Functional capacity evaluations (“FCE”) can be useful tools during workers’ compensation cases. However, it is important that all parties involved be acutely aware of their uses and limitations. An FCE is not equivalent to an independent medical examination (“IME”) or a report from a treating physician; it cannot provide an impairment rating. It can, however, resolve disputes between parties regarding a claimant’s employment prospects. When used wisely, a well-drafted FCE can shed an objective light on a claimant’s capacities and greatly assist deputies in weighing evidence. An FCE is a report drafted by a qualified evaluator—who is, more often than not, a physical therapist—regarding a claimant’s physical abilities in a workplace setting. While preparing the report, the evaluator typically puts the claimant through a battery of tests that assess their ability to perform job-specific movements such as lifting, carrying, standing, sitting, reaching, and bending. After the tests have been conducted, the evaluator compares the results against standardized work classifications from the Dictionary of Occupational Titles: sedentary, light, medium, heavy, and very heavy work. Based upon the results, the evaluator will issue an opinion about the level of work that the claimant is capable of performing. An FCE is most appropriate when a claimant has reached maximum medical improvement, but the parties disagree about the claimant’s future employment prospects or ability to perform certain jobs. In this situation, an FCE can offer an objective assessment of the claimant’s physical abilities. However, it is important to note that FCEs have a key limitation. An FCE alone, without any evidence from a physician, cannot establish the existence of a disability. The Agency “gives little weight to functional capacity evaluations by physical therapists that are not adopted by a licensed physician and conflict with activity restrictions imposed by licensed physicians.” Allen v. Annett Holdings, File No. 5024900 (App. July 28, 2011) at 9. As Deputy Walshire notes in his decision in Allen , “Such therapists simply lack the medical qualifications to make such medical assessments and causally relate their findings to a work injury.” Id. While FCEs can be useful, parties to a case must make sure they are making appropriate use of them. If an FCE contradicts the medical evidence, it likely will not be given much weight by the fact finder; and if it is the only proof offered to substantiate a claimant’s alleged disability, their claim will likely not succeed.
Two recent Iowa Supreme Court decisions have dramatically expanded who qualifies for Second Injury Fund benefits.
What Workers’ Compensation Is Designed to Do Workers’ compensation is a system created to provide benefits to employees who are injured while performing their job duties. In Iowa, this system is intended to offer medical care and wage replacement without requiring injured workers to prove fault. At the same time, workers’ compensation limits an employer’s exposure to lawsuits by providing an exclusive remedy in most workplace injury situations. This balance is a key feature of the system. Who Is Covered Under Iowa Workers’ Compensation Law Most employees in Iowa are covered by workers’ compensation, regardless of whether the injury occurred suddenly or developed over time. Coverage generally applies when an injury arises out of and in the course of employment. There are limited exceptions depending on the nature of the work and employment relationship. Understanding whether an injury qualifies often depends on specific facts and circumstances. Types of Benefits Available Workers’ compensation benefits in Iowa may include medical treatment related to the injury and partial wage replacement if the injury prevents an employee from working. In some cases, benefits may also address permanent impairment or long-term disability. The type and duration of benefits depend on the nature of the injury and how it affects an employee’s ability to work. Why Understanding the System Matters Many injured workers are unfamiliar with workers’ compensation until an injury occurs. Misunderstanding how the system works can lead to missed deadlines or confusion about available benefits. Learning the basics helps injured workers better navigate the process and set realistic expectations. Final Thoughts Workers’ compensation in Iowa is designed to provide support after a workplace injury, but the process can be complex. Understanding how the system works is an important first step for anyone dealing with a work-related injury. This content is for general informational purposes and does not constitute legal advice.
Shoulder injuries, and how they are compensated, have been a controversial issue in Iowa law since 2017. Before the 2017 changes to Chapter 85 of the Iowa Code, shoulder injuries were considered injuries to the body-as-a-whole, and compensable for up to 500 weeks under the industrial disability analysis. After the changes, however, shoulders were treated as scheduled injuries that were compensable for only 400 weeks. On its surface, this sounds like a straightforward change. The years since, however, have seen considerable debate regarding what the term “shoulder” even refers to and exactly how an injury to the region should be assessed and compensated. Nowhere in the statute was the word “shoulder” defined. “Shoulder” was not defined in the AMA Guides , either, or used by doctors when assigning impairment ratings to the region. The term they used was “upper extremity,” which encompasses the entirety of the arm. Moreover, while authorities like Stedmans Medical Dictionary defined the shoulder joint narrowly as “a ball-and-socket synovial joint between the head of the humerus and the glenoid cavity of the scapula,” prior court rulings had decreed that the definition of shoulder also included the “tendons, ligaments, muscles, and articular surfaces connected to the glenohumeral joint.” Chavez v. MS Technology LLC , 972 N.W.2d 662, 667 (Iowa 2022). The end result of this was an ambiguity about what an injury to the shoulder entailed—an ambiguity that claimant-side attorneys used to argue that injuries to the shoulder should be defined as injuries to the joint alone. In their decision in Chavez v. MS Technology LLC , the Supreme Court of Iowa resolved this ambiguity by deciding that the word “shoulder,” as used in Section 85.34(2)(n) “must be defined in the functional sense to include the glenohumeral joint as well as all of the muscles, tendons, and ligaments that are essential for the shoulder to function.” Id. at 668. This decision did a lot to clarify how cases involving shoulder claims would proceed in Iowa; however, some questions still remain. Recently, plaintiff-side attorneys have begun arguing that upper extremity impairment ratings assigned to claimants with shoulder injuries should be multiplied by sixty percent in order to arrive at an impairment rating that applies exclusively to claimant’s shoulder. The rationale behind this theory is that it accounts for the shoulder joint’s involvement in the function of the upper extremity—which, according to the AMA Guides , is sixty percent. Whether or not this theory will prove successful in court remains to be seen. However, it has two significant hurdles to clear before it can become the law of the land: the fact that its rationale runs contrary to the Guides’ own directives for the issuance of impairment ratings, and the fact that this “weighting” has already been accounted for by the shoulder being worth 60% more than the upper extremity, as originally proposed in the 2017 amendments to the Iowa Workers’ Compensation Act. Claims involving shoulder injuries are likely to remain sources of controversy, debate, and novel theories for years to come. Defendants should be careful to ensure that injuries to the shoulder are treated solely as scheduled injuries in accordance with 85.34(2)(n). Claimants, on the other hand, should be mindful to take advantage of any opportunities to expand shoulder claims into body-as-a-whole claims—all while remembering that injuries to the muscles, tendons, and ligaments attached to the glenohumeral joint will not be sufficient for this purpose.
Without strong objective evidence, it is very possible for claims to fail.
When testimony conflicts with the evidence, credibility becomes the deciding factor.
