Court of Appeals Decides Alternate Medical Care Dispute

In Spencer v. Annett Holdings, Inc., No. 11-1032 (Iowa App. March 28, 2012), the court of appeals addressed an alternate medical care issue involving the choice of physician when the treating physician retired.  The hearing deputy had concluded that the employer was allowed to choose the provider, despite the fact that the treating (authorized) physician had made a referral to another physician.  On judicial review, the district court reversed, and concluded that the retiring physician's recommendation of a new physician should be followed.  The court of appeals reverses the finding of the district court.

At the district court level, claimant argued that under a long line of agency precedent, if there is a referral by an authorized treating physician, the physician to whom the referral is made becomes the authorized treater.  The district court accepted that argument.  The court of appeals adopted the deputy's argument that the treating physician was not making a referral but was simply suggesting a replacement physician.  Because the employer had the right to choose the provider of care under 85.27(4), and there was no proof that the doctor selected by the employer was unreasonable, claimant failed to meet his burden of proof for obtaining alternate medical care.  The case turned primarily on the determination that this was a "suggestion" rather than a "referral."

Under the facts of the case, the Spencer decision does not amount to a significant change in the law with respect to alternate medical care.  A distinction can be made between a referral in the normal setting and the suggestion of a physician to take over care when a doctor is retiring.  Nonetheless, it would not be surprising if defendants will now argue that the Spencer decision invalidates the entire line of precedent indicating that a referral by an authorized doctor renders the doctor to whom the referral is made the authorized physician.