Court Remands Alternate Care Dispute to Agency
In Huff v. CRST Expedited, No. 18-0336 (Iowa App. March 6, 2019), the court addressed an alternate medical care dispute and remanded the claim to the agency for a determination of certain facts relating to claimant's access to certain appliances and services. The court concludes that the absence of medical evidence is not a bright line bar to an award of alternate medical care, but finds the agency must make further factual findings.
Claimant had a catastrophic accident, rendering him wheelchair bound. Following his accident, he lived with his son in a second floor apartment, but ultimately requested ADA compliant living arrangement, a handicap van and a home healthcare provider. The agency initially denied the alternate medical care application because claimant had not presented medical support for his alternate care requests. Claimant later filed a second alternate medical care request, which contained an assessment from the Area Agency on Aging relating to his medical needs. The alternate medical care application was again denied.
On judicial review, the district court concluded that evidence from a medical provider was not necessary to support an application for alternate medical care. CRST appealed. The court noted that determining what care is reasonable is a factual decision. The court concluded that although it was generally required that claimant provide medical evidence in support of alternate medical care, there was no provision of law that supported this as a requirement. The court definitively finds that the lack of medical evidence is not a bright line, legal bar to the award of medical care. The court cited Stone Container v. Castle in support of this proposition.
The court concluded that because the agency had not made factual findings as to whether the care sought by Huff was appliances or services, the case had to be remanded to the agency for further fact findings.
Claimant had a catastrophic accident, rendering him wheelchair bound. Following his accident, he lived with his son in a second floor apartment, but ultimately requested ADA compliant living arrangement, a handicap van and a home healthcare provider. The agency initially denied the alternate medical care application because claimant had not presented medical support for his alternate care requests. Claimant later filed a second alternate medical care request, which contained an assessment from the Area Agency on Aging relating to his medical needs. The alternate medical care application was again denied.
On judicial review, the district court concluded that evidence from a medical provider was not necessary to support an application for alternate medical care. CRST appealed. The court noted that determining what care is reasonable is a factual decision. The court concluded that although it was generally required that claimant provide medical evidence in support of alternate medical care, there was no provision of law that supported this as a requirement. The court definitively finds that the lack of medical evidence is not a bright line, legal bar to the award of medical care. The court cited Stone Container v. Castle in support of this proposition.
The court concluded that because the agency had not made factual findings as to whether the care sought by Huff was appliances or services, the case had to be remanded to the agency for further fact findings.
Comments
Post a Comment