Court of Appeals Affirms Award of Alternate Medical Care

In Harris Steel Group v. Botkin, No. 19-0015 (Iowa App. Jan. 9, 2020), claimant was awarded alternate medical care in the face of defendants' contention that the application should not have been granted because the employee refused to attend a defense medical evaluation.  The court affirms the award of alternate medical care.

Claimant suffered a shoulder injury, as a result of which surgery was ultimately performed.  Problems recurred and claimant attempted to obtain care with the treating physician two years after the surgery.  The doctor indicated that claimant should determine from the employer whether they would authorize the care.  Claimant was scheduled for an evaluation by the defendant, but refused to attend.  Subsequently, the employer failed to respond to claimant's written request to authorize care.  

The agency concluded that defendant could not interfere with treatment by Dr. Mendel and concluded that further treatment with Dr. Mendel was reasonable.  On appeal, the Court of Appeals affirmed.  Defendants argue on appeal that because the alternate medical care hearing is an expedited proceeding, the request by defendant for an evaluation must be considered at the same time.  Otherwise, according to defendants, the court "will prevent all employers who contest compensability from challenging a request for alternate medical care."

The court concludes defendants' objections were unwarranted because compensability was not an issue in the claim.  According to the court, "although Harris questioned whether the care Botkin sought related to his work injury, it admitted at the hearing that it authorized Dr. Mendel to treat Botkin's work injury and never conveyed that it was no longer authorizing Dr. Mendel." As a result, the employer had conceded that claimant was entitled to continue care with Dr. Mendel as long as he indicated that care was related to the work injury.  the court notes that an employer must hold the employee harmless for the cost of care "until the employer notifies the employee that the employer is no longer authorizing all or any part of the care and the reason for the change in authorization."  85.27(4).  In a footnote, the court notes that the Supreme Court has rejected the notion that 85.27(4) requires employees to make sure care authorizations are still in force before seeking more care, citing Ramirez-Trujillo v Quality Egg.  

Given the importance of the issue, it would not be surprising if the defendants requested further review from the Supreme Court in this claim, as these issues are commonly seen in alternate medical care proceedings.