File Number: 5005038 Decision Type: Miscellaneous Click here to open a PDF version of this decision.
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:
JERRY MYERS, :
Claimant, :
vs. :
: File No. 5005038
DANKA HOLDINGS, :
: REMAND
Employer, :
: DECISION
and :
ZURICH AMERICAN INSURANCE :
COMPANY, :
Insurance Carrier, :
Defendants. : HEAD NOTE NO.: 1803
_____________________________________________________________________
Jerry Myers, the claimant, seeks workers' compensation benefits from defendants, Danka Holdings, the alleged employer, and its insurer, Zurich American Insurance Company, as a result of an alleged injury on August 14, 2000.
This matter was remanded to me to comply with the court of appeal's ruling of May 24, 2006. In that ruling, the agency must not give greater weight to the expert opinions of treating physicians as a matter of law. However, in that ruling, the court stated that this agency in evaluating the worth of an opinion may consider a physician's employment in connection with litigation. The following decision is issued in compliance with these instructions.
Claimant's exhibits were marked numerically. Defendants' exhibits were marked alphabetically. References in this decision to page numbers of an exhibit shall be made by citing the exhibit number or letter followed by a colon and then the page number(s). For example, a citation to claimant's exhibit 1, pages 2 through 4 will be cited as, "Exhibit 1:2-4."
The parties submitted the following issues for determination in this proceeding:
In these findings, I will refer to the claimant by his first name, Jerry, and to the defendant-employer as Danka.
From my observation of their demeanor at hearing, including body movements, vocal characteristics, eye contact and facial mannerisms while testifying in addition to consideration of the other evidence, I found claimant, his wife and daughter credible.
Jerry worked for Danka, a copier company, from 1995 until his work injury on August 14, 2000. He has not been employed in any capacity since. Eighty percent of Jerry's duties involved delivery of copy machines, both desktop and large, stand alone units. This work consisted of driving and loading/unloading a van truck. Jerry performed a lot of his driving to and from Danka's warehouses located in Cedar Rapids, Iowa City, Des Moines, Dubuque and two locations in Illinois and Wisconsin.
The record indicates that before October 17, 1997 Jerry was diagnosed as suffering from obsessive/compulsive behavior disorder (OCBD). Apparently, Jerry's wife had obtained permission from a health carrier before the injury in this case for six treatments for this condition but this was not done. There are no psychiatric records in evidence concerning past or present care for this disorder. There are only frequent references in reports by treating and evaluating physicians to a course of post-injury treatment including prescriptions for medications from a psychiatrist by the name of Richard Rinehart, M.D., for an aggravation of the OCBD and for depression. There are no records from this physician in evidence. Consequently, I find that Jerry had OCBD before the injury and apparently some depression after the injury. However, there is no evidence that any of these conditions resulted in a permanent impairment or any adverse impact upon Jerry's employability before the injury in this case.
The stipulated injury on August 14, 2000 occurred as a result of a motor vehicle accident while Jerry was driving his van type, straight truck on I-80 just west of the Iowa City area. According to Jerry and the state trooper's report, Jerry was traveling at 65 m.p.h. in the outside lane when a car in the inside lane pulled closely in front of him. Jerry had to swerve to the right to avoid hitting the car but struck a semi parked along the side of the road. The cab of Jerry's truck did not sustain a direct hit but the rear portion of the cab and box of the truck was struck and severely damaged. Jerry's truck then left the roadway. The record is unclear as to the position of Jerry's truck when it came to rest. Jerry stated that although he had his seatbelt on, he was jarred about inside the cab during the accident to the extent that he bent the steering wheel and was struck on the top of his head either by the top of the cab or a loose fire extinguisher in the cab. At any rate, he suffered a severe laceration to the head. A nurse who arrived at the scene initially applied pressure to this head wound until Jerry was removed by emergency personnel. He was then transported to an Iowa City hospital by ambulance.
Jerry initially told ambulance attendants that he did not loose consciousness but later said that he may have. (Exhibit 1:3) Jerry testified that he thinks he lost consciousness for a brief time and only has spotting recollection of his ride to the hospital. Emergency physicians treated the lacerations with stitches and released Jerry the same day. They reported that Jerry had a good recollection of details when they treated him. Jerry stated again that he was "fuzzy" after the incident and may have briefly lost consciousness. (Ex. 4:1) Diagnostic imaging at the hospital was negative. Jerry was driven home by his wife.
Jerry, his wife and daughter, all testified that during the few weeks after the accident Jerry appeared confused. Unlike his normal behavior, Jerry was mostly inactive. He slept a lot and often would nod off or pass out. Jerry had his head stitches removed on August 22, 2000 by Nile Dusdieker, M.D. At that time, Jerry complained to the doctor of dizziness while walking. The doctor diagnosed a concussion and head trauma from the accident and referred Jerry to a neurologist for evaluation. (Ex. 12:1)
The neurologist, Laurence Krain, M.D., evaluated Jerry on August 23, 2000. Although Jerry's chief complaint to Dr. Krain was headaches, dizziness and loss of balance aggravated by activity, Jerry also related episodic vertigo, blurred vision, nausea, sleeplessness and neck pain. Dr. Krain diagnosed mild closed head injury and whiplash with associated myofascial neck pain, headaches, dizziness, blurred vision and sleeplessness along with questionable positional vertigo. He prescribed medication and ordered additional testing. (Ex. 5:19-23) He directed that Jerry remain off work.
Jerry's post-traumatic headaches and other problems appeared to Dr. Krain to improve by early September 2000 but later that month, Jerry worsened and reported to a hospital emergency room with another long-lasting severe headache along with photo and phono phobia, dizziness, blurred vision and impaired concentration. He reported these same symptoms later on September 21, 2000 to Dr. Krain along with the positional vertigo. This was the first time, Dr. Krain mentioned the prior existing OCBD. He felt there was an element of this condition in his current symptoms. The doctor added that although he was not convinced the OCBD was aggravated by the accident, he felt that this was likely impairing Jerry's coping with his headaches and impairing his improvement. (Ex. E)
In October 2000, Jane Collins, a medical case manager from Corvel Corp., referred Jerry to David Durand, D.O., an occupational medicine physician. Dr. Durand's assessment was post-traumatic headaches with vertigo. He recommended continued treatment by Dr. Krain and imposed work restrictions against, lifting, pushing, pulling over 10 pounds; no driving; avoid fall hazards, sedentary work only; and no safety sensitive work. He opined that the OCBD was preexisting and that Jerry should follow up with his own physicians for that condition. Jerry was to continue physical therapy for the neck pain. (Ex. 5:7)
In March 2001, Jerry was referred by Collins, the case manager, to Joseph Nora, M.D., for his "opinion on Jerry's case." Dr. Nora recommended a comprehensive rehabilitation program at Covenant Medical Center in Waterloo, Iowa, for the following stated purpose:
(Ex. F:3)
This in-patient program scheduled for April 16-24, 2001 was conducted by a team including Dr. Nora, therapists, and a neurophysiologist. As suggested by the above quoted language of Dr. Nora, this referral by Collins was at least, in part, for the purpose of litigation as defendants began video taped surveillance of Jerry's home activities on April 11, 2001. (Ex. R) In fact, some of these surveillance tapes were furnished to Dr. Nora for his review. (Ex. 10:4) Despite his causation opinions in this case, Dr. Nora never mentioned use of these tapes in his reports and testimony.
On April 10, 2001, at that time, Jerry reported that he was doing "terrible." His symptoms of neck pain, headache, hollowness in the head, impaired memory, slow thought processing, dizziness, and vertigo continued. At that time, Collins told Dr. Krain of the proposed inpatient therapy. Jerry was to continue the medication he had been on, Ultram. (Ex. 5:11)
Jerry began the asserted "rehabilitation program" as scheduled. As stated by Dr. Nora in his deposition, the team's first emphasis was not rehabilitation but to confirm the diagnosis of traumatic brain injury and determine whether or not Jerry, in fact, has the deficits he complains of. (Ex. V:8) The doctor views his role in the treatment of brain injuries to be similar to that of a neurologist or psychiatrist and apparently does not view their treatment as more specialized than his own. As his standard practice is to "reconfirm" their diagnoses, Dr. Nora also apparently does not believe a neurologist possesses any more special expertise or training in the diagnosis of traumatic brain injuries than his own. (Ex. V:36)
Despite the title of Dr. Nora's program, the various reports in evidence during the course of Jerry's involvement with the program, involved repeated assessments of his functionality rather than efforts to improve functionality. (Ex. 10) The program consisted of numerous evaluations or assessments by a Jane Springer, Ph.D., an asserted neurophysiologist who performed a battery of tests over three days. Dr. Springer then issued a written report which concluded that due to inconsistencies in performances among the three days, and "suspected poor effort and possible malingering," the testing was invalid. Dr. Springer recommended further testing may be helpful in the future for comparison purposes or to determine the stability of some of the test scores. (Ex. 10:31) For example, the first testing day Jerry could not count to 25 correctly in 4 minutes but on the last day counted to 25 without error in 15 seconds. (Ex. 10:8)
At her deposition, Dr. Springer admitted that Jerry was on medications and she was not familiar with the effects of those medications. (Ex. W:23-25) However, she denied that use of such medications would have an impact on the results of her testing. (Ex. W:38) She admitted that depression can impact the results. (Ex. W:26) Although her written report refers to suspected poor effort, Dr. Springer testified that she had evidence of that he was not giving his best effort. (Ex. W:3) Jerry testified that his medications affected his performances in the testing by Dr. Springer.
Other evaluation reports in this program also were found by team members as inconsistent. From these results, Dr. Nora issued a diagnosis of probable malingering versus other psychological conditions. (Ex. W:37) Dr. Nora stated that although he initially felt that Jerry had a traumatic brain injury, the testing results compelled a 180-degree change in his opinions. (Ex. W:12) After completing the rehabilitation program, defendants ended workers' compensation benefits.
In July 2001, Jerry returned to Dr. Krain. After noting the views of Dr. Nora, Dr. Krain stated that he also cannot explain Jerry's multiplicity of symptoms. However, he felt that Jerry is improved with Ultram and that he will continue to prescribe this medication. He concluded that primary treatment is likely best done through psychiatry and he will defer to the treatment of Dr. Rinehart. (Ex. 5:12) Dr. Krain continued to follow Jerry for the next 18 months. Finally, in December 2002, he felt that Jerry had not improved enough and ended all medication except for those prescribed by Dr. Rinehart.
In October and again in December 2001, Jerry was seen by another neurologist, Marc Hines, M.D. Jerry testified that he wanted another opinion and after research, he and his wife found Dr. Hines. Dr. Hines' diagnoses were much the same as those of Dr. Krain: head injury, loss of memory, post-traumatic headaches and dizziness, cervical dysfunction with cervical strain, post-traumatic labyrinthine concussion and episodic syncope of uncertain etiology. (Ex. 11) Despite his awareness of the views of Drs. Nora and Krain, he felt that these findings are completely typical of post-traumatic patients. He felt that Jerry's presentation and difficulties were relatively routine, although difficult to manage. He stated that complicating Jerry's situation was the development of post-traumatic migraines which further develop difficulty with chronic pain, sleep deprivation, serotonin depletion, subsequent depression and which further complicate the overall interpretation of the situation. He strongly recommended continued control of the depression and anxiety.
Dr. Hines continued to follow Jerry through 2002 and 2003. He follows Jerry today. He prescribed a trial of many different medications. In April 2003, Dr. Hines states that Jerry suffered a closed head injury with post concussion symptomatology with post-traumatic labyrinthine concussion, cervical strain and dysfunction, post-traumatic dizziness, memory loss and frontal lobe symptomatology. He opined that all of these problems are permanent and have a direct etiology to the August 2000 truck accident.
Dr. Hines further opined that Jerry's mental condition would significantly impair competitive employment and activities such as working at heights, working on ladders, working with repeated bending, twisting, prolonged standing, fixed positions of the neck, repeated lifting and difficulty riding in conveyances for long periods of time without changing positions. Most impaired in the opinion of Dr. Hines would be Jerry's reliability in the work place, his ability to learn material and acquire new information which impairs the ability to retain new jobs. As far as future treatment, he recommended continued use of effective medications and anesthesiological procedures for the neck. (Ex. 11:13-14)
Dr. Hines opines that Jerry suffered a combined rating under the Fifth Edition of the AMA Guides of 36 percent of the whole person for cervical spine dysfunction, organic affective disorder, impaired mental status, impaired cranial nerve, chronic daily headaches, labyrinthine concussion. (Ex. 11:18-19)
In the fall of 2001, Jerry pursued an application for Social Security Disability benefits and underwent a number of evaluations in conjunction that that application. The initial results were a mixed bag. Herbert Notch, Ph.D., found Jerry's allegations credible and opined that Jerry had mild to moderate degree of difficulty remembering and understanding tasks and instructions. He said that Jerry may have difficulty maintaining adequate attention, concentration and pace but could respond to changes in workplace. (Ex. 14:1-2) J.D. Wilson, M.D., opined that Jerry's physical condition is non-severe in nature. (Ex. 14:3) Jan Hunter, D.O., after noting Dr. Nora's views, stated that Jerry should avoid working at unprotected heights due to possible balance, although the etiology of Jerry's allegations has not been elucidated. (Ex. 14:5) A functional capacity assessment evaluator concluded that Jerry is limited in his ability to consistently perform complex tasks because of his OCBD but otherwise has adequate stamina for ordinary workday or workweek. The evaluator added that Jerry's credibility is eroded by the inconsistencies in the evidence. (Ex. 14:6-8)
Jerry lost his bid for Social Security benefits at hearing but appealed to the next level. That appeal body appointed another clinical psychologist to further evaluate Jerry. Robert Hammer, Ph.D., evaluated Jerry in August 2003. After battery of testing, Dr. Hammer concluded as follows:
(Ex. 17:5)
The board based upon this new evaluation and upon the advice of their medical consultant then reversed the administrative law judge and awarded Social Security benefits. While these Social Security decisions do not impact upon my findings in this case, the evaluations by medical professionals in the Social Security process must be given considerable weight as they are all independent, bias free, evaluations.
As stated before, defendants began secret surveillance of Jerry's home activity in April 2001. There were four separate periods of surveillance, in April, June, July and October over portions of nine days. However, not much actual activity is depicted in these various videotapes. In April, Jerry is seen working on a front porch remodeling project for about 15 minutes on one day. (Ex. R) On June 25, 2001, Jerry is seen mowing his lawn around his home using a push-type powered mower. This appeared to take over an hour. (Exs. S & T) In July 2001, Jerry is seen helping to load small boards into a pickup and sawing a board on one occasion. However, the entire time taped of this activity was only a few minutes. (Ex. U) Of some significance was the tape showing Jerry driving a car on two occasions in October 2001. (Ex. Q) Jerry admitted at hearing that he denied driving after the injury in his deposition. However, Jerry is seen driving only a couple of times, running errands, to and from his residence. Each trip lasted less than six minutes.
At hearing, Jerry admitted to remodeling his front porch consisting of replacing deck boards and doing some sanding. Although he claims that activity, especially bending, aggravates his headaches, he is seen doing repeated bending activity. However, again, the tape shows only a few minutes of activity. What is quite striking about these tapes is that the porch project was seen in progress in early April 2001 and had not been completed as of July 27, 2001. The project took Jerry over four months to complete. A very long time to just replace the deck floor. Jerry admitted that he drove a couple of times against doctor's orders to run short errands to get prescriptions and cigarettes. The tapes do not show otherwise. Jerry explained that he performed many household activities that he probably should not have done because of guilt after his wife became increasing upset with him. She complained that she was working two jobs to support them but that he was doing nothing at home.
During his testimony at hearing, Jerry was articulate and appeared to possess an adequate memory of specific events relative to his claim. He did not exhibit any obvious mental impairment. However, he had an attorney to assist him in presenting the facts and this deputy is obviously not medically trained to assess mental impairment.
It is probably an understatement to state that the evidence is conflicting concerning Jerry's asserted mental problems and their connection to the August 2000 accident. Even objective testing must be subjectively interpreted which is largely why we have such a divergence in medical opinion in this case.
As instructed by the court of appeals, I have re-evaluated the views of the medical experts in this case starting with no pre-conceived notion that treating physicians are more credible than hired experts.
I do not find the views of Dr. Nora or Dr. Springer convincing. What troubled me the most was their depositions. Dr. Springer did not fully explain to me why she only suggested lack of full effort and malingering in her written report but somehow was convinced of it in her deposition as she had not seen Jerry since writing her report. Dr. Nora's attitude in the deposition was quite incredible. I find it unusual for a physiatrist to state that his first duty is to question the diagnosis of more experienced and trained specialists who refer patients to him for rehabilitation. Dr. Springer, the neurophysiologist, at least prior to deposition, only suggested lack of effort and malingering but that Dr. Nora was convinced of it despite no testing on his own. Finally, Dr. Nora's attitude towards the claimant's attorney was unconvincing when the attorney, as any competent attorney does, pressed Dr. Nora on the details of his opinions. The doctor became hostile and refused to answer a straight-forward question because apparently his answer may not have been consistent with his opinions.
This leaves the views of Drs. Krain, Hines and the Social Security evaluators. The views of the occupational physician, Dr. Durand, which were in part supportive and, in part, not supportive of this claim were considered but not given much weight as he was not shown to possess any specialized experience or training in the diagnosis and treatment of mental injuries.
As stated before, Dr. Krain did not question causation until after he learned of the views of Dr. Nora. It is unclear what was provided to him. Possibly, he only learned of this from defendants' case manager, hardly an objective reporter. At any rate, he did opine that he could not explain all of Jerry's symptoms and stated that they may all by psychiatric in nature. However, Dr. Krain continued to treat Jerry's headaches with medication. After stating that he would end all medication at the end of December 2002, Dr. Krain subsequently agreed to reinstate them and month later. (Ex. 5:18) This is hardly the actions of a doctor who thinks Jerry is faking his headache symptoms.
On the other hand, the views of Dr. Hines are unequivocal and unwavering. As they are consistent with the credible testimonies of claimant and his family, his views are the most convincing.
Turning to the mixed bag of Social Security evaluators, I find that most agree with Jerry's claims in this case. The results of the most recent battery of testing by Dr. Hammer are consistent with the testing results showing an extensive mental impairment by Dr. Springer, who at least in the written report stated further testing was necessary to confirm Jerry's mental condition.
Therefore, I find that the work injury of August 14, 2000 is a cause of substantial permanent mental impairment, chronic and debilitating headaches, occasional blurred vision, head numbness, dizziness, instability, and episodic vertigo, all of which constitutes a 36 percent permanent mental impairment to the body as a whole pursuant to the most recent version of the AMA Guides. To the extent this impairment is caused or contributed to by post-injury mental depression and aggravation of Jerry's prior existing OCBD, such is also caused by the work injury of August 14, 2000.
Jerry is 57 years of age. He is a high school graduate.
Jerry had a prior mental condition, OCBD, but I find that this condition was not a cause of permanent impairment or permanent disability until after the work injury of August 14, 2000.
Jerry has not been employed in any capacity since the accident. He has never been released by a treating physician to return to any work. Jerry has suffered a total loss of actual income from his work injury.
Given the views of Dr. Hines and the views of most the evaluators, especially the above quoted excerpt from the report of Dr. Hammer, Jerry's work injury of August 14, 2000 has rendered him mentally incapable of gainful employment.
From examination of all of the factors of industrial disability, it is found that the work injury of August 14, 2000 is a cause of a 100 percent or total loss of earning capacity.
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. George A. Hormel & Co. v. Jordan, 569 N.W.2d 148 (Iowa 1997); Frye v. Smith-Doyle Contractors, 569 N.W.2d 154 (Iowa App. 1997); Sanchez v. Blue Bird Midwest, 554 N.W.2d 283 (Iowa App. 1996).
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. Supportive lay testimony may be used to buttress the expert testimony and, therefore, is also relevant and material to the causation question. The weight to be given to an expert opinion is determined by the finder of fact and may be affected by the accuracy of the facts the expert relied upon as well as other surrounding circumstances. The expert opinion may be accepted or rejected, in whole or in part. St. Luke's Hosp. v. Gray, 604 N.W.2d 646 (Iowa 2000); IBP, Inc. v. Harpole, 621 N.W.2d 410 (Iowa 2001); Dunlavey v. Economy Fire and Cas. Co., 526 N.W.2d 845 (Iowa 1995). Miller v. Lauridsen Foods, Inc., 525 N.W.2d 417 (Iowa 1994). Unrebutted expert medical testimony cannot be summarily rejected. Poula v. Siouxland Wall & Ceiling, Inc., 516 N.W.2d 910 (Iowa App. 1994).
The extent of claimant's entitlement to permanent disability benefits is determined by one of two methods. If it is found that the permanent physical impairment or loss of use is limited to a body member specifically listed in schedules set forth in one of the subsections of Iowa Code section 85.34(2), the disability is considered a scheduled member disability. "Loss of use" of a member is equivalent to "loss" of the member. Moses v. National Union C.M. Co., 194 Iowa 819, 184 N.W. 746 (1921). A scheduled disability is evaluated solely by the functional method and the compensation payable is limited to the number of weeks set forth in the appropriate subdivision of Code section 85.34(2). Barton v. Nevada Poultry Co., 253 Iowa 285, 110 N.W.2d 660 (1961). Pursuant to Iowa Code section 85.34(2)(u), the commissioner may equitably prorate compensation payable in those cases where the functional loss is less than 100 percent. Blizek v. Eagle Signal Co., 164 N.W.2d 84 (Iowa 1969).
On the other hand, if it is found that the work injury was a cause of permanent physical impairment or loss of use involving a body member not listed in the Code section, the disability is considered an unscheduled disability to the body as a whole and compensated under Code subsection 85.34(2)(u). The industrial method is used to evaluate an unscheduled disability. Martin v. Skelly Oil Co., 252 Iowa 128, 133, 106 N.W.2d 95, 98 (1960); Graves v. Eagle Iron Works, 331 N.W.2d 116 (Iowa 1983); Simbro v. Delong's Sportswear, 332 N.W.2d 886, 997 (1983). Industrial disability was defined in Diederich v. Tri-City R. Co., 219 Iowa 587, 258 N.W.2d 899 (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, motivation, loss of earnings, severity and situs of the injury, work restrictions, inability to engage in employment for which the employee is fitted and the employer's offer of work or failure to so offer. McSpadden v. Big Ben Coal Co., 288 N.W.2d 181 (Iowa 1980); Olson v. Goodyear Serv. Stores, 255 Iowa 1112, 125 N.W.2d 251 (1963); Barton v. Nevada Poultry Co., 253 Iowa 285, 110 N.W.2d 660 (1961).
I found in this case that the work injury is a cause of permanent impairment to the body as a whole, a nonscheduled loss of use. Consequently, this agency must measure claimant's loss of earning capacity as a result of this impairment.
Although claimant is closer to a normal retirement age than younger workers, proximity to retirement cannot be considered in assessing the extent of industrial disability. Second Injury Fund of Iowa v. Nelson, 544 N.W.2d 258 (Iowa 1995). However, this agency does consider voluntary retirement or withdrawal from the work force unrelated to the injury. Copeland v. Boones Book and Bible Store, File No. 1059319 (App. November 6, 1997). Loss of earning capacity due to voluntary choice or lack of motivation is not compensable. Id.
A refusal by an employer to return an injured worker to work following a work injury due to new permanent restrictions is evidence of permanent industrial disability. Thilges v. Snap-On Tools, 531 N.W.2d 614, 617 (Iowa 1995); McSpadden v. Big Ben Coal Co., 288 N.W.2d 181, 192 (Iowa 1980); Vosberg v. A. Y. McDonald Manufacturing Company, 519 N.W.2d 405, 408 (Iowa Ct. App. 1994).
In the case sub judice, I found that claimant suffered a total or 100 percent loss of his earning capacity as a result of the work injury. Such a finding entitles claimant to permanent total disability benefits as a matter of law under Iowa Code section 85.34(3), which is weekly benefits from the date of injury for an indefinite time into the future during the period of disability. Such benefits last a lifetime absent a change of condition.
Pursuant to Iowa Code section 85.27, claimant is entitled to payment of reasonable medical expenses incurred for treatment of a work injury.
In the case at bar, given my findings and stipulations, claimant is entitled to an award of all of the requested medical benefits.
Claimant in the hearing report requested a specific taxation of two costs, the filing fee and the cost of two reports from Dr. Hines. As claimant has prevailed, the request will be granted pursuant to our administrative rule, 876 IAC 4.33.
Peter J. Leehey
Attorney at Law
PO Box 10316
Cedar Rapids, IA 52410-0316
Mark W. Thomas
PO Box 10434
Des Moines, IA 50306-0434
LPW/tjr