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City of Ottumwa v. Poole9/1/2004
On review from the Iowa Court of Appeals.
Municipal employer and its workers' compensation claim association appeal from decree granting rescission of agreement for special case settlement of workers' compensation claim. The court of appeals reversed the decree. DECISION OF COURT OF APPEALS AFFIRMED; DISTRICT COURT JUDGMENT REVERSED AND REMANDED.
The City of Ottumwa (the city) and Iowa Municipal Workers' Compensation Association (IMWCA), its workers' compensation claim administrator, appeal from the district court's decree granting rescission of an agreement between the city and Russell Poole for a special case settlement of Poole's workers' compensation claim. The district court ordered rescission of the agreement based on its finding that a claims representative of IMWCA misrepresented certain material information and failed to disclose material information in the handling of Poole's workers' compensation claim. The court of appeals reversed the district court decree, concluding that the claims representative made no material misrepresentations and that her disclosures were sufficiently complete and accurate to preclude granting rescission of the agreement that had been negotiated between the parties. After reviewing the record and considering the arguments presented, we affirm the decision of the court of appeals and reverse the district court decree.
Poole sustained a back injury in March 2001 while working as a transit driver for the city. The employer's examining physician gave him a four-percent impairment rating, and his designated physician gave him a six-percent impairment rating. Poole was paid temporary disability benefits first premised on the four-percent disability rating and later on the six-percent disability rating.
Poole contacted the workers' compensation commissioner's office requesting information on filing a claim. He was told by that office that IMWCA was handling the administration of workers' compensation claims by employees of the City of Ottumwa. He was advised by the commissioner's office that in contacting IMWCA he should request interest on any benefits owed and not yet paid. The commissioner's office mailed Poole information concerning whole-body impairment prepared by the American Medical Association.
Poole then contacted IMWCA and conversed with Toni Lockwood, a claims specialist, concerning his entitlement to workers' compensation benefits. She informed him that he should send a demand letter and gave him advice concerning the information to be included therein. Thereafter, Poole wrote to IMWCA describing the circumstances surrounding his injury, the nature of his medical treatment, his disability rating, permanent work restrictions, and an estimate of future lost wages. He demanded $350,000 as a lump-sum settlement of all claims including future medical benefits.
One month later, Lockwood responded to Poole's demand and advised him that the $350,000 request exceeded the maximum benefits payable for permanent total disability, which would have been $106,990. The letter went on to state:
Based on several factors which include a minimal permanent partial disability rating, and being a non-surgical injury, we are able to extend an offer to you for 10% to the body less the amount of PPD paid at the time of settlement. The 10%* 500 weeks = 50 weeks of benefits at your compensation rate of $213.98 which totals $10,699.00. The total amount of PPD paid thus far has been 22 weeks at your rate of $213.98 which totals $4707.46. Please keep in mind that previously we had voluntarily agreed to pay the additional 2% to the body which was the difference between Dr. Carlstrom (treating physician) and Dr.
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