If you’re a worker there is good news today from the Iowa Supreme Court. The Iowa Supreme Court has held “an injury to the wrist is to be compensated as an injury to the arm under Iowa Code section 85.34(2)(m) (2003).” This is good news for injured workers whose employment caused injury to the arm.  Attorneys who have worked in this area of the law have long assumed this conclusion, but recent decision with previous commissioners put this conclusion in doubt.  The case is Holstein Electric and Integrity Mutual Insurance Company vs. Jay Breyfogle, ___ N.W.2d ___ (Iowa, 2008.) No. 77/07-0468.  

He further opined Breyfogle suffered a nineteen percent impairment to his right wrist based on the AMA Guides to the Evaluation of Permanent Impairment and due to the residual loss of motion in his wrist as well as the loss of carpal height and strength. Dr. Tiedeman recommended continued conservative treatment.

 A hand is worth no more than 190 weeks, an arm being worth no more than 250 weeks. Converting hand impairment to arm impairment is one step closer to getting industrial disability, which is the preferred method of determining reduced earning capacity for those injured.  

IV. Whether a Wrist Injury is Compensated as an Injury to the Hand or to the Arm.

The scheduled injuries contained in the Code applicable to this appeal are as follows:

 l. For the loss of a hand, weekly compensation during one hundred ninety weeks.

 m. 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 and the compensation therefor shall be weekly compensation during two hundred fifty weeks.

 Iowa Code § 85.34(2)(l), (m). The Code is silent as to whether a wrist is part of the hand or the arm for purposes of a scheduled injury. Therefore, we must determine whether the Code compensates a wrist injury as an injury to the hand or an injury to the arm. This requires us to construe sections 85.34(2)(l) and 85.34(2)(m). 

Employers and their insurance companies have felt comfortable choosing doctors and that restrict workers to the extent they have lost their jobs, without recourse. A person whose job requires frequent use of the hand and wrist, which is restricted from this activity, will in all likelihood lose their job. The small amount of weekly benefits paid under the scheduled benefit statute never even comes close to compensating the economic loses suffered. Decisions from the courthouse and commission point to the legislature saying it’s their decision to set policy. To an injured worker and their family this is little consolation.   

Holstein Electric employed Jay Breyfogle as an electrician from 1998 until 2004. His employment required heavy lifting, running power tools, swinging sledgehammers, and various other manual tasks. On July 16, 2002, as Breyfogle grabbed some conduit, he heard his wrist pop. Shortly after he heard the noise, his wrist swelled. A physician diagnosed Breyfogle with Kienbock’s disease, which is avascular necrosis of the carpal lunate. The carpal lunate is a bone located in the wrist.

 What has seemed like a common sense conclusion that the schedule doesn’t discuss a wrist and therefore the wrist must be part of the arm wasn’t without controversy. Many insurance companies in recent years have refused to pay scheduled benefits based on the arm and calculated permanency benefits using the lesser hand weekly values. Many of these cases there wasn’t enough in controversy for someone to “take it up” as we say about appealing to the Supreme Court. Justice Wiggins wrote this decision and looking to precedent of interpretations for the hip and shoulder found the wrist to be a part of the arm. 

The legislature enacted the workers’ compensation statute primarily for the benefit of the worker and the worker’s dependents. Cedar Rapids Cmty. Sch. v. Cady, 278 N.W.2d 298, 299 (Iowa 1979). Therefore, we apply the statute broadly and liberally in keeping with the humanitarian objective of the statute. Id. We will not defeat the statute’s beneficent purpose by reading something into it that is not there, or by a narrow and strained construction. Id.  

The wrist is the joint located between the hand and the arm. The distal point of the wrist is the point between the wrist bones and the hand bones. The proximal point of the wrist is the point between the wrist bones and the arm bones. In the past when faced with analogous situations, this court has looked to the proximal point of the joint to classify an injury under the workers’ compensation statutes. Lauhoff Grain Co. v. McIntosh, 395 N.W.2d 834, 839–40 (Iowa 1986) (holding an injury to the hip joint is compensated as an injury to the body as a whole); Second Injury Fund v. Nelson, 544 N.W.2d 258, 269–70 (Iowa 1995) (holding an injury to the shoulder joint is compensated as an injury to the body as a whole). One rationale for reaching this conclusion is that the workers’ compensation statute is to be construed in favor of the worker. Lauhoff Grain Co., 395 N.W.2d at 839. By choosing the proximal point of a joint to classify an injury, the worker’s impairment rating is applied to a higher number of maximum weeks of compensation than if we classify the injury using the distal point of the joint. 

To be consistent with our prior cases, we look at the proximal side of the wrist joint and hold an injury to the wrist is to be compensated as an injury to the arm. By construing an injury to the wrist as an injury to the arm, a worker’s compensation is based on a 250-week maximum, rather than a 190-week maximum for an injury to the hand. Compare Iowa Code § 85.34(2)(m), with id. § 85.34(2)(l). This construction of the statute is consistent with our prior decisions finding the legislative intent behind the workers’ compensation statute is to apply this law broadly and liberally in favor of a worker when an ambiguity exists. Accordingly, as a matter of law a wrist injury is compensated as an injury to the arm under section 85.34(2)(m). 

This is a very neatly written decision that will clear up a lot miscalculated benefits to the injured workers and their family’s.  Here is the bottom line for the injured worker. Let’s assume a 10% impairment rating. If the 10% is applied to 250 versus 190 weeks the worker is paid 6 more weeks of benefits for the same injury. And that six weeks could be well over $1,000.00 in some instances. Depending on your wage at the time of injury it could mean the difference between making a mortgage payment or buying school clothes for the children. Good news today.




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