Iowa Court of Appeals Provides Guidance on Investigating a Worker’s Claim of Chronic Regional Pain Syndrome

Recently, in Zaglauer vs. Mercy Medical Center, 2013 WL 5276149, the Iowa Court of Appeals determined that a Claimant who had an uncontested work accident did not suffer from chronic regional pain syndrome despite the fact that four of her physicians diagnosed her with this condition. Importantly, in Zaglauer, the Court noted that chronic regional pain syndrome is a highly subjective condition. In investigating the Claimant’s allegations, the employer found records of a preexisting history of similar complaints and presented the same to a defense medical examiner who concluded that Claimant’s condition did not arise out of a work accident. Apparently, Claimant failed to express anything regarding this history to the four treating physicians who diagnosed Claimant with chronic regional pain syndrome.

The Commissioner reasoned that considering the defense medical examiner was the only medical professional fully aware of the Claimant’s medical history, the opinion of the defense medical examiner would be most relevant.

The decision in Zaglauer reaffirms the need for employers to thoroughly investigate not just the circumstances surrounding a Claimant’s alleged injury but also the Claimant’s preexisting medical history. In our experience, most often when physicians have not been given a complete medical history in the form of prior treatment records, subsequent diagnoses based entirely on a claimant’s subjective accounting can be conflicting at best. Under Iowa law, all claimants are required to provide medical records releases to the employer or insurer. This is an effective tool in investigating workers’ compensation claims in Iowa. For any questions regarding an employer’s rights to investigate a claimant’s medical history when a claim has been made, please contact Baylor Evnen’s Iowa workers’ compensation’s attorneys at 402-475-1075 or tclarke@baylorevnen.com, or cwesterhold@baylorevnen.com, or pbarta@baylorevnen.com.