Court of Appeals Affirms Denial of Alternate Medical Care

In Penny v. Whirlpool, No. 16-0495 (Iowa App. Feb. 8, 2017), the agency had denied claimant's request for alternate medical care with a neurosurgeon, finding that the care provided to claimant by the employer had not been unreasonable.  The Court of Appeals affirms the decision of the agency.

Claimant had been seen by Dr. Matos and Dr. Abernathey.  Dr. Abernathey did not believe surgery was indicated, but claimant's pain persisted.  The employer set up additional testing to determine claimant's radicular symptoms, but claimant did not attend the appointments under the believe that Whirlpool did not consider his back injury to be work related. Claimant then sought care with a neurosurgeon.  The deputy concluded that since the employer had authorized care with two doctors, as well as authorized an MRI, physical therapy, acupuncture, an EMG and treatment at a pain clinic, the care authorized was not unreasonable.  The district court affirmed.

On appeal to the Court of Appeals, claimant argued that the district court considered evidence outside the record of this alternate medical care proceeding.  The Court of Appeals noted that the record was limited to the record made before the agency and reviewed the record made on the June 2, 2015 application for alternate medical care.

The court finds that claimant failed to demonstrate that the care provided by Whirlpool was unreasonable to treat his injury.  The court rejected arguments that the commissioner's decision was based on an erroneous legal interpretation, was inconsistent with prior precedent, or was based on a determination of fact that was not supported by substantial evidence.  The court affirmed the decision of the agency.


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