Working as a CNA is a very physically demanding job. A CNA is required to bathe and feed patients, assist with patient transfers, make beds that are sometimes occupied, and help patients who have fallen. All of these duties are done at an intense pace. The result is a great deal of lifting, bending and twisting.
Frequently, the heavy lifting of a CNA job has to be performed in a poor ergonomic situation.
The Dictionary of Occupational Titles usually classifies CNA duties as falling in the medium level work classification. However, in many CNA jobs, and especially involving caring for older populations in a nursing home or an assisted living facility, CNA duties fall in the heavy level work classification.
Facilities frequently do not have enough CNAs to handle all the work. The understaffing can lead to overtime and double shifts that puts more physical strain on the CNAs and increases the risk of injury. The understaffing also results in CNAs being required to assist patients on their own where it would be much better to have multiple CNAs assist the same patient.
Patient emergencies including falls by patients frequently require fast action by a CNA.
CNA duties also frequently cause cumulative trauma to the workers.
As a result of all these factors, Certified Nursing Assistants frequently suffer injuries to their necks, shoulders, backs, and knees.Aggravation of Pre-Existing Injuries in CNA Cases
A CNA may have pre-existing health problems. The pre-existing condition can be the result of the aging process, an earlier work injury, or an off-the-job accident.
Sometimes, a pre-existing condition will make a Certified Nursing Assistant more susceptible to being hurt on the job. For example, a CNA that has had a prior neck surgery might be injured while performing CNA duties that might not have injured a CNA who did not have a pre-existing neck problem.
However, under Iowa work comp law even though a CNA might have a pre-existing condition, if the CNA is injured on the job, then he or she is entitled to receive workers’ compensation benefits. Sometimes a CNA might have limitations or restrictions because of their pre-existing problems. If a CNA with pre-existing restrictions is injured on the job, then the CNA is generally only entitled to be compensated for the increase in their disability caused by the work injury.
In other situations, a CNA may have a pre-existing condition that was non-symptomatic and did not cause the CNA any problems. If a CNA with a latent condition is injured on the job, the CNA will generally be entitled to receive compensation for the entire resulting disability from the work injury.
Under Iowa work comp law in order for a CNA with a pre-existing condition to be able to receive permanent partial disability (PPD) benefits, the aggravation to the pre-existing condition must be permanent, material, and substantial.
The most common dispute in Iowa work comp aggravation cases involving Certified Nursing Assistants is whether the CNA job actually aggravated the pre-existing condition, or was the worsening condition actually caused by the natural progression of the condition. The CNA’s own testimony is very important on this issue. However, the opinions and reasoning of the treating doctors and IME physicians usually end up deciding this type of dispute.Determining the Amount of Work Comp Benefits a CNA is Entitled to Receive
Under Iowa law, an injured Certified Nursing Assistant is entitled to receive lifetime medical care for any work injury.
If a CNA suffers a work injury to a scheduled body part such as an arm, hand, leg, or foot, then he or she is entitled to receive weekly payments under the scheduled benefits section of Iowa law. An explanation of how compensation for scheduled injuries works is set out in the “Overview of Iowa Workers’ Compensation Law” section of our website which can be found here.
If a CNA suffers an injury to an unscheduled body part such as the neck, shoulders, or back, then he or she is entitled to receive weekly benefits based on how the work injury will negatively hurt his or her potential future earning capacity.
Determining how a CNA’s future earning capacity will potentially be affected by an unscheduled work injury requires looking at a number of factors including:
- Work Restrictions. A CNA who is given more limiting work restrictions will generally receive a larger amount of benefits than a CNA who is only given minor restrictions or no restrictions. Unfortunately, because of the physical requirements of CNA work, a Certified Nursing Assistant who suffers an injury to his or her neck, shoulder, or back frequently ends up with restrictions that prevent the CNA from being able to return to regular duty.
- Functional Impairment from the Injury. The AMA Guides to the Evaluation of Permanent Impairment set out a standardized system for determining the amount of functional impairment caused by a work injury. As a general matter, a CNA with a higher impairment rating will receive a larger award than a CNA with a lower impairment rating. The insurance carrier generally obtains the first impairment rating. As part of representing our clients, our law firm also helps injured workers to be evaluated under an independent medical examination for a second impairment rating of their work injuries.
- Actual Effect on Earnings. If an injured CNA’s earnings go down because of their work injury that will generally lead to a higher workers’ compensation award. If the earnings of an injured CNA remain the same or even go up, the CNA is still eligible for work comp benefits. However, that CNA will probably receive a lower award than a CNA who suffers a decrease in earnings.
- Qualifications to do Other Types of Work. A Certified Nursing Assistant who does not have the job experience or qualifications to work outside of the CNA area will generally receive a higher award. A CNA who has the qualifications and work experience to transition to other types of jobs where his or her work comp injuries will not hold him or her back, will generally receive a lower award.
- Whether the Employer Terminates the CNA. If the employer ends up firing the CNA after the work injury, that will generally result in a higher workers’ compensation award for the CNA. In contrast, if the employer accommodates the CNA’s problems and limitations from the injury and continues to employ the CNA, then the CNA will usually receive a lower award.
- Age of the Injured Driver. Generally an older Certified Nursing Assistant will receive a higher award than a younger CNA with the same injury. The underlying basis for this rule is the recognition that most employers would generally prefer to hire a younger CNA. Therefore, an older CNA who has limitations from a work comp injury is going to have even a harder time getting a new job.
- Education. A CNA with a lower level of education will receive a higher award than a CNA with more education. The rule is based on the reasoning that a CNA with more education usually has a better chance of being able to transition to a new job outside of the medical field where physical limitations from a work comp injury are not as big of a problem.
If you have a question about a CNA work comp case or any other Iowa workers’ compensation injury, call or email us now and our lawyers would be happy to talk to you and answer your questions without charge or obligation.