BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
         ____________________________________________________________
 
                                       :
 
         NANCY J. SORENSON,            :
 
                                       :
 
              Claimant,                :
 
                                       :
 
         vs.                           :
 
                                       :       File No. 877045
 
         YOUNKERS,                     :
 
                                       :         A P P E A L
 
              Employer,                :
 
                                       :       D E C I S I O N
 
         and                           :
 
                                       :
 
         AETNA LIFE & CASUALTY,        :
 
                                       :
 
              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.
 
         
 
                                      ISSUES
 
         
 
              Those portions of the proposed agency decision pertaining to 
 
         issues not raised on appeal are adopted as a part of this appeal 
 
         decision.  The issues raised by claimant on appeal are:
 
         
 
              Issue I:  Did the deputy err in determining that there 
 
                        was no cumulative trauma?
 
         
 
              Issue II: Did the deputy industrial commissioner err in 
 
                        determining that the discovery rule did not 
 
                        operate to defeat respondents' statute of 
 
                        limitations defense?
 
         Defendants did not appeal or cross-appeal.  Defendants' issues 
 
         raised in their appeal brief that do not correspond to claimant's 
 
         appeal issues will not be considered on appeal.
 
         
 
                                 FINDINGS OF FACT
 
         
 
              The findings of fact contained in the proposed agency 
 
         decision filed April 30, 1991 are adopted as set forth below.  
 
         Segments designated by asterisks (*****) indicate portions of the 
 
         language from the proposed agency decision that have been 
 
         intentionally deleted and do not form a part of this final agency 
 
         decision.
 
         
 
              *****
 
         
 
              Without making a determination as to whether claimant 
 
         sustained an injury or occupational disease, it is, nevertheless, 
 

 
         
 
         Page   2
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 
         determined that the nature of claimant's complaints, symptoms and 
 
         problems are not of a cumulative nature, but rather they are 
 
         traceable to a date of specific onset.
 
         
 
              Claimant, age 45 at the time of the hearing, sold Avon 
 
         products for approximately two years.  She graduated from the La 
 
         James College of Cosmetology at Fort Dodge on October 14, 1983 
 
         (joint exhibit 12, pages 7 & 8).  She then worked as a 
 
         cosmetologist for approximately eight months.  Claimant started 
 
         to work for employer on April 4, 1984, as a part-time sales 
 
         person of Clinique.  She became a full-time employee on November 
 
         12, 1984, as the Elizabeth Arden sales person (jt. ex. 15, p. 7).  
 
         In addition to sales, she sprayed cleaner on the counter to 
 
         remove fingerprints quite frequently.  Except for one item, 
 
         Clinique was fragrance free and nonallergenic.  The perfume 
 
         department had a drop ceiling, spotlights and counterlights which 
 
         generated heat and had very poor ventilation.  It was a common 
 
         occurrence for customers to spray perfume on themselves, in the 
 
         air and onto the sales person.  On June 22, 1986, claimant 
 
         transferred to the accessories department which was adjacent to 
 
         the perfume department and it too had a drop ceiling, warm air 
 
         and poor ventilation.  Claimant stopped working on August 31, 
 
         1986 (transcript pp. 47-55).  
 
         
 
              Claimant testified that in September of 1984, she had a 
 
         specific onset of symptoms.  At the time she first noticed being 
 
         able to taste the perfumes and she experienced vaginal burning 
 
         (tr. p. 56).  She was unpacking Polo cologne, marking it and 
 
         putting it on the shelf when she noticed that she could start to 
 
         taste it.  Shortly after that her lips, tongue and mouth would 
 
         burn (tr. p. 57).  Claimant testified:
 
         
 
                 I could start tasting the perfumes.  I had vaginal 
 
              burning.  My skin would burn.  My eyes would burn.  I 
 
              had numbness.  Sometimes my whole body, usually 
 
              starting with my feet, and it would work up, a 
 
              numbness.  I had the sensation of pins or needles in my 
 
              feet and sometimes in my hands.  A vibrating feeling, 
 
              almost a shaky feeling.  I wasn't -- you know, I would 
 
              look at myself and I wasn't actually shaking, but it 
 
              was just -- I just felt like I was vibrating.
 
         
 
         (Transcript page 56)
 
         
 
              She also reported changes in her mental processes.  She 
 
         related, "I would get these symptoms and I just felt like I 
 
         couldn't cope.  It was just kind of overwhelming.  Just kind of 
 
         felt like I'd been hit by a truck.  Very fatigued."  (Tr. p. 59)  
 
         She was also fatigued at home (tr. p. 59).  Three years later at 
 
         the time of the hearing, on December 19, 1989, she testified, 
 
         "Yes, I'm still very fatigued." (Tr. p. 65).  Claimant testified 
 
         that there was a direct relationship with exposure to perfumes.  
 
         She testified:
 
         
 
              A.  Yes.  I'm still very sensitive to perfumes, 
 
              aftershave lotions, colognes.  Things with fragrance in 
 
     
 
         
 
         
 
         Page   3
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 
              it. 
 
         
 
              Q.  What happens if you are in too close of contact 
 
              with someone wearing perfume?
 
         
 
              A.  My symptoms will return, the burning will start, my 
 
              mouth will burn.  If I'm there long enough, my skin 
 
              will start burning.  Depending on how long the 
 
              exposure, the symptoms will all return.
 
         
 
         (Transcript pages 64 & 65)
 
         
 
              Further evidence of a specific onset problem, rather than a 
 
         cumulative problem, is found in claimant's testimony to the 
 
         effect that she had similar problems prior to being employed by 
 
         employer, but they became continuous after her employment with 
 
         employer (tr. pp. 76 & 77).  
 
         
 
              Claimant also testified that her arms ache, legs ache, she 
 
         has chest pain when the neighbors spray for dandelions, severe 
 
         headaches if she is near new asphalt, earaches, blurring of 
 
         vision, itching, upset stomach and diarrhea from exposure to 
 
         pesticides and uncontrollable crying on some occasions (tr. pp. 
 
         73-76).  Claimant stated that she reacts to anything that is 
 
         scented, including deodorants, detergents, window cleaners, 
 
         cigarette smoke, new asphalt, lawn chemicals, pesticides, corn, 
 
         dust and molds, new carpet, new furniture, paint, varnish, 
 
         newsprint, colored paper, soft plastic and polyester and anything 
 
         with phenol or formaldehyde in it, such as clothing (tr. pp. 
 
         78-80).  Claimant testified that her employment for employer was 
 
         the trigger for all of her symptoms (tr. p. 76).  
 
         
 
              Claimant testified to continuing problems while employed by 
 
         employer, but she did not testify to cumulative, progressive, or 
 
         a gradual worsening of her condition.  Rather, her symptoms were 
 
         directly related to exposure or nonexposure to the chemicals to 
 
         which she was sensitive.  
 
         
 
              There is no medical evidence of a cumulative injury.  At one 
 
         point in the testimony of Vernon P. Varner, M.D., a board 
 
         certified psychiatrist with a certain degree of expertise in 
 
         toxicology, he stated that her symptoms would continue to 
 
         escalate as long as she was exposed and not protected from 
 
         certain chemicals (claimant's ex. 1, p. 37).  However, this 
 
         statement falls far short of establishing a cumulative injury 
 
         during the course of her employment with employer from April 4, 
 
         1984 until August 31, 1986.  Furthermore, it is prospective 
 
         rather then retrospective in its application.
 
         
 
              Consequently, it is determined that the nature of claimant's 
 
         symptoms, complaints and problems are not cumulative, but rather 
 
         are traceable to a specific onset in September of 1984.  
 
         
 
              Therefore, with regard to determining the date of injury or 
 
         occupational disease for purposes of the commencement of the 
 
         statute of limitations, the proper time the injury or 
 
         occupational disease occurred would be September 1984, the date 
 

 
         
 
         Page   4
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 
         of specific onset, rather than when claimant first lost time from 
 
         work due to these symptoms, complaints and problems.  McKeever 
 
         Custom Cabinets v. Smith, 379 N.W.2d 368 (Iowa 1985).  Actually, 
 
         claimant lost time from work for medical treatment in April and 
 
         May of 1985, even before her medical leave of absence on August 
 
         31, 1986.
 
         
 
                              STATUTE OF LIMITATIONS
 
         
 
              It is determined that claimant failed to commence this 
 
         action in a timely manner as required by Iowa Code section 
 
         85.26(1).  
 
         
 
              Defendants made no payments of any kind to claimant.  Iowa 
 
         Code section 85.26(1) states that an original proceeding for 
 
         benefits shall not be maintained in any contested case unless the 
 
         proceeding is commenced within two years from the date of the 
 
         occurrence of the injury for which benefits are claimed where no 
 
         weekly compensation has been paid to claimant.  Mousel v. 
 
         Bituminous Material & Supply Co., 169 N.W.2d 763 (1969); Beier 
 
         Glass v. Brundige, 329 N.W.2d 280 (1983).
 
         
 
              *****
 
         
 
              The petition, dated June 1, 1988, was filed with the 
 
         industrial commissioner on June 3, 1988.  
 
         
 
              In the resistance to the motion for summary judgement and in 
 
         her testimony at the hearing, claimant maintained that she first 
 
         discovered that she might have a compensable claim on September 
 
         30, 1986.
 
         
 
              Her affidavit attached to the resistance for summary 
 
         judgement, filed on September 8, 1989, states, "That after 
 
         reviewing the medical records of Dr. Varner, it is my belief that 
 
         it was on 9/30/86 that I first realized that I might have a 
 
         compensable claim against Younkers."  (Affidavit-resistance to 
 
         summary judgement, paragraph 3)
 
         
 
              Claimant testified at the hearing that Dr. Varner told her 
 
         in May of 1986 that she could cut down on exposures, but it was 
 
le     recognize her (tr. p. 32).  
 
         
 
              Hoskins also testified that claimant underwent a personality 
 
         change where she became quiet, withdrawn, paranoid and, "We 
 
         thought that she was headed for a nervous breakdown, it got to 
 

 
         
 
         Page   6
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 
         that point."  (Tr. p. 33).
 
         
 
              Hoskins testified that claimant was then transferred to 
 
         accessories, an adjacent department, on November 12, 1984 (tr.
 
         p. 29).  Hoskins could not understand why they transferred her 
 
         out of the perfume area to the adjacent accessories area which 
 
         also had a drop ceiling, warm temperatures, poor ventilation and 
 
         the aroma of perfume because it was her understanding that 
 
         perfume was the cause of claimant's problem (tr. pp. 35 & 36).  
 
         
 
              Eileen McLuckie, claimant's sister, testified that when 
 
         claimant began work for employer she was enthusiastic and happy 
 
         (tr. pp. 41 & 42).  McLuckie then testified that during the 
 
         period from April of 1984, when claimant started to work for 
 
         employer, and September of 1986, when she took a medical leave of 
 
         absence, claimant's energy seemed to disappear.  She did not feel 
 
         well, she was more tired and she lost a lot of weight for someone 
 
         her size and started looking very thin (tr. pp. 43 & 44).  She 
 
         said claimant lost the ability to be enthusiastic and the 
 
         attitude of being ready to try something new.  Her activities 
 
         became extremely limited within the family.  McLuckie testified, 
 
         "[W]e all know that you don't wear aftershave and you don't wear 
 
         perfume and you try to make everything so that she can be there 
 
         and feel comfortable."  (Tr. pp. 45 & 46)  At a celebration for 
 
         the graduation of the daughter of the witness claimant spent the 
 
         evening outdoors to avoid being closed up in the house with 
 
         persons who were wearing perfume.  These changes came about after 
 
         claimant started to work for employer (tr. p. 46).  
 
         
 
              Claimant saw three local doctors:  Janet Secor, M.D.; 
 
         Charles Dagle, M.D.; and Herman M. Tan, M.D.  Dr. Tan referred 
 
         claimant to N. K. Rinderknecht, an ob/gyn specialist in Des 
 
         Moines who referred claimant to Jay William Holtze, M.D., a 
 
         dermatologist in Des Moines (cl. exs. 5 & 6; jt exs. 4, 8, & 9).  
 
         Dr. Dagle referred claimant to the University of Iowa where 
 
         Rudolph P. Galask, M.D., saw claimant on April 17, 1985.  He 
 
         stated, "Because of her generalized symptoms, I suspect this is a 
 
         systemic problem or can very well be related to the cosmetics 
 
         which she sells at Younkers." (Jt. ex. 3, p. 4)  Dr. Galask, an 
 
         ob/gyn specialist, then referred claimant to Duane C. Whitaker, 
 
         M.D., a dermatologist at the University of Iowa.  Dr. Whitaker 
 
         stated on May 17, 1985, that patch tests at the dermatology 
 
         clinic were positive for chlorocresol and isopropyl myristate.  
 
         
 
              He said chlorocresol was a bactericidal agent found in many 
 
         creams as a preservative, in shampoos, topical medications and 
 
         hair tonic.  Isopropyl myristate is also a common ingredient in 
 
         cosmetics and pharmaceuticals (jt. ex. 7, p. 1).  Thus, claimant 
 
         was told in 1985 by both an ob/gyn doctor and a dermatologist 
 
         that her condition was work related.
 
         
 
              At the time of her deposition on July 20, 1989, claimant 
 
         testified that she attributed all of her sensitivities to her 
 
         employment for employer.  These symptoms started appearing in 
 
         September of 1984 (deposition p. 18).  Then this colloquy 
 
         transpired between claimant and counsel:
 
         
 

 
         
 
         Page   7
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 
              Q.  When did you first decide that work at Younkers was 
 
              causing these problems?
 
         
 
              A.  Well, I had suspicioned it.  I don't know when.  I 
 
              don't know.  I was going to doctors, and I would tell 
 
              them where I worked, and they didn't seem to relate it, 
 
              so I guess I really didn't until I saw Doctor Varner.  
 
              He told me that if I didn't get out of that department, 
 
              that I could be completely disabled.  That was the 
 
              first time, I guess, I knew for sure that it was from 
 
              that.
 
         
 
         (Deposition, page 21)
 
         
 
              A second colloquy between counsel and claimant reads as 
 
         follows:
 
         
 
              Q.  When did you decide to file a worker's [sic] 
 
              compensation claim?
 
         
 
              A.  I guess I considered it probably in about December 
 
              of 1984 when I realized that it probably was a 
 
              permanent injury, or a long-term injury.
 
         
 
              Q.  Why did you not file one until June of 1988?
 
         
 
              A.  I guess I had to find an attorney, and it took that 
 
              long to get it filed, I guess.
 
         
 
         (Deposition, page 33)
 
         
 
              After a recess, in response to questions from her own 
 
         attorney, claimant corrected her testimony to say that she first 
 
         realized she had a permanent injury after she had stopped working 
 
         and had been off work for several months in December of 1986 
 
         (dep. pp. 35 & 36).  The questioning continued and this dialogue 
 
         occurred between claimant and defendants' counsel:
 
         
 
              Q.  Maybe I misunderstood your testimony, then, because 
 
              I thought I asked you twice about December of 1984.  
 
              Did you mean to state December of 1986?
 
         
 
              A.  Yes.
 
         
 
              Q.  When did you first realize that the symptoms that 
 
              you were having were caused by your working at 
 
              Younkers?
 
         
 
              A.  When did I realize it?  When did I know it for 
 
              sure?
 
         
 
              Q.  When did you believe that the symptoms you were 
 
              experiencing were caused by exposures to work at 
 
              Younkers?
 
         
 
              A.  I guess it was confirmed when I saw Doctor Varner, 
 
              and he told me that I could become disabled if I didn't 
 

 
         
 
         Page   8
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 
              get treatment.
 
         
 
              Q.  So that would have been in May of 1986?
 
         
 
              A.  Right.
 
         
 
              Q.  At that point you believed your problems were 
 
              causally connected to exposures at Younkers?
 
         
 
              A.  Yes.
 
         
 
         (Deposition, pages 36 & 37)
 
         
 
              Claimant changed her testimony at the time of hearing to 
 
         indicate that in May of 1985, after the patch test by Dr. 
 
         Whitaker in Iowa City, and in May of 1986, after she saw Dr. 
 
         Varner for the first time, that she knew something was wrong with 
 
         her, but she didn't know what it was and she didn't know what was 
 
         causing it (tr. pp. 100-111).  
 
         
 
              Based on claimant's testimony on direct examination:  (1) 
 
         that she worked in a warm, closed, poorly ventilated area; (2) 
 
         that her symptoms first arose when she could taste perfume, 
 
         experienced vaginal burning and burning on other parts of her 
 
         body while working with fragrances; (3) Hoskin's testimony that 
 
         claimant changed from an outgoing, bubbly, fun-loving, 
 
         happy-go-lucky person to a quiet, withdrawn, paranoid, 
 
         anorexic-type person not recognized by people who had known her 
 
         before, all of which was allegedly due to her exposure to 
 
         perfumes and fragrances; (4) the testimony of McLuckie that 
 
         claimant was in good health, but shortly after she started to 
 
         work for employer her energy disappeared, she looked as if she 
 
         did not feel well, she lost weight to the point of looking very 
 
         thin, that claimant lost her enthusiasm and attitude of ready to 
 
         try something new and who was socially unable to be indoors with 
 
         persons wearing perfume; (5) the testimony of Dr. Galask on April 
 
         17, 1985, that he suspected a systemic problem which could very 
 
         well be related to cosmetics which she sells at Younkers; (6) the 
 
         testimony of Dr. Whitaker that she had a positive patch test 
 
         reaction to two chemicals which are found in shampoos, hair 
 
         tonics, cosmetics and pharmaceuticals; and (7) Dr. Varner's 
 
         testimony that claimant told him that she knew that she was 
 
         sensitive to perfume even before she saw him in May of 1986; it 
 
         is determined that claimant's voluntary, spontaneous and 
 
         straightforward answers to the questions in the deposition, 
 
         rather than her testimony at hearing, are the most reliable 
 
         indicator of when she first realized that her symptoms were 
 
         caused by her work for employer (dep. pp. 36 & 37).
 
         
 
              The evidence established that not only claimant, but also, 
 
         her coemployee Hoskins and her sister McLuckie, believed that 
 
         work was causing both physical and psychological problems in 1984 
 
         and 1985.  The testimony of Dr. Galask in April of 1985 related 
 
         her symptoms to work.  The testimony of Dr. Whitaker in May of 
 
         1985 related claimant's symptoms to work.
 
         
 
              The symptoms, complaints and problems related by claimant, 
 

 
         
 
         Page   9
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 
         Hoskins, and McLuckie certainly define a serious problem which 
 
         they believed was work-related.  The fact that claimant saw three 
 
         doctors in Fort Dodge, two doctors in Des Moines, three or four 
 
         doctors in Iowa City plus Dr. Varner and George F. Kroker, M.D., 
 
         at LaCrosse, Wisconsin, certainly indicates that claimant 
 
         considered this a serious injury and she testified a number of 
 
         times that work triggered all of her symptoms.  Both Dr. Gaslask 
 
         and Dr. Whitaker told claimant that her complaints were related 
 
         to her job working with cosmetics.
 
         
 
              Claimant's testimony that she realized that the symptoms 
 
         were caused by work after she talked to Dr. Varner in May of 1986 
 
         is confirmed because Rebecca Johnson, store manager, testified:
 
         
 
              [S]he requested that I move her out of cosmetics 
 
              department because she was having a little bit of 
 
              problem with the fragrances of the cosmetics, and she 
 
              requested that she be moved out of the area, and I 
 
              moved her out of the area in June of 1986.  It would 
 
              have been previous to that, I don't know the exact 
 
              date, that she would have told me of the problem.
 
         
 
         (Transcript, page 121)
 
         
 
              Claimant herself admitted that she first realized and 
 
         believed the symptoms she was experiencing were caused by work 
 
         for employer in May of 1986 when she saw Dr. Varner.  Claimant 
 
         stated, "I guess it was confirmed when I saw Doctor Varner, and 
 
         he told me that I could become disabled if I didn't get 
 
         treatment."  "So that would have been in May of 1986?"  "Right."  
 
         "At that point you believed your problems were causally connected 
 
         to exposures at Younkers?"  "Yes." (dep. pp. 36 & 37).  
 
         
 
              Therefore, by claimant's own admission, she realized that 
 
         her injury was serious and work-related at the very latest in May 
 
         of 1986.  The petition was filed more than two years after that 
 
         time on June 3, 1988.  Consequently, it is determined that 
 
         claimant failed to bring a timely action within two years after 
 
         the occurrence of her injury in September of 1984 or within two 
 
         years after she discovered that it was both serious and work 
 
         related.
 
         
 
                                CONCLUSIONS OF LAW
 
         
 
              The conclusions of law contained in the proposed agency 
 
         decision filed April 30, 1991 are adopted as set forth below.  
 
         Segments designated by asterisks (*****) indicate portions of the 
 
         language from the proposed agency decision that have been 
 
         intentionally deleted and do not form a part of this final agency 
 
         decision.
 
         
 
              *****
 
         
 
              That claimant sustained a specific date of onset occurrence 
 
         and did not sustain a cumulative occurrence.
 
         
 
              That defendants did sustain the burden of proof by a 
 

 
         
 
         Page  10
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 
         preponderance of the evidence and proved the affirmative defense 
 
         that claimant failed to commence this action in a timely manner 
 
         within two years of the occurrence of the injury or when she 
 
         discovered the injury as required by Iowa Code section 85.26(1).  
 
         DeLong v. Highway Commissioner, 229 Iowa 700, 295 N.W. 91 
 
         (1940); Reddick v. Grand Union Tea Co., 230 Iowa 108, 296 N.W. 
 
         800 (1941); Mefferd v. Ed Miller & Sons, Inc., Thirty-third 
 
         Biennial Report of the Industrial Commissioner 191 (Appeal 
 
         Decision 1977).
 
         
 
              *****
 
         
 
              That the issue of whether this is an injury under Iowa Code 
 
         section 85 or whether this is an occupational disease under Iowa 
 
         Code section 85A is moot because both of these chapters of the 
 
         Code have a two-year statute of limitations.  Iowa Code section 
 
         85.26(1) and Iowa Code section 85A.16.
 
         
 
              That all other issues in this case are, likewise, moot in 
 
         view of the foregoing findings of fact and conclusions of law.
 
         
 
              WHEREFORE, the decision of the deputy is affirmed.
 
         
 
                                      ORDER
 
         
 
              THEREFORE, it is ordered:
 
         
 
              That no monies are owed by defendants to claimant.
 
         
 
              That claimant shall pay the costs of this matter including 
 
         the transcription of the hearing.
 
         
 
              
 
              Signed and filed this ____ day of March, 1993.
 
         
 
         
 
         
 
         
 
         
 
                                       ________________________________
 
                                                BYRON K. ORTON
 
                                           INDUSTRIAL COMMISSIONER
 
         
 
         Copies to:
 
         
 
         Mr. Edward M. Blando
 
         Mr. Jack C. Paige
 
         Ms. Tamra L. Mitchell
 
         Attorneys at Law
 
         700 Higley Bldg
 
         PO Box 1968
 
         Cedar Rapids, Iowa  52406
 
         
 
         Mr. Glenn Goodwin
 
         Ms. Dawn Siebert
 
         Attorneys at Law
 
         4th Floor Equitable Bldg.
 

 
         
 
         Page  11
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 
         Des Moines, Iowa  50309
 
         
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                                              1401; 1402; 1402.20;
 
                                              2203; 2205; 2209
 
                                              Filed April 30, 1993
 
                                              BYRON K. ORTON
 
                      
 
            
 
                     BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
            ____________________________________________________________
 
                                          :
 
            NANCY J. SORENSON,            :
 
                                          :
 
                 Claimant,                :
 
                                          :
 
            vs.                           :
 
                                          :       File No. 877045
 
            YOUNKERS,                     :
 
                                          :         A P P E A L
 
                 Employer,                :
 
                                          :       D E C I S I O N
 
            and                           :
 
                                          :
 
            AETNA LIFE & CASUALTY,        :
 
                                          :
 
                 Insurance Carrier,       :
 
                 Defendants.              :
 
            ___________________________________________________________
 
            
 
            
 
            1401; 1402; 1402.20; 2203; 2205; 2209
 
            
 
            It was not necessary to determine whether claimant's 
 
            sensitivities to perfume, fragrances and other substances 
 
            was an injury or an occupational disease.  
 
            It was determined that this was a specific date of onset 
 
            occurrence rather than a cumulative occurrence.
 
            It was determined that the statute of limitations had 
 
            expired based on both the specific date of onset and also 
 
            based on the discovery rule.
 
            
 
 
            
 
            
 
            
 
            
 
            
 
            
 
                    BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
            ____________________________________________________________
 
                                          :
 
            NANCY J SORENSON,             :
 
                                          :
 
                 Claimant,                :
 
                                          :
 
            vs.                           :
 
                                          :      File No.  877045
 
            YOUNKERS,                     :
 
                                          :  A R B I T R A T I O N
 
                 Employer,                :
 
                                          :      D E C I S I O N
 
            and                           :
 
                                          :
 
            AETNA CASUALTY & SURETY,      :
 
                                          :
 
                 Insurance Carrier,       :
 
                 Defendants.              :
 
            ___________________________________________________________
 
            
 
                                   INTRODUCTION
 
            
 
                 This is a proceeding in arbitration brought by Nancy J. 
 
            Sorenson, claimant, against Younkers, employer, and Aetna 
 
            Casualty and Surety Company, insurance carrier, for benefits 
 
            as a result of an alleged injury which occurred on August 
 
            31, 1986.  A hearing was held in Fort Dodge, Iowa, on 
 
            December 19, 1989, and the case was fully submitted at the 
 
            close of the hearing.  Claimant was represented by Jack C. 
 
            Paige.  Defendants were represented by Glenn Goodwin.  The 
 
            record consists of the testimony of Carolyn Hoskins, former 
 
            coemployee; Eileen McLuckie, claimant's sister; Nancy J. 
 
            Sorenson, claimant; Rebecca Johnson, store manager; joint 
 
            exhibits 1 through 17; claimant's exhibits 1, 5, 6, 8, 9 and 
 
            11; and defendants' exhibits 1 through 5.  At the time of 
 
            the hearing, defendants presented a written description of 
 
            the disputes.  The deputy ordered a transcript of the 
 
            hearing.  Both attorneys submitted outstanding posthearing 
 
            briefs.
 
            
 
                                      ISSUES
 
            
 
                 The parties submitted the following issues for 
 
            determination at the time of the hearing:
 
            
 
                 Whether claimant sustained an injury under Iowa Code 
 
            section 85 or whether claimant sustained an occupational 
 
            disease under Iowa Code section 85A, which arose out of and 
 
            in the course of employment with employer, to include 
 
            whether claimant sustained a cumulative injury or disease or 
 
            an injury or disease with a specific date of onset.
 
            
 
                 Whether the alleged injury or occupational disease was 
 
            the cause of either temporary or permanent disability.
 
            
 
                 Whether claimant is entitled to temporary or permanent 
 
            disability benefits, and if so, the extent of benefits to 
 
            which she is entitled.
 

 
            
 
            Page   2
 
            
 
            
 
            
 
            
 
            
 
                 What is the proper rate of compensation in the event of 
 
            an award.
 
            
 
                 Whether claimant is entitled to medical benefits.
 
            
 
                 Whether claimant is an odd-lot employee.
 
            
 
                 Whether claimant gave timely notice of claim as 
 
            required by Iowa Code section 85.23 has been asserted as an 
 
            affirmative defense by employer.
 
            
 
                 Whether claimant commenced this action in a timely 
 
            manner as required by Iowa Code section 85.26(1) has been 
 
            asserted as an affirmative defense by employer.
 
            
 
                                PRELIMINARY MATTER
 
            
 
                 Official notice is taken of defendants' motion for 
 
            summary judgement, brief in support of motion for summary 
 
            judgement, and defendants' statement of material facts which 
 
            are not in dispute, all of which were filed on August 22, 
 
            1989.  [Iowa Administrative Procedure Act 17A.14(4)].  
 
            Likewise, official notice is taken of claimant's response to 
 
            respondents' statement of material facts, claimant's 
 
            resistance to motion for summary judgement, and claimant's 
 
            brief in support of resistance of motion for summary 
 
            judgement and affidavit of claimant all filed on September 
 
            8, 1989.  Likewise, official notice is taken of defendants' 
 
            response to claimant's resistance for motion for summary 
 
            judgement filed on September 18, 1989.
 
            
 
                 Claimant gave a deposition prior to hearing on July 20, 
 
            1989.  The deposition itself was not introduced into 
 
            evidence.  It is quoted in the transcript.  Portions of the 
 
            deposition are attached to the summary judgement pleadings.  
 
            Therefore, reference to statements made in the deposition 
 
            will be cited with a transcript page number or a deposition 
 
            page number, but the deposition pages are to be found with 
 
            the motion for summary judgement pleadings.
 
            
 
                                 FINDINGS OF FACTS
 
            
 
            cumulative or specific onset injury or occupational disease
 
            
 
                 Without making a determination as to whether claimant 
 
            sustained an injury or occupational disease, it is, 
 
            nevertheless, determined that the nature of claimant's 
 
            complaints, symptoms and problems are not of a cumulative 
 
            nature, but rather they are traceable to a date of specific 
 
            onset.
 
            
 
                 Claimant, age 45 at the time of the hearing, sold Avon 
 
            products for approximately two years.  She graduated from 
 
            the La James College of Cosmetology at Fort Dodge on October 
 
            14, 1983 (joint exhibit 12, pages 7 & 8).  She then worked 
 
            as a cosmetologist for approximately eight months.  Claimant 
 
            started to work for employer on April 4, 1984, as a 
 
            part-time sales person of Clinique.  She became a full-time 
 
            employee on November 12, 1984, as the Elizabeth Arden sales 
 

 
            
 
            Page   3
 
            
 
            
 
            
 
            
 
            person (jt. ex. 15, p. 7).  In addition to sales, she 
 
            sprayed cleaner on the counter to remove fingerprints quite 
 
            frequently.  Except for one item, Clinique was fragrance 
 
            free and nonallergenic.  The perfume department had a drop 
 
            ceiling, spotlights and counterlights which generated heat 
 
            and had very poor ventilation.  It was a common occurrence 
 
            for customers to spray perfume on themselves, in the air and 
 
            onto the sales person.  On June 22, 1986, claimant 
 
            transferred to the accessories department which was adjacent 
 
            to the perfume department and it too, had a drop ceiling, 
 
            warm air and poor ventilation.  Claimant stopped working on 
 
            August 31, 1986 (transcript pp. 47-55).  
 
            
 
                 Claimant testified that in September of 1984, she had a 
 
            specific onset of symptoms.  At the time she first noticed 
 
            being able to taste the perfumes and she experienced vaginal 
 
            burning (tr. p. 56).  She was unpacking Polo cologne, 
 
            marking it and putting it on the shelf when she noticed that 
 
            she could start to taste it.  Shortly after that her lips, 
 
            tongue and mouth would burn (tr. p. 57).  Claimant 
 
            testified:
 
            
 
                    I could start tasting the perfumes.  I had 
 
                 vaginal burning.  My skin would burn.  My eyes 
 
                 would burn.  I had numbness.  Sometimes my whole 
 
                 body, usually starting with my feet, and it would 
 
                 work up, a numbness.  I had the sensation of pins 
 
                 or needles in my feet and sometimes in my hands.  
 
                 A vibrating feeling, almost a shaky feeling.  I 
 
                 wasn't -- you know, I would look at myself and I 
 
                 wasn't actually shaking, but it was just -- I just 
 
                 felt like I was vibrating.
 
            
 
            (transcript page 56).
 
            
 
                 She also reported changes in her mental processes.  She 
 
            related, "I would get these symptoms and I just felt like I 
 
            couldn't cope.  It was just kind of overwhelming.  Just kind 
 
            of felt like I 'd been hit by a truck.  Very fatigued."  
 
            (tr. p. 59).  She was also fatigued at home (tr. p. 59).  
 
            Three years later at the time of the hearing, on December 
 
            19, 1989, she testified, "Yes, I'm still very fatigued." 
 
            (tr. p. 65).  Claimant testified that there was a direct 
 
            relationship with exposure to perfumes.  She testified:
 
            
 
                 A.  Yes.  I'm still very sensitive to perfumes, 
 
                 aftershave lotions, colognes.  Things with 
 
                 fragrance in it. 
 
            
 
                 Q.  What happens if you are in too close of 
 
                 contact with someone wearing perfume?
 
            
 
                 A.  My symptoms will return, the burning will 
 
                 start, my mouth will burn.  If I'm there long 
 
                 enough, my skin will start burning.  Depending on 
 
                 how long the exposure, the symptoms will all 
 
                 return.
 
            
 
            (transcript pages 64 & 65).
 
            
 

 
            
 
            Page   4
 
            
 
            
 
            
 
            
 
                 Further evidence of a specific onset problem, rather 
 
            than a cumulative problem, is found in claimant's testimony 
 
            to the effect that she had similar problems prior to being 
 
            employed by employer, but they became continuous after her 
 
            employment with employer (tr. pp. 76 & 77).  
 
            
 
                 Claimant also testified that her arms ache, legs ache, 
 
            she has chest pain when the neighbors spray for dandelions, 
 
            severe headaches if she is near new asphalt, earaches, 
 
            blurring of vision, itching, upset stomach and diarrhea from 
 
            exposure to pesticides and uncontrollable crying on some 
 
            occasions (tr. pp. 73-76).  Claimant stated that she reacts 
 
            to anything that is scented, including deodorants, 
 
            detergents, window cleaners, cigarette smoke, new asphalt, 
 
            lawn chemicals, pesticides, corn, dust and molds, new 
 
            carpet, new furniture, paint, varnish, newsprint, colored 
 
            paper, soft plastic and polyester and anything with phenol 
 
            or formaldehyde in it, such as clothing (tr. pp. 78-80).  
 
            Claimant testified that her employment for employer was the 
 
            trigger for all of her symptoms (tr. p. 76).  
 
            
 
                 Claimant testified to continuing problems while 
 
            employed by employer, but she did not testify to cumulative, 
 
            progressive, or a gradual worsening of her condition.  
 
            Rather, her symptoms were directly related to exposure or 
 
            nonexposure to the chemicals to which she was sensitive.  
 
            
 
                 There is no medical evidence of a cumulative injury.  
 
            At one point in the testimony of Vernon P. Varner, M.D., a 
 
            board certified psychiatrist with a certain degree of 
 
            expertise in toxicology, he stated that her symptoms would 
 
            continue to escalate as long as she was exposed and not 
 
            protected from certain chemicals (claimant's ex. 1, p. 37).  
 
            However, this statement falls far short of establishing a 
 
            cumulative injury during the course of her employment with 
 
            employer from April 4, 1984 until August 31, 1986.  
 
            Furthermore, it is prospective rather then retrospective in 
 
            its application.
 
            
 
                 Consequently, it is determined that the nature of 
 
            claimant's symptoms, complaints and problems are not 
 
            cumulative, but rather are traceable to a specific onset in 
 
            September of 1984.  
 
            
 
                 Therefore, with regard to determining the date of 
 
            injury or occupational disease for purposes of the 
 
            commencement of the statute of limitations, the proper time 
 
            the injury or occupational disease occurred would be 
 
            September 1984,the date of specific onset, rather than when 
 
            claimant first lost time from work due to these symptoms, 
 
            complaints and problems.  McKeever Custom Cabinets v. Smith, 
 
            379 N.W.2d 368 (Iowa 1985).  Actually, claimant lost time 
 
            from work for medical treatment in April and May of 1985, 
 
            even before her medical leave of absence on August 31, 1986.
 
            
 
                              STATUTE OF LIMIATIONS
 
            
 
                 It is determined that claimant failed to commence this 
 
            action in a timely manner as required by Iowa Code section 
 
            85.26(1).  
 

 
            
 
            Page   5
 
            
 
            
 
            
 
            
 
            
 
                 Defendants made no payments of any kind to claimant.  
 
            Iowa Code section 85.26(1) states that an original 
 
            proceeding for benefits shall not be maintained in any 
 
            contested case unless the proceeding is commenced within two 
 
            years from the date of the occurrence of the injury for 
 
            which benefits are claimed where no weekly compensation has 
 
            been paid to claimant.  Mousel v. Bituminous Material & 
 
            Supply Co., 169 N.W.2d 763 (1969); Beier Glass v. Brundige, 
 
            329 N.W.2d 280 (1983).
 
            
 
                 Claimant asserts that she is entitled to the discovery 
 
            rule.  The general rule is that an action accrues when all 
 
            of the elements are known or in the exercise of reasonable 
 
            care should have been known.  LeBean v. Demig, 446 N.W.2d 
 
            800, 801 (Iowa 1989); Franzen v. Deere and Company, 377 
 
            N.W.2d 660, 662 (Iowa 1985).
 
            
 
                 The petition, dated June 1, 1988, was filed with the 
 
            industrial commissioner on June 3, 1988.  
 
            
 
                 In the resistance to the motion for summary judgement 
 
            and in her testimony at the hearing, claimant maintained 
 
            that she first discovered that she might have a compensable 
 
            claim on September 30, 1986.
 
            
 
                 Her affidavit attached to the resistance for summary 
 
            judgement, filed on September 8, 1989, states, "That after 
 
            reviewing the medical records of Dr. Varner, it is my belief 
 
            that it was on 9/30/86 that I first realized that I might 
 
            have a compensable claim against Younkers."  
 
            (affidavit-resistance to summary judgement, paragraph 3).
 
            
 
                 Claimant testified at the hearing, that Dr. Varner told 
 
            her in May of 1986 that she could cut down on exposures, but 
 
      nugh change where 
 
                 customers asked me who the girl was working in 
 
                 Elizabeth Arden."  
 
            
 
            (transcript pages 31 & 32)
 
            
 
                 Hoskins testified that people who had known her did not 
 
            recognize her (tr. p. 32).  
 
            
 
                 Hoskins also testified that claimant underwent a 
 
            personality change where she became quiet, withdrawn, 
 
            paranoid and, "We though that she was headed for a nervous 
 
            breakdown, it got to that point."  (tr. p. 33).
 
            
 
                 Hoskins testified that claimant was then transferred to 
 
            accessories, an adjacent department, on November 12, 1984 
 
            (tr. p. 29).  Hoskins could not understand why they 
 
            transferred her out of the perfume area to the adjacent 
 
            accessories area which also had a drop ceiling, warm 
 

 
            
 
            Page   7
 
            
 
            
 
            
 
            
 
            temperatures, poor ventilation and the aroma of perfume 
 
            because it was her understanding that perfume was the cause 
 
            of claimant's problem (tr. pp. 35 & 36).  
 
            
 
                 Eileen McLuckie, claimant's sister, testified that when 
 
            claimant began work for employer she was enthusiastic and 
 
            happy (tr. pp. 41 & 42).  McLuckie then testified that 
 
            during the period from April of 1984, when claimant started 
 
            to work for employer, and September of 1986, when she took a 
 
            medical leave of absence, claimant's energy seemed to 
 
            disappear.  She did not feel well, she was more tired and 
 
            she lost a lot of weight for someone her size and started 
 
            looking very thin (tr. pp. 43 & 44).  She said claimant lost 
 
            the ability to be enthusiastic and the attitude of being 
 
            ready to try something new.  Her activities became extremely 
 
            limited within the family.  McLuckie testified, "[W]e all 
 
            know that you don't wear aftershave and you don't wear 
 
            perfume and you try to make everything so that she can be 
 
            there and feel comfortable." (tr. pp. 45 & 46).  At a 
 
            celebration for the graduation of the daughter of the 
 
            witness claimant spent the evening outdoors to avoid being 
 
            closed up in the house with persons who were wearing 
 
            perfume.  These changes came about after claimant started to 
 
            work for employer (tr. p. 46).  
 
            
 
                 Claimant saw three local doctors; Janet Secor, M.D.; 
 
            Charles Dagle, M.D.; and Herman M. Tan, M.D.  Dr. Tan 
 
            referred claimant to N.K. Rinderknecht, an ob/gyn specialist 
 
            in Des Moines, who referred claimant to Jay William Holtze, 
 
            M.D., a dermatologist in Des Moines (cl. exs. 5 & 6; jt exs. 
 
            4, 8, & 9).  Dr. Dagle referred claimant to the University 
 
            of Iowa where Rudolph P. Galask, M.D., saw claimant on April 
 
            17, 1985.  He stated, "Because of her generalized symptoms, 
 
            I suspect this is a systemic problem or can very well be 
 
            related to the cosmetics which she sells at Younkers." (jt. 
 
            ex. 3, p. 4).  Dr. Galask, an ob/gyn specialist, then 
 
            referred claimant to Duane C. Whitaker, M.D., a 
 
            dermatologist at the University of Iowa.  Dr. Whitaker 
 
            stated on May 17, 1985, that patch tests at the dermatology 
 
            clinic were positive for chlorocresol and isopropyl 
 
            myristate.  
 
            
 
                 He said chlorocresol, was a bacteriocidal agent found 
 
            in many creams as a preservative, in shampoos, topical 
 
            medications and hair tonic.  Isopropyl myristate is also a 
 
            common ingredient in cosmetics and pharmaceuticals (jt. ex. 
 
            7, p. 1).  Thus, claimant was told in 1985 by both an ob/gyn 
 
            doctor and a dermatologist that her condition was work 
 
            related.
 
            
 
                 At the time of her deposition on July 20, 1989, 
 
            claimant testified that she attributed all of her 
 
            sensitivities to her employment for employer.  These 
 
            symptoms started appearing in September of 1984 (deposition 
 
            p. 18).  Then this colloquy transpired between claimant and 
 
            counsel:
 
            
 
                 Q.  When did you first decide that work at 
 
                 Younkers was causing these problems?
 
            
 

 
            
 
            Page   8
 
            
 
            
 
            
 
            
 
                 A.  Well, I had suspicioned it.  I don't know 
 
                 when.  I don't know.  I was going to doctors, and 
 
                 I would tell them where I worked, and they didn't 
 
                 seem to relate it, so I guess I really didn't 
 
                 until I saw Doctor Varner.  He told me that if I 
 
                 didn't get out of that department, that I could be 
 
                 completely disabled.  That was the first time, I 
 
                 guess, I knew for sure that it was from that.
 
            
 
            (deposition page 21)
 
            
 
                 A second colloquy between counsel and claimant reads as 
 
            follows:
 
            
 
                 Q.  When did you decide to file a worker's [sic] 
 
                 compensation claim?
 
            
 
                 A.  I guess I considered it probably in about 
 
                 December of 1984 when I realized that it probably 
 
                 was a permanent injury, or a long-term injury.
 
            
 
                 Q.  Why did you not file one until June of 1988?
 
            
 
                 A.  I guess I had to find an attorney, and it took 
 
                 that long to get it filed, I guess.
 
            
 
            (deposition page 33)
 
            
 
                 After a recess, in response to questions from her own 
 
            attorney, claimant corrected her testimony to say that she 
 
            first realized she had a permanent injury after she had 
 
            stopped working and had been off work for several months in 
 
            December of 1986 (dep. pp. 35 & 36).  The questioning 
 
            continued and this dialogue occurred between claimant and 
 
            defendants' counsel:
 
            
 
                 Q.  Maybe I misunderstood your testimony, then, 
 
                 because I thought I asked you twice about December 
 
                 of 1984.  Did you mean to state December of 1986?
 
            
 
                 A.  Yes.
 
            
 
                 Q.  When did you first realize that the symptoms 
 
                 that you were having were caused by your working 
 
                 at Younkers?
 
            
 
                 A.  When did I realize it?  When did I know it for 
 
                 sure?
 
            
 
                 Q.  When did you believe that the symptoms your 
 
                 were experiencing were caused by exposures to work 
 
                 at Younkers?
 
            
 
                 A.  I guess it was confirmed when I saw Doctor 
 
                 Varner, and he told me that I could become 
 
                 disabled if I didn't get treatment.
 
            
 
                 Q.  So that would have been in May of 1986?
 
            
 
                 A.  Right.
 

 
            
 
            Page   9
 
            
 
            
 
            
 
            
 
            
 
                 Q.  At that point you believed your problems were 
 
                 causally connected to exposures at Younkers?
 
            
 
                 A.  Yes.
 
            
 
            (deposition pages 36 & 37)
 
            
 
                 Claimant changed her testimony at the time of hearing 
 
            to indicate that in May of 1985, after the patch testby Dr. 
 
            Whitaker in Iowa City, and in May of 1986, after she saw Dr. 
 
            Varner for the first time, that she knew something was wrong 
 
            with her, but she didn't know what it was and she didn't 
 
            know what was causing it (tr. pp. 100-111).  
 
            
 
                 Based on claimant's testimony on direct examination (1) 
 
            that she worked in a warm, closed, poorly ventilated area; 
 
            (2) that her symptoms first arose when she could taste 
 
            perfume, experienced vaginal burning and burning on other 
 
            parts of her body while working with fragrances; (3) 
 
            Hoskin's testimony that claimant changed from an outgoing, 
 
            bubbly, fun-loving, happy-go-lucky person to a quiet, 
 
            withdrawn, paranoid, anarexic-type person not recognized by 
 
            people who had known her before, all of which was allegedly 
 
            due to her exposure to perfumes and fragrances; (4) the 
 

 
            
 
            Page  10
 
            
 
            
 
            
 
            
 
            testimony of McLuckie that claimant was in good health, but 
 
            shortly after she started to work for employer her energy 
 
            disappeared, she looked as if she didn't feel well, she lost 
 
            weight to the point of looking very thin, that claimant lost 
 
            her enthusiasm and attitude of ready to try something new 
 
            and who was socially unable to be indoors with persons 
 
            wearing perfume; (5) the testimony of Dr. Galask on April 
 
            17, 1985, that he suspected a systemic problem which could 
 
            very well be related to cosmetics which she sells at 
 
            Younkers; (6) the testimony of Dr. Whitaker that she had a 
 
            positive patch test reaction to two chemicals which are 
 
            found in shampoos, hair tonics, cosmetics and 
 
            pharmaceuticals; and (7) Dr. Vaner's testimony that claimant 
 
            told him that she knew that she was sensitive to perfume 
 
            even before she saw him in May of 1986; it is determined 
 
            that claimant's voluntary, spontaneous and straightforward 
 
            answers to the questions in the deposition, rather than her 
 
            testimony at hearing, are the most reliable indicator of 
 
            when she first realized that her symptoms were caused by her 
 
            work for employer (dep. pp. 36 & 37).
 
            
 
                 The evidence established that not only claimant, but 
 
            also, her coemployee Hoskins and her sister McLuckie, 
 
            believed that work was causing both physical and 
 
            psychological problems in 1984 and 1985.  The testimony of 
 
            Dr. Galask in April of 1985 related her symptoms to work.  
 
            The testimony of Dr. Whitaker in May of 1985 related 
 
            claimant's symptoms to work.
 
            
 
                 The symptoms, complaints and problems related by 
 
            claimant, Hoskins, and McLuckie certainly define a serious 
 
            problem which they believed was work related.  The fact that 
 
            claimant saw three doctors in Fort Dodge, two doctors in Des 
 
            Moines, three or four doctors in Iowa City plus Dr. Varner 
 
            and George F. Kroker, M.D., at LaCrosse, Wisconsin, 
 
            certainly indicates that claimant considered this a serious 
 
            injury and she testified a number of times that work 
 
            triggered all of her symptoms.  Both Dr. Gaslask and Dr. 
 
            Whitaker told claimant that her complaints were related to 
 
            her job working with cosmetics.
 
            
 
                 Claimant's testimony that she realized that the 
 
            symptoms were caused by work after she talked to Dr. Varner 
 
            in May of 1986 is confirmed because Rebecca Johnson, store 
 
            manager, testified:
 
            
 
                 [S]he requested that I move her out of cosmetics 
 
                 department because she was having a little bit of 
 
                 problem with the fragrances of the cosmetics, and 
 
                 she requested that she be moved out of the area, 
 
                 and I moved her out of the area in June of 1986.  
 
                 It would have been previous to that, I don't know 
 
                 the exact date, that she would have told me of the 
 
                 problem.
 
            
 
            (transcript page 121)
 
            
 
                 Claimant herself admitted that she first realized and 
 
            believed the symptoms she was experiencing were caused by 
 

 
            
 
            Page  11
 
            
 
            
 
            
 
            
 
            work for employer in May of 1986 when she saw Dr. Varner.  
 
            Claimant stated, "I guess it was confirmed when I saw Doctor 
 
            Varner, and he told me that I could become disabled if I 
 
            didn't get treatment."  "So that would have been in May of 
 
            1986?"  "Right."  "At that point you believed your problems 
 
            were causally connected to exposures at Younkers?"  "Yes." 
 
            (dep. pp. 36 & 37).  
 
            
 
                 Therefore, by claimant's own admission she realized 
 
            that her injury was serious and work-related at the very 
 
            latest, in May of 1986.  The petition was filed more then 
 
            two years after that time on June 3, 1988.  Consequently, it 
 
            is determined that claimant failed to bring a timely action 
 
            within two years after the occurrence of her injury in 
 
            September of 1984 or within two years after she discovered 
 
            that it was both serious and work related.
 
            
 
                                CONCLUSIONS OF LAW
 
            
 
                 Wherefore, based upon the foregoing and following 
 
            principles of law, these conclusions of law are made:
 
            
 
                 That claimant sustained a specific date of onset 
 
            occurrence and did not sustain a cumulative occurrence.
 
            
 
                 That defendants did sustain the burden of proof by a 
 
            preponderance of the evidence and proved the affirmative 
 
            defense that claimant failed to commence this action in a 
 
            timely manner within two years of the occurrence of the 
 
            injury or when she discovered the injury as required by Iowa 
 
            Code section 85.26(1).  DeLong v. Highway Commissioner, 229 
 
            Iowa 700, 295 N.W. 91 (1940); Reddick v. Grand Union Tea 
 
            Co., 230 Iowa 108, 296 N.W. 800 (1941); Mefferd v. Ed 
 
            Miller & Sons, Inc., Thirty-third Biennial Report of the 
 
            Industrial Commissioner 191 (Appeal Decision 1977).
 
            
 
                 That claimant is not entitled to the discovery rule.  
 
            The general rule is that an action accrues when all of the 
 
            elements are known or in the exercise of reasonable care 
 
            should have been known.  LeBean, 446 N.W.2d 800, 801; 
 
            Franzen, 377 N.W.2d 660, 662.
 
            
 
                 That the issue of whether this is an injury under Iowa 
 
            Code section 85 or whether this is an occupational disease 
 
            under Iowa Code section 85A is moot because both of these 
 
            chapters of the Code have a two-year statute of limitations.  
 
            Iowa Code section 85.26(1) and Iowa Code section 85A.16.
 
            
 
                 That all other issues in this case are, likewise, moot 
 
            in view of the foregoing findings of fact and conclusions of 
 
            law.
 
            
 
                                      ORDER
 
            
 
                 THEREFORE, IT IS ORDERED:
 
            
 
                 That no monies are owed by defendants to claimant.
 
            
 
                 That the costs of this action, including the costs of 
 
            the attendance of the court reporter at the hearing and the 
 

 
            
 
            Page  12
 
            
 
            
 
            
 
            
 
            transcript, are charged to claimant pursuant to rule 343 IAC 
 
            4.33; Iowa Code section 85.19(1).
 
            
 
                 Signed and filed this ____ day of April, 1991.
 
            
 
            
 
            
 
            
 
                                          ______________________________
 
                                          WALTER R. McMANUS, JR.
 
                                          DEPUTY INDUSTRIAL COMMISSIONER    
 
            
 
            Copies to:
 
            
 
            Mr. Edward M. Blando
 
            Mr. Jack C. Paige
 
            Ms. Tamra L. Mitchell
 
            Attorneys at Law
 
            700 Higley Bldg
 
            PO Box 1968
 
            Cedar Rapids, Iowa  52406
 
            
 
            Mr. Glenn Goodwin
 
            Ms. Dawn Siebert
 
            Attorneys at Law
 
            4th Floor Equitable Bldg.
 
            Des Moines, Iowa  50309
 
            
 
            
 
            
 
 
            
 
            Page   1
 
            
 
            
 
            
 
            
 
                      1401 1402.20 2203 2205 2209 1402
 
                      Filed April 30, 1991
 
                      Walter R. McManus, Jr.
 
            
 
                     before the iowa industrial commissioner
 
            ____________________________________________________________
 
                                          :
 
            NANCY J SORENSON,             :
 
                                          :
 
                 Claimant,                :
 
                                          :
 
            vs.                           :
 
                                          :      File No.  877045
 
            YOUNKERS,                     :
 
                                          :  A R B I T R A T I O N
 
                 Employer,                :
 
                                          :      D E C I S I O N
 
            and                           :
 
                                          :
 
            AETNA CASUALTY & SURETY,      :
 
                                          :
 
                 Insurance Carrier,       :
 
                 Defendants.              :
 
            ___________________________________________________________
 
            
 
            1401 1402.20 2203 2205 2209 1402
 
            It was not necessary to determine whether claimant's 
 
            sensitivities to perfume, fragrances and other substances 
 
            was an injury or an occupational disease.
 
            It was determined that this was a specific date of onset 
 
            occurrence rather than a cumulative occurrence.
 
            It was determined that the statute of limitations had 
 
            expired based on both the specific date of onset and also 
 
            based on the discovery rule.
 
            
 
 
         
 
         Page   1
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 
         before the iowa industrial commissioner
 
         ____________________________________________________________
 
                   :
 
         TERESA R. WEST,     :
 
                   :
 
              Claimant, :       File No. 877049
 
                   :
 
         vs.       :         A P P E A L
 
                   :
 
         IBP, INC.,     :       D E C I S I O N
 
                   :
 
              Employer, :
 
              Self-Insured,  :
 
              Defendant.     :
 
         ___________________________________________________________
 
         STATEMENT OF THE CASE
 
         Claimant appeals from an arbitration decision denying benefits.  
 
         The record on appeal consists of the transcript of the 
 
         arbitration hearing, joint exhibits 1 through 24 and 27.  
 
         issues
 
         Neither party filed an appeal brief.  The appeal will be 
 
         considered generally and without regard to specific issues.
 
         findings of fact
 
         The arbitration decision filed February 7, 1991 adequately and 
 
         accurately reflects the pertinent evidence and it will not be 
 
         reiterated herein.
 
         conclusions of law
 
         The analysis of the evidence in conjunction with the law in the 
 
         arbitration decision is adopted with the following additional 
 
         analysis.  Claimant was examined by several physicians, many of 
 
         them specialists in neurology.  Only one physician, Dr. Golnick, 
 
         diagnosed reflex sympathetic dystrophy.  Dr. Sundell and Dr. 
 
         Cooper, both neurologists, specifically disputed this finding.  
 
         All objective tests were negative or within normal limits.  
 
         Claimant's tendinitis was seen as temporary or resolving.  
 
         Claimant bears the burden of proof.  Claimant has failed to carry 
 
         that burden.  The greater weight of the medical evidence 
 
         indicates that claimant does not suffer from a permanent 
 
         condition as a result of her work injury.  Claimant's condition 
 
         appears to be tendinitis, which resolves once claimant is removed 
 
         from repetitious work.  Claimant has failed to establish 
 
         entitlement to permanent disability benefits.
 
         However, the parties stipulated that claimant has suffered an 
 
         injury arising out of and in the course of her employment.  
 
         Although claimant's work injury did not cause permanent 
 
         disability, claimant's medical expenses incurred in connection 
 
         with treating and evaluating her tendinitis is compensable.  
 
         Iowa Code section 86.27 provides:  "Notwithstanding the terms of 
 
         the Iowa administrative procedure Act, no party to a contested 
 
         case under any provision of the 'Workers' Compensation Act' may 
 
         settle a controversy without the approval of the industrial 
 

 
         
 
         Page   2
 
         
 
         
 
         
 
         
 
         
 
         
 
         
 
         commissioner."
 
         The settlement agreement had not been approved by the industrial 
 
         commissioner and therefore was not an enforceable settlement.
 
         WHEREFORE, the decision of the deputy is affirmed and modified.
 
         order
 
         THEREFORE, it is ordered:
 
         That defendant shall pay claimant's medical expenses incurred as 
 
         a result of her tendinitis.
 
         That defendant shall pay the costs of the appeal, including the 
 
         preparation of the hearing transcript.
 
         Signed and filed this ____ day of September, 1991.
 
         
 
         
 
         
 
         
 
                   ________________________________
 
                            BYRON K. ORTON
 
                       INDUSTRIAL COMMISSIONER
 
         
 
         Copies To:
 
         
 
         Mr. William McGinn
 
         Attorney at Law
 
         3rd Floor, Council Bluffs
 
           Savings Bank Bldg.
 
         Council Bluffs, Iowa 51503
 
         
 
         Ms. Marie L. Welsh
 
         Attorney at Law
 
         P.O. Box 515
 
         Dept #41
 
         Dakota City, NE  68731
 
         
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                      5-1803 - 2505
 
                      Filed September 17, 1991
 
                      BYRON K. ORTON
 
                      JMI
 
            before the iowa industrial commissioner
 
            ____________________________________________________________
 
            _____
 
                      :
 
            THERESA R. WEST,    :
 
                      :
 
                 Claimant, :      File No. 877049
 
                      :
 
            vs.       :        A P P E A L
 
                      :
 
            IBP, INC.,     :      D E C I S I O N
 
                      :
 
                 Employer, :
 
                 Self-Insured,  :
 
                 Defendant.     :
 
            ____________________________________________________________
 
            _____
 
            
 
            5-1803
 
            Claimant failed to carry her burden to establish permanent 
 
            disability where medical evidence showed only one physician 
 
            diagnosed claimant's tendonitis as permanent, whereas this 
 
            finding was specifically disputed by several other 
 
            physicians of equal qualifications.  The evidence also 
 
            showed that claimant's tendonitis tended to resolve when she 
 
            was removed from repetitious work. 
 
            
 
            2505
 
            Although claimant failed to show permanent disability, the 
 
            parties stipulated to an injury arising out of and in the 
 
            course of her employment, and therefore medical benefits 
 
            associated with treating and diagnosing the injury were 
 
            awarded.
 
            
 
 
            
 
            Page   1
 
            
 
            
 
            
 
            
 
            
 
                     before the iowa industrial commissioner
 
            ____________________________________________________________
 
                                          :
 
            TERESA R. WEST,               :
 
                                          :    File Nos. 868362 & 877049
 
                 Claimant,                :
 
                                          :      A R B I T R A T I O N
 
            vs.                           :
 
                                          :         D E C I S I O N
 
            IBP, INC.,                    :
 
                                          :
 
                 Employer,                :
 
                 Self-Insured,            :
 
                 Defendant.               :
 
            ___________________________________________________________
 
            
 
            
 
                              STATEMENT OF THE CASE
 
            
 
                 This is a proceeding in arbitration brought by Teresa 
 
            R. West, claimant, against Iowa Beef Processors (IBP), Inc., 
 
            self-insured employer, as a result of an injury sustained on 
 
            April 7, 1988.
 
            
 
                 A hearing was held in Council Bluffs, Iowa on November 
 
            27, 1990.  The claimant was present and represented by her 
 
            attorney, Mr. William McGinn.  Employer was represented by 
 
            Mr. Wendell F. Cowan.  The record consists of joint exhibits 
 
            1-24 and 27; and testimony of claimant, Teresa R. West; and 
 
            Lisa Ann Brockway.
 
            
 
                                      issues
 
            
 
                 Pursuant to the prehearing report and order submitted 
 
            and approved on November 27, 1990, the parties have 
 
            stipulated that defendant paid to claimant temporary total 
 
            disability payments from November 5, 1987 through January 3, 
 
            1988, in the amount of $1,207.87 and medical benefits in the 
 
            amount of $1,129.13 for a left ankle injury arising out of 
 
            and in the course of her employment.  Claimant does not 
 
            request additional benefits in regard to the November 4, 
 
            1987 injury and the parties stipulated that no further 
 
            claims would be made in File No. 868362.  Parties further 
 
            stipulate that claimant sustained an injury on April 7, 
 
            1988, which arose out of and in the course of her 
 
            employment.
 
            
 
                 The prehearing report identified the following issues 
 
            for resolution:
 
            
 
                 1.  Whether claimant sustained a compensable injury 
 
            which is causally related to the disability on which she now 
 
            bases her claim;
 
            
 
                 2.  The nature and extent of claimant's disability, if 
 
            any;
 
            
 
                 3.  Whether claimant is entitled to medical benefits 
 
            under section 85.27; and,
 

 
            
 
            Page   2
 
            
 
            
 
            
 
            
 
            
 
                 4.  Whether claimant and employer entered into an 
 
            enforceable settlement agreement.
 
            
 
                                 findings of fact
 
            The undersigned has carefully considered the testimony 
 
            received at the hearing, the arguments made and the evidence 
 
            contained in the exhibits herein and makes the following 
 
            findings:
 
            
 
                 Claimant was born on June 20, 1951 and has a G.E.D. 
 
            certificate.  She completed two years of business classes 
 
            and obtained an Associate Degree from the University of 
 
            Nebraska, Omaha.  She worked at various times as an 
 
            inventory clerk, retail price marker, credit clerk, 
 
            cashier/checker and self-service store stock clerk.  From 
 
            October 1987 through May 19, 1988, she was employed by Iowa 
 
            Beef Processors in various capacities including meat 
 
            packager, meat trimmer and knife sharpener.
 
            
 
                 On April 7, 1988, claimant reported to IBP dispensary 
 
            with complaints of triggering of the right ring finger.  A 
 
            treatment program was prescribed which included warm soaks, 
 
            finger taping, and palm padding.  Her complaints persisted 
 
            and a notation in her company dispensary file indicates that 
 
            she had not been taping her finger as instructed.  She was 
 
            taken off knife work and restricted to no grasping or 
 
            lifting (Exhibit 1, page 8).  On April 12, 1988, she was 
 
            referred by IBP to Frank P. LaMarte, M.D., for evaluation.  
 
            Her complaints were referable to pain, stiffness and 
 
            catching of the third and fourth digits of the right hand 
 
            and discomfort in the right arm and hand (Ex. l, p. 8).  An 
 
            examination of the right upper extremity revealed no 
 
            swelling or erythema.  Pain with palpitation over the area 
 
            of the M1 pulleys of the third and fourth digits was noted 
 
            as was catching of these digits with extension and flexion.  
 
            Dr. LaMarte diagnosed trigger finger of the third and fourth 
 
            digits of the right hand.  He prescribed Motrin and 
 
            recommended she return to work with restricted duties 
 
            including no use of the knife.
 
            
 
                 Claimant's trigger finger symptoms waxed and waned from 
 
            April through June and she continued in treatment with Dr. 
 
            LaMarte.  On May 10, 1988, he felt that she was responding 
 
            well to treatment and could return to knife work four hours 
 
            per day (Ex. 5, p. 3).  By May 16th, she had no catching or 
 
            pain in her fingers with flexion or extension (Ex. 2).  
 
            However, due to a recent job change she was required to do 
 
            heavy lifting and now reported pain in her wrists and 
 
            forearms.  Dr. LaMarte felt that claimant was prone to 
 
            developing cumulative trauma of the upper extremities with 
 
            repetitive motion and recommended that she look for work not 
 
            requiring repetitive arm motion.  Claimant testified she 
 
            quit her job at IBP on May 19, 1988, because they could not 
 
            provide her with such work.  Claimant continued in treatment 
 
            with Dr. LaMarte for bilateral wrist and distal forearm 
 
            pain.  A diagnosis of tendinitis was made and she was 
 
            started on Dolobid.
 
            
 
                 On May 24, 1988, claimant was involved in a motor 
 

 
            
 
            Page   3
 
            
 
            
 
            
 
            
 
            vehicle accident.  She presented to Dr. LaMarte with 
 
            complaints of left shoulder strain and left forearm pain.  
 
            She appeared to respond to conservative treatment.  However, 
 
            on June 13, 1988, she reported a recurrence of wrist pain 
 
            and numbness.  Claimant was referred by employer for EMG 
 
            studies and an orthopedic evaluation by William R. Hamsa, 
 
            Jr., M.D., with whom a prior patient relationship had been 
 
            established.
 
            
 
                 In his examination on June 20, 1988, Dr. Hamsa found a 
 
            resolving nonspecific tendinitis in both forearms and wrists 
 
            and concurred with Dr. LaMarte's treatment schedule and his 
 
            recommendation that she not engage in repetitive motion of 
 
            her arms.  At this time, claimant related improvement in her 
 
            symptoms (Ex. 3).  Dr. Hamsa found normal range of motion 
 
            and reflexes and doubted that any permanent residual 
 
            disability would result in her upper extremities (Ex. 3).  
 
            EMG studies were normal and Dr. Hamsa opined that her 
 
            symptoms would probably disappear with time and disuse of 
 
            her wrists and forearms.
 
            
 
                 In conjunction with her evaluation by Dr. Hamsa, Dr. 
 
            LaMarte referred claimant to Robert Sundell, M.D., a 
 
            neurologist, for evaluation.  She was seen on June 27, 1988 
 
            and presented with complaints of intermittent numbness and 
 
            pain involving both upper extremities since April 1988.  Dr. 
 
            Sundell could find no objective evidence to explain 
 
            claimant's subjective complaints (Ex. 9).  However, because 
 
            of a possible spinal cord abnormality, an MRI was performed 
 
            on June 28, 1988 which was within normal limits (Ex. 6, pp. 
 
            1-5).
 
            
 
                 On July 6, 1988, the claimant presented to the 
 
            University of Nebraska Medical Center Outpatient Clinic with 
 
            complaints of bilateral intermittent tingling in her hands 
 
            and wrists.  On examination, no swelling or redness was 
 
            evident and motor strength and grip was intact.  Deep tendon 
 
            reflexes were symmetrical in the upper extremities and 
 
            Tinel's sign was negative.  Percussion over the median nerve 
 
            did not provoke any tingling or numbness sensation in the 
 
            distribution of the median nerve.  M. Sammour, M.D., felt 
 
            that her pain may be secondary to overuse.
 
            
 
                 Claimant testified that despite her treatment with Dr. 
 
            LaMarte and evaluations by consulting specialists, her 
 
            condition failed to improve and she referred herself to Jan 
 
            J. Golnick, M.D., for evaluation and testing on August 8, 
 
            1988.  She complained of aching and pain in both forearms 
 
            with tingling in all fingers and a stiff sensation in both 
 
            fingers in the morning.  Nerve conduction testing and EMG 
 
            studies of the right upper extremity were normal.  A 
 
            tentative diagnosis of bilateral forearm tendinitis was 
 
            made.  On August 31, 1988, three sets of thermograms were 
 
            taken of both upper arms and demonstrated bilateral vascular 
 
            compromise.  After conducting thermogram studies, Dr. 
 
            Golnick diagnosed reflex sympathetic dystrophy in both upper 
 
            extremities (Ex. 7, pp. 1-8).
 
            
 
                 Dr. Sundell reported to Dr. LaMarte in November 1988 
 
            that there is no neurological evidence to support a 
 

 
            
 
            Page   4
 
            
 
            
 
            
 
            
 
            diagnosis of reflex sympathetic dystrophy (Ex. 12).
 
            
 
                 Claimant continued in treatment with Dr. Golnick and 
 
            she underwent four sympathetic blocks in an attempt to 
 
            relieve her symptoms.  These procedures provided only 
 
            short-term relief.
 
            
 
                 On February 7, 1989, claimant was evaluated by Ronald 
 
            A. Cooper, M.D., neurologist, pursuant to her claim for 
 
            social security disability benefits.  He found no 
 
            abnormalities or evidence to support a finding of reflex 
 
            sympathetic dystrophy (Ex. 20).
 
            
 
                 In April 1989, Dennis Hayes, M.D., performed a 
 
            right-sided cervical/dorsal sympathectomy with resection of 
 
            the first rib (Ex. 17).  On September 12, 1989, Dr. Golnick 
 
            gave claimant a 20 percent impairment rating that he 
 
            attributed to the body as a whole.
 
            
 
                                conclusions of law
 
            
 
                 The parties do not dispute that the claimant sustained 
 
            an injury on April 7, 1988, which arose out of and in the 
 
            course of her employment with Iowa Beef Processors.  
 
            However, there is a dispute as to whether such injury is 
 
            causally related to the disability on which she now bases 
 
            her claim.
 
            
 
                 "An injury occurs in the course of the employment when 
 
            it is within the period of employment at a place the 
 
            employee may reasonably be, and while he is doing his work 
 
            or something incidental to it."  Cedar Rapids Comm. Sch. 
 
            Dist. v. Cady, 278 N.W.2d 298 (Iowa 1979), McClure v. Union 
 
            et al. Counties, 188 N.W.2d 283 (Iowa 1971); Musselman v. 
 
            Central Telephone Co., 261 Iowa 352, 154 N.W.2d 128 (1967). 
 
            
 
                 The supreme court of Iowa in Almquist v. Shenandoah 
 
            Nurseries, 218 Iowa 724, 731-32, 254 N.W. 35, 38 (1934) 
 
            discussed the definition of personal injury in workers' 
 
            compensation cases as follows:
 
            
 
                 
 
            
 
                 While a personal injury does not include an occupa
 
                 tional disease under the Workmen's Compensation 
 
                 Act, yet an injury to the health may be a personal 
 
                 injury.  [Citations omitted.]  Likewise a personal 
 
                 injury includes a disease resulting from an 
 
                 injury....The result of changes in the human body 
 
                 incident to the general processes of nature do not 
 
                 amount to a personal injury.  This must follow, 
 
                 even though such natural change may come about 
 
                 because the life has been devoted to labor and 
 
                 hard work.  Such result of those natural changes 
 
                 does not constitute a personal injury even though 
 
                 the same brings about impairment of health or the 
 
                 total or partial incapacity of the functions of 
 
                 the human body. 
 
            
 
                    ....
 

 
            
 
            Page   5
 
            
 
            
 
            
 
            
 
            
 
                 
 
                 A personal injury, contemplated by the Workmen's 
 
                 Compensation Law, obviously means an injury to the 
 
                 body, the impairment of health, or a disease, not 
 
                 excluded by the act, which comes about, not through the 
 
                 natural building up and tearing down of the human body, 
 
                 but because of a traumatic or other hurt or damage to 
 
                 the health or body of an employee.  [Citations 
 
                 omitted.]  The injury to the human body here 
 
                 contemplated must be something, whether an accident or 
 
                 not, that acts extraneously to the natural processes of 
 
                 nature, and thereby impairs the health, overcomes, 
 
                 injures, interrupts, or destroys some function of the 
 
                 body, or otherwise damages or injures a part or all of 
 
                 the body.
 
            
 
                 The claimant has the burden of proving by a 
 
            preponderance of the evidence that the injury of April 7, 
 
            1988, is causally related to the disability on which she now 
 
            bases her claim.  Bodish v. Fischer, Inc., 257 Iowa 516, 133 
 
            N.W.2d 867 (1965).  Lindahl v. L. O. Boggs, 236 Iowa 296, 18 
 
            N.W.2d 607 (1945).  A possibility is insufficient; a 
 
            probability is necessary.  Burt v. John Deere Waterloo 
 
            Tractor Works, 247 Iowa 691, 73 N.W.2d 732 (1955).  The 
 
            question of causal connection is essentially within the 
 
            domain of expert testimony.  Bradshaw v. Iowa Methodist 
 
            Hospital, 251 Iowa 375, 101 N.W.2d 167 (1960). 
 
            
 
                 However, expert medical evidence must be considered 
 
            with all other evidence introduced bearing on the causal 
 
            connection.  Burt, 247 Iowa 691, 73 N.W.2d 732.  The opinion 
 
            of experts need not be couched in definite, positive or 
 
            unequivocal language.  Sondag v. Ferris Hardware, 220 N.W.2d 
 
            903 (Iowa 1974).  However, the expert opinion may be 
 
            accepted or rejected, in whole or in part, by the trier of 
 
            fact.  Id. at 907.  Further, the weight to be given to such 
 
            an opinion is for the finder of fact, and that may be 
 
            affected by the completeness of the premise given the expert 
 
            and other surrounding circumstances.  Bodish, 257 Iowa 516, 
 
            133 N.W.2d 867.  See also Musselman, 261 Iowa 352, 154 
 
            N.W.2d 128 (1967).
 
            
 
                 After carefully considering the total evidence in this 
 
            case, including assessments made by physicians who have 
 
            treated and/or examined claimant, the undersigned concludes 
 
            that she has not established by a preponderance of the 
 
            evidence a causal connection between her current disability 
 
            and her work injury of April 7, 1988.
 
            
 
                 It is well settled in Iowa Workers' Compensation law 
 
            that the evidence must show that the injury not only arose 
 
            from the employment, but, as a cause, was a substantial 
 
            factor in bringing about the result.  Blacksmith v. 
 
            All-American, Inc., 290 N.W.2d 348 (Iowa 1984).
 
            
 
                 Claimant alleges her current injuries began on April 7, 
 
            1988, with the diagnosis and treatment of a trigger finger.  
 
            This resolved with conservative therapy by May 16, 1988, but 
 
            claimant developed other complaints of bilateral wrist and 
 

 
            
 
            Page   6
 
            
 
            
 
            
 
            
 
            forearm pain.  Dr. LaMarte and Dr. Hamsa predicted complete 
 
            resolution of her symptoms with disuse of work requiring 
 
            repetitive hand movements.  Clinical and laboratory studies 
 
            have consistently been within normal limits.  Specialists in 
 
            neurology and orthopedic medicine have disputed Dr. 
 
            Golnick's diagnosis of sympathetic reflex dystrophy.  Aside 
 
            from Dr. Golnick, no other physician recommended surgery to 
 
            remedy claimant's symptoms.  Therefore, the greater weight 
 
            of the medical evidence fails to establish a causal con
 
            nection between the claimant's injury and the disability on 
 
            which she now bases her claim.  Claimant has not met her 
 
            burden of proof and cannot prevail in her claim for workers' 
 
            compensation benefits.
 
            
 
                 Accordingly, all other issues are moot.
 
            
 
                                      order
 
            
 
                 THEREFORE, IT IS ORDERED:
 
            
 
                 That claimant takes nothing from this proceeding.
 
            
 
                 That costs of this action, including the cost of the 
 
            transcript, are charged to defendant pursuant to rule 343 
 
            IAC 4.33.
 
            
 
                 That defendant file a claim activity report as 
 
            requested by this agency pursuant to rule 343 IAC 3.1.
 

 
            
 
            Page   7
 
            
 
            
 
            
 
            
 
            
 
            
 
            
 
            
 
            
 
            
 
                 Signed and filed this ____ day of February, 1991.
 
            
 
            
 
            
 
            
 
            
 
                                          ______________________________               
 
            JEAN M. INGRASSIA
 
                                          DEPUTY INDUSTRIAL COMMISSIONER
 
            
 
            Copies To:
 
            
 
            Mr. William McGinn
 
            Attorney at Law
 
            3rd Flr Council Bluffs Savings Bank
 
            Council Bluffs  IA  51503
 
            
 
            Mr. Robert L. Harris
 
            Mr. Wendell F. Cowan
 
            Attorneys at Law
 
            P O Box 515
 
            Dept #41
 
            Dakota City  NE  68731
 
            
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                           1108
 
                           February 7, 1991
 
                           JEAN M. INGRASSIA
 
            
 
                     before the iowa industrial commissioner
 
            ____________________________________________________________
 
                                          :
 
            TERESA R. WEST,               :
 
                                          :    File Nos. 868362 & 877049
 
                 Claimant,                :
 
                                          :      A R B I T R A T I O N
 
            vs.                           :
 
                                          :         D E C I S I O N
 
            IBP, INC.,                    :
 
                                          :
 
                 Employer,                :
 
                 Self-Insured,            :
 
                 Defendant.               :
 
            ___________________________________________________________
 
            
 
            
 
            
 
            1108
 
            Claimant did not prove by a preponderance of the evidence 
 
            that her work injury is causally related to the disability 
 
            on which she now bases her claim.  Claimant's complaints are 
 
            not supported by clinical and laboratory findings.