employer pumping out hog 
 
         confinement units (tr. pp. 31-36 & 74; def. ex. A).
 
         
 
              Claimant testified that Van Cleve came up to him after he 
 
         got out of the hospital and said that employer had hired somebody 
 
         else temporarily, but would consider letting claimant have a job 
 
         if claimant would sign a statement that employer would not be 
 
         responsible for future medical expenses (tr. pp. 35, 35, 71 & 
 
         72). Claimant did not sign a paper (tr. pp. 36 & 72).  Claimant 
 
         testified that he assumed that he had a job until Van Cleve 
 
         notified him on August 18, 1986, that he would not be rehired 
 
         (tr. p. 38; ex. 4, p. 7).  By contrast, employer contended that 
 
         it was a release of medical information that Van Cleve asked 
 
         claimant to sign (tr. pp. 73, and 80-83).  Claimant obtained 
 
         other employment on August 23, 1986 (tr. p. 37).  Claimant 
 
         identified the bills in exhibit 3 as his medical expenses for 
 
         this injury.
 
         
 
              No medical record is in evidence for the office visit to Dr. 
 
         Stilley on July 8, 1986.  The outpatient and emergency record for 
 
         July 9, 1986, at 2200 hours, shows claimant was admitted to the 
 
         hospital at that time.  The nursing assessment (paraphrased) 
 
         shows that yesterday afternoon claimant had formaldehyde sprayed 
 
         into his face.  He saw a doctor this afternoon.  He encountered 
 
         more respiratory difficulty at home at night.  His eyes were 
 
         reddened and were edematous.  He had a rash on his chest.  The 
 
         physician assessment stated that the eye patches were removed.  
 
         Lids and sclera inflamed.  Decreased breath sounds.  Expiratory 
 
         wheezes at bases.  Dr. Stilley diagnosed irritant pneumonitis and 
 
         conjunctivitis.  Dr. Stilley commented that claimant had much 
 
         more shortness of breath than earlier that day and that he was 
 
         more comfortable on oxygen (ex. 3, p. 3).
 
         
 
              Another nursing assessment on July 9, 1986, at 2315 hours 
 
         states that claimant was sprayed in the face yesterday with 
 
         formaldehyde.  Today he has red, puffy and weeping eyes and rash 
 
         on his chest and neck.  This report further shows vision blurred 
 
         due to swelling, a lot of dyspnea, frequent cough, chest 
 
         tightness, unable to do much today due to shortness of breath, 
 
         slight chest pain, very wheezy, some rales, respiration rate 32 
 
         with labored depth and quality, gait slightly unsteady and a 
 
         papular rash on chest and neck (ex. B).
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              The hospital admitting history records that claimant was 
 
         sprayed in the eyes with formaldehyde and also inhaled 
 
         formaldehyde.  The doctor reported eye pain, skin rash and 
 
         shortness of breath.  Claimant denied any significant history of 
 
         emphysema or other respiratory disease.  Claimant was placed on 
 
         oxygen for respiratory distress.
 
         
 
              The x-ray report was as follows:
 
         
 
              Chest x-ray remarkable for a large bleb in the left lower 
 
              lung field as well as some significant interstitial fibrosis 
 
              suggestive of previous heavy smoking history.  However, it 
 
              is unusual to see a bleb of this size in a person in his age 
 
              group.  Additionally the patient has what appears to be an 
 
              interstitial infiltrate and/or fluid accumulation in the 
 
              upper poles of his lungs.  This is probably representing of 
 
              the chemical pneumonitis.
 
              
 
         (ex. 3, p. 2, reverse side of sheet)
 
         
 
              Dr Stilley's admitting diagnosis was:
 
              
 
              ASSESSMENT:  1.  Chemical pneumonitis.  2.  Chemical 
 
              conjunctivitis.  3.  Probable significant underlying 
 
              obstructive pulmonary disease with bleb formation.
 
              
 
         (ex. 3, p. 2, reverse side of sheet)
 
         
 
              Dr. Stilley's discharge diagnosis was:
 
              
 
              FINAL DIAGNOSIS:  Chemical pneumonitis and conjunctivitis 
 
              [sic] secondary to Formaldehyde exposure.
 
                                Severe obstructive pulmonary disease with 
 
              a large bulla in the left lower chest.
 
              
 
         (ex. 3, p. 1)
 
         
 
              He said that claimant should be considered totally disabled 
 
         until his recheck on July 15 or 16, 1986 (ex. 3, p. 1).
 
         
 
              Dr. Stilley's office notes on July 11, 1986, note that he 
 
         refused to give information to employer without a release of 
 
         information signed by claimant.  The office note on July 16, 
 
         1986, as well as a return to work slip dated July 16, 1986, show 
 
         that claimant could return to work light duty on July 17, 1987, 
 
         and he could return to work on full duty with no restriction 
 
         after July 24, 1986(ex. 3, p. 4; ex. 1; tr. p. 87).  Dr. 
 
         Stilley's notes show that he saw claimant one more time on August 
 
         18, 1986, for some eye inflammation.  He observed a large sty in 
 
         the inner canthus of the right upper lid and an internal sty of 
 
         the right lower lid.  He prescribed warm compresses and 
 
         medication (ex. 3, p. 4).
 
         
 
              X-rays on both July 9, 1986 and July 16, 1986, disclosed a 
 
         large bolus of bullus in the left base and compression of the 
 
         adjacent lung.  These x-rays also showed pleural reactive change 
 
         at the left costo phrenic angle which may be long standing in 
 
         nature (ex. 3, pp. 6 & 7).
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              Defendant contends he was denied a medical release of 
 
         information (patient waver) so that he could obtain medical 
 
         information from Dr. Stilley.  There is a patient's waiver in 
 
         evidence which is signed by claimant on July 17, 1986, 
 
         authorizing that information be furnished to his then attorney, 
 
         Daniel J. Murtaugh (ex. 3, p. 8).  Dr. Stilley had refused to 
 
         answer questions of employer without a patient waiver (ex. 3, p. 
 
         4). Employer also contended that claimant would not disclose 
 
         whether he was making a workers' compensation claim or not.  
 
         Claimant contended that employer refused to take him back to work 
 
         before signing a release of future medical benefits.  Claimant 
 
         denied he withheld medical information.
 
         
 
              Claimant testified that Dr. Stilley advised him to get an 
 
         attorney because employer was trying to finagle around and not 
 
         take care of this problem.  Claimant consulted attorney Dan 
 
         Murtaugh (tr. pp. 39 & 81).  Claimant said his medical expense 
 
         creditors were charging him interest on his unpaid medical 
 
         expenses (tr. p. 40).
 
         
 
              Claimant contended that Dr. Larson indicated that he did 
 
         have workers' compensation coverage for this incident, but 
 
         refused to disclose the name of the carrier to his attorney 
 
         Murtaugh or his attorney Anderson.  Claimant contends he was 
 
         wrongfully discharged because he was injured on the job and filed 
 
         a workers' compensation claim (tr. p. 110).  Defendant contended 
 
         that claimant lied in his interrogatories about prior problems 
 
         with his breathing and that part of the radiologist's reports had 
 
         been altered to cover up the radiologist's clinical 
 
         interpretations (tr. pp. 50-70, 89 and 127-130).  Employer was 
 
         allowed to introduce defendant's exhibit B as rebuttal evidence 
 
         to show that claimant told a nurse at the time of his admission 
 
         to the hospital on July 9, 1986, that he had pneumonia a year ago 
 
         (tr. pp. 61 & 67).
 
         
 
              Dan Murtaugh testified he represented claimant in 1986 until 
 
         he became a Ph.D. candidate at the University of Kansas in the 
 
         English department.  He said employer refused to claim three 
 
         certified letters giving notice of the injury.  He finally had 
 
         the sheriff personally serve employer on the ninetieth day (tr. 
 
         pp. 96 & 97).  He denied that employer was denied medical records 
 
         by claimant (tr. p. 97).  Employer indicated he was a doctor, he 
 
         disputed Dr. Stilley and claimed he knew more than Dr. Stilley 
 
         concerning the effects of formaldehyde (tr. pp. 98-100 & 128). 
 
         Employer indicated he had a workers' compensation carrier, but 
 
         refused to disclose the name of the carrier (tr. pp. 98 & 99). 
 
         Murtaugh testified that all he and claimant wanted was to get the 
 
         medical bills paid (tr. pp. 95 & 111).
 
         
 
              Tim Van Cleve testified that he was manager of Hill Top Pork 
 
         at the time of this injury.  He was personally responsible for 
 
         overseeing the work of claimant at that time.  Prior to the 
 
         injury he thought claimant's shortness of breath was only normal 
 
         (tr. pp. 146 & 147).  He verified he was in the vicinity when 
 
         claimant was sprayed in the face with formaldehyde from the 
 
         coupling to the power washer.  He saw claimant come staggering 
 
         down the walkway. There is a lot of pressure in those lines.  He 
 
         took claimant to Dr. Stilley on his own initiative.  Claimant was 
 
         in respiratory distress (tr. pp. 147-151).  Van Cleve said 
 
         employer wanted him to get a medical release rather than a 
 
         liability release because employer was concerned about claimant's 
 
         sensitivity to formaldehyde (tr. pp. 152-155, 157).
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              Dr. Daryl Larson, employer, testified that there is no 
 
         evidence of chemical pneumonia and that the x-ray reports do not 
 
         support chemical pneumonitis.  He said he tried to find out if 
 
         this was a workers' compensation claim or not.  He denied he 
 
         tried to get a release of future medical expenses, but wanted a 
 
         release to obtain medical information.  He denied that he 
 
         attempted to control the treatment of claimant's condition.  He 
 
         asserted that claimant and Dr. Stilley tried to cover up 
 
         claimant's prior respiratory problems.  He denied Murtaugh tried 
 
         to settle this matter.  He denied claimant had any permanent 
 
         disability from mattering of the eyes.  He found it unlikely that 
 
         claimant maintained a day-to-day calendar of this injury (tr. pp. 
 
         119-134; ex. 4).
 
         
 
              There are a number of medical bills.  Some of them appear 
 
         two or three times.  The bills which appear to apply to this 
 
         injury, with the duplication eliminated, are as follows:
 
         
 
              David G. Stilley, M.D.         $263.50
 
              Myrtue Memorial Hospital        758.00
 
              Myrtue Memorial Hospital
 
                 (x-ray 7-16-86)               37.50
 
              Nebraska-Iowa Radiology
 
                 (x-ray 7-16-86)               24.00
 
         
 
                                    TOTAL             $1,083.00
 
         
 
         (ex. 2)
 
         
 
              Claimant did not submit a bill for the unknown traveling eye 
 
         physician that visits Myrtue Hospital and examined his eyes.  He 
 
         claimed that he paid this physician himself by his personal 
 
         check, but the check was not introduced into evidence (tr. p. 
 
         75).
 
         
 
              Claimant verified by his testimony that the charges in 
 
         exhibit 2, which total $1,083, are the bills that he incurred for 
 
         this injury (tr. p. 33).
 
         
 
              Claimant admitted he was asserting a claim for 5 percent 
 
         permanent disability, but could not explain what evidence 
 
         supported this claim (tr. pp. 75 & 76).  Claimant contended he 
 
         also needed a new prescription for eye glasses as a result of 
 
         this injury (tr. pp. 90-92).
 
         
 
              Murtaugh was initially subpoenaed by employer for this 
 
         hearing.  The hearing was continued at the request of the 
 
         employer.  Employer did not revoke or terminate the subpoena. 
 
         Murtaugh appeared at the rescheduled hearing.  Employer did not 
 
         notify him to come to the rescheduled hearing and did not call 
 
         him as a witness.  Since he was there, claimant called Murtaugh 
 
         as a witness.  Employer obtained information from Murtaugh by way 
 
         of cross-examination (tr. pp. 140-146).
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
              As to rate, the parties stipulated that claimant earned $175 
 
         per week, was single and entitled to one income tax exemption.
 
         
 
                           APPLICABLE LAW AND ANALYSIS
 
         
 
              An employee is entitled to compensation for any and all 
 
         personal injuries which arise out of and in the course of the 
 
         employment.  Section 85.3(1).
 
         
 
              Claimant has the burden of proving by a preponderance of the 
 
         evidence that he received an injury on July 8, 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).
 
         
 
              The claimant has the burden of proving by a preponderance of 
 
         the evidence that the injury of July 8, 1986, is causally related 
 
         to the disability on which he now bases his claim.  Bodish v. 
 
         Fischer, Inc., 257 Iowa 516, 133 N.W.2d 867 (1965).  Lindahl v. 
 
         L.O. Boggs, 236 Iowa 296, 18 N.W.2d 607 (1945).  A possibility is 
 
         insufficient; a probability is necessary.  Burt v. John Deere 
 
         Waterloo Tractor Works, 247 Iowa 691, 73 N.W.2d 732 (1955).  The 
 
         question of causal connection is essentially within the domain of 
 
         expert testimony.  Bradshaw v. Iowa Methodist 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.2nd 756, 760-761 
 
         (1956).  If the claimant had a preexisting condition or 
 
         disability that is aggravated, accelerated, worsened or lighted 
 
         up so that it results in disability, claimant is entitled to 
 
         recover.  Nicks v. Davenport Produce Co., 254 Iowa 130, 115 
 
         N.W.2d 812, 815 (1962).
 
         
 
              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 Hospital Sch., 
 
         266 N.W.2d 139 (Iowa 1978); Gosek v. Garmer and Stiles Co., 158 
 
         N.W.2d 731 (Iowa 1968); Barz v. Oler, 257 Iowa 508, 133 N.W.2d 
 
         704 (1965); Olson v. Goodyear Service Stores, 255 Iowa 1112, 125 
 
         N.W.2d 251 (1963); Yeager v. Firestone Tire & Rubber Co., 253 
 
         Iowa 369, 112 N.W.2d 299 (1961); Ziegler v. United States Gypsum 
 
         Co., 252 Iowa 613, 106 N.W.2d 591 (1960).
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              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 691 
 
         (1960), and cases cited.
 
         
 
              Claimant did sustain the burden of proof by a preponderance 
 
         of the evidence that he sustained an injury on July 8, 1986, 
 
         which arose out of and in the course of his employment with 
 
         employer. Claimant related that formaldehyde diluted with water 
 
         under pressure struck him in the face.  It affected his vision 
 
         and breathing.  Van Cleve saw claimant staggering out of the 
 
         building, washed his eyes again, told him to rest, and took him 
 
         to Dr. Stilley on the following day for these same symptoms.  
 
         Claimant related the same incident to Dr. Stilley who accepted 
 
         this history as true and treated claimant on this basis.  The 
 
         hospital records confirm a physical injury in July as described 
 
         by claimant.  Even though there is evidence that claimant has had 
 
         prior respiratory problems, there is no evidence that any prior 
 
         problems were treated at this time.  The entire treatment at this 
 
         time was for eye problems and breathing problems caused in this 
 
         formaldehyde accident.
 
         
 
              Defendant did not introduce any medical evidence or other 
 
         evidence to show that claimant's current injury to his eyes and 
 
         lungs were from any cause other than the accident that occurred 
 
         at employer's place of employment while performing work for 
 
         employer on July 8, 1986.  Claimant's prior respiratory problems 
 
         were not causing any disability or medical problems on the date 
 
         of this injury.  He had worked since June 4, 1986, without any 
 
         problems.
 
         
 
              Claimant sustained the burden of proof by a preponderance of 
 
         the evidence that the injury was the cause of temporary 
 
         disability.  Dr. Stilley said the injury was workers' 
 
         compensation related (ex. 3, p. 4).  Dr. Stilley said on the 
 
         discharge diagnosis dictated on July 21, 1986, chemical 
 
         pneumonitis and conjunctivitis secondary to formaldehyde exposure 
 
         (ex. 3, p. 1).
 
         
 
              Dr. Stilley took claimant off work beginning on July 10, 
 
         1986 through July 24, 1986.  He was allowed to return to work on 
 
         July 25, 1986, without any restrictions.  He could have returned 
 
         to work light duty on July 17, 1986.  However, employer did not 
 
         provide him with light duty work at that time.  Claimant further 
 
         testified that there was no light duty in the job he performed. 
 
         Employer never did take claimant back to work.  Claimant was 
 
         discharged on August 18, 1986.  Claimant is entitled to temporary 
 
         disability benefits from July 10, 1986 to July 25, 1986, a period 
 
         of two weeks and two days [Iowa Code section 85.33(1)].
 
         
 
              Claimant was paid wages for a portion of this period and 
 
         defendant should be entitled to a credit.  However, defendant did 
 
         not introduce any evidence on how much claimant was paid or for 
 
         what dates claimant was paid.  Claimant did not present precise 
 
         evidence on how much he was paid.  On the prehearing report at 
 
         paragraph nine, it shows that claimant received sick pay or 
 
         disability income to July 11 or 15 and that defendant is entitled 
 
         to a credit for the amount paid.  Claimant established an injury, 
 
         causation and entitlement to temporary disability.  The burden of 
 
         proof to prove a credit is upon defendant.  Since defendant did 
 
         not prove the amount of his entitlement to a credit for wages 
 
         continued after the injury, the most defendant can establish is 
 
         that claimant received wages through July 11, 1986, the shortest 
 
         period of time that claimant was willing to stipulate.  It is 
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         determined that defendant is entitled to a credit from July 10, 
 
         1986, to July 11, 1986, a period of one day.
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              Claimant did not sustain the burden of proof by a 
 
         preponderance of the evidence that the injury was the cause of 
 
         permanent disability.  Dr. Stilley never discussed permanent 
 
         injury or impairment or even mentioned it.  He was never asked 
 
         point blank whether claimant sustained permanent impairment as a 
 
         result of this injury.  There is no other medical evidence of a 
 
         permanent impairment or disability.  The only evidence of a 
 
         permanent injury is that claimant testified that his eyes still 
 
         matter.  He indicated it could affect his driving.  However, he 
 
         gave no testimony to establish a permanent disability from 
 
         performing the work that he has always been able to perform 
 
         before the injury.  He immediately found other employment and is 
 
         now performing a job doing similar work for another employer.  He 
 
         testified that his breathing has been alright ever since he was 
 
         discharged from the hospital.  His eyes were bloodshot for a 
 
         while, but cleared up.  He saw a specialist for his eyes, but the 
 
         specialist did nothing for him.  There is no evidence of a 
 
         permanent impairment from this unknown specialist to establish a 
 
         permanent disability.  Claimant's testimony about the continued 
 
         mattering of his eyes did not indicate that it was a problem of 
 
         any significance.  Therefore, it is determined that claimant did 
 
         not sustain the burden of proof that the injury was the cause of 
 
         permanent disability.  Accordingly, he is not entitled to 
 
         permanent disability benefits.
 
         
 
              Claimant did establish that he is entitled to the payment of 
 
         his medical bills for this injury in the amount of $1,083, as set 
 
         forth in the summary of the evidence.  Defendant is ordered to 
 
         pay claimant for these bills.
 
         
 
              Claimant sustained the burden of proof by a preponderance of 
 
         the evidence that he is entitled to be reimbursed for the eye 
 
         examination that he paid for.  Claimant testified that Dr. 
 
         Stilley referred him to any eye specialist that travels to the 
 
         local hospital because of this eye injury.  Referral by an 
 
         authorized physician to another physician is also authorized 
 
         care.
 
         
 
              Defendant stipulated in the prehearing order that providers 
 
         of medical services would testify that their charges were 
 
         reasonable and that the charges were for reasonable and necessary 
 
         medical treatment.  Causal connection is provided by the office 
 
         note of August 18, 1986, of Dr. Stilley.  He said that he 
 
         intended to refer claimant to an ophthalmology clinic for his 
 
         continued eye complaints from this injury (ex. 3, p. 4).
 
         
 
              Claimant did not sustain the burden of proof by a 
 
         preponderance of the evidence that he is entitled to a new 
 
         eyeglasses prescription as a result of this injury.  Claimant's 
 
         testimony that an eye physician once told him that he would never 
 
         need another new prescription for glasses is not acceptable to 
 
         prove that the injury here is the cause for a new prescription. 
 
         Claimant's entitlement would depend on a medical opinion.  
 
         Claimant submitted no medical evidence in support of his 
 
         contention.
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              A subpoena once issued continues in effect and applies to a 
 
         continuation of a hearing.  Subpoenas generally continue until 
 
         revoked or terminated.  Defendant did not revoke or terminate the 
 
         subpoena.  Therefore, defendant is liable for the witness fee and 
 
         mileage of Dan Murtaugh to attend the hearing.
 
         
 
              The many other points of contention between the parties and 
 
         attorneys about who said or did or did not do what, when where 
 
         and how need not be resolved in order to determine the workers' 
 
         compensation issues in this case.
 
          
 
              The Guide to Iowa Workers' Compensation Claim Handling, 
 
         dated July 1, 1986, shows that the proper rate of compensation 
 
         for a single person with one exemption, earning $175 per week, is 
 
         $133.06 per week.
 
         
 
                                 FINDING OF FACT
 
         
 
              Wherefore, based upon the evidence presented, the following 
 
         findings of fact are made.
 
         
 
              That claimant was employed by employer from June 4, 1986 
 
         until July 10, 1986.
 
         
 
              That claimant sustained an injury arising out of and in the 
 
         course of employment on July 8, 1986, when he was sprayed in the 
 
         face with water diluted formaldehyde by a high pressure hose 
 
         which caused eye/vision problems and respiratory problems.
 
         
 
              That Dr. Stilley said that claimant's injury was workers' 
 
         compensation related.  That Dr. Stilley said that claimant's 
 
         chemical pneumonitis and conjunctivitis was secondary to 
 
         formaldehyde exposure.
 
         
 
              That Dr. Stilley, the treating physician, took claimant off 
 
         work from July 10, 1986 to July 25, 1986.
 
         
 
              That claimant was authorized to work light duty from July 
 
         17, 1986 to July 25, 1986, but employer did not provide claimant 
 
         with light duty during this period of time.
 
         
 
              That there is no medical evidence of a permanent injury, 
 
         diminished vision or of any other nature from this injury due to 
 
         mattering of the eyes.
 
         
 
              That claimant incurred $1,083 in medical expenses as shown 
 
         above plus interest charges imposed by creditors and also another 
 
         amount for an examination by an eye specialist to whom claimant 
 
         was referred by Dr. Stilley.
 
         
 
              That defendant subpoenaed a witness, Dan Murtaugh, to 
 
         testify at the hearing, the hearing was continued, but defendant 
 
         did not terminate or revoke the subpoena.
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
              That claimant earned $175 per week, was single and entitled 
 
         to one exemption.
 
         
 
                                CONCLUSIONS OF LAW
 
                                                                                                                    
 
         
 
              WHEREFORE, based upon the evidence presented and the 
 
         foregoing principles of law, the following conclusions of law are 
 
         made.
 
         
 
              That claimant sustained an injury on July 8, 1986, which 
 
         arose out of and in the course of employment with employer.
 
         
 
              That the injury was the cause of temporary disability from 
 
         July 10, 1986 to July 25, 1986.
 
         
 
              That claimant is entitled to temporary total disability 
 
         benefits for that period of time.
 
         
 
              That defendant is entitled to a credit for wages paid to 
 
         claimant on July 10, 1986.
 
         
 
              That claimant did not sustain the burden of proof by a 
 
         preponderance of the evidence that the injury was the cause of 
 
         permanent disability.
 
         
 
              That claimant is not entitled to permanent disability 
 
         benefits.
 
         
 
              That the proper rate of compensation is $113.06 per week.
 
         
 
              That claimant is entitled to medical expenses in the amount 
 
         of $1,083 and also reimbursement for the amount paid to the eye 
 
         specialist.
 
         
 
              That claimant is not entitled to new prescription glasses.
 
         
 
              That defendant is liable for the witness fee and mileage 
 
         expense for the witness he subpoenaed and did not revoke or 
 
         terminate the subpoena.
 
         
 
                                      ORDER
 
         
 
              THEREFORE, IT IS ORDERED:
 
         
 
              That defendant file a first report of injury within 10 days 
 
         of the signing and filing of this order.
 
         
 
              That defendant pay to claimant two weeks and two days (2.286 
 
         weeks) of workers' compensation benefits at the rate of one 
 
         hundred thirteen and 06/100 dollars ($113.06) per week in the 
 
         total amount of two hundred fifty-eight and 46/100 dollars 
 
         ($258.46) commencing on July 10, 1986.
 
         
 
              That defendant is entitled to a credit in the amount of 
 
         sixteen and 15/100 dollars ($16.15) for one day for wages paid 
 
         during this period on July 10, 1986.
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
              That the remaining benefits be paid in a lump sum.
 
         
 
              That interest will accrue pursuant to Iowa Code section 
 
         85.30.
 
         
 
              That defendant pay to claimant one thousand eight-three 
 
         dollars ($1,083) in medical expenses as shown above plus any 
 
         interest charges because of late payment and also reimburse 
 
         claimant the amount he paid to the eye physician.
 
         
 
              That defendant pay the costs of this action pursuant to 
 
         Division of Industrial Services Rule 343-4.33.  The costs include 
 
         the attendance of the court reporter at hearing, the cost of the 
 
         transcript, sheriff's fee of twelve dollars ($12), the witness 
 
         and mileage fee of Dan Murtaugh, who was subpoenaed by the 
 
         defendant and not revoked, and any other costs allowed by the 
 
         above rule or the Code of Iowa.
 
         
 
              That defendant file claim activity reports as requested by 
 
         this agency pursuant to Division of Industrial Services Rule 
 
         343-3.1.
 
         
 
              Signed and filed this 19th day of October, 1989.
 
         
 
         
 
         
 
         
 
         
 
         
 
                                            WALTER R. McMANUS, JR.
 
                                            DEPUTY INDUSTRIAL COMMISSIONER
 
         
 
         Copies to:
 
         
 
         Mr. Brian Anderson
 
         Attorney at Law
 
         405 Tracy Street
 
         Audubon, IA  50025
 
         
 
         Hill Top Pork
 
         c/o Dr. Daryl Larson
 
         RR 2 Box 94A
 
         Carroll, IA  51401
 
         Certified and Regular Mail
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
         
 
         
 
                                                                                       
 
         
 

 
         
 
 
 
 
 
 
 
 
 
 
 
         
 
 
                                            
 
 
 
 
 
 
 
 
 
 
 
                                            51106; 51108.30; 51108.50;
 
                                            51401; 51402.20; 51402.30;
 
                                            51402.40; 51402.60; 52205;
 
                                            51801; 51803; 52501; 52700;
 
                                            Filed October 19, 1989
 
                                            Walter R. McManus,Jr.
 
         
 
                     BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         
 
         
 
         LEWIS HALL
 
         
 
              Claimant,                            File No. 846905
 
         
 
         vs.                                    A R B I T R A T I O N
 
         
 
         DR. DARYL LARSON, d/b/a                   D E C I S I O N
 
         HILL TOP PORK,
 
         
 
              Employer,
 
              Uninsured,
 
              Defendant.
 
         
 
         
 
         51106; 51108.30; 51108.50; 51401; 51402.20; 51402.30; 51402.40;
 
         51402.60; 52205
 
         
 
              Claimant proved an injury arising out of and in the course 
 
         of employment of pneumonitis and conjunctivitis from being 
 
         sprayed in the face with dilute formaldehyde.  The only doctor 
 
         said it was the cause of claimant's temporary disability for two 
 
         weeks and two days.
 
         
 
         51801; 51803
 
         
 
              Claimant awarded temporary total disability benefits. 
 
         Claimant did not prove permanent disability and was denied 
 
         permanent disability benefits.
 
         
 
         52501; 52700
 
         
 
              Claimant awarded medical benefits.