Court Affirms Dismissal of Alternate Medical Care Proceeding Without Hearing

Cooksey v. Cargill, Inc., No. 12-1729 (Iowa App. Oct. 2, 2013), is a case in which claimant filed three alternate medical care proceedings against the employer.  In the first two proceedings, the employer agreed to provide the care sought by claimant and that care was provided.  In the first proceeding, a hearing was held, but the parties came to an agreement that claimant could see Dr. Abernathey and claimant would voluntarily dismiss his claim for alternate medical care.  In the second proceeding, claimant voluntarily dismissed before hearing because defendants agreed to provide the care requested.  In the third proceeding, the employer denied liability for the claim, after getting reports from two doctors questioning causation, and the alternate medical care hearing was dismissed under 876 IAC 4/48(7).

Claimant, after having the AMC petition dismissed, filed a request for a ruling on the petition, based on due process grounds and judicial estoppel.  The deputy issued the final decision of the agency on this ground, and the district court affirmed the agency action.

On the estoppel issue, the court of appeals concludes that judicial estoppel was only available when the party's inconsistent position, in this case the acceptance of the claim, was "judicially accepted" in the earlier decision.  Citing Tyson Foods, Inc. v. Hedlund, 740 N.W.2d 192, 197 (Iowa 2007).  The court noted that without such judicial acceptance, there was no risk of inconsistent, misleading results.  Claimant argued that under Winnebago Industries v. Haverly, 727 N.W.2d 569 (Iowa 2006), judicial estoppel applied.  The court disagreed, noting that in Haverly, there had been a judicial determination (an AMC decision) that the employer was responsible for providing care, and that the employer had admitted as much.  The court found Hedlund more analogous.  In that case, because the agency had not taken a position on the employer's liability, judicial estoppel did not apply.  Similarly, in this case the court of appeals found that because the agency had never issued a decision, judicial estoppel could not apply.

The claimant also urged that the agency's interpretation denied due process.  The court concludes that claimant did not lose a property because he did not have such a property interest because benefits were not being terminated.  Moreover, since Cooksey still had the opportunity for an arbitration hearing, he was not losing the right to hearing on the overall claim.  The action of the agency was affirmed.

The word to the wise from Cooksey is that if an alternate medical care proceeding is filed, it is prudent to from a claimant's standpoint obtain a judicial ruling from the agency on the issue of medical care rather than voluntarily dismissing a claim because the employer agrees to provide care.  It is likely that Cooksey will result in many more alternate medical care claims being pursued to conclusion before the commissioner.
















































































































Comments

Popular posts from this blog

Court of Appeals Affirms Denial of Workers' Compensation Benefits; Rules on Credit Issue

2021 Workers' Compensation Appeal Decisions

2024 Workers' Compensation Appeal Decisions