Can an injured welder get workers’ compensation benefits despite two doctors’ different diagnoses regarding ongoing neck and shoulder pain?
The Iowa Court of Appeals upheld a workers’ compensation commissioner’s denial of benefits for the neck and shoulder since one doctor’s diagnosis wasn’t convincing enough to support a relationship between the work injury and the other issues.
Employer approves benefits for arm injury only
Robert Shrum was a welder for Boldt Group, Inc. In September 2015, Shrum injured his right arm at work and was diagnosed with a partial biceps tear. He underwent surgery, participated in physical therapy and was released to work less than a year later with no permanent restrictions.
However, while receiving treatment for his right arm, Shrum periodically reported pain in his neck and right shoulder.
Boldt approved treatment for Shrum’s arm, but not for his other conditions. In January 2019, Shrum filed a workers’ compensation claim for his right shoulder, right bicep and neck.
A deputy workers’ compensation commissioner found the conditions causally related to the work injury and awarded permanent partial disability benefits and granted a request for alternate, ongoing care. The workers’ compensation commissioner reversed the deputy’s decision finding that the medical evidence supported one doctor’s opinion that these issues were not related to the work injury. A district court affirmed the denial of benefits.
Decision hinged on conflicting diagnoses
On appeal, the court agreed with the commissioner’s determination and upheld the denial of benefits.
This decision hinged on the diagnoses of two doctors with conflicting opinions on what was causing Shrum’s shoulder and neck problems.
A doctor who performed an independent examination on Shrum found that the shoulder and neck problems were related to the work injury. One of Shrum’s treating doctors blamed those issues on injuries Shrum had suffered in a car crash 20 years before the work injury.
Treating doctor’s opinion supported by medical evidence
The treating doctor’s notes mentioned Shrum’s occasional complaints regarding his shoulder and neck and pointed to the fact that an X-ray showed nothing remarkable. Shrum eventually stopped complaining about pain in his shoulder and only ever mentioned his neck problem once early in his treatment.
Further, medical evidence revealed that Shrum had occasionally received treatment for chronic neck and shoulder pain following a car crash he’d been in 20 years prior to the work injury.
Meanwhile, the doctor who performed the independent examination “failed to identify what, if any, of Shrum’s medical history he reviewed, or was even aware of.”
This made the treating doctor’s opinion, which was supported by the preponderance of medical evidence, more credible, according to the appeals court.
