Appeal from the Iowa District Court for Linn County, Robert E. Sosalla, Judge.
Quaker Oats Company appeals the Iowa Workers' Compensation Commissioner's award of healing benefits, permanent partial disability benefits, and medical benefits to Farar, claiming the findings are not supported by substantial evidence.
Mark A. Woollums and Edward J. Rose of Betty, Neuman & McMahon, P.L.C., Davenport, for appellants.
William G. Nicholson of Rush & Nicholson, P.L.C., Cedar Rapids, for appellee.
Considered by Vogel, P.J., and Vaitheswaran and Bower, JJ.
I. Factual and Procedural Background
Larry Farar began working for Quaker Oats Company in 1975. He worked in several different positions, though all involved manual labor, including moving heavy objects and going up and down stairs or ladders. Farar's knee pain began in 1996, when he sustained a knee injury at work running after a rail car. His physical exam and MRI revealed abnormalities in the distal quadriceps tendon. The exam also showed he was markedly overweight. In 1997, Farar's knee pain grew worse, and he reported having difficulty putting weight on it after sitting or lying down for significant periods of time. He was diagnosed with chronic right patellofemoral syndrome. Quaker Oats accepted responsibility for these injuries but, at some point in 1999, declined to pay for further treatment.
In 2000, Farar reported an increase in knee pain after climbing bins and rail cars at work. Craig Dove, M.D., performed a right knee scope that revealed significant arthritic changes. Dr. Dove found this condition to be partially work related, though Farar's weight contributed to the problem. Dr. Dove suggested weight loss and exercise, as Farar's weight ranged from 320 to 375 pounds during this time, and was 320 pounds at the time of the arbitration hearing. Quaker Oats denied responsibility for his knee condition.
Farar continued to have problems with both knees and was diagnosed in 2000 with internal derangement of the knees by Jeffrey Nassif, M.D. Farar underwent physical therapy but continued to have pain. Dr. Nassif treated Farar with injections.
James Pape, M.D., saw Farar in August 2001 and opined he suffered from bilateral patellofemoral chondromalacia, which is a degenerative condition. Dr. Pape continued to prescribe anti-inflammatories to Farar for a number of years.
In 2007 Farar went back to Dr. Nassif, and a September 2007 X-ray showed severe osteoarthritis of the knees with lost joint space. Knee replacement surgery was recommended, and Dr. Nassif suggested Farar lose weight in preparation for this surgery.
On March 14, 2008, Farar submitted an incident report to Quaker Oats, alleging he had sustained bilateral knee injuries by repetitive trauma. Specifically, Farar attributed his knee pain to the years he worked at Quaker Oats, which required him to climb, kneel, and crawl, coupled with production pressures and working overtime. This is the date of the manifestation of Farar's disability used for purposes of determining cumulative injury.
In 2008 and 2009, Farar experienced wrist and hand problems, for which he had two surgeries and did not attend work for three months. In 2010, another x-ray revealed "severe grade 4 bone-on-bone arthritis" in both knees. On March 15 and May 17, 2010, Dr. Nassif performed knee replacement surgeries on Farar. Following these ...