Court of Appeals Affirms Award of Alternate Medical Care

In Tomlinson Cannon v. Whited, No. 1-878 (Iowa App. Jan. 19, 2012), the court affirmed a decision of the agency which had concluded that claimant was entitled to alternate medical care.  Claimant had originally seen Dr. Neiman for his injuries, and later filed an alternate medical care proceeding to allow him to continue care with Dr. Neiman.  During the course of the case, Dr. Neiman recommended that claimant see a podiatrist for a foot injury he had developed.  Defendants had earlier indicated that claimant should see another physician, but claimant declined to see that physician.  On the alternate medical care proceeding, claimant argued, and the agency held, that since Dr. Neiman was the authorized treating physician, the employer was not entitled to interfere with his recommendations for care.  The finding of the agency was consistent with the agency's general rule that the recommendations of the authorized treating physician cannot be contravened by the employer.

Defendants argued on appeal that there was no showing that the care they had authorized was less extensive or inferior than that requested by claimant.  Claimant argued that under agency precedent, if any employer failed to follow the recommendation of an authorized treater, this alone was a failure to provide reasonable treatment.  Defendants also noted that its referral to its doctor came before Dr. Neiman's referral.  The court found that the fact that Dr. Neiman wished to send claimant to a podiatrist rather than a general medicine physician made the timing argument unimportant as the care sought by claimant was more effective.  The court affirmed the decision of the agency.

The court did not explicitly affirm the commissioner's practice of noting that defendants cannot interfere with the care recommendations of the authorized treating physician.  In a footnote, the court noted that the controlling legal standards are those in the statutes and the decisions of the court, not in the commissioner's decisions.  The court did note, however, that the agency could not reverse prior precedent absent credible reasons to indicate a fair and reasonable basis for the inconsistency.  Thus, although it would have been helpful to have an explicit affirmance of agency policy, the result of the court's decision is supportive of that policy, and would require the agency to have cogent reasons for changing that policy.