by | Jul 15, 2022

In Bolinger v. Trillium, an Iowa Deputy Workers’ Compensation Commissioner provided guidance as to whether a reverse shoulder replacement surgery is considered an injury to the shoulder or if it extends to the body as a whole.

The claimant in Bolinger argued that her reverse shoulder replacement surgery should be treated as a body as a whole injury, which increases exposure and allows for the assessment of industrial disability, rather than an injury limited to the shoulder, which is compensated functionally.

Based on expert testimony, the Deputy distinguished Bolinger from earlier decisions regarding what is, and what is not, a “shoulder” under Section 85.34(2)(n). In Deng, the Commissioner determined the muscles that make up the rotator cuff should be included in the definition of a shoulder. In Chavez, the Commissioner held both the labrum and the acromion should also be included in the definition of “shoulder.” Key to the Commissioner’s reasoning was that a “shoulder” under the statute was not limited to the glenohumeral joint itself, but also includes parts of the body that are located near and ‘integral’ to the function of the glenohumeral joint.

The Supreme Court of Iowa later affirmed both holdings. Our prior blog posts discussing these cases can be found here for Deng, here for Chavez, and here for the Supreme Court of Iowa’s decision affirming Chavez and Deng.

In Bolinger, the expert’s uncontradicted opinion stated that a reverse shoulder replacement surgery is more involved than the rotator cuff surgeries seen in Deng and Chavez. According to the expert, the claimant’s surgery extended proximally beyond the glenohumeral joint. The reverse shoulder replacement surgery impacted both the muscles in the claimant’s shoulder and back. The impacted areas included the muscles and tendons of the rotator cuff, as well as the rhomboids, serratus, and trapezius muscles, and the scapula.

Therefore, since the body parts affected by the procedure were not limited to only those body parts located near and integral to the function of the glenohumeral joint, the Deputy Commissioner held that the claimant’s injury extended to the body as a whole.

This is not to say that all reverse shoulder replacement surgeries will be treated as body as a whole injuries. The ruling suggests that the determination will have to be on a case by case basis, depending on what parts of the body were affected. Furthermore, this is a Deputy Commissioner ruling, so it is not binding precedential authority on the agency. It is possible that the Commissioner will disagree with the Deputy’s analysis. For now, this is best described as guidance.

This post was drafted by Faith Kowalski, a law clerk at Baylor Evnen. If you have questions regarding whether an injury or surgery of the shoulder extends to the body as a whole, please call Paul Barta or Micah Hawker-Boehnke at 402-475-1075.