Recent Appeal Decision Expands the Definition of the Shoulder

  • Oct 06, 2020

Legal Update by Attorney Alison Stewart and Law Clerk Jordan Gehlhaar

A recent Commissioner Appeal Decision in Deng v. Farmland Foods, Inc., Workers’ Compensation Commissioner Joseph Cortese II determined that the Iowa Legislature intended “shoulder” in section 85.34(2)(n) to encompass more than just the glenohumeral joint. It was found that the rotator cuff should be classified as a scheduled member injury of the shoulder.

Claimant Deng sustained injuries to her infraspinatus muscle and labrum. The parties agreed that the glenohumeral joint – or the “ball and socket” – falls within the parameters of the “shoulder” under 85.34(2)(n). The labrum would be compensated under this provision since it is located in the joint space. The issue, then, was whether the infraspinatus, one of four muscles of the rotator cuff, should be classified as an injury to the shoulder or body as a whole.

In interpreting legislative intent, the Commissioner looked to debates in the House and Senate files as well as the study bills preceding the files. Originally, the proposal was to make the shoulder joint and everything on the “arm side” of the joint compensable as an arm under § 85.34(2)(m). However, the changes to subsection ‘m’ were stricken and the legislature instead created an additional subsection adding “shoulder” to the list of scheduled members. The Commissioner found this reflective of the legislature’s intent for 85.34(2)(m) to encompass more than just the glenohumeral joint.

The Commissioner also considered that the legislature was aware of the courts’ prior holdings and the adopted rule that the proximal point of a joint was used to classify an injury. For example, the wrist is considered an arm injury, not a hand injury. Unlike the cases in which this rule was applied, the shoulder was specifically classified as a scheduled member.

In the former cases, it may have seemed simple that a leg clearly did not include a hip or an arm clearly did not include a shoulder as they were clearly distinct. However, in this case, the Commissioner emphasized how the shoulder is unique in that “the glenohumeral joint and its surrounding muscles, tendons, bones and surfaces are extremely intricate and intertwined.” Therefore, it could not be assumed that the legislature intended or expected the “proximal” rule to apply to section 85.34(2)(n).

The muscles surrounding the shoulder joint stabilize the socket and work as an “engine” to move the shoulder joint itself. It was reasoned that since the rotator cuff is essential to the function of the glenohumeral joint, it would seem arbitrary to exclude it from the definition of “shoulder.”

Claimant’s injuries were both considered shoulder injuries under 85.34(2)(n). The statute is silent on whether the upper extremity or whole person rating should be applied to the 400 week schedule. Ultimately, because the rating doctor relied on the “upper extremity” chapter of the AMA Guides, and the agency historically had not relied on whole person rating for scheduled member injuries, the upper extremity rating was applied. Her eight percent rating was used to determine she was entitled to 32 weeks of PPD benefits.

In sum, this decision expanded the definition of “shoulder” beyond just the glenohumeral joint – but it is far from clearly defined. As the opinion asserted, this expansion will result in “temporary uncertainty,” and increased litigation as additional connected components are considered. Note, the impact of a distal clavicle resection was not discussed.

View our previous posting to see how the “proximal” rule was formerly applied to the shoulder.

Peddicord Wharton will continue to monitor case law on this issue.

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