Correct Use of the AMA Guides Determines Outcome in Brus v. Tyson Fresh Meats

 Ms. Brus, a Tyson employee, alleged that injuries sustained during a slip-and-fall at work resulted in an abdominal hernia. She underwent surgery with a mesh implant to repair the hernia, but still complained of pain afterwards and ultimately brought an action against Tyson. As part of her case, she underwent an IME with Dr. Sunil Bansal. Dr. Bansal assigned Ms. Brus a whole-body impairment rating of 9% based on the fact that she was still experiencing pain at her surgery site that “went beyond ‘occasional mild’.” Areli Brus v. Tyson Fresh Meats, File No. 22000220.02(Arb. 2/10/2026) at 7. 

Dr. Bansal’s assessment contradicted the conclusion reached by Defendant’s expert, Dr. Douglas Martin. Dr. Martin, a co-chair of the AMA Guides Editorial Panel, stated in his report that an impairment rating can only be assigned for a hernia if there is a “palpable defect in the supporting structures of the abdominal wall.” Id. at 8. Given that Ms. Brus underwent a successful mesh implant surgery, she suffered from no such defect in her abdominal wall—and, therefore, had no impairment attributable to her hernia. 

The outcome in this case is another reminder of the importance of ensuring that IME providers utilize the Guides carefully and correctly. By her own admission, Deputy Gerrish-Lampe found portions of Dr. Bansal’s report persuasive. Id. Iowa law, however, requires deputies to assign impairment ratings in accordance with the Guides—and Dr. Martin was the only provider who did that correctly.