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Showing posts from February, 2023

Court of Appeals Holds That Reimbursement of IME Under 85.39 is Limited to the "Typical Fee Charged by the Medical Provider to Perform an Impairment Rating""

  Midamerican Construction LLC v. Sandlin No. 22-0471 (Iowa App. Feb. 22, 2023) This case solely involved the payment for an IME.  Defendants claimed that claimant was not entitled to reimbursement of the IME and if there was such reimbursement, the amount awarded was unreasonable. The commissioner awarded the full cost of the IME. As a part of the case, Dr. Kenndy rated claimant's impairment as 0%. The fee for the impairment was $174.25.  Claimant subsequently saw Dr. Taylor for an IME and he provided a 2% impairment.  As a part of the IME, Dr. Taylor also determined causation.  His charge was $2020.00.   Defendants argued that the IME should not be paid because Dr. Kennedy had not been retained by the employer, as required by 85.39 and IBP, Inc. v. Harker , 633 N.W.2d 322 (Iowa 2001).  The Court concluded that substantial evidence supported the commissioner's determination that defendants, through the medical case manager, had chosen Dr. Kennedy to perform the initial rating

Court of Appeals Holds That Section 85.34(7) Apportionment Provisions Only Apply to Preexisting Disability, Not A Preexisting Condition

Newton Community School District v. Hubbard-McKinney , No. 22-0030 (Iowa App. Feb. 22, 2023) In this claim, Ms. Hubbard-McKinney suffered an injury to her leg, which resulted in a 9% impairment.  The parties also agreed that of the 9% impairment, 7% of the 9% was attributable to a preexisting condition and 2% was directly caused by the fall at work.  Defendants argued that it was not responsible for that portion of the disability relating to the preexisting condition.  The commissioner rejected this argument and awarded claimant the entire 9% impairment. The Court indicated that the issue was one of apportionment and noted that the pre-2017 case of Warren Props. v. Stewart , 864 N.W.2d 307, 315 (Iowa 2015) referred to 85.34(7) as a rule of apportionment. On appeal, the employer relied on the language in 85.34(7) that an "employer is not liable for compensating an employee's preexisting disability that arose out of an in the course of employment . . . from causes unrelated to e

Court of Appeals Affirms Award of Alternate Medical Care

  Waterloo Community School District v. DeMaldonado , No. 22-0845 (Iowa App. Feb. 8, 2023) Claimant was injured at work and received treatment for several years.  After a time, she became dissatisfied with care, as the employer refused to authorize pain management, referred her to providers unsuited to treating her condition, lied about the authorization for care and interfered with care she sought from her own selected providers.  After filing an application for alternate medical care, the deputy ordered defendants to provide pain management with Dr. Mathew.  There was found to be insufficient proof that the employer had abandoned DeMaldonado's care.  Defendants were cautioned, however, not to interfere with the medical judgment of its own treating physician.  The district court affirmed the decision of the agency. On appeal, claimant first raised an issue of the timeliness of of the judicial review petition.  Claimant had filed an alternate care petition (No. 5059882.03) and then

Court of Appeals Affirms Permanent Total Award on Substantial Evidence Grounds

  Regional Care Hospital Partners, Inc. v. Marrs No. 22-0959 (Iowa App. Feb. 8, 2023) This action, previously before the Court Regional Care Hosp. Part., Inc. v. Marrs , No. 19-2138 (Iowa App. Feb. 17, 2021) was a decision by the commissioner finding claimant had suffered a permanent total disability.  Defendants argued that because a FCE had placed claimant in the light work category, she was not permanently and totally disabled.  That FCE, however, had also indicated that claimant should limit sitting and standing to a rare basis, 1-5% of an 8 hour day.  Claimant had also testified that she spent most of the day laying down.  Defendants also aruged that a vocational report had found that jobs were available for claimant and claimant argues that the VE never met with her and that she could not perform the jobs listed by the VE.  Based on this, the deputy concluded claimant had an 80% industrial disability.  The commissioner awarded permanent and total disability benefits, finding tha