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                     before the iowa industrial commissioner
 
            ____________________________________________________________
 
                                          :
 
            DAVID CORBETT,                :
 
                                          :
 
                 Claimant,                :
 
                                          :
 
            vs.                           :
 
                                          :       File No. 936478
 
            ROLSCREEN COMPANY,            :
 
                                          :     A R B I T R A T I O N
 
                 Employer,                :
 
                                          :        D E C I S I O N
 
            and                           :
 
                                          :
 
            EMPLOYERS MUTUAL COMPANIES,   :
 
                                          :
 
                 Insurance Carrier,       :
 
                 Defendants.              :
 
            ___________________________________________________________
 
            
 
                              statement of the case
 
            
 
                 This case came on for hearing on February 15, 1993, at 
 
            Des Moines, Iowa.  This is a proceeding in arbitration 
 
            wherein claimant seeks compensation for permanent partial 
 
            disability benefits as a result of an alleged injury 
 
            occurring on May 8, 1989.  The record in the proceeding 
 
            consists of the testimony of the claimant and Arlin Harvey, 
 
            and joint exhibits 1 through 8.
 
            
 
                                      issues
 
            
 
                 The issues for resolution are:
 
            
 
                 1.  Whether there is a causal connection between 
 
            claimant's alleged permanent disability and his May 8, 1989 
 
            injury;
 
            
 
                 2.  The extent of claimant's permanent disability, if 
 
            any, and entitlement to disability benefits; and,
 
            
 
                 3.  An 85.27 medical issue involving causal connection 
 
            and authorization.  The medical bill in question is joint 
 
            exhibit 2, a University of Iowa Hospital bill in the amount 
 
            of $12,302.51, including mileage.
 
            
 
                                 FINDINGS OF FACT
 
            
 
                 The undersigned deputy, having heard the testimony and 
 
            considered all the evidence, finds that:
 
            
 
                 Claimant is a 35-year-old high school graduate who upon 
 
            finishing high school entered the army in July 1975.  He 
 
            served three years before beginning work for defendant 
 
            employer in July of 1978.
 
            
 
                 Claimant related his experience in the service.  There 
 
            were no skills learned there that were of any real benefit 
 

 
            
 
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            in his post-service employment.  While in high school, 
 
            claimant cooked hamburgers and on occasion helped farmers by 
 
            driving a tractor, baling hay, walking beans, etc.  Claimant 
 
            described the nature of his jobs and positions while working 
 
            for defendant employer before he was termination on January 
 
            3, 1991.  These jobs involved standing nine hours on his 
 
            feet hand rolling in a gasket for windows which weighed from 
 
            two to 40 or 50 pounds.  He described what he would do in 
 
            working on the windows.  His jobs, at times, also involved 
 
            loading trains and hauling products off the lines.  He drove 
 
            a fork lift truck which involved getting off and on.  At 
 
            times, this job required no lifting.  Claimant indicated he 
 
            switched to days and was working in the stockroom and 
 
            unloading trailers which required more lifting and lifting 
 
            anything the defendant produced.  He indicated a fork lift 
 
            would be used to lift pallets but otherwise he did the rest 
 
            of the work by hand.  Claimant continued to work at his job 
 
            after his May 8, 1989 injury up through his date of 
 
            termination in January of 1991.
 
            
 
                 Claimant said that he had no problem operating the fork 
 
            lift, getting on or off or doing the twisting and turning as 
 
            required prior to his May 8, 1989 injury.
 
            
 
                 Claimant testified that on May 8, 1989, while taking 
 
            care of factory stock, he had to sort the parts that came in 
 
            on skids.  On this particular day, he indicated there were 
 
            two or three people absent from work who would normally help 
 
            in this process so he had to do it himself.  He indicated he 
 
            unloaded 20 to 30 skids which required bending and his low 
 
            back began to hurt and kept getting tighter and tighter and 
 
            that this pain went around his back.  Claimant indicated he 
 
            reported his problem to the employer who in turn sent him to 
 
            a nurse who told him to take Advil.
 
            
 
                 Claimant testified regarding the various doctors he saw 
 
            and the treatment he received, including physical therapy.
 
            
 
                 Claimant said that William R. Boulden, M.D., released 
 
            him on January 31, 1990, and indicated there was nothing 
 
            more he could do for him but did issue restrictions of no 
 
            repetitive bending or twisting, but that claimant could 
 
            drive a fork lift as long as he got off it every two hours.  
 
            Claimant indicated he was driving a fork lift prior to 
 
            seeing Dr. Boulden in September 1989 but that he was taken 
 
            off driving the fork lift in October 1989 and never returned 
 
            to that particular job.  Claimant indicated he was taken off 
 
            the fork lift because he couldn't change the fuel tank.  He 
 
            indicated this tank was changed sometimes once a day and 
 
            would weigh more than his restrictions allowed.  Claimant 
 
            said his job after October 1989 involved cleaning floors, 
 
            building crates and painting.  He said these jobs violated 
 
            his restrictions as he had to bend and stoop while painting 
 
            and cleaning the floors.
 
            
 
                 Claimant testified as to his termination date which has 
 
            been referred to as both January 3 and January 4, 1991.  
 
            Claimant indicated that he was notified on the fourth that 
 
            he was no longer part of the employment team because of his 
 
            attendance record.  Claimant rationalized his understanding 
 

 
            
 
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            of his attendance situation and why he missed and when he 
 
            missed.  Claimant also indicated that he was moved from a 
 
            Class 5 to a Class 3 status which amounted to approximately 
 
            $2 per hour pay decrease.
 
            
 
                 Claimant indicated he then applied for unemployment 
 
            benefits and received them.
 
            
 
                 Claimant indicated that after he was off unemployment 
 
            compensation for some time, he had gone for a three week 
 
            vocational rehabilitation program in May or June 1992.
 
            
 
                 Claimant developed a tremor in his hand and in January 
 
            1992 went to the University of Iowa Hospitals in Iowa City.  
 
            Claimant indicated eventually he went through the spine 
 
            clinic at the University of Iowa Hospitals in the neurology 
 
            department in July and August 1992.  He indicated this 
 
            helped him to understand how to deal with his pain as he was 
 
            having trouble dealing with it.  Claimant indicated at this 
 
            time he was having back problems on and off whereby he would 
 
            be stiff two or three days and had a hard time doing 
 
            anything.  He described the nature of his treatment.  He 
 
            indicated it helped him understand how to deal with his 
 
            pain.
 
            
 
                 Claimant testified he is currently attending William 
 
            Penn College and taking business and accounting, which is a 
 
            four year course.  He has completed one semester with a "C" 
 
            average and is retaking a computer course.  He indicated he 
 
            has no trouble in school with his back as he is not sitting 
 
            more than 15 minutes during class and he can move around the 
 
            chair.  Claimant indicated that it is his intent to finish 
 
            school and get a degree.  It appears he just began this four 
 
            year course in 1992.
 
            
 
                 Claimant indicated he cannot stand in one spot on 
 
            concrete for more than twenty or thirty minutes at a time, 
 
            on carpet in one spot about one hour at a time.  He 
 
            indicates that when sitting while driving, he must get out 
 
            and walk around about every hour or hour and a half.  He 
 
            would have a hard time pushing an object forward where there 
 
            is friction and indicates that his daughter pushes the 
 
            grocery cart when he shops and does the vacuuming at home 
 
            and his father does the lawn mowing.  Claimant indicated he 
 
            cannot carry more than 40 to 50 pounds two or three times 
 
            per hour and cannot bend constantly.  He has sleeping 
 
            problems and get up every two or three hours because his 
 
            back hurts.
 
            
 
                 Claimant said today he cannot do the fork lift job for 
 
            Rolscreen because riding on the fork lift is so bumpy.  He 
 
            also cannot do the sweeping all day or paint as he cannot 
 
            bend over all day.  Claimant emphasized that since he left 
 
            defendants' employment in January of 1990, his condition has 
 
            become worse.
 
            
 
                 On cross-examination, claimant started to be asked some 
 
            questions concerning his deposition testimony and claimant 
 
            then testified that when he had a chance to look at the 
 
            transcript of the deposition, he made statements that were 
 

 
            
 
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            stupid or not true.  Claimant claims that at the time of his 
 
            deposition he was going through a low part of his life and 
 
            was very mad and when he gets mad he doesn't tell the truth.  
 
            He acknowledged that this workers' compensation situation 
 
            was the first time he experienced the fact that he had a 
 
            hard time not telling the truth at the time of his 
 
            deposition.  Claimant was referred to pages 79 and 80 of his 
 
            deposition (Joint Exhibit 6).  Claimant acknowledged that he 
 
            had no intention at the time of making application for a 
 
            job.  Claimant indicated at his hearing that he was not 
 
            making any applications for work and emphasized that he 
 
            would not be able to work and go to school at the same time 
 
            and take care of the two kids which are in his custody 
 
            pursuant to a divorce.
 
            
 
                 Claimant acknowledged that he lost no time from work 
 
            between the time of his May 1989 injury and his termination 
 
            on January 3, 1991, except when he had to go to physical 
 
            therapy.
 
            
 
                 Claimant was asked questions concerning personal 
 
            problems he was having since May 8, 1989, involving his now 
 
            ex-wife.  Claimant acknowledged that there had been several 
 
            garnishments on his wages as a result of his wife's 
 
            mismanagement of money and having trouble covering her 
 
            bills.  Claimant said he sued for a divorce in 1986 and the 
 
            wife was awarded child support and that the employer was 
 
            withholding money weekly from his paycheck.  Claimant also 
 
            acknowledged that he actually got back with his wife in 1986 
 
            and yet claims his wife required him to make child support 
 
            payments.  He indicated he was still paying child support up 
 
            to the time of his termination even though he got a divorce 
 
            and has custody of the children.
 
            
 
                 Claimant acknowledged that in 1989 he had problems with 
 
            his wife (ex-wife) in both the spring and the fall and that 
 
            his wife was arrested in July 1989 or l990 and was charged 
 
            with writing bad checks.  Claimant said he was required to 
 
            make the checks good on some in which she signed his name.  
 
            He acknowledged that his wife filed for a divorce and when 
 
            they arrested his wife, the kids went with him and have been 
 
            with him every since.  Claimant said this caused stress and 
 
            that is when he went to see B. G. Wiltfang, M.D.
 
            
 
                 Claimant acknowledged that he saw no other doctor after 
 
            his April 24, 1990 visit with Dr. Boulden until he was 
 
            terminated on January 3, 1991.  He also acknowledged that he 
 
            had no further back treatment until April of 1992 at the 
 
            University of Iowa Hospitals.  He did indicate that in 
 
            January of 1992, he went to the University of Iowa Hospitals 
 
            because of hand tremors.  He indicted that he related this 
 
            to his back.  There is no dispute that from April 24, 1990 
 
            to January of 1992, he did not see anyone for his back.  He 
 
            understood the company procedure as to going to the company 
 
            nurse and getting a note to take to the doctor which in turn 
 
            would be brought back to the company after the doctor made 
 
            some notation thereon.  He again acknowledged that between 
 
            April 24, 1990 and his termination on January 3, 1991, he 
 
            had no contact with any doctor as to his back problem.
 
            
 

 
            
 
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                 Claimant was extensively questioned as to his 
 
            attendance record and the reasons for his termination on 
 
            January 3, 1991.  Claimant was referred to his deposition 
 
            and various exhibits connected therewith (Jt. Ex. 6, Dep. 
 
            Exs. G,H,I).  There is no dispute that these letters and 
 
            warnings were given and it appears to the undersigned that 
 
            there is no dispute of the reason for claimant's termination 
 
            in that this was within the company policy and claimant 
 
            understood the policy.  The undersigned sees no reason to go 
 
            into any further depth as to this issue.  The claimant is 
 
            not now contending he was terminated because of his workers' 
 
            compensation claim.  Due to the considerable amount of time 
 
            devoted to this particular area, there appeared possibly an 
 
            inference that claimant may have thought or defendants may 
 
            have thought there was a claim or inference of unlawful 
 
            discharge because of his workers' compensation matter.  So 
 
            there is no doubt in one's mind, the undersigned finds that 
 
            the record is clear and overwhelming that the company did 
 
            follow company policy and that claimant's termination was 
 
            because of his record of absences and infractions contrary 
 
            to company rules of which he was fully aware and that his 
 
            discharge was not because of his workers' compensation 
 
            claim.  Claimant had a history going back to a considerable 
 
            period of time prior to his work injury in which he had 
 
            problems with attendance and complying with the company 
 
            rules.
 
            
 
                 Claimant acknowledged that when he had filed for 
 
            unemployment benefits he saw two prospective employers per 
 
            week in his small town of New Sharon until July 1991 when 
 
            his employment compensation ran out.  At this time, he also 
 
            stopped looking for a job.  This is also reflected in joint 
 
            exhibit 3, pages 17 and 18.
 
            
 
                 Claimant indicated that he had applied at Tama Packing 
 
            Company in November 1991 (Jt. Ex. 6, p. 30 and 31).  This 
 
            incident is reflected on joint exhibit 3, pages 17 and 18.  
 
            Claimant said that he was ready to take a physical 
 
            examination but that he had cut his finger and therefore was 
 
            not able to take it.  He stated that he told the packing 
 
            plant he had no back problems.  Claimant indicated he never 
 
            did go back to take the physical.
 
            
 
                 Claimant was referred to joint exhibit 1, pages 26 and 
 
            28, in which he was evaluated on April 9, 1992.  There were 
 
            certain recommendations set out therein, which included that 
 
            claimant should go on a suggested exercise program, lose 
 
            weight through a diet and exercise program, and discontinue 
 
            smoking.  Claimant admitted that he hasn't stopped smoking 
 
            but couldn't relate how much he smoked compared to the two 
 
            packs a day at the time of the evaluation and that he didn't 
 
            go on a diet or do any exercises.  On that same date, 
 
            additional notes of Dr. Ernest M. Found, Jr., from the same 
 
            Spine Diagnostic and Treatment Center, at the University of 
 
            Iowa, reflect that in January 1992, claimant developed an 
 
            acute exacerbation of the back and left posterior thigh pain 
 
            that has been persistent.  The doctor's notes go on to 
 
            indicate that upon physical examination, no acute distress 
 
            was revealed and claimant's backward bending and side 
 
            bending and rotation were within normal limits and there was 
 

 
            
 
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            no evidence of instability with flexion or extension (Jt. 
 
            Ex. 1, p. 32).
 
            
 
                 Arlin Harvey, the personnel supervisor for defendant 
 
            employer, which is now known as Pella Window Company, 
 
            testified as to his capacity and duties with defendant 
 
            employer.  He went through in depth the company procedures 
 
            for terminating employees.  He referred to the various 
 
            exhibits attached to defendants' deposition (Jt. Ex. 6, Dep. 
 
            Exs. G,H,I).  As indicated earlier, the undersigned sees no 
 
            reason to go into detail over Mr. Harvey's testimony as the 
 
            undersigned has found and the evidence fully shows that 
 
            claimant was terminated for cause under the company 
 
            procedures and it appears to the undersigned that 
 
            notwithstanding the overwhelming evidence of the reason for 
 
            termination, claimant is not now claiming that the 
 
            termination was the result of his workers' compensation 
 
            claim.
 
            
 
                 It is obvious claimant had rights of appeal in all the 
 
            instances and did not appeal and that there were several 
 
            individuals involved as far as determinations being reached.  
 
            Mr. Harvey also responded to the claimant's contention that 
 
            he was treated differently as far as his warnings procedure 
 
            versus two others that he named.  Mr. Harvey adequately and 
 
            sufficiently explained the instances of the other two and 
 
            there was no discrimination.
 
            
 
                 Joint exhibit 1, pages 6 through 8, is a report of Dr. 
 
            Found, and orthopedic surgeon, and Ted Wernimont, M.S.W, a 
 
            rehabilitation coordinator with the treatment center, 
 
            department of orthopedic surgery, University of Iowa.  This 
 
            report mentions the results of claimant's evaluation and 
 
            certain restrictions, one of which is that he was not to 
 
            lift more than 40 pounds four times per hour.  The doctor 
 
            emphasized these were not permanent restrictions and should 
 
            continue to increase with his adherence to a good home 
 
            exercise program.  It is obvious the doctor means the 
 
            restrictions should decrease over time.  The report 
 
            emphasizes that claimant should continue with a good home 
 
            exercise program on a regular basis and to continue using 
 
            the coping skills learned in the program.  From the 
 
            claimant's testimony, it would appear that he did not pay 
 
            much attention to the recommended follow-up in this program 
 
            that he went through which was rather expensive.  He 
 
            indicated he has not been doing exercises, hasn't quit 
 
            smoking, etc.
 
            
 
                 Joint exhibit 1, pages 10 through 13, is a letter sent 
 
            to Dr. Found that the undersigned reasonably believes sets 
 
            out certain facts and asked Dr. Found to either agree or 
 
            disagree with a couple of items or write his own narrative 
 
            report.  Dr. Found indicated that his medical examination of 
 
            the claimant at the Spine Diagnostic and Treatment Center 
 
            failed to reveal any objective evidence of an impairment 
 
            which could be causally related to an alleged injury at work 
 
            in May of 1989.  He also indicated that based on the medical 
 
            evidence available to him, he could not state to a 
 

 
            
 
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            reasonable degree of medical certainty that claimant's need 
 
            for the rehabilitation program was the result of an alleged 
 
            injury occurring at work in May of 1989.  Joint exhibit 1, 
 
            page 31, is an April 9, 1992 evaluation report from Eugene 
 
            F. Gauron, Ph.D., clinical psychologist, with the Spine 
 
            Diagnostic and Treatment Center.  It is of interest to note 
 
            that his report indicates he cannot tell for sure to what 
 
            extent claimant is taking initiative to make something 
 
            happen but that claimant told him he has been applying for 
 
            jobs without success.  Mr. Gauron goes on to say that 
 
            however there appears to be an air about him of waiting for 
 
            someone else to do something beneficial for him.  The 
 
            undersigned believes that the evidence and testimony seems 
 
            to contradict the apparent effort claimant seems to have 
 
            told Mr. Gauron as to applying for jobs.  Claimant testified 
 
            that he applied only for two a week during the approximate 
 
            six month period ending in July of 1991 while he was getting 
 
            his unemployment compensation and that he had not applied 
 
            for any jobs since that time except for one or two possibly 
 
            at a packing company in November 1991.  In all instances 
 
            except for Tama Pack, he did not apply in writing but had 
 
            just made a contact.  At those times, it was clear claimant 
 
            was inquiring to comply with the unemployment laws and made 
 
            no effort to follow up or seek other jobs or even use a 
 
            telephone to make contacts.  The undersigned believes 
 
            claimant left a false impression with the clinical 
 
            psychologist, but it appears a psychologist saw "an air 
 
            about him" waiting for someone else to do something 
 
            beneficial for the claimant.  It appears that this is the 
 
            attitude reflected in claimant's conduct.
 
            
 
                 Dr. Boulden's report of July 17, 1990, reflected in 
 
            joint exhibit 1, page 34, indicates claimant has a 
 
            disability based upon the degenerative changes of 5 percent 
 
            and that he was suffering from degenerative disc disease of 
 
            L5/S1.
 
            
 
                 Dr. Boulden's report of October 26, 1989, approximately 
 
            five and one-half months after claimant's work injury, gives 
 
            the impression that claimant has a degenerative disc disease 
 
            which was aggravated by a work-related injury and 
 
            recommended that claimant could continue the fork lift job 
 
            and make sure he gets up from sitting/standing positions 
 
            frequently and there was to be no bending, lifting or 
 
            twisting with his back (Jt. Ex. 1, p. 40).  
 
            
 
                 Joint exhibit 1, pages 57 through 63, are the employee 
 
            health records of defendant employer.  They reflect that the 
 
            last company notation concerning claimant's seeing any 
 
            doctor or requesting any medical attention was April 24, 
 
            1990.  This confirms the other evidence in claimant's 
 
            testimony that he didn't see any other doctors since that 
 
            April 24, 1990 date up to the date he was terminated and, in 
 
            fact, as claimant testified and as set out earlier, he had 
 
            not seen another doctor until January of 1992.
 
            
 
                 Joint exhibit 2 is the University of Iowa Hospitals 
 
            medical bills summary amounting to $12,302.51 that is in 
 

 
            
 
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            dispute.  This bill includes $304.50 mileage expense.  These 
 
            services were rendered, it appears, beginning May 31, 1991 
 
            to August 31, 1992, as to the hospital, and the mileage 
 
            expense begins January 3, 1992 to December 16, 1992.  It is 
 
            not clear to the undersigned why the mileage expense covers 
 
            a period three plus months after the date of the medical 
 
            services at the University of Iowa Hospitals.  The testimony 
 
            indicated that claimant first went in January 1992 to the 
 
            hospital because of tremors in his hand.  It appears in 
 
            looking at the hospital bills that services were begun 
 
            because of claimant's nerve condition.  Claimant has had 
 
            nerve trouble, it appears, over the years and joint exhibit 
 
            1, page 66, indicates that he has had nerve trouble up to 
 
            that time, said exhibit being dated, it appears, sometime in 
 
            1980, at least between July 1978 and March 1981, if the 
 
            exhibits are in a somewhat chronological order.
 
            
 
                 Claimant is 35 years old.  Claimant has not worked 
 
            since he was terminated from his employment on January 3, 
 
            1991.  The record indicates claimant had been living on 
 
            unemployment benefits and when they terminated, it appears 
 
            he also was using his retirement or similar  benefits that 
 
            he withdrew and has also been receiving ADC.
 
            
 
                 Claimant lost no time from work as a result of his May 
 
            8, 1989 injury up until the time of his termination on 
 
            January 3, 1991, with the exception possibly of time going 
 
            to the therapist.
 
            
 
                 Claimant had not seen a doctor since his April 24, 1990 
 
            appointment with Dr. Boulden until he was terminated on 
 
            January 3, 1991, and he received no further back treatment 
 
            basically until April 1992 at the University of Iowa 
 
            Hospitals.  He did go to the University of Iowa Hospitals in 
 
            January of 1992 due to tremors in his hand which he relates 
 
            to a nervous condition.  Claimant contends his condition is 
 
            worse now than it was at the time of his injury.
 
            
 
                 When claimant filed for unemployment benefits shortly 
 
            after he was terminated on January 3, 1991, he indicated 
 
            that he was willing, ready and able to work and that he made 
 
            two contacts for employment per week so as to comply with 
 
            the unemployment law.  It appeared in all of those cases the 
 
            employer was not hiring (Jt. Ex. 3, pp. 17 and 18) and the 
 
            record is undisputed that he made no additional effort to 
 
            find employment after he made the two contacts.  He 
 
            indicated that he did not have the money or resources to 
 
            drive to places or make long distance calls but it is 
 
            undisputed he made no effort of any kind even locally, 
 
            whether it be on the phone or personal contacts, beyond the 
 
            two contacts.  It is obvious to the undersigned that he 
 
            wasn't very motivated to find work and was only making the 
 
            two contacts to enable him to get unemployment compensation 
 
            benefits.  As soon as his unemployment ran out in July of 
 
            1991, claimant stopped looking for work entirely except it 
 
            appears he did make contacts in the latter part of 1991 at 
 
            one or possibly two packing companies.  He was ready to take 
 
            a physical but because of a cut finger, that was delayed.  
 

 
            
 
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            He never followed up.  It appears to the undersigned he 
 
            wasn't very enthused about getting a job.
 
            
 
                 Claimant has custody of his two kids he got from an 
 
            apparent acrimonious divorce proceeding and he indicates 
 
            that he could not afford child care for the two kids if he 
 
            got a job.  It appears to the undersigned that claimant is 
 
            satisfied with staying home with the children which would 
 
            save child care and collect ADC benefits and any other 
 
            benefits that might be available to claimant without having 
 
            to work.
 
            
 
                 Claimant contends he has had this back problem ever 
 
            since his injury but it appears to be no coincidence that as 
 
            soon as he was terminated from work and off of unemployment 
 
            benefits, his medical condition appeared to have worsened.
 
            
 
                 Claimant has had a lot of personal problems over the 
 
            years and this seems to have contributed to claimant's basic 
 
            attitude.
 
            
 
                 Claimant admitted that he was not telling the truth in 
 
            his deposition and that he had a tendency to not tell the 
 
            truth when he gets angry.  He indicated that he was angry at 
 
            the time he took his deposition and that that is the only 
 
            time he has gotten angry whereby he was not telling the 
 
            truth.
 
            
 
                 Claimant was emphatic both in his deposition and his 
 
            testimony that he was not looking for a job and did not 
 
            intend to look for a job.  Claimant is now enrolled in 
 
            college and has completed one semester.  He indicates he 
 
            could not work now because he is going full time to school 
 
            and has two kids he must care for.  It appears he didn't 
 
            begin school until 1992.
 
            
 
                 There was no healing period or temporary total 
 
            disability paid as claimant lost no time from work because 
 
            of this injury.
 
            
 
                 The undersigned is concerned with the fact that 
 
            claimant was able to work and after his injury apparently 
 
            got along alright other than he had attendance problems and 
 
            problems with the rules of his employer.  It appears 
 
            claimant's termination was in accordance with the company 
 
            rules and that claimant's own actions brought about his 
 
            termination.  His actions were not as a result of his injury 
 
            but as a result of his inability to comply with the company 
 
            rules, the main one being attendance.  It seems like 
 
            claimant has had this problem for years and has been on the 
 
            verge of a possible discharge.  It appears that the 
 
            defendant company had tried to accommodate claimant through 
 
            his employment.
 
            
 
                 We have a claimant who missed no work and was able to 
 
            work after his injury for approximately 20 months until his 
 
            termination and then when he gets away from any work, 
 
            lifting or strenuous work exercise, and receives all his 
 
            unemployment benefits, he all of a sudden has alleged 
 
            problems resulting from his May 8, 1989 injury.  There is no 
 

 
            
 
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            evidence of what claimant was doing to cause this and he 
 
            strictly blames it on his May 1989 injury.
 
            
 
                 Claimant has the burden or proof that he has a 
 
            permanent injury which was caused by a May 8, 1989 work 
 
            injury.  Claimant through his own testimony raised a 
 
            credibility problem.  The undersigned believes that claimant 
 
            lacks motivation and is in a mode since his discharge in 
 
            January of 1989 whereby he is satisfied with and appears to 
 
            continue to desire to receive benefits from whatever source 
 
            there is without working.
 
            
 
                 The claimant requests defendants to pay a medical bill 
 
            represented by joint exhibit 2 in the amount of $12,302.51, 
 
            including mileage.  Defendants contend the same was not 
 
            authorized nor causally connected.  It is undisputed that 
 
            claimant went to the University of Iowa Hospitals in January 
 
            of 1992 because of hand tremors and a nervous situation.  
 
            The record shows he has had a nervous condition dating back 
 
            prior to his injury ultimately resulting in the January 1992 
 
            visit to the University of Iowa Hospitals.  Claimant then 
 
            started having treatment for his back.  Claimant has not 
 
            carried his burden to show a causal connection between the 
 
            need for that medical treatment and an injury which occurred 
 
            approximately three years earlier.  The undersigned believes 
 
            that on the facts of this case had claimant not had his 
 
            other personal problems and his attendance problems and was 
 
            able to comply with the rules of his employer, he would have 
 
            still been employed.  It does not make sense to the 
 
            undersigned that claimant was not having any 
 
            employment-ending medical problems before his termination 
 
            and once removed from the work area that he contends causes 
 
            his work injury or aggravation of the same, he now becomes 
 
            worse when he is removed from the work.
 
            
 
                 The undersigned therefore finds that claimant takes 
 
            nothing from these proceedings and that he has failed to 
 
            show that he has any permanent disability that is caused by 
 
            his May 8, 1989 work injury.  Claimant has also failed to 
 
            show that the medical bills at the University of Iowa 
 
            Hospitals, including mileage, of $12,302.51 is causally 
 
            connected to a May 8, 1989 injury.
 
            
 
                    
 
            
 
            
 
            Page  11
 
            
 
            
 
            
 
            
 
            conclusions of law
 
            
 
                 The claimant has the burden of proving by a 
 
            preponderance of the evidence that the injury of May 8, 
 
            1989, is causally related to the disability on which he now 
 
            bases his claim.  Bodish v. Fischer, Inc., 257 Iowa 516, 133 
 
            N.W.2d 867 (1965).  Lindahl v. L. O. Boggs, 236 Iowa 296, 18 
 
            N.W.2d 607 (1945).  A possibility is insufficient; a 
 
            probability is necessary.  Burt v. John Deere Waterloo 
 
            Tractor Works, 247 Iowa 691, 73 N.W.2d 732 (1955).  The 
 
            question of causal connection is essentially within the 
 
            domain of expert testimony.  Bradshaw v. Iowa Methodist 
 
            Hospital, 251 Iowa 375, 101 N.W.2d 167 (1960). 
 
            
 
                 However, expert medical evidence must be considered 
 
            with all other evidence introduced bearing on the causal 
 
            connection.  Burt, 247 Iowa 691, 73 N.W.2d 732.  The opinion 
 
            of experts need not be couched in definite, positive or 
 
            unequivocal language.  Sondag v. Ferris Hardware, 220 N.W.2d 
 
            903 (Iowa 1974).  However, the expert opinion may be 
 
            accepted or rejected, in whole or in part, by the trier of 
 
            fact.  Id. at 907.  Further, the weight to be given to such 
 
            an opinion is for the finder of fact, and that may be 
 
            affected by the completeness of the premise given the expert 
 
            and other surrounding circumstances.  Bodish, 257 Iowa 516, 
 
            133 N.W.2d 867.  See also Musselman v. Central Telephone 
 
            Co., 261 Iowa 352, 154 N.W.2d 128 (1967).
 
            
 
                 It is further concluded that claimant has failed to 
 
            prove his alleged disability or medical condition is 
 
            causally connected to a May 8, 1989 work injury.
 
            
 
                 Claimant has failed to prove that his medical expense 
 
            and mileage represented by exhibit 2 in the amount of 
 
            $12,302.51 is causally connected to a May 8, 1989 work 
 
            injury.
 
            
 
                                      order
 
            
 
                 THEREFORE, it is ordered:
 
            
 
                 That claimant takes nothing from these proceedings.
 
            
 
                 That costs are assessed against the claimant.
 
            
 
                 Signed and filed this ____ day of February, 1993.
 
            
 
            
 
            
 
                                          ______________________________
 
                                          BERNARD J. O'MALLEY
 
                                          DEPUTY INDUSTRIAL COMMISSIONER
 

 
            
 
            Page  12
 
            
 
            
 
            
 
            
 
            
 
            Copies to:
 
            
 
            Mr David D Drake
 
            Attorney at Law
 
            West Towers Office Complex
 
            1200 35th St  Ste 500
 
            West Des Moines IA 50265
 
            
 
            Mr Cecil L Goettsch
 
            Attorney at Law
 
            801 Grand Ave  Ste 3700
 
            Des Moines IA 50309-2727
 
            
 
            
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                      5-1402.40; 5-1402.60
 
                      Filed February 25, 1993
 
                      Bernard J. O'Malley
 
            
 
                     before the iowa industrial commissioner
 
            ____________________________________________________________
 
                                          :
 
            DAVID CORBETT,                :
 
                                          :
 
                 Claimant,                :
 
                                          :
 
            vs.                           :
 
                                          :       File No. 936478
 
            ROLSCREEN COMPANY,            :
 
                                          :     A R B I T R A T I O N
 
                 Employer,                :
 
                                          :        D E C I S I O N
 
            and                           :
 
                                          :
 
            EMPLOYERS MUTUAL COMPANIES,   :
 
                                          :
 
                 Insurance Carrier,       :
 
                 Defendants.              :
 
            ___________________________________________________________
 
            
 
            5-1402.40
 
            Found claimant failed to prove he incurred a work-related 
 
            industrial disability.
 
            
 
            5-1402.40
 
            Claimant failed to prove his alleged permanent disability 
 
            was caused by a work injury.
 
            
 
            5-1402.60
 
            Claimant failed to prove some of his medical expenses were 
 
            causally connected to a work injury.
 
            
 
 
            
 
 
 
 
 
 
 
 
 
 
 
            before the iowa industrial commissioner
 
            ____________________________________________________________
 
            _____
 
                                          :
 
            JAMES A. BLAIR,               :
 
                                          :
 
                 Claimant,                :
 
                                          :
 
            vs.                           :
 
                                          :    File Nos. 936504/901455
 
            FARMLAND FOODS, INC.,         :
 
                                          :          A P P E A L
 
                 Employer,                :
 
                                          :        D E C I S I O N
 
            and                           :
 
                                          :
 
            AETNA CASUALTY & SURETY CO.,  :
 
                                          :
 
                 Insurance Carrier,       :
 
                 Defendants.              :
 
            ____________________________________________________________
 
            ____
 
            The record, including the transcript of the hearing before 
 
            the deputy and all exhibits admitted into the record, has 
 
            been reviewed de novo on appeal.  The decision of the deputy 
 
            filed August 9, 1991 is affirmed and is adopted as the final 
 
            agency action in this case. 
 
            Defendants shall pay the costs of the appeal, including the 
 
            preparation of the hearing transcript.
 
            Signed and filed this ____ day of December, 1991.
 
            
 
            
 
            
 
            
 
                      ________________________________
 
                               BYRON K. ORTON
 
                           INDUSTRIAL COMMISSIONER
 
            
 
            Copies To:
 
            
 
            Mr. Harry H. Smith
 
            Attorney at Law
 
            P.O. Box 1194
 
            Sioux City, Iowa 51102
 
            
 
            Mr. Thomas M. Plaza
 
            Attorney at Law
 
            P.O. Box 3086
 
            Sioux City, Iowa 51102
 
            
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                                          9998
 
                                          Filed December 17, 1991
 
                                          BYRON K. ORTON
 
                                          JMI
 
            before the iowa industrial commissioner
 
            ____________________________________________________________
 
                                          :
 
            JAMES A. BLAIR,               :
 
                                          :
 
                 Claimant,                :
 
                                          :
 
            vs.                           :
 
                                          :    File Nos. 936504/901455
 
            FARMLAND FOODS, INC.,         :
 
                                          :          A P P E A L
 
                 Employer,                :
 
                                          :        D E C I S I O N
 
            and                           :
 
                                          :
 
            AETNA CASUALTY & SURETY CO.,  :
 
                                          :
 
                 Insurance Carrier,       :
 
                 Defendants.              :
 
            ___________________________________________________________
 
            
 
            9998
 
            
 
                 Summary affirmance of deputy's decision filed August 9, 
 
            1991.
 
            
 
 
         
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                        5-1802; 5-1803; 5-2209
 
                        Filed August 9, 1991
 
                        JEAN M. INGRASSIA
 
         
 
                     before the iowa industrial commissioner
 
         ____________________________________________________________
 
                                       :
 
         JAMES A. BLAIR,               :
 
                                       :
 
              Claimant,                :
 
                                       :
 
         vs.                           :
 
                                       :    File Nos. 936504 & 901455
 
         FARMLAND FOODS, INC.,         :
 
                                       :      A R B I T R A T I O N
 
              Employer,                :
 
                                       :         D E C I S I O N
 
         and                           :
 
                                       :
 
         AETNA CASUALTY AND SURETY CO.,:
 
                                       :
 
              Insurance Carrier,       :
 
              Defendants.              :
 
         ___________________________________________________________
 
         
 
         
 
         5-1802; 5-1803; 5-2209
 
         All of the evidence, including claimant's testimony, support the 
 
         conclusion that claimant's symptoms arose at the same time.  
 
         Therefore, it was found that even though there are two claim 
 
         files and two carpal tunnel surgeries, there was only one injury 
 
         and not separate injuries in this case.  The uncontroverted 
 
         testimony of claimant verified that his job as a boner required 
 
         the simultaneous use of both hands and wrists.
 
         This case is governed by Iowa Code section 85.34(2)(s) as an 
 
         injury to both wrists caused by a single incident and is 
 
         compensated on the basis of 500 weeks.  Simbro v. DeLong's 
 
         Sportswear, 332 N.W.2d 886 (Iowa 1983).
 
         The greater weight of the evidence was found to support the 
 
         impairment rating given by Dr. Pat Luse rather than claimant's 
 
         treating surgeon who last saw him on October 17, 1989.  Dr. Luse 
 
         gave a 10 percent impairment rating to each upper extremity.  
 
         Using the AMA Guides, 10 percent of the right upper extremity 
 
         converts to six percent of the body as a whole and 10 percent of 
 
         the left upper extremity converts to six percent of the body as a 
 
         whole.  Placing these two values on the combined values chart on 
 
         page 254 of the AMA Guides, produces a combined value of 12 
 
         percent of the body as a whole.  Claimant was awarded 60 weeks of 
 
         permanent partial disability benefits.
 
         
 
 
            
 
            
 
            
 
            
 
            
 
            
 
                      BEFORE THE IOWA INDUSTRIAL COMMISSIONER            
 
            ____________________________________________________________
 
                                           :
 
            LaVERNE K. HALEEN,             :
 
                                           :         File Nos. 936505
 
                 Claimant,                 :                   936506
 
                                           :
 
            vs.                            :      A R B I T R A T I O N
 
                                           :
 
            OSCAR MAYER FOODS CORPORATION, :         D E C I S I O N
 
                                           :
 
                 Employer,                 :
 
                 Self-Insured,             :
 
                 Defendant.                :
 
            ____________________________________________________________
 
            
 
                              STATEMENT OF THE CASE
 
            
 
                 This decision concerns two proceedings in arbitration 
 
            brought by LaVerne K. Haleen against his former employer, 
 
            Oscar Mayer Foods Corporation, based upon alleged injuries 
 
            of January 23, 1989, and February 3, 1989.  Claimant asserts 
 
            that he injured his left shoulder, left wrist and right 
 
            wrist as a result of cumulative trauma to which he was 
 
            subjected over the years of his employment by Oscar Mayer.  
 
            Claimant seeks compensation for healing period, permanent 
 
            partial disability and reimbursement pursuant to section 
 
            85.39 of The Code for the expense of an independent medical 
 
            examination in the amount of $250.  Issues contained within 
 
            the case include whether the conditions of which the 
 
            claimant complains are injury as opposed to changes relating 
 
            to normal aging and a lifetime of labor, and whether any 
 
            permanent disability is scheduled rather than body as a 
 
            whole.
 
            
 
                 The case was heard at Des Moines, Iowa, on August 19, 
 
            1991.  The record in the proceeding consists of testimony 
 
            from LaVerne K. Haleen, joint exhibits 1 through 7 and 
 
            claimant's exhibit A.
 
            
 
                                 FINDINGS OF FACT
 
            
 
                 Having considered all the evidence received, together 
 
            with the appearance and demeanor of the witness, the 
 
            following findings of fact are made.
 
            
 
                 LaVerne K. Haleen is a 60-year-old man born October 23, 
 
            1931.  He lives on a farm near Boxholm, Iowa.  LaVerne 
 
            attended four years of school, but fell four credits short 
 
            of obtaining a high school diploma.  After leaving school, 
 
            he worked in the construction industry for approximately a 
 
            year and then joined the Navy.  In 1954, after approximately 
 
            three and one-half years of service, he was honorably 
 
            discharged.  LaVerne then commenced farming the 160-acre 
 

 
            
 
            Page   2
 
            
 
            
 
            
 
            
 
            family farm with the assistance of his wife, Mary Anne.  
 
            During the first few years, LaVerne raised livestock, but 
 
            thereafter it was strictly a crop operation.  Since 1986, 
 
            LaVerne's son-in-law has performed the farming operation.  
 
            LaVerne's only physical contribution has been to drive a 
 
            tractor occasionally.  During the summers, LaVerne performed 
 
            construction work.  Two years were spent as a carpenter and 
 
            approximately five years were spent performing masonry work.
 
            
 
                 LaVerne commenced employment with Oscar Mayer Foods 
 
            Corporation on January 15, 1968.  At that time, he had no 
 
            problems with his shoulders, arms or wrists and passed a 
 
            preemployment physical examination.
 
            
 
                 Over the years, LaVerne's principal job was boning 
 
            picnics, although on occasion he performed other jobs such 
 
            as boning blades.  He worked at a rate of 51 or 53 picnics 
 
            per hour.  During approximately the last half of his 21 
 
            years of employment, a conveyor system moved the product.
 
            
 
                 In the fall of 1988, LaVerne learned that the plant 
 
            would be closing.  A few months prior to the plant closing 
 
            on February 3, 1989, LaVerne began experiencing discomfort 
 
            in his shoulders and wrists.  On January 23, 1989, he 
 
            contacted the plant nurse and was seen by Steven Sohn, M.D., 
 
            with complaints of persistent aching in his wrists and 
 
            recent pain in his left shoulder (exhibit 1, page 1).  
 
            LaVerne continued working at his regular job until the plant 
 
            closed on February 3, 1989.  Thereafter, he drew 
 
            unemployment and unsuccessfully participated in the Oscar 
 
            Mayer dislocated worker program.
 
            
 
                 On September 20, 1989, he again sought treatment from 
 
            Dr. Sohn.  Dr. Sohn referred claimant to physical therapy at 
 
            Dallas County Hospital.  He participated in the program for 
 
            approximately five weeks and showed marked improvement 
 
            (exhibit 3).
 
            
 
                 Claimant was seen by Peter D. Wirtz, M.D., a Des Moines 
 
            orthopaedic surgeon, on November 2, 1989.  After conducting 
 
            diagnostic tests, Dr. Wirtz concluded that claimant had 
 
            degenerative joint disease of both wrists, tendinitis of 
 
            wrist structures, inflammation of the rotator cuff tendon 
 
            and degeneration of the acromioclavicular joint in his left 
 
            shoulder.  Dr. Wirtz stated that the conditions are a 
 
            natural degenerative process and are not related to any one 
 
            specific incident of trauma (exhibit 3, page 11).  He did 
 
            not comment upon cumulative trauma as a possible cause.  Dr. 
 
            Wirtz felt that claimant had no permanent impairment as a 
 
            result of these conditions (exhibit 3, page 10).  The MRI 
 
            scan showed fibrillary degeneration of the rotator cuff 
 
            tendon.  Ligaments of the acromioclavicular articulation 
 
            were shown to impinge upon a portion of the supraspinatus 
 
            musculotendinous junction (exhibit 4).
 
            
 
                 LaVerne was also examined by orthopaedic surgeon Marvin 
 

 
            
 
            Page   3
 
            
 
            
 
            
 
            
 
            H. Dubansky, M.D., in July 1990.  Dr. Dubansky diagnosed 
 
            tendinitis of the rotator cuff of the left shoulder and 
 
            tendinitis or tenosynovitis of both wrists.  Dr. Dubansky 
 
            also stated that the changes he found are not unusual for 
 
            claimant's age and that a combination of aging and a 
 
            lifetime of labor work were the cause of the claimant's 
 
            symptoms (exhibit 5, pages 14-16).  Dr. Dubansky reported in 
 
            a subsequent letter that the changes he found are due to 
 
            farming and the heavy work which LaVerne performed at Oscar 
 
            Mayer.  He rated LaVerne as having a 16 percent impairment 
 
            of the left shoulder and a 3 percent impairment of each 
 
            wrist (exhibit 5, page 17).  Dr. Dubansky noted that 
 
            LaVerne's right shoulder was also restricted but 
 
            asymptomatic.  Dr. Dubansky felt that claimant's work at 
 
            Oscar Mayer was a contributing factor in aggravating and 
 
            causing the condition, but it would not necessarily be the 
 
            primary factor (exhibit 5, page 18).
 
            
 
                 Claimant was evaluated by David T. Berg, D.O., in May 
 
            1991.  Dr. Berg found LaVerne to have chronic tenosynovitis 
 
            of his hands and wrists which was due to meat cutting.  He 
 
            stated that LaVerne possibly had carpal tunnel syndrome.  
 
            Dr. Berg also stated that LaVerne had obvious impingement 
 
            syndrome in his shoulder and left acromioclavicular joint 
 
            degeneration of a type which was very consistent with the 
 
            type of work LaVerne had performed.  He found LaVerne's 
 
            right shoulder to also be symptomatic and felt that it 
 
            probably also had an impingement syndrome.  Dr. Berg rated 
 
            LaVerne as having a 15 percent impairment of his left 
 
            shoulder, a 10 percent impairment of his right shoulder and 
 
            a 5 percent impairment of each hand.  Dr. Berg stated that 
 
            the shoulder and bilateral wrist problems were a result of 
 
            claimant's employment with Oscar Mayer and that the injuries 
 
            are very typical for that kind of work.  Dr. Berg felt that 
 
            claimant should follow restrictions of not working above 
 
            chest level and of avoiding repetitive gripping, pulling or 
 
            pushing with his hands (exhibit 6).
 
            
 
                 A report appears in the record from Karma J. Gibson, 
 
            M.S., dated April 29, 1991.  The stated goal of the report 
 
            is to assess claimant's employability status and the 
 
            availability of employment within his stated work 
 
            restrictions.  The report contains a detailed history, but 
 
            does not address the issues defined in the stated goal.
 
            
 
                 Since leaving Oscar Mayer, LaVerne was unemployed until 
 
            March 1990 when he obtained a temporary job with the state 
 
            nursery at Ames, Iowa.  He harvested and graded tree 
 
            seedlings and was paid $5.85 per hour.  When the project was 
 
            completed, he was laid off.  The job lasted four weeks.
 
            
 
                 LaVerne completed a course in small engine repair at 
 
            the area community college and drew unemployment until 
 
            starting at R & W Tire and Turf in April 1991.  LaVerne 
 

 
            
 
            Page   4
 
            
 
            
 
            
 
            
 
            assembles, delivers, picks up and repairs lawn mowers.  He 
 
            expects to also work on snow blowers when the winter season 
 
            approaches.  LaVerne's work hours fluctuate due to the 
 
            amount of work which is available.  He earns $5.00 per hour, 
 
            but has no fringe benefits.
 
            
 
                 LaVerne complained of a constant ache in his shoulders 
 
            which worsens with work.  He described the left as being 
 
            worse than the right.  He stated that his wrists and arms 
 
            ache.  He is able to perform his present job, but works at 
 
            his own pace.  He complained of pain and aching, but has no 
 
            plans to leave the job.  He plans to continue working until 
 
            age 62.
 
            
 
                 LaVerne formerly water skied, but ceased the activity 
 
            approximately three years ago due to his wrists and 
 
            shoulders.  He also has a heart problem and is diabetic.  He 
 
            has suffered from gall and kidney stones as well as an 
 
            ulcer.  He complained that his legs ache.
 
            
 
                 After the plant closed, LaVerne applied for a number of 
 
            jobs as shown on exhibit A.  He stated at hearing that he 
 
            felt that he was capable of performing all those jobs.
 
            
 
                 Dr. Berg was chosen by the claimant for an independent 
 
            examination.  The charges were $250 which LaVerne has paid.
 
            
 
                 The assessment of this case made by Dr. Dubansky is 
 
            consistent with that made by Dr. Berg.  They are found to be 
 
            correct.  Where the assessment from Dr. Wirtz is in conflict 
 
            with that of Drs. Dubansky and Berg, Dr. Wirtz' assessment 
 
            is rejected.  Greater weight is given to the assessments 
 
            made by Drs. Dubansky and Berg because they appear to reach 
 
            a consensus with each other, whereas Dr. Wirtz stands alone 
 
            in finding that there is no permanent impairment.  The 
 
            assessment from Dr. Wirtz which states that the claimant's 
 
            problems are not related to any one specific incident or 
 
            trauma does not address the issue of whether they have 
 
            resulted from cumulative trauma or repetitive activity.
 
            
 
                                CONCLUSIONS OF LAW
 
            
 
                 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 
 
                 occupational disease under the Workmen's 
 
                 Compensation Act, yet an injury to the health may 
 
                 be a personal injury.  [Citations omitted.]  
 
                 Likewise a personal injury includes a disease 
 
                 resulting from an injury. . . . The result of 
 
                 changes in the human body incident to the general 
 
                 processes of nature do not amount to a personal 
 
                 injury.  This must follow, even though such 
 
                 natural change may come about because the life has 
 

 
            
 
            Page   5
 
            
 
            
 
            
 
            
 
                 been devoted to labor and hard work.  Such result 
 
                 of those natural changes does not constitute a 
 
                 personal injury even though the same brings about 
 
                 impairment of health or the total or partial 
 
                 incapacity of the functions of the human body. 
 
            
 
                    . . . .
 
                 
 
                 A personal injury, contemplated by the Workmen's 
 
                 Compensation Law, obviously means an injury to the 
 
                 body, the impairment of health, or a disease, not 
 
                 excluded by the act, which comes about, not through the 
 
                 natural building up and tearing down of the human body, 
 
                 but because of a traumatic or other hurt or damage to 
 
                 the health or body of an employee.  [Citations 
 
                 omitted.]  The injury to the human body here 
 
                 contemplated must be something, whether an accident or 
 
                 not, that acts extraneously to the natural processes of 
 
                 nature, and thereby impairs the health, overcomes, 
 
                 injures, interrupts, or destroys some function of the 
 
                 body, or otherwise damages or injures a part or all of 
 
                 the body.
 
            
 
                 According to Dr. Wirtz, LaVerne's condition is entirely 
 
            the result of natural aging and a life devoted to labor and 
 
            hard work.  The distinction between those conditions which 
 
            do not constitute a personal injury and those which 
 
            constitute a cumulative trauma injury or occupational 
 
            disease resulting from repeated pressure on the parts of the 
 
            body affected is often difficult to ascertain.  In theory, 
 
            every impact or exertion which affects an individual is an 
 
            incident of cumulative trauma which plays some part in any 
 
            impairment of health which subsequently occurs.  A personal 
 
            injury, in order to be compensable, requires more than some 
 
            exposure to a theoretically injurious trauma.  It requires 
 
            exposure to a real, identifiable trauma which produces a 
 
            known or identifiable physical abnormality which produces 
 
            disability, rather than merely symptoms or discomfort.  In 
 
            this case, LaVerne Haleen was exposed to repetitive trauma 
 
            and he has conditions which are known to result from 
 
            exposure to repetitive trauma.  The facts in this case show 
 
            LaVerne's wrist and shoulder conditions to be personal 
 
            injury from cumulative trauma rather than mere aging or the 
 
            noncompensable results of a life devoted to labor and hard 
 
            work.
 
            
 
                 Claimant has the burden of proving by a preponderance 
 
            of the evidence that he received an injury which arose out 
 
            of and in the course of his employment. McDowell v. Town of 
 
            Clarksville, 241 N.W.2d 904 (Iowa 1976); Musselman v. Cent. 
 
            Tel. Co., 261 Iowa 352, 154 N.W.2d 128 (1967).
 
            
 
                 The evidence from Dr. Berg appears to contain evidence 
 
            which, if accepted, would make a prima facie showing of at 
 
            least a part of this claimant's condition as being an 
 

 
            
 
            Page   6
 
            
 
            
 
            
 
            
 
            occupational disease.  The one condition is tenosynovitis, a 
 
            condition formerly listed as an occupational disease in 
 
            chapter 85A.  He also indicates that the condition is 
 
            typical for the industry in which this claimant had worked.  
 
            The shoulder condition could likewise be termed to be an 
 
            occupational disease resulting from repeated pressure on the 
 
            parts affected.  Calahan v. Oscar Mayer, IV Iowa Industrial 
 
            Commissioner Report 53, 55 (App. 1983); Johnson v. Franklin 
 
            Mfg. Co., Thirty-fourth Biennial Report of the Industrial 
 
            Commissioner 152, 154 (App. 1978).  It is a theory which was 
 
            not raised by any party.  The evidence introduced in this 
 
            case does not compel a finding of occupational disease.  If 
 
            it did, the issue of disablement under section 85A.4 would 
 
            need to be addressed.  There is a possibility that if 
 
            treated as an occupational disease, the claim might be 
 
            barred by section 85A.12.
 
            
 
                 As previously indicated, the record in this case 
 
            permits the conditions to be treated as cumulative injury 
 
            rather than as occupational disease.  The normal rule is 
 
            that the date of injury is the day that disability from the 
 
            condition prevents the individual from working.  McKeever 
 
            Custom Cabinets v. Smith, 379 N.W.2d 368 (Iowa 1985).  That 
 
            situation did not arise in this case.  LaVerne continued 
 
            working until the plant closed.  Thereafter, he was not 
 
            exposed to the traumas presented by his work as a boner.  It 
 
            is therefore concluded that the date of injury in this case 
 
            is February 3, 1989, the day the plant closed.  There is but 
 
            one cumulative trauma injury.  The injury affects both of 
 
            LaVerne's wrists and shoulders.  While claimant had symptoms 
 
            on January 23, 1989, those symptoms were not yet disabling.
 
            
 
                 LaVerne seeks compensation for healing period.  There 
 
            is no evidence in the record of this case which shows him to 
 
            have been disabled in the sense of being taken off work or 
 
            directed to refrain from working by any physician.  He 
 
            underwent physical therapy for approximately five weeks, but 
 
            the fact of undergoing physical therapy does not necessarily 
 
            eliminate the individual from being able to engage in 
 
            gainful employment.  It is quite common to see cases where 
 
            an individual undergoes therapy while maintaining regular 
 
            work hours.  It is therefore concluded that LaVerne Haleen 
 
            is not entitled to recover any healing period compensation 
 
            as a result of the February 3, 1989, injury.
 
            
 
                 Drs. Dubansky and Berg have both rated LaVerne as 
 
            having permanent impairment affecting his wrists and left 
 
            shoulder.  Dr. Berg has also found an impairment of the 
 
            right shoulder, while Dr. Dubansky found a restricted range 
 
            of motion of the right shoulder, but did not assign an 
 
            impairment rating.  Both of those physicians have indicated 
 
            that LaVerne's work at Oscar Mayer was a substantial factor 
 
            in bringing about the conditions which now affect his 
 

 
            
 
            Page   7
 
            
 
            
 
            
 
            
 
            shoulders and wrists.  For a cause to be proximate, it need 
 
            not be the only cause.  Blacksmith v. All-American, Inc., 
 
            290 N.W.2d 348, 354 (Iowa 1980).  It is therefore concluded 
 
            that the condition of LaVerne's shoulders and wrists is the 
 
            result of a cumulative trauma injury which he sustained 
 
            during the years of his employment with Oscar Mayer Foods 
 
            Corporation.  That cumulative trauma injury process produced 
 
            the permanent impairment which has been found by Drs. 
 
            Dubansky and Berg.  The difference between their impairment 
 
            ratings is not significant.
 
            
 
                 The shoulder injury is an injury to the body as a whole 
 
            since the abnormality and disability is not limited to his 
 
            arm.  Lauhoff Grain v. McIntosh, 395 N.W.2d 834 (Iowa 1986).  
 
            If claimant has an impairment to the body as a whole, an 
 
            industrial disability has been sustained.  Industrial 
 
            disability was defined in Diederich v. Tri-City Railway Co., 
 
            219 Iowa 587, 593, 258 N.W.2d 899, 902 (1935) as follows: 
 
            "It is therefore plain that the legislature intended the 
 
            term `disability' to mean `industrial disability' or loss of 
 
            earning capacity and not a mere `functional disability' to 
 
            be computed in the terms of percentages of the total 
 
            physical and mental ability of a normal man."
 
            
 
                 Functional impairment is an element to be considered in 
 
            determining industrial disability which is the reduction of 
 
            earning capacity, but consideration must also be given to 
 
            the injured employee's age, education, qualifications, 
 
            experience and inability to engage in employment for which 
 
            he is fitted.  Olson v. Goodyear Service Stores, 255 Iowa 
 
            1112, 1121, 125 N.W.2d 251, 257 (1963).
 
            
 
                 Industrial disability or loss of earning capacity is a 
 
            concept that is quite similar to impairment of earning 
 
            capacity, an element of damage in a tort case.  Impairment 
 
            of physical capacity creates an inference of lessened 
 
            earning capacity.  The basic element to be determined, 
 
            however, is the reduction in value of the general earning 
 
            capacity of the person, rather than the loss of wages or 
 
            earnings in a specific occupation.  Post-injury earnings 
 
            create a presumption of earning capacity.  The earnings are 
 
            not synonymous with earning capacity and the presumption may 
 
            be rebutted by evidence showing the earnings to be an 
 
            unreliable indicator.  Bearce v. FMC Corp., 465 N.W.2d 531 
 
            (Iowa 1991); DeWall v. Prentice, 224 N.W.2d 428, 435 (Iowa 
 
            1974); Carradus v. Lange, 203 N.W.2d 565 (Iowa 1973); 
 
            Holmquist v. Volkswagon of America, Inc., 261 N.W.2d 516 
 
            (Iowa App. 1977) A.L.R.3d 143; Michael v. Harrison County, 
 
            Thirty-fourth Biennial Report of the Industrial Commissioner 
 
            218 (1979); 2 Larson Workmen's Compensation Law, sections 
 
            57.21 and 57.31.
 
            
 
                 A great deal of LaVerne's reduction in actual earnings 
 
            is the fact that the good paying job with good fringe 
 

 
            
 
            Page   8
 
            
 
            
 
            
 
            
 
            benefits is no longer available since the plant closed.  The 
 
            fact that he is now working at $5.00 per hour is much more 
 
            closely related to the results of the plant closing than it 
 
            is to LaVerne's physical condition or disability.  The only 
 
            physician to impose activity restrictions is Dr. Berg and 
 
            those restrictions are not particularly severe.  This is an 
 
            injury for which there was no loss of work time.  There is 
 
            reason to suspect that, if the plant had not closed, LaVerne 
 
            might still be working there today and may have continued 
 
            working until his eventual retirement.  Whether or not he 
 
            would have become actually disabled from performing his 
 
            usual employment cannot be determined.  Nevertheless, he 
 
            does have significant physical impairment.  He is at an age 
 
            where he is approaching the age at which individuals 
 
            typically retire.  Becke v. Turner-Busch, Inc., 
 
            Thirty-fourth Biennial Report of the Industrial Commissioner 
 
            34 (App. 1979).  It is not practical for him to seek 
 
            substantial retraining.  His current employment seems very 
 
            appropriate under the circumstances which exist.  When all 
 
            the pertinent factors of industrial disability are 
 
            considered, it is determined that LaVerne Haleen has a ten 
 
            percent permanent partial disability as a result of the 
 
            cumulative trauma injury to his wrists and shoulders which 
 
            he sustained over the years of his employment with Oscar 
 
            Mayer Foods Corporation.  Since there is no healing period, 
 
            the permanent partial disability compensation is payable 
 
            commencing with the day after the plant closed, namely 
 
            February 4, 1989.  Brincks v. Case Power & Equipment, File 
 
            No. 843233 (App. April 18, 1990).  He is entitled to recover 
 
            50 weeks of compensation pursuant to section 85.34(2)(u).
 
            
 
                 LaVerne also seeks to recover $250 as the expenses of 
 
            an independent medical examination pursuant to Code section 
 
            85.39.  From the record made, it appears as though Dr. Sohn 
 
            was the company physician and referred LaVerne to Dr. Wirtz.  
 
            Dr. Wirtz made an evaluation of permanent impairment in 
 
            which he concluded that there was none.  From the record 
 
            made, it is not clear whether Dr. Dubansky was a physician 
 
            retained by the employer, but Dr. Wirtz certainly was.  
 
            LaVerne is therefore entitled to an independent medical 
 
            examination under the provisions of section 85.39.  In the 
 
            prehearing report, it is stipulated that the charges made by 
 
            Dr. Berg are reasonable.  The fact that claimant paid the 
 
            charges is likewise evidence of their reasonableness.  
 
            LaVerne is therefore entitled to recover the $250 fee 
 
            charged by Dr. Berg for the independent medical examination.
 
            
 
                                      ORDER
 
            
 
                 IT IS THEREFORE ORDERED that Oscar Mayer Foods 
 
            Corporation pay LaVerne K. Haleen fifty (50) weeks of 
 
            compensation for permanent partial disability at the 
 
            stipulated rate of two hundred sixty-three and 30/100 
 

 
            
 
            Page   9
 
            
 
            
 
            
 
            
 
            dollars ($263.30) per week payable commencing February 4, 
 
            1989.  The entire amount thereof is past due and owing and 
 
            shall be paid to the claimant in a lump sum together with 
 
            interest pursuant to section 85.30 of The Code computed from 
 
            the date each weekly payment came due until the date of its 
 
            actual payment.  This award is made under file number 
 
            936506.
 
            
 
                 IT IS FURTHER ORDERED that Oscar Mayer Foods 
 
            Corporation pay LaVerne K. Haleen two hundred fifty and 
 
            00/100 dollars ($250.00) as reimbursement for the expenses 
 
            of a medical examination performed by Dr. Berg pursuant to 
 
            section 85.39 of The Code.  This award is made under file 
 
            number 936506.
 
            
 
                 IT IS FURTHER ORDERED that the costs of both 
 
            proceedings are assessed against the employer pursuant to 
 
            rule 343 IAC 4.33.
 
            
 
                 IT IS FURTHER ORDERED that the employer file claim 
 
            activity reports as requested by this agency pursuant to 
 
            rule 343 IAC 3.1.
 
            
 
                 Signed and filed this ______ day of ____________, 1991.
 
            
 
                 
 
            
 
                 
 
                 
 
                                          ______________________________
 
                                          MICHAEL G. TRIER
 
                                          DEPUTY INDUSTRIAL COMMISSIONER
 
            
 
            Copies To:
 
            
 
            Mr. Robert E. McKinney
 
            Attorney at Law
 
            480 6th Street
 
            P.O. Box 209
 
            Waukee, Iowa  50263
 
            
 
            Mr. Harry W. Dahl III
 
            Attorney at Law
 
            974 73rd Street
 
            Suite 16
 
            Des Moines, Iowa  50312
 
            
 
 
            
 
 
 
 
 
 
 
                                                 1802; 1803; 2201; 2209
 
                                                 Filed November 7, 1991
 
                                                 MICHAEL G. TRIER
 
 
 
                   BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
            ____________________________________________________________
 
                       
 
            LaVERNE K. HALEEN,   
 
                                                   File Nos. 936505
 
                 Claimant,                                   936506
 
                       
 
            vs.                                  A R B I T R A T I O N
 
                       
 
            OSCAR MAYER FOODS CORPORATION,          D E C I S I O N
 
                       
 
                 Employer,  
 
                 Self-Insured,   
 
                 Defendant.      
 
            ____________________________________________________________
 
            
 
            1802; 1803; 2201; 2209
 
            Fifty-nine-year-old claimant had worked at the Oscar Mayer 
 
            plant as a boner for over 20 years and remained so employed, 
 
            without being disabled from working, up to the time the 
 
            plant closed.  Shortly before the closing, he began to 
 
            express complaints affecting his shoulders and wrists.  
 
            Subsequent evaluations found him to have medically-diagnosed 
 
            conditions affecting the shoulders and wrists and permanent 
 
            impairment ratings were assigned.  The physicians related 
 
            the conditions in part to the claimant's work.
 
            It was held that the conditions did constitute a compensable 
 
            injury rather than noncompensable changes due to age or a 
 
            life devoted to labor and hard work.  The conditions were 
 
            held to be cumulative trauma injuries though there was 
 
            evidence in the record which made a prima facie showing that 
 
            at least some part of the condition was an occupational 
 
            disease.  The evidence of occupational disease was not 
 
            overwhelming and the theory was not supported by either 
 
            party.  The claim might have been barred by section 85A.12 
 
            if the condition had been treated as an occupational 
 
            disease.  There was further a question regarding whether 
 
            disablement had occurred as defined in section 85A.4.
 
            Since the case was treated as one of cumulative trauma 
 
            injury, the date of injury was held to be the last day of 
 
            exposure to the injurious work, namely the day the plant 
 
            closed.  No healing period compensation was awarded and 
 
            permanent partial disability was awarded commencing on the 
 
            day following the date of the plant closure.  Claimant 
 
            awarded ten percent permanent partial disability.
 
            
 
 
            
 
            Page   1
 
            
 
            
 
            
 
            
 
            
 
            
 
            
 
            
 
                     before the iowa industrial commissioner
 
            ____________________________________________________________
 
                                          :
 
            RANDALL L. LESS,              :
 
                                          :         File No. 936509
 
                 Claimant,                :
 
                                          :      A R B I T R A T I O N
 
            vs.                           :
 
                                          :         D E C I S I O N
 
            HAROLD BECKER,                :
 
                                          :
 
                 Employer,                :
 
                 Defendant.               :
 
            ____________________________________________________________
 
            
 
                              statement of the case
 
            
 
                 This is a proceeding in arbitration brought by the 
 
            claimant, Randall L. Less, against his alleged employer, 
 
            Harold Becker, to recover benefits under the Iowa Workers' 
 
            Compensation Act as the result of an injury sustained on 
 
            April 1, 1989.  This matter came on for hearing before the 
 
            undersigned deputy industrial commissioner at Cedar Rapids, 
 
            Iowa on July 30, 1991.  A first report of injury has not yet 
 
            been filed.  The record in this matter consists of joint 
 
            exhibits numerously numbered 2 through 34 as identified on 
 
            the submitted exhibit list.  The record also consists of the 
 
            testimony of claimant, of Harold John Becker, of Jim Becker 
 
            and of Mark Allan Fiedler.
 
            
 
                                      issues
 
            
 
                 Pursuant to the hearing assignment order, the 
 
            prehearing report and the oral stipulations of the parties 
 
            at hearing, the parties have stipulated that costs for 
 
            medical charges were fair and reasonable for the condition 
 
            treated and that treatment was reasonable and necessary 
 
            treatment for the condition treated; that claimant was not 
 
            off work on account of the alleged work incident; and, that 
 
            claimant was a single individual entitled to one exemption 
 
            who was not a student at the time of his injury.
 
            
 
                 Issues remaining to be decided are whether claimant 
 
            received an injury which arose out of and in the course of 
 
            his employment; whether an employer-employee relationship 
 
            existed between claimant and his alleged employer; whether a 
 
            causal relationship exists between claimant's alleged injury 
 
            and claimed disability; the nature and extent of any benefit 
 
            entitlement; whether claimant is entitled to payment of 
 
            certain medical costs pursuant to section 85.27; and, 
 
            claimant's rate of weekly compensation, in the event of any 
 
            award.
 
            
 
                                 findings of fact
 

 
            
 
            Page   2
 
            
 
            
 
            
 
            
 
            
 
            
 
            
 
            
 
                 The deputy, having heard the testimony and considered 
 
            the evidence, finds:
 
            
 
                 Claimant was 24 years old at time of hearing.  Claimant 
 
            had worked for Harold Becker at Becker's farming operation 
 
            from approximately December 1, 1988 through May 1989.  At 
 
            claimant's pre-hiring interview, Mr. Becker had advised 
 
            claimant that he would be paid 14 percent of the gross 
 
            recovery on the milk check.  No direct discussion of 
 
            independent contractor status took place.  Claimant had no 
 
            understanding of what an independent contractor was at the 
 
            time he agreed to work on Becker's farm.  Harold Becker's 
 
            understanding of independent contractor was "if I take a job 
 
            and do it on my own."  Becker left on an approximately 
 
            six-week vacation shortly after claimant's hire and left 
 
            claimant in charge of the farming operation.  Apparently, 
 
            the cows were wholly owned by Becker.  Claimant had 
 
            authority and did charge items to Harold Becker on Becker's 
 
            accounts with various farm suppliers and veterinarians.  
 
            Claimant also consulted a veterinarian on numerous 
 
            occasions.  Both Harold and Jim Becker testified that this 
 
            was more often than Harold Becker would have called a 
 
            veterinarian.  It is found that such consultations did not 
 
            represent an exercise of control over the work, but rather 
 
            reflect the judgment calls of a less experienced, younger 
 
            individual left to manage a dairy operation in the owner's 
 
            absence.
 
            
 
                 Likewise, claimant initiated feed testing through 
 
            Triangle Agri Services Corporation.  Harold Becker did not 
 
            generally use Triangle Agri Services Corporation for feed 
 
            analysis.  Without further evidence in the record as to why 
 
            claimant chose to use the feed testing service in Becker's 
 
            absence and given that the charge for the feed testing 
 
            service was to Harold Becker, claimant's ordering of the 
 
            feed analysis does not evidence that claimant had a right to 
 
            control the work at the Becker farm.  Becker required that 
 
            the daily milking take place at established intervals twice 
 
            daily.  Claimant could choose the milking times, provided 
 
            that the times were consistent from day to day.  Becker 
 
            instructed claimant as to how the cows should be bedded down 
 
            and chastised claimant when Becker perceived that bedding 
 
            had not been properly done.
 
            
 
                 Claimant's earnings were apparently paid from Swiss 
 
            Valley Farms Company as an assignment on producer number 
 
            456-0, apparently Harold Becker's producer number.  Neither 
 
            federal nor state tax withholdings or FICA withholdings were 
 
            made from claimant's checks.  Claimant had worked on several 
 
            other farming operations prior to beginning work on the 
 
            Becker operation.  Claimant testified that such withholdings 
 
            had never been made on his farm earnings checks.
 
            
 
                 Claimant brought a pressure sprayer unit with him to 
 

 
            
 
            Page   3
 
            
 
            
 
            
 
            
 
            
 
            
 
            
 
            the Becker farm and had it installed in the Becker barn.  
 
            Claimant otherwise used Becker's tools on the Becker farming 
 
            operation.  It is expressly found that claimant and Harold 
 
            Becker did not have the requisite meeting of minds required 
 
            to form a mutual intent that claimant should function as an 
 
            independent contractor and not as an employee.  It is 
 
            further found that Harold Becker retained the right to 
 
            control claimant's work.  It is further found that claimant 
 
            was an employee of Harold Becker and not an independent 
 
            contractor.
 
            
 
                 Claimant had sustained an initial dislocation of his 
 
            left shoulder in a domestic incident in 1983.  In 
 
            approximately December 1984, claimant underwent left 
 
            anterior, "Putti Platt" shoulder repair.  Claimant had had 
 
            recurrent subluxations of the left shoulder from that point 
 
            onward.  Claimant had informed Becker of a problem with his 
 
            shoulder at the time of his hiring.  Claimant had not 
 
            discussed his prior surgery or the subluxations, however.  
 
            Claimant had several subluxations of the shoulder prior to 
 
            April 1, 1989 while working at the Becker farm.  On each of 
 
            those occasions, either claimant alone or with another's 
 
            assistance had been able to manually relocate the shoulder.
 
            
 
                 On April 1, 1989, claimant was on a ladder fixing the 
 
            chain on a manure spreader at Harold Becker's direction.  
 
            Claimant fell off the ladder.  His shoulder dislocated.  
 
            Neither Jim Becker nor claimant could "pop" the shoulder in.  
 
            Harold Becker took claimant to the emergency room.  Claimant 
 
            was released later that evening with his arm in a sling.  He 
 
            did the evening milking and continued to work at the Becker 
 
            farm until the end of May 1989.  Claimant then left the 
 
            Becker farm as Harold Becker was retiring and Jim Becker, 
 
            Harold's son, was taking over the farming operation.  
 
            Claimant testified he left because he was tired of farming 
 
            for someone else and wished an opportunity to farm for 
 
            himself.  The April 1, 1989 work incident was not a factor 
 
            in claimant's leaving.
 
            
 
                 Claimant sustained another shoulder dislocation in late 
 
            May 1989 while moving a dresser at his home.
 
            
 
                 On July 27, 1989, William A. Roberts, M.D., apparently 
 
            a board-certified orthopaedic physician, performed a Bankart 
 
            anterior capsulorrhaphy repair for recurrent left anterior 
 
            glenohumeral dislocation.  The doctor subsequently assigned 
 
            claimant a seven percent permanent impairment rating based 
 
            on restriction of range of motion of the left shoulder 
 
            produced by the repair.  In his deposition taken June 5, 
 
            1990, Dr. Roberts opined that claimant's functional 
 
            condition was improved subsequent to surgery in that the 
 
            shoulder was now stable, but that permanency was produced 
 
            under the AMA guides because claimant post-surgery had a 
 
            reduction of range of motion not present prior to surgery.  
 

 
            
 
            Page   4
 
            
 
            
 
            
 
            
 
            
 
            
 
            
 
            Dr. Roberts' uncontradicted opinion, which is accepted, was 
 
            that claimant's recurrent dislocation of April 1, 1989 did 
 
            not impact on his permanent impairment rating.  The doctor 
 
            stated the following as regards the relationship between 
 
            claimant's April 1, 1989 incident and his ultimate surgery 
 
            and decrease in range of motion and subsequent impairment:
 
            
 
                 A.  I don't believe the fall on the 1st of April, 
 
                 1989 --
 
            
 
                 Q.  That's the date.
 
            
 
                 A.  -- affected the function of his shoulder 
 
                 because he had dislocated prior to that.
 
            
 
                 Q.  Okay.
 
            
 
                 A.  So, in terms of it having an effect upon his 
 
                 impairment it didn't because it had been 
 
                 dislocating prior to that.
 
            
 
                 Q.  Okay.
 
            
 
                 A.  That's the primary message that I want to 
 
                 leave with you.  Now, it could have been that 
 
                 Doctor McMenamin after his dislocation that he 
 
                 cared for him for could have said, "Randall, you 
 
                 need another shoulder repair."  And he could have 
 
                 done surgery at that time, resulting in a decrease 
 
                 in range of motion and a subsequent impairment.
 
            
 
                 So, utilizing the A.M.A. guidelines they don't 
 
                 deal with recurrent dislocation.  All they deal 
 
                 with is limitation of range of motion.  In fact, 
 
                 before I did his surgery he would have had no 
 
                 impairment because his range of motion was normal.
 
            
 
            (Dr. Roberts deposition, page 10, line 23 through page 11, 
 
            line 18)
 
            
 
                 Based on the doctor's uncontroverted opinion, it is 
 
            expressly found that claimant's surgery of July 27, 1989 
 
            related to the overall instability of his shoulder 
 
            subsequent to his initial injury in 1984 and initial surgery 
 
            at the University of Iowa and did not relate to and was not 
 
            substantially aggravated by the work incident of April 1, 
 
            1989.
 
            
 
                                conclusions of law
 
            
 
                 We first consider whether claimant was an employee of 
 
            defendant Harold Becker on April 1, 1989.
 
            
 
                 Section 85.61(1) provides in part:
 
            
 
                 2.  "Worker" or "employee" means a person who has 
 
                 entered into employment of, or works under 
 

 
            
 
            Page   5
 
            
 
            
 
            
 
            
 
            
 
            
 
            
 
                 contract of service, express or implied, or 
 
                 apprenticeship, for an employer. . . .
 
            
 
                 It is claimant's duty to prove, by a preponderance of 
 
            the evidence, that claimant or claimant's decedent was an 
 
            employee within the meaning of the law.  Where claimant 
 
            establishes a prima facie case, defendants then have the 
 
            burden of going forward with the evidence which rebuts 
 
            claimant's case.  The employer must establish, by a 
 
            preponderance of the evidence, any pleaded affirmative 
 
            defense or bar to compensation.  Nelson v. Cities Serv. Oil 
 
            Co., 259 Iowa 1209, 146 N.W.2d 261 (1967).
 
            
 
                 Factors to be considered in determining whether an 
 
            employer-employee relationship exists are:  (1) the right of 
 
            selection, or to employ at will, (2) responsibility for 
 
            payment of wages by the employer, (3) the right to discharge 
 
            or terminate the relationship, (4) the right to control the 
 
            work, and (5) identity of the employer as the authority in 
 
            charge of the work or for whose benefit it is performed.  
 
            The overriding issue is the intention of the parties.  Where 
 
            both parties by agreement state they intend to form an 
 
            independent contractor relationship, their stated intent is 
 
            ignored if the agreement exists to avoid the workers' 
 
            compensation laws, however.  Likewise, the test of control 
 
            is not the actual exercise of the power of control over the 
 
            details and methods to be followed in the performance of the 
 
            work, but the right to exercise such control.  Also, the 
 
            general belief or custom of the community that a particular 
 
            kind of work is performed by employees can be considered in 
 
            determining whether an employer-employee relationship 
 
            exists.  Caterpillar Tractor Co. v. Shook, 313 N.W.2d 503 
 
            (Iowa 1981); McClure v. Union, et al., Counties, 188 N.W.2d 
 
            283 (Iowa 1971); Nelson v. Cities Serv. Oil Co., 259 Iowa 
 
            1209, 146 N.W.2d 261 (1966); Lembke v. Fritz, 223 Iowa 261, 
 
            272 N.W. 300 (1937); Funk v. Bekins Van Lines Co., I Iowa 
 
            Industrial Commissioner Report 82 (Appeal Decision 1980).
 
            
 
                 As stated above, the overriding issue is the intention 
 
            of the parties.  Both claimant and Mr. Becker agree that no 
 
            discussion of claimant's status as anything other than 
 
            employee ever took place.  It is not so outside the ordinary 
 
            course for an employee to be paid on a percentage basis that 
 
            claimant could have gleaned from that fact that Becker was 
 
            asking him to work as an independent contractor and not as 
 
            an employee.  Likewise, ownership of the dairy herd and 
 
            ownership of all the tools and machines used on the dairy 
 
            operation with the exception of claimant's own sprayer lay 
 
            with Mr. Becker.  Likewise, all charges were made on Mr. 
 
            Becker's accounts.  The limited exercise of control by 
 
            claimant was within that which might well be expected to be 
 
            exercised by a dairy herdsman left to run an operation in 
 
            his employer's absence.  It cannot be said to show clear 
 
            intent to form an independent contractor arrangement, 
 
            particularly in the face of such overriding evidence that 
 
            that had never been a mutual intent of the parties and that 
 
            actual control, both of how the work was performed and of 
 

 
            
 
            Page   6
 
            
 
            
 
            
 
            
 
            
 
            
 
            
 
            the property and means for performing the work, continued to 
 
            lie with Mr. Becker.
 
            
 
                 We reach the issue of whether claimant received an 
 
            injury arising out of and in the course of his employment.
 
            
 
                 The claimant has the burden of proving by a 
 
            preponderance of the evidence that the alleged injury 
 
            actually occurred and that it arose out of and in the course 
 
            of employment.  The words "arising out of" refer to the 
 
            cause or source of the injury.  The words "in the course of" 
 
            refer to the time, place and circumstances of the injury.  
 
            Sheerin v. Holin Co., 380 N.W.2d 415, 417 (Iowa 1986); 
 
            McClure v. Union, et al., Counties, 188 N.W.2d 283, 287 
 
            (Iowa 1971).
 
            
 
                 The credible evidence does establish that claimant did 
 
            fall from a ladder in the course of his employment on April 
 
            1, 1989 and that that fall produced another recurrent 
 
            dislocation of his left shoulder.  It can fairly be said 
 
            that claimant received an injury arising out of and in the 
 
            course of his employment on that date.
 
            
 
                 We consider the issue of causation, both as it relates 
 
            to entitlement to medical benefits and as it relates to 
 
            entitlement to weekly workers' compensation benefits.
 
            
 
                 The claimant has the burden of proving by a 
 
            preponderance of the evidence that the injury is a proximate 
 
            cause of the disability on which the claim is based.  A 
 
            cause is proximate if it is a substantial factor in bringing 
 
            about the result; it need not be the only cause.  A 
 
            preponderance of the evidence exists when the causal 
 
            connection is probable rather than merely possible.  
 
            Blacksmith v. All-American, Inc., 290 N.W.2d 348, 354 (Iowa 
 
            1980); Holmes v. Bruce Motor Freight, Inc., 215 N.W.2d 296, 
 
            297 (Iowa 1974).
 
            
 
                 The question of causal connection is essentially within 
 
            the domain of expert testimony.  The expert medical evidence 
 
            must be considered with all other evidence introduced 
 
            bearing on the causal connection between the injury and the 
 
            disability.  The weight to be given to any expert opinion is 
 
            determined by the finder of fact and may be affected by the 
 
            accuracy of the facts relied upon by the expert as well as 
 
            other surrounding circumstances.  The expert opinion may be 
 
            accepted or rejected, in whole or in part.  Sondag v. Ferris 
 
            Hardware, 220 N.W.2d 903 (Iowa 1974); Anderson v. Oscar 
 
            Mayer & Co., 217 N.W.2d 531 (Iowa 1974); Bodish v. Fischer, 
 
            Inc., 257 Iowa 516, 133 N.W.2d 867 (1965).
 
            
 
                 While a claimant is not entitled to compensation for 
 
            the results of a preexisting injury or disease, its mere 
 
            existence at the time of a subsequent injury is not a 
 
            defense.  Rose v. John Deere Ottumwa Works, 247 Iowa 900, 76 
 
            N.W.2d 756 (1956).  If the claimant had a preexisting 
 
            condition or disability that is materially aggravated, 
 

 
            
 
            Page   7
 
            
 
            
 
            
 
            
 
            
 
            
 
            
 
            accelerated, worsened or lighted up so that it results in 
 
            disability, claimant is entitled to recover.  Nicks v. 
 
            Davenport Produce Co., 254 Iowa 130, 115 N.W.2d 812 (1962); 
 
            Yeager v. Firestone Tire & Rubber Co., 253 Iowa 369, 112 
 
            N.W.2d 299 (1961).
 
            
 
                 It is clear that claimant's recurrent dislocation of 
 
            the left shoulder on April 1, 1989 and the inability of 
 
            claimant or other individuals to manually relocate the 
 
            shoulder at that time produced the need for claimant to seek 
 
            emergency room medical treatment at that time and subsequent 
 
            follow-up care on April 5, 1989.  Defendant Becker then is 
 
            liable for any costs related to the emergency room visit and 
 
            for costs related to claimant's follow-up office visit and 
 
            x-ray examination of his shoulder of April 5, 1989 with Iowa 
 
            Musculoskeletal Center, P.C., under section 85.27.  We note 
 
            claimant is not entitled to payment of costs related to his 
 
            May 24, 1989 emergency room visit or expenses with Cedar 
 
            Rapids Radiologists, P.C., or costs with the John McDonald 
 
            Hospital in Monticello of $74.00 dated May 25, 1989 in that 
 
            those appear to relate to the subsequent dislocation when 
 
            claimant was opening a dresser drawer at home.
 
            
 
                 As claimant lost no work time on account of the April 
 
            1, 1989 incident, he is not entitled to either temporary 
 
            total disability or healing period benefits for any period 
 
            immediately subsequent to the April 1, 1989 incident through 
 
            his voluntary leaving of employment with the Becker farming 
 
            operation.
 
            
 
                 The remaining questions are whether claimant is 
 
            entitled to payment of medical costs related to his 
 
            subsequent July 27, 1989 left shoulder surgery and follow-up 
 
            treatment therefrom and whether a causal relationship exists 
 
            between the original April 1, 1989 injury and such surgery 
 
            such that claimant would be entitled to either temporary or 
 
            permanent benefits, or both, on account of the injury.  The 
 
            facts found support a negative legal conclusion.  Dr. 
 
            Roberts' testimony suggests that the April 1, 1989 incident 
 
            was only another of multiple recurrent dislocations of 
 
            claimant's shoulder which dislocations had their origins in 
 
            claimant's original injury of 1983 and the subsequent 
 
            initial attempted shoulder repair.  The facts do not support 
 
            a finding that the April 1, 1989 incident materially 
 
            aggravated claimant's prior shoulder condition such that 
 
            surgery was necessary subsequent to the April 1 incident, 
 
            but had not been necessary or desirable prior to the April 1 
 
            incident.  Given such, claimant is not entitled to costs of 
 
            medical care related to his July 27, 1989 surgery or other 
 
            medical care related to his recurrent shoulder dislocations, 
 
            but not directly related to his emergency room visit of 
 
            April 1, 1989.  Hence, all medical care costs of July 24, 
 
            1989 and subsequent thereto are payments for which the 
 
            employer is not liable.  Likewise, claimant is not entitled 
 
            to either temporary total disability, healing period or 
 

 
            
 
            Page   8
 
            
 
            
 
            
 
            
 
            
 
            
 
            
 
            permanent weekly benefits as related to the July 27, 1989 
 
            surgery as that surgery did not have its origins in and 
 
            cannot be said to be found directly traceable to the April 
 
            1, 1989 incident.
 
            
 
                 It is therefore concluded that claimant has established 
 
            a causal relationship between his April 1, 1989 injury and 
 
            medical costs related to his April 1, 1989 emergency room 
 
            visit.  Claimant has not established a causal relationship 
 
            between his April 1, 1989 injury and his subsequent July 27, 
 
            1989 surgery.  Likewise, claimant has not established a 
 
            causal relationship between his April 1, 1989 injury and any 
 
            period of temporary disability related to the July 27, 1989 
 
            surgery.  Claimant has not established a causal relationship 
 
            between his April 1, 1989 injury and any permanent 
 
            impairment or permanent disability related to his July 27, 
 
            1989 surgery.
 
            
 
                 As claimant has not established a causal relationship 
 
            between his April 1, 1989 injury and any period of temporary 
 
            or permanent disability, it is not necessary to inquire into 
 
            the extent of any temporary or permanent disability.
 
            
 
                 As claimant has not established any entitlement to 
 
            weekly disability benefits, it is not necessary to attempt 
 
            to establish a rate of weekly compensation for claimant.
 
            
 
                                      order
 
            
 
                 THEREFORE, IT IS ORDERED:
 
            
 
                 Defendant Harold Becker pay claimant the costs of 
 
            medical care as follows:
 
            
 
                 Cedar Rapids Radiologists, P.C.      $   32.00
 
                 Iowa Musculoskeletal Center, P.C.        74.00
 
                 Mercy Medical Center                    475.82
 
            
 
                 Defendant Harold Becker pay the costs of this action 
 
            pursuant to rule 343 IAC 4.33.
 
            
 
                 Defendant Harold Becker shall file a first report of 
 
            injury for this claim within twenty (20) days of the signing 
 
            and filing of this decision pursuant to rule 343 IAC 3.1.
 
            
 
                 Defendant Harold Becker file claim activity reports as 
 
            the agency requires pursuant to rule 343 IAC 3.1.
 
            
 
                 Signed and filed this ______ day of ____________, 1991.
 
            
 
                 
 
            
 
                 
 
                 
 
                                          ______________________________
 
                                          HELENJEAN WALLESER
 
                                          DEPUTY INDUSTRIAL COMMISSIONER
 

 
            
 
            Page   9
 
            
 
            
 
            
 
            
 
            
 
            
 
            
 
            
 
            Copies To:
 
            
 
            Mr. James L. Chipokas
 
            Attorney at Law
 
            Suite A, 860 2nd Avenue SE
 
            Cedar Rapids, Iowa  52403
 
            
 
            Mr. James F. Pickens
 
            Attorney at Law
 
            Tenth Floor American Building
 
            P.O. Box 74170
 
            Cedar Rapids, Iowa  52407-4170
 
            
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                           1108.50; 2001; 2002
 
                           2200; 2206; 2500; 2700
 
                           Filed September 5, 1991
 
                           HELENJEAN WALLESER
 
            
 
                     before the iowa industrial commissioner
 
            ____________________________________________________________
 
                                          :
 
            RANDALL L. LESS,              :
 
                                          :         File No. 936509
 
                 Claimant,                :
 
                                          :      A R B I T R A T I O N
 
            vs.                           :
 
                                          :         D E C I S I O N
 
            HAROLD BECKER,                :
 
                                          :
 
                 Employer,                :
 
                 Defendant.               :
 
            ____________________________________________________________
 
            
 
            2001; 2002
 
            Claimant found an employee of farmer for whom claimant 
 
            worked as a herdsman where no explicit discussion of 
 
            independent contractor status had taken place and where 
 
            farmer owned dairy herd, tools and equipment used and all 
 
            charges were made to farmer's account.  Farmer also 
 
            instructed claimant re times of milking and methods of 
 
            bedding cows to be used.  Claimant's payment of percentage 
 
            of milk check not sufficient to create independent 
 
            contractor status.
 
            
 
            1108.50; 2200; 2206; 2500; 2700
 
            Claimant sustained a work injury when fall from ladder 
 
            produced another recurrent dislocation of his left shoulder.  
 
            Claimant entitled to payments for medical care related 
 
            directly to that incident.  Claimant not entitled to payment 
 
            for subsequent shoulder surgery which related to long-term 
 
            problem with multiple recurrent dislocations and not 
 
            directly to work injury.  No lost time or permanent 
 
            disability related to work injury.
 
            
 
 
            
 
            Page   1
 
            
 
            
 
            
 
            
 
            before the iowa industrial commissioner
 
            ____________________________________________________________
 
            _____
 
                                          :
 
            DOUGLAS S. GOODDING,          :
 
                                          :
 
                 Claimant,                :
 
                                          :
 
            vs.                           :
 
                                          :      File No. 936511
 
            MIDLANDS BUSINESS EQUIPMENT,  :
 
                                          :        A P P E A L
 
                 Employer,                :
 
                                          :      D E C I S I O N
 
            and                           :
 
                                          :
 
            AMERICAN FAMILY INSURANCE     :
 
            COMPANY,                      :
 
                                          :
 
                 Insurance Carrier,       :
 
                 Defendants.              :
 
            ____________________________________________________________
 
            _____
 
            The record has been reviewed de novo on appeal.  The ruling 
 
            of the deputy filed November 19, 1991 is affirmed and is 
 
            adopted as the final agency action in this case with the 
 
            following additional analysis:
 
            Claimant, in his appeal brief raises the issue whether the 
 
            defendant employer as a successor comporation should be 
 
            liable for his injuries.  That issue was not argued before 
 
            the deputy when the motion for summary judgment was 
 
            considered.  That issue should not now be considered in this 
 
            appeal.  Even if the issue were to be considered, 
 
            consideration of the issue would not result in a denial of 
 
            defendants' motion for a summary judgment.  Assuming for the 
 
            sake of argument that the law relied upon by claimant, C. 
 
            Mac Chambers Co. v. Iowa Tae Kwon Do Academy, 412 N.W.2d 593 
 
            (Iowa 1987) were applicable, claimant has presented no 
 
            evidence to satisfy the tests for successor liability given 
 
            in that case.
 
            Signed and filed this ____ day of February, 1992.
 
            
 
            
 
            
 
            
 
                      ________________________________
 
                               BYRON K. ORTON
 
                          INDUSTRIAL COMMISSIONER
 
            
 

 
            
 
            Page   2
 
            
 
            
 
            
 
            
 
            Copies To:
 
            
 
            Mr. Thomas J. Reilly
 
            Attorney at Law
 
            4900 University, Ste 200
 
            Des Moines, Iowa 50311
 
            
 
            Ms. Nancy C. Coon
 
            Attorney at Law
 
            P.O. Box 65630
 
            West Des Moines, Iowa 50265
 
            
 
 
            
 
 
 
 
 
 
 
 
 
 
 
            5-2000
 
            Filed February 24, 1992
 
            Byron K. Orton
 
            DRR
 
            before the iowa industrial commissioner
 
            ____________________________________________________________
 
            _____
 
                                          :
 
            DOUGLAS S. GOODDING,          :
 
                                          :
 
                 Claimant,                :
 
                                          :
 
            vs.                           :
 
                                          :      File No. 936511
 
            MIDLANDS BUSINESS EQUIPMENT,  :
 
                                          :        A P P E A L
 
                 Employer,                :
 
                                          :      D E C I S I O N
 
            and                           :
 
                                          :
 
            AMERICAN FAMILY INSURANCE     :
 
            COMPANY,                      :
 
                                          :
 
                 Insurance Carrier,       :
 
                 Defendants.              :
 
            ____________________________________________________________
 
            _____
 
            
 
            5-2000
 
            Grant of defendant employer's motion for summary judgment 
 
            affirmed on appeal where claimant was not employed by named 
 
            employer on the date of the alleged injury.  Claimant's 
 
            attempt to argue cumulative injury and liability of 
 
            successor corporation was rejected.
 
            
 
 
            
 
            Page   1
 
            
 
            
 
            
 
            
 
            before the iowa industrial commissioner
 
            ____________________________________________________________
 
                        :
 
            CHARLES M. SCHROEDER,      :
 
                        :
 
                 Claimant,   :
 
                        :
 
            vs.         :
 
                        :    File No. 936517
 
            DCS SANITATION MANAGEMENT, INC, :
 
                        :  A R B I T R A T I O N
 
                 Employer,   :
 
                        :     D E C I S I O N
 
            and         :
 
                        :
 
            AETNA CASUALTY AND SURETY,      :
 
                        :
 
                 Insurance Carrier,    :
 
                 Defendants.      :
 
            ___________________________________________________________
 
            
 
                 This is a proceeding in arbitration filed by Charles M. 
 
            Schroeder, claimant, against DCS Sanitation Management, 
 
            employer and Aetna Casualty and Surety, insurance carrier, 
 
            defendants for benefits as the result of an alleged injury 
 
            which occurred on February 22, 1990.  A hearing was held on 
 
            August 26, 1992 at 8:00 a.m. at Sioux City, Iowa, which is 
 
            the time and place previously set by the order of the 
 
            industrial commissioner.  Claimant was represented by Robert 
 
            L. Brink.  Defendants were represented by Judith A. Higgs.  
 
            The record consists of the testimony of James Schiltz, 
 
            claimant's friend, James Schroeder, claimant's father, 
 
            Norman Pullen, claimant's friend and foreman, Charles 
 
            Schroeder, claimant, joint exhibits I through X, claimant's 
 
            exhibits 1 through 4 and defendants' exhibits 1 through 13.  
 
            Both attorneys filed a brief description of disputes at the 
 
            time of the hearing.  Claimant's attorney filed a trial 
 
            brief, defendants' attorney submitted a post-hearing brief.  
 
            Claimant's attorney submitted a post-hearing supplemental 
 
            brief.  The deputy ordered a transcript of the hearing.
 
            
 
                                      issues
 
            
 
                 The parties submitted the following issues for 
 
            determination at the time of the hearing.
 
            
 
                 Whether claimant sustained an injury on February 22, 
 
            1990, which arose out of and in the course of employment 
 
            with employer.
 
            
 
                 Whether the injury was the cause of temporary 
 
            disability.
 
            
 
                 Whether claimant is entitled to temporary disability 
 
            benefits.
 
            
 
                 Whether claimant is entitled to medical benefits.
 
            
 
                 Defendants asserted the affirmative defense of whether 
 
            intoxication was a substantial factor in causing the injury.
 

 
            
 
            Page   2
 
            
 
            
 
            
 
            
 
            
 
                                 findings of fact
 
            
 
                                      injury
 
            
 
                 It is determined that claimant sustained an injury on 
 
            February 22, 1990, which arose out of and in the course of 
 
            employment with employer.
 
            
 
                 Claimant started to work for employer on February 22, 
 
            1990.  He started to work at 4:00 p.m. and was injured at 
 
            approximately 9:45 p.m. (Transcript page 70).  Thus, 
 
            claimant had worked five hours and 45 minutes (Tran., p. 
 
            71).  Claimant was cleaning the line and walls on the kill 
 
            floor with a steam hose (Trans., pp. 72-75; Defendants' 
 
            Exhibit 8, p. 3; Ex. 9, p. 2).  The room was hot and steamy 
 
            and wet (Tran., p. 75).  Claimant was not used to working in 
 
            heat and steam.  He could hardly breath and he got dizzy 
 
            (Tran., p. 81).  Claimant specifically testified that he 
 
            passed out because it was hot in there and he could not 
 
            breath (Tran., p. 116).  
 
            
 
                 Claimant testified that he passed out and fell and was 
 
            burned on the right side of his body by the steam hose 
 
            (Tran., pp. 75, 81, 83 and 108).  A large portion of his 
 
            right side received second degree burns from his arm pit 
 
            down to his hip onto his back and into his abdomen (Tran., 
 
            p. 84; Claimant's Ex. C-3A to C-3F; Defendants' Ex. 9, p. 
 
            6).  It was reported that claimant sustained burns over 
 
            eight to ten percent of his body.
 
            
 
                 Sherry Namanny,  who was working only a few feet away 
 
            from claimant, testified that claimant told her that he was 
 
            getting weak.  She said he was sweating.  However, she said 
 
            that claimant told her that he wanted to finish out the 
 
            night (Clmt's Ex. 4A, p. 8).  Namanny told the supervisor, 
 
            who talked to claimant, and claimant told him that he wanted 
 
            to stay and work (Clmt's Ex. 4A, p. 11).  Namanny testified 
 
            that in her opinion the room temperature was 100 to 105 
 
            degrees and that the water temperature was 160 to 180 
 
            degrees (Clmt's Ex. 4A, pp. 7-12).  Namanny testified that 
 
            she noticed that claimant was running out of energy and 
 
            advised him to sit down but he insisted on continuing to 
 
            work and the next thing she knew he was down on the floor 
 
            (Clmt's Ex. 4A, p. 10).  Namanny thought that claimant 
 
            passed out from the heat (Clmt's Ex. 4A, p. 13).
 
            
 
                 Based on the foregoing evidence it is determined that 
 
            claimant sustained an injury on February 22, 1990, which 
 
            arose out of and in the course of his employment with 
 
            employer.
 
            
 
              
 
            
 
            
 
            Page   3
 
            
 
            
 
            
 
            
 
            intoxication-substantial factor
 
            
 
                 It is determined that intoxication was a substantial 
 
            factor in causing the injury.
 
            
 
                 Claimant admitted to drinking with his father and a 
 
            friend until about 2:00 a.m. on the morning of February 22, 
 
            1990.  Prior to hearing claimant denied that he drank after 
 
            2:00 a.m. on February 22, 1990, but at the hearing he 
 
            admitted that he drank possibly four beers sometime during 
 
            the day on February 22, 1990, but he was not sure of exactly 
 
            how much he drank and he was not sure of exactly when he 
 
            drank it.  Claimant denied that he drank after he arrived at 
 
            work at 4:00 p.m. on February 22, 1990.
 
            
 
                 Claimant's father, James Schroeder, did not observe his 
 
            son drinking anything on February 22, 1990, after they got 
 
            up late that morning.  He testified that he drove claimant 
 
            to work and that claimant was not intoxicated at that time 
 
            (Tran., pp. 32-46).  
 
            
 
                 James Schiltz, claimant's friend, testified that he 
 
            drank with claimant and his father until about 2:00 a.m.  He 
 
            did not observe claimant drinking anything on February 22, 
 
            1990, after they got up late that morning.  Schiltz further 
 
            testified that claimant was not intoxicated when he and 
 
            claimant's father took him to work (Tran., pp. 14-32).  
 
            
 
                 Norman Pullen, who hired claimant, and who was also a 
 
            friend of claimant, saw him in a group of people at work at 
 
            approximately 4:00 p.m., when claimant reported to work on 
 
            February 22, 1990.  Pullen did not speak with claimant 
 
            directly but did observe him in the group and he testified 
 
            that claimant did not appear to be intoxicated to him 
 
            (Tran., pp. 47-63). 
 
            
 
                 Namanny, who worked close to claimant for approximately 
 
            five hours saw no signs of intoxication or alcohol use 
 
            (Clmt's Ex., 4A, pp. 5-8).  She indicated that she believed 
 
            that claimant passed out because it was his first day on the 
 
            job, the steam, the heat, the wet environment and the 
 
            exertion of the job under those conditions.
 
            
 
                 Thomas L. Bennett, M.D., a board certified pathologist 
 
            in both general pathology and forensic pathology, who is 
 
            admitted to practice in Iowa, Nebraska and North Carolina, 
 
            and in addition to his practice of medicine is also the 
 
            medical examiner for the state of Iowa, testified by 
 
            deposition on July 21, 1992, that he did not examine 
 
            claimant or the workplace but that he did examine a number 
 
            of records introduced into evidence in this case.  Dr. 
 
            Bennett testified that he has also taught medicine and 
 
            written a number of papers (Defs'. Ex. 6, pp. 2-8 and 
 
            Deposition Ex. 14).  Dr. Bennett examined the documents in 
 
            this case and wrote a report on July 8, 1992 (Defs'. Ex. 5).  
 
            Dr. Bennett wrote to defendants' counsel as follows:  
 
            
 
                 "The ambulance was reportedly notified at 9:48 
 
                 p.m., arriving at the scene at 9:52 p.m. and 
 
                 arriving at the hospital at 10:16 p.m.  The 
 

 
            
 
            Page   4
 
            
 
            
 
            
 
            
 
                 Crawford County Memorial Hospital laboratory 
 
                 records from that evening note that a blood 
 
                 specimen was collected at 11:40 p.m., finding a 
 
                 blood alcohol content of 80.5 mg/dl.  Thus, 
 
                 approximately two hours following the time of his 
 
                 injury, he had a blood alcohol content of 80 
 
                 mg/dl.  A healthy individual will metabolize 
 
                 alcohol at a rate between 18 and 25 mg/dl per 
 
                 hour, roughly equating to about 20 mg/dl per hour 
 
                 for practical purposes.  Anything which would make 
 
                 him unhealthy would be immediately obvious, such 
 
                 as frank liver insufficiency or kidney 
 
                 insufficiency, neither of which this man has.  
 
                 Doing the proper calculations allows one to 
 
                 conclude that his blood alcohol content would have 
 
                 been approximately 120 mg/dl at the time his 
 
                 injury, well above the 100 mg/dl which has been 
 
                 set by our Iowa legislature as indicating that an 
 
                 individual is under the influence of alcohol for 
 
                 purposes of driving a motor vehicle." (Defs'. Ex. 
 
                 5; Defs'. Ex. 7, p. 25).
 
            
 
                 Dr. Bennett enumerated three other factors that might 
 
            be considered to determine that claimant's blood alcohol 
 
            level was even higher at the time he lost consciousness:  
 
            (1) a person like claimant with a history of chronic 
 
            alcoholic abuse will metabolize alcohol faster than an 
 
            unexperienced drinker, (2) claimant lost additional body 
 
            fluids because of the burn and (3) the resuscitative 
 
            measures added nonalcoholic fluids to claimant's system 
 
            after the injury and before the sample was taken (Defs'. Ex. 
 
            5, p. 2; Defs'. Ex. 7, pp. 20-26 & 32).
 
            
 
                 Dr. Bennett's final conclusion was:
 
            
 
                 "It is my opinion that Mr. Schroeder was clearly 
 
                 under the influence of alcohol at the time he 
 
                 received these injuries.  If he had been on the 
 
                 job approximately five hours at the time he was 
 
                 injuried [sic], you may calculate back further 
 
                 that he was much higher at the time he came to 
 
                 work, unless he was drinking on the job.  Alcohol 
 
                 is clearly a substantial factor in his injuries, 
 
                 contributing greatly to the circumstances which 
 
                 lead to his injuries."  (Ex. 5, p. 2)  
 
            
 
                 Another specific indication that claimant's alcohol use 
 
            made him more susceptible to heat and hot steam is supported 
 
            by this dialogue.
 
            
 
                 "Q.  And for someone who was not used to that type 
 
                 of condition, could that cause them to pass out?
 
            
 
                 A.  Yes, sir, especially with alcohol on board 
 
                 (Ex. 7, p. 43).  
 
            
 
                 The key issue in this case is whether alcohol was a 
 
            substantial factor in causing the injury.  On this point Dr. 
 
            Bennett further testified,
 
            
 

 
            
 
            Page   5
 
            
 
            
 
            
 
            
 
                 "Q.  Doctor, you reach another conclusion.  You 
 
                 say that alcohol is clearly a substantial factor 
 
                 in his injuries.  Can you amplify on how alcohol 
 
                 was a substantial factor in causing the injury?
 
            
 
                 A.  Alcohol would be a substantial factor in his 
 
                 injury insofar as he was physically and mentally 
 
                 impaired by virtue of that level of alcohol in his 
 
                 system.  He was therefore operating some equipment 
 
                 that has, granted, a risk to it because just the 
 
                 nature of cleaning while operating that equipment 
 
                 while he was impaired and that's not necessarily 
 
                 through a natural medical condition.  This is one 
 
                 that is alcohol produced.  In my opinion the loss 
 
                 of control of that equipment, the loss of 
 
                 consciousness that he evidently had experienced 
 
                 can directly be attributed to his alcohol 
 
                 consumption." (E. 7, pp. 37-38)
 
            
 
                 Dr. Bennett testified in his deposition that claimant's 
 
            blood alcohol level of .12 would certainly be sufficient to 
 
            have the person markedly under the influence of alcohol and 
 
            is consistent with being intoxicated (Ex. 7, p. 27).  He 
 
            added that .12 would make him significantly impaired and 
 
            qualify as being intoxicated (Ex. 7, p. 28).  He did not 
 
            think that the alcohol claimant drank the night before with 
 
            his father and friend would have a significant effect at the 
 
            time of the injury (Ex. 7, p. 30). 
 
            
 
                 A strong specific indication that the alcohol in 
 
            claimant's system was a substantial factor in causing the 
 
            injury is Dr. Bennett's testimony to the effect that alcohol 
 
            use disturbs the body's ability to cope with heat.  This 
 
            point, the relationship between alcohol use and heat, seems 
 
            to be the critical determination in this case as to whether 
 
            claimant's intoxication was a substantial cause of the 
 
            injury.  
 
            
 
                 This colloquy transpired,
 
            
 
                 "Q.  Is -- does alcohol cause any increase in 
 
                 sensitivity to temperature?
 
            
 
                 A.  It can.
 
            
 
                 Q.  And how does that work?
 
            
 
                 A.  Alcohol will have the effects of dilating 
 
                 blood vessels, and by virtue of having dilated 
 
                 blood vessels he can lose heat more rapidly from 
 
                 his body, absorb heat from the environment more 
 
                 rapidly, a host of things, but it interferes with 
 
                 the body's internal abilities to maintain body 
 
                 temperature by virtue of interfering with blood 
 
                 vessel contractions.  The blood vessels in our 
 
                 skin serve like a radiator to get rid of heat and 
 
                 absorb heat or whatever.  They serve like a 
 
                 radiator effect, and if you interfere with that 
 
                 through the effects of alcohol, you've changed the 
 
                 body's ability to watch itself (Ex. 7, p. 31).
 

 
            
 
            Page   6
 
            
 
            
 
            
 
            
 
            
 
                 The expertise of Dr. Bennett based upon the objective 
 
            evidence of a blood alcohol test two hours after the injury 
 
            is preferred over the opinion testimony of claimant's father 
 
            and friends.  Dr. Bennett's testimony is based on the 
 
            objective evidence of the blood alcohol test whereas the 
 
            testimony of claimant's father and friends is based upon lay 
 
            opinion.  Furthermore, claimant testified that it has been 
 
            his practice for quite sometime to drink approximately a 12 
 
            pack of beer a day and some wine.  He further indicated that 
 
            is the quantity of alcohol that he drank as a daily practice 
 
            before this injury occurred and after this injury occurred.  
 
            Therefore, if claimant regularly drank a 12 pack of beer a 
 
            day plus some wine then claimant's appearance on the day of 
 
            the injury would have been no different to his family and 
 
            friends than it was on any other day.  
 
            
 
                 Claimant admitted that he can conceal the fact that he 
 
            is intoxicated after drinking as many as six beers.  Dr. 
 
            Bennett testified that experienced drinkers with high blood 
 
            alcohol have demonstrated in controlled tests that they have 
 
            been able to fool trained highway patrol troopers (Ex. 7, p. 
 
            56, 57).
 
            
 
                 Wherefore, it is determined that claimant's 
 
            intoxication was a substantial factor in causing the injury 
 
            which occurred on February 22, 1990.  
 
            
 
                                conclusions of law
 
            
 
                 Wherefore, based upon the following principles of law, 
 
            these conclusions of law are made:
 
            
 
                 That claimant sustained an injury on February 22, 1990, 
 
            which arose out of and in the course of employment with his 
 
            employer.  Iowa Code section 85.3(1); McDowell v. Town of 
 
            Clarksville, 241 N.W.2d 904 (Iowa 1976); Musselman v. 
 
            Central Telephone Co., 261 Iowa 352, 154 N.W.2d 128 (1967). 
 
            
 
                 That defendants have sustained the burden of proof by 
 
            preponderance of the evidence that intoxication was a 
 
            substantial factor in causing the injury of February 22, 
 
            1990.  Iowa Code section 85.16(2).  
 
            
 
                                      order
 
            
 
                 THEREFORE IT IS ORDERED:
 
            
 
                 That no amounts are owed by defendants to claimant.
 
            
 
                 That the costs of this action are charged to claimant 
 
            pursuant to Iowa Code sections 86.19(1) and 86.40 and rule 
 
            343 IAC 4.33, except that the cost of the attendance of the 
 
            court reporter at hearing and the cost of the transcript are 
 
            charged to defendants.
 
            
 
                 That defendants file any claim activity reports that 
 
            might be requested by this agency pursuant to rule 343 IAC 
 
            3.1.
 
            
 

 
            
 
            Page   7
 
            
 
            
 
            
 
            
 
                 Signed and filed this ____ day of February, 1993.
 
            
 
            
 
            
 
            
 
                                          ______________________________
 
                                          WALTER R. McMANUS, JR.
 
                                          DEPUTY INDUSTRIAL COMMISSIONER    
 
            
 
            Copies to:
 
            
 
            Mr. Robert L. Brink
 
            Attorney at Law
 
            40 North Main, P.O. Box 308
 
            Denison, IA  51442
 
            
 
            Ms. Judith Ann Higgs
 
            Attorney at Law
 
            P.O. Box 3068
 
            Sioux City, IA  51102
 
            
 
            
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                        51106, 51108.50. 51401. 51402.20,            
 
            51402.30
 
                        1403.30, 1601, 2902
 
                        Filed February 17, 1993
 
                        Walter M. McManus, Jr.
 
            before the iowa industrial commissioner
 
            ____________________________________________________________
 
                        :
 
            CHARLES M. SCHROEDER,      :
 
                        :
 
                 Claimant,   :
 
                        :
 
            vs.         :
 
                        :    File No. 936517
 
            DCS SANITATION MANAGEMENT, INC, :
 
                        :  A R B I T R A T I O N
 
                 Employer,   :
 
                        :     D E C I S I O N
 
            and         :
 
                        :
 
            AETNA CASUALTY AND SURETY,      :
 
                        :
 
                 Insurance Carrier,    :
 
                 Defendants.      :
 
            ___________________________________________________________
 
            
 
            51106, 51108.50, 51401, 51402.20, 51402.30
 
            The testimony of claimant and a co-employee established that 
 
            he sustained a burn injury to his right side from a steam 
 
            hose after he passed out in the hot, steamy, and wet 
 
            environment in which he was working his first day on the job 
 
            performing a strenuous job that he was not accustomed to 
 
            performing.
 
            
 
            1403.30, 1601, 2902
 
            Defendants proved the affirmative defense that claimant's 
 
            intoxication was a substantial factor causing his injury.  
 
            The testimony of Thomas L. Bennett, the state medical 
 
            examiner, who is board certified in general pathology and 
 
            forensic pathology, which was based on the objective 
 
            evidence of a blood alcohol sample taken two hours after the 
 
            injury, was preferred over the lay opinion evidence of 
 
            claimant's father and friends who testified that claimant 
 
            did  not appear to be intoxicated to them.  It was 
 
            claimant's daily practice to drink a 12 pack of beer and 
 
            some wine every day both before and after this injury and 
 
            therefore his appearance on the date of the injury would 
 
            have been no different than on any other day.
 
            
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                      BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
            ____________________________________________________________
 
            
 
            REGINA HARRIS,   
 
                        
 
                 Claimant,                    File No. 936529
 
                        
 
            vs.                                 A P P E A L
 
                        
 
            IBP, INC.,                       D E C I S I O N
 
                        
 
                 Employer,   
 
                 Self-Insured,    
 
                 Defendant.       
 
            ____________________________________________________________
 
            The record, including the transcript of the hearing before 
 
            the deputy and all exhibits admitted into the record, has 
 
            been reviewed de novo on appeal.  The decision of the deputy 
 
            filed August 27, 1991 is affirmed and is adopted as the 
 
            final agency action in this case.
 
            Claimant shall pay the costs of the appeal, including the 
 
            preparation of the hearing transcript.
 
            Signed and filed this ____ day of October, 1992.
 
            
 
            
 
            
 
            
 
                                     ________________________________
 
                                            BYRON K. ORTON
 
                                       INDUSTRIAL COMMISSIONER
 
            
 
            Copies To:
 
            
 
            Mr. Steve Hamilton
 
            Attorney at Law
 
            P.O. Box 188
 
            Storm Lake, Iowa 50588
 
            
 
            Mr. John M. Comer
 
            Attorney at Law
 
            Dept. 41
 
            P.O. Box 515
 
            Dakota City, NE  68731
 
            
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                                               9998
 
                                               Filed October 28, 1992
 
                                               Byron K. Orton
 
            
 
                      BEFORE THE IOWA INDUSTRIAL COMMISSIONER
 
            ____________________________________________________________
 
            REGINA HARRIS,   
 
                        
 
                 Claimant,                       File No. 936529
 
                        
 
            vs.                                   A P P E A L
 
                        
 
            IBP, INC.,                          D E C I S I O N
 
                        
 
                 Employer,   
 
                 Self-Insured,    
 
                 Defendant.       
 
            ____________________________________________________________
 
            
 
            9998
 
            
 
                 Summary affirmance of deputy's decision filed August 
 
            27, 1991.
 
            
 
 
            
 
            Page   1
 
            
 
            
 
            
 
            
 
            
 
                     before the iowa industrial commissioner
 
            ____________________________________________________________
 
                                          :
 
            REGINA HARRIS,                :
 
                                          :         File No. 936529
 
                 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 Regina 
 
            Harris, claimant, against IBP Pork Division, self-insured 
 
            employer, to recover benefits under the Iowa Workers' 
 
            Compensation Act as a result of an injury sustained on 
 
            October 10, 1989.  This matter came on for hearing before 
 
            the undersigned deputy industrial commissioner on August 14, 
 
            1991, in Storm Lake, Iowa.  The record was considered fully 
 
            submitted at the close of the hearing.  The record in this 
 
            case consists of exhibits 1 through 3 and 5 through 59; and 
 
            claimant's testimony.
 
            
 
                                      issues
 
            
 
                 Pursuant to the prehearing report and order dated 
 
            August 14, 1991, the parties have presented the following 
 
            issues for resolution:
 
            
 
                 1.  The extent of entitlement to weekly compensation 
 
            for permanent disability; and,
 
            
 
                 2.  The type of permanent disability, if the injury is 
 
            found to be a cause of permanent disability.
 
            
 
                                 findings of fact
 
            
 
                 The undersigned has carefully considered all the 
 
            testimony given at the hearing, the arguments made, the 
 
            evidence contained in the exhibits, and makes the following 
 
            findings:
 
            
 
                 Claimant was born on August 11, 1954, and completed the 
 
            twelfth grade of school.  She worked at various times as a 
 
            secretary, salesperson, assistant store manager, store 
 
            manager, waitress, and owner/operator of a Waffle House 
 
            Restaurant.  On November 22, 1988, she started working at 
 
            the IBP processing plant in Storm Lake, Iowa.  She was 
 
            assigned to the Chitts Department and pulled casings eight 
 
            hours per day.  By October 1989, she developed an onset of 
 
            right shoulder pain.  She had conservative therapy, without 
 
            improvement, and on March 21, 1990, she underwent surgery.  
 

 
            
 
            Page   2
 
            
 
            
 
            
 
            
 
            This was followed by physical therapy and light duty at IBP.  
 
            She voluntarily quit at IBP in January 1990 and moved to 
 
            Hampton, Iowa where she was employed filming documents.  In 
 
            September 1990, she worked at a bar and grill in Cherokee, 
 
            Iowa until quitting on July 3, 1991.  She has not worked 
 
            since July 1991.
 
            
 
                 The pertinent medical evidence of record reveals that 
 
            claimant presented to the IBP nurse with complaints of 
 
            tenderness in the right biceps region.  An appointment was 
 
            made for her to see Bodo W. Treu, M.D., company doctor.  She 
 
            was seen by Dr. Treu at the Buena Vista Clinic on October 
 
            31, 1989.  On examination, she was noted to have tenderness 
 
            over the bicipital groove and biceps.  She was given Motrin 
 
            and Flexeril.  She was referred for physical therapy 
 
            treatments from November 20 through November 22, 1989.  At 
 
            the time of discharge, she complained of spasms in the 
 
            biceps with active shoulder flexion but overall was doing 
 
            better.  On December 4, 1989, Dr. Treu took a right shoulder 
 
            x-ray which was negative (Exhibits 41-50).
 
            
 
                 Claimant's pain persisted and Dr. Treu referred her to 
 
            Rick D. Wilkerson, D.O., orthopedic surgeon.  She was 
 
            initially evaluated on December 4, 1989.  On examination, 
 
            she was found to have full active range of motion of the 
 
            right shoulder.  She had negative impingement sign and no 
 
            evidence of shoulder instability.  She did have a markedly 
 
            positive tender area on palpitating the long head bicep 
 
            tendon.  She was diagnosed with right shoulder bicep 
 
            tendonitis (Ex. 51-1).
 
            
 
                 Claimant's symptoms remained unchanged during two 
 
            subsequent examinations by Dr. Wilkerson on December 26, 
 
            1989 and January 8, 1990.  On March 5, 1990, Dr. Wilkerson 
 
            decided that due to her unchanged symptoms, an arthroscopic 
 
            evaluation would be helpful (Ex. 51-1).
 
            
 
                 On March 21, 1990, claimant entered Spencer Municipal 
 
            Hospital under the care of Dr. Wilkerson.  The claimant 
 
            underwent the following procedures:  (1) diagnostic 
 
            arthroscopy with arthroscopic labial tear resection; (2) 
 
            arthroscopic decompressive bursectomy; and, (3) open Neer 
 
            acromioplasty.  The procedures revealed an extremely thicken 
 
            enlarged subacromial bursa.  This was excised allowing good 
 
            visualization of the rotator cuff which was found to be 
 
            normal (Ex. 17).
 
            
 
                 Claimant saw Dr. Wilkerson for follow-up evaluation on 
 
            March 28, 1990.  He noted she was improving and having less 
 
            pain.  Her sutures were removed and her incision appeared 
 
            well healed.  She was noted to be neurovascularly intact 
 
            (Ex. 51-3).
 
            
 
                 Claimant was referred by Dr. Wilkerson for physical 
 
            therapy exercise sessions in order to improve her right 
 
            shoulder range of motion.  Physical therapy notes dated 
 
            March 23 through June 12, 1990, indicate improved range of 
 
            motion (Exs. 21-22 and 30-32).
 
            
 
                 Claimant had a follow-up evaluation with Dr. Wilkerson 
 

 
            
 
            Page   3
 
            
 
            
 
            
 
            
 
            on October 11, 1990.  He reported on January 14, 1991, that 
 
            "[a]t that time she was found to have occasional discomfort 
 
            of the shoulder but was back to working with apparent little 
 
            difficulty.  On examination she did have some slight loss of 
 
            motion."  In his report, Dr. Wilkerson indicated that 
 
            claimant had reached maximum medical improvement.  He stated 
 
            that "I would rate her out at five percent permanent 
 
            physical impairment due to loss of motion and persistent 
 
            discomfort of the right shoulder."  (Ex. 8)
 
            
 
                 On January 19, 1991, claimant's attorney wrote to Dr. 
 
            Wilkerson.  In response to questions contained in his 
 
            letter, Dr. Wilkerson reported on June 23, 1991, that "[o]n 
 
            her last visit here she had returned to pretty much normal 
 
            activity, stating she only had occasional problems with the 
 
            shoulder and, even then, it was much less than she had 
 
            previously."  At this time, and without examining claimant, 
 
            and without explanation, Dr. Wilkerson gave claimant a 
 
            permanent physical impairment rating of ten percent of the 
 
            right upper extremity (Ex. 7).
 
            
 
                 Claimant testified that after not seeing Dr. Wilkerson 
 
            for more than ten months, she returned for a follow-up 
 
            examination of her right shoulder on July 15, 1991.  She 
 
            related that she had been doing a lot of heavy lifting of 
 
            cases of liquor and pop while working in a bar.  Prior to 
 
            that time, she had been doing well.  Dr. Wilkerson reported 
 
            that on examination she lacked about 10-20 degrees of full 
 
            forward flexion and abduction.  She had full external 
 
            rotation and full internal rotation with negative 
 
            impingement sign.  Her surgical incision was well healed.  
 
            X-rays were normal and the prominence of her acromion which 
 
            was previously present was completely resolved.  He stated 
 
            that she should avoid any work requiring overhead lifting.  
 
            He listed no other physical restrictions (Ex. 5).
 
            
 
                 Defendants have previously paid to claimant 12.143 
 
            weeks of healing period benefits from March 21, 1990 through 
 
            June 13, 1990, at the rate of $194.94 and 12.50 weeks of 
 
            permanent partial disability benefits at the rate of $194.94
 
            
 
                    
 
            
 
            
 
            Page   4
 
            
 
            
 
            
 
            
 
            conclusions of law
 
            
 
                 The issue to be determined in this case is whether 
 
            claimant is entitled to weekly compensation for permanent 
 
            disability and, if so, the type of permanent disability.  
 
            Claimant urges that she has suffered an injury that is not 
 
            limited to her right arm but extends to her shoulder, neck 
 
            and back.
 
            
 
                 An injury to a scheduled member may, because of after 
 
            effects or compensatory change, result in permanent 
 
            impairment of the body as a whole.  Such impairment may in 
 
            turn be the basis for a rating of industrial disability.  It 
 
            is the anatomical situs of the permanent injury or 
 
            impairment which determines whether the schedules in section 
 
            85.34(2)(a) - (t) are applied.  Lauhoff Grain v. McIntosh, 
 
            395 N.W.2d 834 (Iowa 1986); Blacksmith v. All-American, 
 
            Inc., 290 N.W.2d 348 (Iowa 1980); Dailey v. Pooley Lumber 
 
            Co., 10 N.W.2d 569 (Iowa 1943).  Soukup v. Shores Co., 268 
 
            N.W. 598 (Iowa 1936).
 
            
 
                 When there is an injury to the shoulder, an injury to 
 
            the body as a whole may exist.  Alm v. Morris Barick Cattle 
 
            Co., 240 Iowa 1174, 38 N.W.2d 161 (1949).  In Nazarenus v. 
 
            Oscar Mayer & Co., II Iowa Industrial Commissioner Report 
 
            281 (App. Decn. 1982), a torn rotator cuff was found to 
 
            cause disability to the body as a whole.
 
            An injury is the producing cause; the disability, however, 
 
            is the result, and it is the result which is compensated.  
 
            Barton v. Nevada Poultry Co., 253 Iowa 285, 110 N.W.2d 660 
 
            (1961); Dailey v. Pooley Lumber Co., 233 Iowa 758, 10 N.W.2d 
 
            569 (1943).
 
            
 
                 Claimant relies on Speer v. Super Valu Stores, Inc., 
 
            File No. 792171 (Appeal Decision December 20, 1988), to 
 
            support her claim that a shoulder injury is an injury to the 
 
            body as a whole and not to a scheduled member.  However, 
 
            Speer was diagnosed with a torn rotator cuff and 
 
            tendonitis.  It is well established in Iowa that a shoulder 
 
            rotator cuff injury is an injury to the body as a whole.
 
            
 
                 Section 85.34(2)(m) states:  "The loss of two-thirds of 
 
            that part of an arm between the shoulder joint and the elbow 
 
            joint shall equal the loss of an arm..."
 
            
 
                 In this case, only Dr. Wilkerson has expressed an 
 
            opinion as to the degree of claimant's impairment.  In his 
 
            letter of January 14, 1991, Dr. Wilkerson based his opinion 
 
            on evidence of loss of motion and persistent discomfort of 
 
            the right shoulder.  Based on this, Dr. Wilkerson was of the 
 
            view that claimant had sustained a five percent permanent 
 
            physical impairment which he did not convert to an 
 
            impairment to the body as a whole.  On June 23, 1991, Dr. 
 
            Wilkerson, without explanation, gave claimant a permanent 
 
            physical impairment rating of ten percent of the right upper 
 
            extremity, which he did not convert to an impairment of the 
 
            body as a whole.  There is no medical evidence demonstrating 
 
            that claimant's condition has an overall effect on the body 
 
            as a whole.  Because Dr. Wilkerson's opinion was based on a 
 
            loss of function of the right upper extremity only, it is 
 

 
            
 
            Page   5
 
            
 
            
 
            
 
            
 
            found that claimant's injury does not extend into the body 
 
            as a whole and should not be compensated industrially.  Hike 
 
            v. IBP, Inc. and Webster Construction Co., File Nos. 764571 
 
            & 776652 (Filed November 3, 1989).
 
            
 
                 Claimant's testimony as to subjective symptoms beyond 
 
            the upper extremity is not supported by the medical 
 
            evidence.  Claimant saw Dr. Wilkerson in October 1990 and 
 
            thereafter secured a job as a part-time bartender.  She did 
 
            not see him again until July 1991, when she complained of 
 
            recurrent shoulder pain.  X-rays showed normal internal and 
 
            external rotation  and completely resolved acromion.  Dr. 
 
            Wilkerson attributed the aggravation of her symptomatology 
 
            to heavy lifting of cases of liquor and pop.  He again 
 
            recommended no overhead lifting type work but imposed no 
 
            other restrictions (Ex. 5).
 
            
 
                 Claimant testified that she has not participated in 
 
            physical therapy since June 1990, nor has she exercised her 
 
            right upper extremity.  After working as a bartender lifting 
 
            heavy objects, scrubbing walls and doing other general 
 
            activities, it is conceivable that these activities 
 
            aggravated claimant's condition but such aggravation is not 
 
            the subject of this claim.  Although claimant testified that 
 
            Dr. Wilkerson restricted her to a 15 pound weight limit, 
 
            this is not evident in the medical record.  She has been 
 
            instructed to avoid work activity requiring overhead lifting 
 
            but no weight lifting restrictions have been imposed 
 
            (Ex. 5).
 
            After carefully considering the total evidence in this case, 
 
            it is found that such evidence supports an award of five 
 
            percent permanent partial disability which entitles claimant 
 
            to recover 12.5 weeks of benefits under Iowa Code section 
 
            85.34(2)(m) as a result of the injury to her arm.  Although 
 
            Dr. Wilkerson gave two permanent impairment ratings, one in 
 
            January and the other in June of 1991, he makes no 
 
            explanation as to why he changed from five percent to ten 
 
            percent since he did not examine claimant on either 
 
            occasion.  Accordingly, the greater weight of the evidence 
 
            lies with the first impairment rating which was given six 
 
            months postoperatively and at the time Dr. Wilkerson 
 
            determined claimant reached maximum medical improvement.
 

 
            
 
            Page   6
 
            
 
            
 
            
 
            
 
            order
 
            
 
                 THEREFORE, IT IS ORDERED:
 
            
 
                 That defendant pay to claimant twelve point five (12.5) 
 
            weeks of permanent partial disability benefits at the rate 
 
            of one hundred ninety-four and 94/l00 dollars ($194.94) per 
 
            week commencing June 14, 1990.
 
            
 
                 That defendant receive credit for any benefits 
 
            previously paid.
 
            
 
                 That defendant pay accrued amounts, if any, in a lump 
 
            sum.
 
            
 
                 That defendant pay interest pursuant to Iowa Code 
 
            section 85.30.
 
            
 
                 That defendant file claim activity reports as required 
 
            by the agency.
 
            
 
                 That defendant pay all other costs pursuant to rule 343 
 
            IAC 4.33.
 
            
 
            
 
            
 
                 Signed and filed this ____ day of August, 1991.
 
            
 
            
 
            
 
            
 
            
 
                                          ______________________________               
 
            JEAN M. INGRASSIA
 
                                          DEPUTY INDUSTRIAL COMMISSIONER
 
            
 
            Copies To:
 
            
 
            Mr. Steve Hamilton
 
            Attorney at Law
 
            606 Ontario St
 
            P O Box 188
 
            Storm Lake  IA  50588
 
            
 
            Ms. Marie L. Welsh
 
            Attorney at Law
 
            P O Box 515
 
            Dept #41
 
            Dakota City  NE  68731
 
            
 
 
            
 
 
 
 
 
 
 
 
 
 
 
                           5-1803.1
 
                           Filed August 27, 1991
 
                           JEAN M. INGRASSIA
 
            
 
                     before the iowa industrial commissioner
 
            ____________________________________________________________
 
                                          :
 
            REGINA HARRIS,                :
 
                                          :         File No. 936529
 
                 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.               :
 
            ___________________________________________________________
 
            
 
            
 
            5-1803.1
 
            Claimant relying on Speer v. Super Valu Stores, Inc., File 
 
            No. 792171 (Appeal Decision December 20, 1988), argues that 
 
            where there is an injury to the shoulder, an injury to the 
 
            body as a whole exists and claimant is entitled to be 
 
            compensated industrially.  In the Speer case, medical 
 
            evidence indicated that claimant suffered a rotator cuff 
 
            tear and expert testimony stated that his injury extended 
 
            beyond the joint to the body namely, to the rear of his 
 
            shoulder into his back.
 
            When there is an injury to the shoulder, an injury to the 
 
            body as a whole may exist.  Alm v. Morris Barick Cattle Co., 
 
            38 N.W.2d 161 (1949).  In this case, claimant developed 
 
            sharp right shoulder pain while pulling casings.  She was 
 
            diagnosed as having bicep tendonitis.  X-rays of the right 
 
            shoulder were normal and her rotator cuff intact.  An 
 
            arthroscopy revealed extremely thicken enlarged subacromial 
 
            bursa which was excised.  Seven months later, claimant 
 
            returned to normal activity and found to reach maximum 
 
            medical improvement on January 14, 1991.  A five percent 
 
            impairment rating to the right upper extremity was given in 
 
            January 19, 1991, without further examination.  This was 
 
            changed in June 1991, again without further examination, to 
 
            10 percent of the right upper extremity.
 
            Claimant's impairment was found to be a scheduled member 
 
            impairment under Iowa Code section 85.34(2)(m) and she was 
 
            awarded 5 percent permanency as was her treating surgeon's 
 
            first assessment.