Patricia Ellen Knowlton v. Grinnell Select Insurance Company ( 2016 )


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  •                        IN THE COURT OF APPEALS OF IOWA
    No. 14-1738
    Filed January 13, 2016
    PATRICIA ELLEN KNOWLTON,
    Plaintiff-Appellant,
    vs.
    GRINNELL SELECT INSURANCE
    COMPANY,
    Defendant-Appellee.
    ________________________________________________________________
    Appeal from the Iowa District Court for Chickasaw County, Richard D.
    Stochl, Judge.
    Patricia Knowlton appeals the jury verdict awarding her damages for an
    underinsured motorist claim. AFFIRMED.
    Judith O’Donohoe of Elwood, O’Donohoe, Braun & White, L.L.P., Charles
    City, for appellant.
    David L. Riley of McCoy, Riley & Shea, P.L.C., Waterloo, for appellee.
    Heard by Vogel, P.J., and Vaitheswaran and Bower, JJ.
    2
    BOWER, Judge.
    Patricia Knowlton appeals the jury verdict awarding her damages for an
    underinsured motorist claim against her insurer Grinnell Select Insurance
    Company (Grinnell). Knowlton claims multiple errors in virtually every facet of
    the trial claiming the court erred by: (1) denying evidence of the terms of the
    underinsurance contract; (2) refusing to admit her claim for medical expenses or
    denying a new trial based on its ruling; (3) denying her request to take the
    treating neurosurgeon’s deposition during trial, substitute a local non-treating
    orthopedist or postpone trial; (4) directing a verdict or denying a new trial on
    claims for future loss of bodily function and/or future pain and suffering; (5)
    admitting evidence or denying a new trial because of payments made to
    Knowlton, which were excludable under the collateral source rule; (6) denying a
    new trial for the jury’s failure to award any damages for lost income; (7) denying
    a new trial based on the cumulative prejudicial effect of its conduct and rulings;
    and(8) reducing the verdict ex parte without a record or hearing. For the reasons
    stated herein, we affirm the judgment of the district court.
    I.     BACKGROUND FACTS AND PROCEEDINGS
    Knowlton was diagnosed with multiple sclerosis (MS) in 1996. Initially,
    Knowlton struggled with loss of sensation from the waist down, decreased
    balance, leg weakness, and loss of bowel and bladder function. Medical records
    show Knowlton experienced difficulty with short-term memory loss, dizziness,
    and fatigue.   She worried her symptoms would affect her job performance—
    especially the short-term memory loss.
    3
    On June 21, 2011, Knowlton was involved in a car accident when a car in
    which she was a passenger was struck by a car driven by Shaine Slick.
    Knowlton initiated the present lawsuit on June 4, 2013, by filing a petition against
    Grinnell. She claimed the accident was solely the result of Slick’s negligence.
    She claimed Slick was underinsured and did not have sufficient coverage to pay
    the damages she sustained.           Knowlton’s underinsurance coverage was
    $300,000. Grinnell admitted Knowlton was insured and if Slick was underinsured
    Knowlton was entitled to benefits under the policy.
    A trial scheduling order was filed on October 29, 2013. The order required
    all depositions to be completed sixty-days before trial, Knowlton to disclose her
    expert witnesses 210 days before trial, and both parties to file a witness and
    exhibit list seven days before trial. If the parties did not adhere to the deadlines
    the court reserved the right to impose sanctions.
    Knowlton filed two designations of expert witnesses.          The first, on
    November 7, 2013, designated Dr. Brian Weinshenker as the “treating physician
    for neck,” and Dr. Wayne Newkirk as an economist. The second version, filed
    December 5, 2013, added Thomas Burr, forensic scientist. Knowlton conducted
    a deposition of Weinshenker on June 11, 2014, at the Mayo Clinic in Minnesota.
    A pre-trial conference was scheduled for June 24, 2014. After Knowlton’s
    counsel, Judith O’Donohoe, did not respond as scheduled Grinnell’s counsel
    learned O’Donohoe was on vacation. O’Donohoe’s legal assistant also could not
    reach O’Donohoe.      The district court conducted the pre-trial conference in
    O’Donohoe’s absence but with her legal assistant on the phone.           The court
    4
    confirmed both parties were ready to go forward with trial and reminded the
    parties of the scheduling deadlines.
    On June 24, 2014, Knowlton advised Grinnell of her intention to call Dr.
    Val Lyons, an orthopedic surgeon, to testify about Knowlton’s neck impairment
    rating. The content of Lyons’s opinion was disclosed for the first time on July 7,
    2014, two days before trial. The court sustained Grinnell’s motion in limine to
    exclude Lyons’s testimony due to its late disclosure.
    On July 2, Knowlton filed her witness and exhibit list, an amended version
    was filed on July 9—the morning of trial. Medical bills were not included as
    exhibits. Later in the morning of July 9, Knowlton filed a third witness and exhibit
    list, in which she included three new proposed medical witnesses and medical
    bills from Mayo Clinic and Mercy Medical Center.
    Also on the morning of trial, Grinnell offered to confess judgment in the
    amount of $100,000, which Knowlton declined. After a five-day trial, the jury
    returned a verdict for Knowlton in the amount of $75,000. Separate damage
    awards were granted to Knowlton’s three children in the amount of $7500 each.
    After several post-trial motions, the district court offset the $75,000 by the
    $50,000 Knowlton had received from Slick’s insurance company and entered
    judgment against Grinnell in the amount of $25,000.
    Knowlton appeals.1
    1
    Of the eight issues Knowlton has raised on appeal, she has not preserved error on the
    following five issues: (Knowlton’s issues I and III) Knowlton failed to make an offer of
    proof after the district court excluded evidence on the terms of the underinsurance
    contract and the expert medical testimony. “Generally, a ruling sustaining a motion in
    limine is not a ruling on the evidence; the ruling merely adds a procedural step to the
    5
    II.      STANDARD OF REVIEW
    We review the court’s evidentiary rulings for an abuse of discretion. Hall
    v. Jennie Edmundson Mem’l Hosp., 
    812 N.W.2d 681
    , 685 (Iowa 2012). A district
    court abuses its discretion when its decision rests on grounds or on reasons
    clearly untenable or to an extent clearly unreasonable. 
    Id. There will
    be no
    abuse of discretion found unless a party has suffered prejudice. 
    Id. The district
    court is given broad discretion in evidentiary matters, and we will disturb its
    rulings upon a showing of abuse. 
    Id. Similarly, we
    review a claim concerning whether the trial court should have
    given a party’s requested jury instruction for an abuse of discretion. Hagenow v.
    Schmidt, 
    842 N.W.2d 661
    , 670 (Iowa 2014).
    District courts have considerable discretion to allow amendments at any
    point in the litigation, and we will only reverse the district court’s decision if it has
    abused that discretion. Baker v. City of Iowa City, 
    867 N.W.2d 44
    , 51 (Iowa
    2015).
    offer of evidence. If the evidence is not offered, there is nothing preserved to review on
    appeal.” Twyford v. Weber, 
    220 N.W.2d 919
    , 922–23 (Iowa 1974); see also Quad City
    Bank & Trust v. Jim Kircher & Associates, P.C., 
    804 N.W.2d 83
    , 91–92 (Iowa 2011).
    (Knowlton’s issue VI) Knowlton did not object to the submission of the damages for lost
    income to the jury, and therefore she has not preserved error on this issue by
    mentioning it for the first time in her motion for new trial. See Iowa R. Civ. P. 1.924;
    Summy v. City of Des Moines, 
    708 N.W.2d 333
    , 338 (Iowa 2006) (“To preserve error for
    appellate review, a party must alert the district court to the issue at a time when the
    district court can take corrective action.”). (Knowlton’s issue VII) Knowlton has not
    preserved error on her claim the cumulative effect of the district court’s conduct caused
    an unfair trial. Knowlton did not object at any point during trial when the court engaged
    in the complained of behavior, and since the district court has not ruled on this issue, we
    decline to address it on appeal. See 
    Summy, 708 N.W.2d at 338
    . Finally, (Knowlton’s
    issue VIII) Knowlton claims there was insufficient evidence in the record to support any
    reduction in the $75,000 in damages. The parties discussed this issue with the court
    and Knowlton did not object. Knowlton first objected to this arrangement in a post-trial
    motion, therefore we decline to address it on appeal. See 
    id. 6 We
    review the trial court’s decision to direct a verdict for the correction of
    errors of law.     Determan v. Johnson, 
    613 N.W.2d 259
    , 261 (Iowa 2000). A
    defendant’s motion for directed verdict should be denied if there is substantial
    evidence to support the plaintiff’s claim. 
    Id. “Evidence is
    substantial when a
    reasonable mind would accept it as adequate to reach a conclusion.” 
    Id. III. DISCUSSION
    A.     Medical Expenses
    Knowlton claims the district court erred in refusing to submit her claims for
    medical expenses.
    1.      Error Preservation
    Grinnell contends Knowlton has not preserved error on her claim the court
    erred in refusing to submit her request for past medical expenses. Both parties
    filed their proposed jury instructions on July 8, 2014. Knowlton did not include
    medical expenses in her proposed jury instructions or interrogatories.           The
    morning of trial, Knowlton’s counsel decided to include medical expenses.
    The Court: At 8:40 this morning Plaintiff filed its proposed
    jury instructions. Those proposed jury instructions, there’s no
    mention of a loss for medical expenses. In Plaintiff’s petition she
    seeks damages for sustained injuries and other damages including
    lost wages, pain and suffering and loss of enjoyment of life.
    Medical expenses were not pled.
    Ms. O’Donohoe: However, they are in Answers to
    Interrogatories.
    The Court: They’re not pled.      Plaintiff did not notify
    Defendant of any intention to claim medical expenses until twenty
    minutes before we were to start trial. Plaintiff advised the Court
    that they were unaware of any subrogation claim for medical
    expenses despite the fact the insurance company with the claim
    advised this Court of multiple communications between counsel’s
    7
    office and the company in writing and also communication by
    telephone confirming that subrogation claim. I do find that the
    defendant would be prejudiced by allowing medical bills to be
    submitted at this time and the exhibit list be modified. Therefore,
    Plaintiff’s application to modify its exhibit list and now claim medical
    expenses twenty—that were identified twenty minutes before trial
    started is denied. Ready for openings?
    Ms. O’Donohoe: Okay. Your Honor, I do—not right now, but
    I want to make a record and provide Weinshenker’s deposition, my
    Answer’s to interrogatories which clearly showed medical
    expenses.
    The Court: My reason is that you were told by the Court to
    submit your witness and exhibit list seven days before trial and to
    identify each and every exhibit. You didn’t say you were submitting
    any medical bills. This morning you told the Court, you told Mr.
    Riley—you filed a pleading asking for proposed jury instructions
    that in no way ask for medical bills. And now you’re telling the
    Court and Mr. Riley that you want forty-eight thousand dollars or
    thirty-five thousand. I don’t know what amount. You don’t even
    know what amount. How is the jury going to sort out what amount
    of medical bills to give when you don’t even know what they are?
    Ms. O’Donohoe: Well, I know what I think is a valid medical
    expense.
    The Court: Well, we’re five minutes away from openings. I
    think you should know exactly the amount of medical bills claimed.
    Ms. O’Donohoe: Well—
    The Court: Well, my ruling stands, but you’re certainly willing
    to make an offer of proof and make an argument.
    Although Knowlton’s attorney made an offer of proof counsel did not make
    a formal objection to the court’s refusal to submit the proposed instruction on
    past medical expenses as required by Iowa Rule of Civil Procedure 1.924.2
    2
    That rule provides in part:
    Before jury arguments, the court shall give to each counsel a copy of its
    instructions in their final form, noting this fact of record and granting
    reasonable time for counsel to make objections, which shall be made and
    ruled on before arguments to the jury. Within such time, all objections to
    giving or failing to give any instruction must be made in writing or dictated
    into the record, out of the jury’s presence, specifying the matter objected
    to and on what grounds. No other grounds or objections shall be
    asserted thereafter, or considered on appeal.
    Iowa R. Civ. P. 1.924.
    8
    However, our supreme court, in Ostrem v. State Farm Mutual Automotive
    Insurance Company, held a jury instruction was properly raised and preserved if
    the party advised the court what she wanted and why, the court ruled on the
    matter before arguments, and a record was made on the instruction. 
    666 N.W.2d 544
    , 548 (Iowa 2003). Based on the pre-trial exchange between the court and
    Knowlton’s counsel, and Knowlton’s offer of proof, Knowlton adequately raised
    the issue concerning the district court’s refusal to submit an instruction on past
    medical expenses.
    2.     Merits
    In support of Knowlton’s claim, she raises several arguments on why the
    court erred. Ultimately, we must decide if the court erred in excluding Knowlton’s
    claim for past medical expenses.
    As noted above, the first time Knowlton expressed a desire to claim past
    medical expenses was a few minutes before trial. The court found Grinnell would
    be prejudiced by their submission. The court relied on the untimely nature of
    Knowlton’s claim as she did not include medical expenses in any of her
    pleadings. The language used by the district court tracks with the law concerning
    amendments to pleadings:
    Iowa Rule of Civil Procedure [1.402(4)] governs the
    amendment of pleadings. This rule instructs district courts to freely
    grant leave to amend when required by the interests of justice.
    Iowa R. Civ. P. [1.402(4)]; Davis [v. Ottumwa Young Men’s
    Christian Ass’n], 438 N.W.2d [10,] 14 [(Iowa 1989)]. Generally, a
    party may amend a pleading at any time before a decision is
    rendered, even after the close of the presentation of the evidence.
    Ackerman v. Lauver, 
    242 N.W.2d 342
    , 345 (Iowa 1976). As long as
    the amendment does not substantially change the issues or
    9
    defense of the case, the court should permit the amendment.
    Glenn v. Carlstrom, 
    556 N.W.2d 800
    , 804 (Iowa 1996); 
    Davis, 438 N.W.2d at 14
    ; . . . . Even an amendment that substantially changes
    the issues may still be allowed if the opposing party is not
    prejudiced or unfairly surprised. See McElroy [v. State], 637
    N.W.2d [488,] 495 [(Iowa 2001)]; Chao v. City of Waterloo, 
    346 N.W.2d 822
    , 825–26 (Iowa 1984).
    Rife v. D.T. Corner, Inc., 
    641 N.W.2d 761
    , 767 (Iowa 2002).           “The relevant
    ‘issues’ are established either by the initial pleadings . . . or by those matters on
    which the parties have ‘consented’ to litigate, either expressly or impliedly.”
    Allison-Kesley Ag Ctr., Inc. v. Hildebrand, 
    485 N.W.2d 841
    , 846 (Iowa 1992)
    (citations omitted).
    Here, the initial pleadings did not include a request for medical expenses.
    The first time Knowlton made a claim for past medical expenses was the morning
    of trial. While the medical records at issue were included in discovery, Grinnell’s
    counsel did not have an opportunity to analyze the records and discern the
    amount directly related to the injury. Grinnell’s counsel stated he relied on the
    witness and exhibit list and determined medical expenses were not at issue. The
    district court found Grinnell was prejudiced by Knowlton’s eleventh-hour
    amendment to her pleadings and disallowed her claim for medical expenses. We
    find the district court did not abuse its discretion.
    B.     Directed Verdict on Future Loss of Function of the Body
    and/or Future Pain and Suffering
    Knowlton claims the district court erred in granting Grinnell’s motion for
    directed verdict on future loss of function of the body and future pain and
    suffering.
    10
    At the close of Knowlton’s case, Grinnell moved for a directed verdict. In
    its motion, Grinnell argued Knowlton had presented insufficient evidence to
    support these claims because they included medical questions and no expert
    testimony had been presented to show the injuries were permanent or may
    cause future problems for Knowlton.       In granting Grinnell’s motion the court
    reasoned:
    Last evening I thoroughly reviewed plaintiff’s medical records
    with an eye on trying to find some support in these records that
    would justify the submission of future damages, looking at them in
    the light most favorable to the plaintiff. The last record I could find
    addresses her—that addresses her true orthopedic issues is April
    of 2012, more than two years ago. The only other evidence is her
    subjective statements and the opinions of her family members.
    Ironically, there is evidence in this record plaintiff suffered a neck
    fracture in an auto accident while a teenager. She claims no
    permanency from that injury, but demonstratively presents at trial
    with severe limitations before this jury without any medical
    testimony as to why that is. . . . We also don’t know from medical
    support why she was having neck pain—on a scale of one to ten, a
    three—several years before this accident that she described as
    constant. All of these things needed to be addressed by medical
    expert testimony which is absent in the record.
    . . . . It is clear to this Court that if I would have allowed Dr.
    Lyons to testify, many of these issues would have been addressed
    and perhaps, rectified. However, that issue has been previously
    addressed by this Court. It is important to note that no motion to
    continue was ever filed.
    Knowlton claims expert medical testimony is not required to establish a
    permanent injury if its permanency can be inferred from its nature and sufficient
    evidence was presented to justify submitting the future damage claim to the jury.
    There can be no recovery for future pain and suffering unless reasonably
    certain it resulted from the injury. Mercer v. Ridnour, 
    218 N.W.2d 625
    , 627 (Iowa
    1974). Expert testimony is often necessary to establish future pain and suffering.
    11
    DeBurkarte v. Louvar, 
    393 N.W.2d 131
    , 140 (Iowa 1986). However, “when pain
    is suffered right up to the time of trial and there is evidence plaintiff has not fully
    recovered, future pain and suffering may be submitted to the jury without medical
    testimony.” 
    Id. (quoting Mabrier
    v. A.M. Servicing Corp., 
    161 N.W.2d 180
    , 183
    (Iowa 1968)). “The mere statement by the plaintiff that she still suffers pain is not
    sufficient per se to warrant a finding that there will be any future pain or physical
    suffering because of her injuries.” Daniels v. Bloomquist, 
    138 N.W.2d 868
    , 873
    (Iowa 1965). Where “the symptoms from which personal injury may be inferred
    are subjective only,” and plaintiff presents no medical testimony to establish
    future pain and suffering or permanent injury are “reasonably certain,” the trial
    court need not instruct the jury on that element of damage. See 
    id. Our court
    has addressed this issue in recent years.           In Brundage v.
    McElderry, we affirmed the district court’s decision not to instruct the jury on
    future pain and suffering and future loss of function. No. 00-0811, 
    2001 WL 725688
    , at *3 (Iowa Ct. App. June 29, 2001).           The claimant seeking future
    damages presented evidence consisting of his own testimony on pain in his daily
    life and his mother’s testimony concerning her observations of him experiencing
    pain. 
    Id. The treating
    physician reported the claimant’s injury was fully healed,
    risk of future injury was minimal, and individuals with similar injuries do not
    experience long-term pain. 
    Id. In Horn
    v. Chicoine, our court affirmed the district court’s decision to
    submit a claim for future pain and suffering to the jury. No. 08-0902, 
    2009 WL 2169148
    , at *6 (Iowa Ct. App. July 22, 2009). The evidence supporting the
    12
    submission of the claim to the jury included claimant’s testimony he had
    numbness and soreness and can no longer do some household tasks.
    Additionally, at the time of trial claimant was receiving treatment from an
    orthopedist who testified the claimant had incurred nine percent impairment to his
    whole body and had not yet fully recovered from the injury. 
    Id. At the
    time of trial
    an orthopedic spine specialist had limited the claimant to lifting ten pounds or
    less. 
    Id. Here, as
    the district court noted, viewing the evidence presented by
    Knowlton in the light most favorable to her, there is insufficient evidence to
    present her future damage claim to the jury. The last orthopedic medical record
    is from 2012—two years before the accident. Further complicating the issue was
    the fact Knowlton had suffered a previous neck injury (fracturing her seventh
    vertebrae as a teenager), and was currently suffering from multiple sclerosis.
    The only evidence in support of her claim, as noted by the district court, was the
    subjective evidence presented by Knowlton and the observations of her family.
    The district court summed up the evidence as follows:
    She walks with a walker and she had to use a high-back
    chair during trial. But as I waited throughout this trial, not knowing
    what was coming, I was waiting to hear testimony as to why. What
    was—what is her condition in her neck which is causing this?
    Fractures heal; and when they don’t, we generally hear testimony
    from a doctor that these are the complicating factors that are
    causing lack of motion, the loss of range of motion at this time,
    these are the issues that are causing the pain, arthritic changes
    have taken place. Nothing. And with nothing, it leaves me only
    speculating. And I cannot imagine what the jury is thinking when
    they watch her in her high-back chair, thinking, what’s causing
    these problems in her neck? You can’t just say she broke her neck
    two years ago. That’s it. That’s what we have. That’s all we have.
    13
    We find the district court did not err in granting Grinnell’s motion for
    directed verdict on future loss of function of the body and future pain and
    suffering.
    C.     Evidence of Payments Made to Knowlton
    Knowlton claims the district court erred in admitting evidence of disability
    payments Knowlton received for multiple sclerosis, which prejudiced her claims
    for lost income.
    1.     Error Preservation
    Grinnell claims Knowlton has not preserved error on this issue. Knowlton
    sought to exclude the evidence of payments made by her private insurance
    policies in her motion in limine. The court ruled on this issue prior to trial and
    stated:
    The Court: Finally, plaintiff moves to limit any testimony that
    she received disability benefits following this accident. Plaintiff was
    diagnosed with multiple sclerosis prior to the accident that is the
    basis of this action. And my understanding is there’s some
    evidentiary dispute of whether disability payments she began
    receiving were for the purposes of her multiple sclerosis or for the
    purpose—or caused by this accident. Is that a fair statement?
    Ms. O’Donohoe: I believe it is, your honor.
    The Court: And because that’s an evidentiary issue and a
    factual issue that, I think, has to be determined by this jury,
    although disability payments, which are clearly collateral source
    payments, are normally not admissible, the question here is
    whether she has lost wages caused by this accident or whether the
    disability payments would have been made despite this accident.
    And because of that, defendant has to have a right to discuss that
    those payments exist. My position on that is reinforced by the
    plaintiff’s own expert who did originally reduce those future
    damages—or those past lost damages by those insurance
    payments in his initial report, which leads me to believe even
    14
    plaintiff is struggling with how much is caused by that and how
    much is not. So the jury must be allowed to consider it.
    Subsequently, the district court denied Knowlton’s motion in limine.
    “Generally, a ruling sustaining a motion in limine is not a ruling on the
    evidence; the ruling merely adds a procedural step to the offer of evidence.
    
    Twyford, 220 N.W.2d at 922
    –23; see also Quad City 
    Bank, 804 N.W.2d at 91
    –92.
    To preserve error after a motion in limine has been denied, it is necessary to
    make a proper objection at the time the evidence is offered.           
    Twyford, 220 N.W.2d at 924
    .
    Knowlton’s counsel objected when the disability payments made to
    Knowlton were mentioned.
    Mr. Riley: Then when your disability came through, could
    you tell the jury what benefits you started receiving?
    Ms. O’Donohoe: I’m going to object as a violation of the
    collateral source rule.
    The Court: Based on the ruling in the motion in limine, the
    objection is overruled. You may answer.
    We find Knowlton’s objection sufficient for our error preservation rules and
    address the merits.
    2.       Merits
    Knowlton claims the evidence concerning disability benefits made to
    Knowlton were excludable under the collateral source rule, and admission of
    evidence of the benefits prejudiced her claim for lost income.
    This issue was summarized by the district court in the following fashion:
    The Court: In this case plaintiff is claiming that she was
    disabled in December of 2011 as a result of this motor vehicle
    accident. Defendant contends that the medical evidence proves
    15
    that she was disabled in December of 2011 not because of the
    injuries she sustained in this accident but because of her symptoms
    related to multiple sclerosis. If she was disabled in December of
    2011 because of the multiple sclerosis, her disability was not
    caused by this accident and we’re not in an offset situation. The
    statute, in fact, would not apply in that situation. If, however, she
    was disabled primarily as a result of her disability—I mean, as a
    result of her injuries in this accident, any lost wages she was
    proven would not be offset, pursuant to that statutory provision, by
    her disability payments. So the issue really is whether or not she
    was disabled in December as a result of her multiple sclerosis. I
    drafted instruction 17[3] based on the request made by the plaintiff
    and I do think it accurately sets forth the law.
    Ms. O’Donohoe: I guess I don’t have any objection to it as
    stated.
    The Court: I just think it was important for me to identify it.
    It’s somewhat misleading—and I may hear this from Mr. Riley—in
    that I am saying if you find that she was eligible for and received
    disability payments based primarily on her symptoms related to MS,
    despite the injuries, you shall reduce any claim, when, in fact, I
    can’t go so far as to say in this instruction that if you find it was MS
    alone, because the testimony is it may have accelerated it. So for
    3
    Instruction 17 states:
    You have heard evidence that Patricia Knowlton received
    disability payments after leaving her employment in December of 2011. If
    you find that she has proven by a preponderance of the evidence that the
    primary cause of her separation from employment in December of 2011
    was the injuries she sustained in the accident of June 21, 2011, you may
    not reduce any damages for loss of past income by the disability
    payments she received. If however, you find that she was eligible for and
    received disability payments based primarily on her symptoms related to
    her diagnosis of Multiple Sclerosis despite the injuries she received in the
    accident of June 11, 2011, you shall reduce any claim for past lost wages
    by the amount of the disability payments she received subject to the
    qualifications below.
    If you decide her claim for lost wages should be reduced by the
    disability payments she received, you shall consider the nature and type
    of the payments made in reference to the purpose for those payments
    and their usage by Patricia Knowlton as they relate to the replacement of
    her lost income. If you find payments were made to reimburse her for
    expenses she incurred for her daily care and rehabilitation and to
    reimburse her for assistance she received to support her in her activities
    of daily living, you shall not consider show payments in offsetting her
    claim for lost wages.
    16
    that purpose, I’m going to say that if you find that it’s primarily, so
    they can still want to give some lost wages. Mr. Riley’s free to
    argue that if this was all MS, and if they find all MS, she’s not going
    to get lost wages. We know that. So any further requested
    instructions, Ms. O’Donohoe, or changes?
    Ms. O’Donohoe: No, your honor.
    The collateral source rule is a common law rule of evidence that bars
    evidence of compensation received by an injured party from a collateral source.
    
    Pexa, 686 N.W.2d at 156
    ; Schonberger v. Roberts, 
    456 N.W.2d 201
    , 202 (Iowa
    1990). Under the rule a tortfeasor’s obligation to make restitution for an injury he
    or she caused is not reduced by any compensation received by the injured party
    from a collateral source.      
    Id. The rule
    prevents the jury from reducing the
    tortfeasor’s obligation to make full restitution for the injuries caused by the
    tortfeasor’s negligence. 
    Id. Here, the
    jury was asked to use the evidence of disability payments made
    to Knowlton only if it determined they were paid primarily for her symptoms
    relating to her MS diagnosis. The jury was then permitted to use those payments
    to reduce the damages for lost income, subject to other qualifications. If the jury
    determined the payments were made because of injuries Knowlton received from
    the accident then it was not allowed to use them to reduce damages as that
    would have violated the collateral source rule.       Knowlton has not shown the
    introduction of the disability payments was prejudicial. Therefore, the district
    court did not abuse its discretion.
    IV.    CONCLUSION
    We find the district court did not abuse its discretion in refusing to submit
    Knowlton’s claim for medical expenses, directing a verdict on her claims for
    17
    future loss of bodily function and/or future pain and suffering, and submitting
    evidence of disability payments paid to Knowlton.         Knowlton has failed to
    preserve error on her other claims. We affirm the judgment of the district court.
    AFFIRMED.