In Westling v. Hormel Foods Corporation, No. 16-0236 (Iowa App. Jan. 11, 2017), the Court of Appeals affirmed the decision of the deputy denying claimant treatment for his right knee. The authorized provider had indicated that claimant wait until he had "more trouble" before considering revision of claimant's total knee replacement. The deputy concluded that claimant failed to show the services provided by the doctor were unreasonable.
Claimant had originally seen Dr. Crane, but following one of his surgeries, he developed a DVT and opted to have knee replacement surgery with Dr. Wolbrink. When he began to have further difficulties, he sought treatment with Dr. Alvine, but the employer instead approved care with Dr. Crane again. Dr. Crane evaluated claimant's knee (claimant alleged this took only five minutes), concluded that a revision of the total knee surgery was not necessary and indicated that claimant should wait. Claimant expressed dissatisfaction and requested care with Dr. Alvine. This was denied and Dr. Crane's recommendations were reviewed by Dr. Albright at UIHC. He agreed that a revision surgery was not indicated.
Claimant subsequently filed an application for alternate medical care. The deputy concluded that claimant had not met his burden, the case went to the district and was remanded for further findings. A remand decision was filed in February of 2015 and another decision was issued finding that claimant failed to meet his burden. The district court affirmed the decision on substantial evidence grounds.
The court indicates that it appeared as though claimant was not alleging a legal challenge, but only a challenge based on substantial evidence. Claimant argued that because Dr. Crane did not provide treatment, only an opinion that revision surgery was not necessary, the employer had not offered reasonable medical care. The court disagreed that a diagnostic appointment could not be considered reasonable services under 85.27. The court found that claimant did not produce evidence that the wait and see approach advocated by Dr. Crane was unreasonable. The court concluded that substantial evidence supported the decision of the agency.
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