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The Collaborative Clearinghouse for Lawsuits and Other Claims Against ACE Group Insurance Companies


ATTENTION: It is possible that this information may no longer be current and therefore may be inaccurate. The index contains both open and closed cases and is not a complete list of cases in which an ACE Insurance Group company is involved. This information is provided to give interested persons an idea of the issues disputed in the indexed cases. For a full understanding of a case, one should read the rest of the court file, including the response. For the most up-to-date and complete information on a case, visit or contact the clerk of the relevant court.

Case Number: 
11-0255 Search Pacer
ACE Group party(s): 
Opposing Party: 
Court Type: 
State Court: 
Iowa.Court of Appeals
Date Filed: 
Sep 8 2011

"I. Background Facts and Proceedings.

Laurie Bensley quit high school when she was fifteen years old. She had a continuum of minimum-wage jobs, with a seven-year hiatus staying at home tending to her children. In September 2001, Bensley fell off a porch at her home. She was diagnosed with a strained left shoulder and was out of work for a brief period thereafter. In 2002, she was employed by firms in packaging, requiring the lifting of parcels exceeding fifty pounds above shoulder level.

Bensley was hired full-time by Dee Zee in February 2006. Her principal assignment was “deburring” running boards in the fabrication stage. This required the operation of a five-pound drill suspended from an overhead source. The drill was manually forced down to chest level to grind loose metal away from fourteen drilled holes per tube, a series of tubes comprising a part of the fabrication. She estimated deburring eighty-eight to one hundred tubes per hour, ten hours per day. Additionally, she assisted in assembling and packing the end product.

On January 26, 2007, Bensley struck her left elbow on a corner of a control stand, incurring pain to her left arm. Though continuously requested, she was not authorized for medical care until March 26, 2007. The company 3 physician injected the elbow, prescribed medication, and released her for light duty. She had missed work due to increased symptoms. Bensley was terminated on April 7, 2007, for alleged excessive absences.

Bensley filed a petition with the Iowa Workers‟ Compensation Commissioner in June 2007, alleging she had suffered injuries to her left elbow and shoulder on January 26, 2007. A second petition filed several months later alleged injuries to her left shoulder, neck, and arm due to the repetitious work she performed at Dee Zee.

Following those filings, Bensley was referred by her family physician to an orthopedic surgeon, Dr. Scott Neff. She submitted to surgery on her left elbow on January 21, 2008.3 Bensley continued to sustain left shoulder discomfort. Upon evaluation, Dr. Neff concluded:
she has a definite infringement syndrome in the left shoulder. The pain in her elbow may have masked the shoulder. There is no direct anatomic relationship between the elbow and the shoulder, other than that they both can occur as a result of repetitive activity, push, pull, lifting, and work. She says her left shoulder is bothering her a great deal.

Dr. Neff scheduled arthroscopic left shoulder surgery. Bensley sought second opinions, which recommended a more conservative pre-surgical procedure. Surgery was delayed due to her concerns about its costs and insurance coverage. Bensley‟s pain persisted, persuading her to opt for an August 8, 2008 surgery on her left shoulder, decompressing it, and the debridement of a lesion that had developed from “wear and tear.” Physical therapy followed. The surgeon opined that “the work at Dee Zee Manufacturing aggravated her arm and shoulder necessitating the subsequent surgical treatment.”4 Her family physician concluded, “Bensley told me she did a lot of overhead working and pulling down of objects. All the work was very repetitive, therefore, I believe her work activities are related to aggravating her left elbow and shoulder discomfort.” An independent medical examiner concluded that her osteoarthritis in her left shoulder was “aggravated by repetitive pushing, pulling, and lifting from her job,” resulting in compensatory impairment. The surgeon acknowledged a report by an ergonomics expert that analyzed and studied the functional applications of Bensley‟s job, including “cutting, drilling, hole punching, bending, and deburring” at chest or above level, with the conclusion that the diagnosis of left shoulder pain resulting in surgery was causally connected to her fabrication position at Dee Zee.

Following an arbitration hearing in March 2009, the deputy workers‟ compensation commissioner found Bensley had not met her burden of proof on her claimed left shoulder injury, as “it could not be determined how the claimant‟s shoulder injury occurred.” The deputy commented in his findings that Bensley:
had a fairly serious fall onto her left shoulder in 2001 . . . at home for which she missed approximately six weeks of work. Given the previous injury, the fact that the shoulder became symptomatic eight months after the work ended, the claimant‟s nearly year delay in claiming the left shoulder was from work activities, and the significant non-work related arthritic condition, it is unknown how the injury to the left shoulder occurred.
On intra-agency appeal, the commissioner affirmed and adopted the deputy‟s decision after “[c]onceding that the presiding deputy made limited mention of the medical opinions contained within the record.” The commissioner stated the greater weight of the evidence is that “claimant‟s shoulder condition 5 was a result of non-work injuries predating her employment,” notably the 2001 fall followed by medical attention to her shoulder in April 2006.

Bensley filed a petition for judicial review, alleging the commissioner erred in determining she failed to prove a causal connection between her work and left shoulder injury. The district court reversed and remanded the agency‟s decision, finding “the Agency decision lacks substantial evidence to support it”; the medical evidence was “overwhelmingly” in favor of work-related causation; and “the Agency‟s application of the law to the facts was irrational, illogical, and wholly unjustifiable and otherwise arbitrary and capricious” due to its summary dismissal of the uncontradicted medical evidence.

Dee Zee appeals, claiming the district court erred by finding the decision of the workers‟ compensation commissioner was not supported by substantial evidence."

The provided text is an excerpt from a document filed in this case. For a full understanding of the case, one should read the complete court file, including the response.

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