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  Claimant had filed an alternate care petition (No. 5059882.03) and then withdrawn that claim and refiled.  The refiled claim (No. 5059882.04), resulted in the alternate care decision dated September 23.  Defendants appealed, but cited case No. 5059882.03, the case that had been withdrawn.  Since this case had been dismissed without prejudice on July 19 and the judicial review petition was not filed until September 29, claimant argued that the petition was not timely filed.  On appeal, the Court looked to the content of the filing to determine its real nature, which the Court found was to appeal the actual alternate medical care decision.  The petition for judicial review referred explicitly to the events leading to the decision in case No. 5059882.04 and the Court found the petition was timely filed.

On the merits, the Court affirms the award of alternate medical care.  The Court notes that substantial evidence supported the conclusion of the agency that claimant's physical therapy course had ended and that defendants offer of physical therapy was "not a reasonable service offer."  The Court also found that substantial evidence supported the conclusion that claimant's pain was neurological and that a clinical psychology evaluation with Dr. Tranel was not a reasonable offer of further treatment.  The Court also rejected defendants' contention that Dr. Mathew should be disqualified from treating claimant, as he was a physiatrist and pain specialist, who would provide appropriate evaluation and treatment for claimant.  The agency was found to have properly determined that Dr. Mathew was a suitable alternate care option and the agency's decision was affirmed.


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