In a ruling that affirmed the Iowa Workers' Compensation Commissioner, the Iowa Supreme Court held that a wrist injury should be treated as an injury to the arm, rather than an injury to the hand. See Holstein Electric and Integrity Mutual v. Breyflogle.

Under Iowa law, injuries to the arm that do not extend into the shoulder are generally treated in a much more limited way than injuries to the shoulder. They are compensated based on Section 85.34 of the Iowa Code.

In most cases, if someone loses the full use of a hand, he or she is entitled to an award of 190 weeks of permanent partial disability benefits. If someone loses the full use of an arm, the award is 250 weeks. Likewise, a 50% loss of use of the hand would be paid for 95 weeks, while a 50% shoulder injury would be paid for 125 weeks. As a result of the Breyflogle decision, an award for a wrist injury could potentially be worth about 30% more weeks.