The Iowa Court of Appeals recently rendered an interesting decision in Nestle USA v. Connell.

Judge David Langham

Of course every case has a point, and the rights of the parties to a case will be affected. However, studying the outcome of cases also has the benefit of a better educated and prepared community. And it is from Iowa, recently named the "best place to live" by U.S. News.

Well, perhaps.

This case involved a significant hand injury, which occurred when an employee was attempting to un-jam an industrial machine in a production facility. A somewhat amazing fact noted by the appellate court is that the employee himself "was forced to manually take apart the machine to get his hand out."

Though he was able to summon others to assist, he orchestrated the response to his accident. After "several surgeries," the hand was seriously damaged and he was ultimately diagnosed "with neck pain, post-traumatic stress disorder (PTSD) and depression."

There was litigation regarding some of those conditions, but the employer voluntarily provided "a mechanical prosthetic device that allowed him to manipulate his thumb and index finger." This device could be used by the worker only "for three to four hours a day" and was described as an "unwieldy hand." The worker said that use of it "caused him emotional distress," and he avoided public places, as he felt he was "being regarded as a Frankenstein figure with a visibly damaged hand.” 

To alleviate those feelings, the worker additionally sought a "passive prosthetic left hand 'that looked like a natural hand.'” The case was heard by a deputy commissioner who "ordered the payment of permanent total disability benefits as well as payment for a passive prosthetic hand."

That decision was appealed to the Workers' Compensation Commissioner, who reversed the award of a passive prosthetic hand. The commissioner concluded that the award of a second prosthesis was not supported by the statute. 

Next, the claim was reviewed by the district court, which in Iowa is the court of "general jurisdiction" for trials and disputes. It is the court in which a personal injury case such as this would originate if it were not for the statutory administrative process that is workers' compensation.

The district court reversed the commissioner regarding the prosthetic hand, concluding that the injured worker was not limited to a single prosthetic, but was instead entitled to what was "reasonable." And the matter proceeded to the Iowa Court of Appeal, which authored this opinion. 

The appeals court cited Iowa Code section 85.27, which "obligates an employer 'to furnish reasonable services and supplies to treat an injured employee.'” It also requires the employer to provide "reasonably necessary transportation expenses" for obtaining medical care, an issue recently discussed in An Illustrative Story. Thus, the Iowa Code requires providing prosthesis generally. However, the statute also limits this to "one set of permanent prosthetic devices."

The appeals court noted that the commissioner's decision "did not focus on the 'reasonable and necessary' language" but instead "on the 'one set' language."

The employer argued that only one prosthetic was appropriate, and that the "one set" language ("set" being seemingly plural, as "one prosthetic" would be singular) was intended to provide multiple apparatus (a "set") only when a worker suffered multiple amputations and thus needed more than one prosthetic. The employer contended that this interpretation is clear from the statute. 

The appeals court explained that its burden was to decide "whether we would reach the same result as the district court," and that it had recently "repeatedly declined to give deference to the commissioner’s interpretations."

The appeals court affirmed the district court and rejected the commissioner’s interpretation. It concluded that "for all practical purposes, the passive hand and the mechanical hand were a single device, to be used interchangeably in a 24-hour day."

The two devices were in fact one device, as the worker used only one at a time. The passive hand was "simply an extension of the mechanical prosthetic hand." The court cited precedent in which it had previously concluded that an accessible van conversion was (similarly?) "merely an extension of" the worker's wheelchair. 

This decision is an illustration of a court interpreting two provisions or phrases within a single statute. It bears some similarity to the decision of the Florida Supreme Court in Murray v. Mariner Health. There, the court perceived conflict between the word "reasonable," applied to attorney fees, and the plain statutory language limiting fees to a formula calculation. The Florida court found the "reasonable" more persuasive than the limitation. 

Similarly, the Iowa court here found the "reasonable and necessary" language more persuasive than the seemingly limiting language of "one set."

There will be those who will question the logic that two devices are, in effect, only one device. That explanation is perhaps a little harder to accept than the simpler "reasonable and necessary" argument. And, simpler still, some might argue that the court could as easily have concluded that the two prosthetics in this case were in fact "one set of permanent prosthetic devices" as provided in the statute.

That, of course, would require recognition that sometimes a "set" is needed because of multiple losses/needs, and sometimes a "set" is needed simply because of multiple needs (a mechanical device and a less functional but more aesthetically pleasing device). 

The court's analysis is interesting reading. It is also a good illustration of the challenges presented when statutes and codes present language that might be conflicting. When such conflict is perceived, courts will provide interpretation. And, if that interpretation differs from the legislature's, then it is up to the legislature to change the law. 

David Langham is deputy chief judge of the Florida Office of Judges of Compensation Claims. This column is reprinted, with his permission, from his Florida Workers' Comp Adjudication blog.