Court of Appeals Affirms Grant of Alternate Medical Care

 Waterloo Community School District v. DeMaldonado No. 22-0845 (Iowa App. Feb. 8, 2023)

Claimant had years of treatment, primarily physical therapy, for numerous injuries sustained while working.  After several years of treatment, she sought alternate medical care in the form of pain management recommended by her treating physician, which was denied by the employer.  In the application for alternate medical care, the deputy concluded that claimant had proved that the care provided was unreasonable but denied that the employer had abandoned care.  The school district appealed to the district court, which affirmed the decision of the commissioner.

As an initial matter, the Court of Appeals addressed an argument made by claimant that the employer's judicial review petition had not been timely filed.  The claimant had initially filed for alternate medical care, but had dismissed the petition and then refiled.  In the judicial review action, the employer had appealed and cited the case number of the original alternate medical care petition and not the one decided by the agency.  Claimant argued that the appeal was therefore untimely filed.  The district court rejected this argument and the Court of Appeals affirms the district court opinion and finds that the appeal was properly filed.  The Court notes that the judicial review action had specifically cited the actions of the agency in the second petition and concluded that the use of the wrong case number was not fatal to the filing of the application for judicial review.

On the merits, the employer argues that the record lacked substantial evidence that a neurospsychological consult was unreasonable and inferior to the pain management that claimant was seeking.  Although the treating physician had recommended a referral to a neuropsychiatrist, defendants authorized a visit with a neuropsychologist, which claimant refused to attend.  The treating physician also found that physical therapy visits were of no further use.  Claimant had earlier seen Dr. Mathew, who believed claimant would benefit from pain management supervised by a physiatrist and pain specialist.  The Court finds that the conclusion that claimant would not benefit from further physical therapy was supported by substantial evidence.  The Court also concludes that a clinical psychology evaluation with Dr. Tranel was not a reasonable offer of further treatment and that treatment with a pain specialist was a superior treatment option.  The Court also concluded that Dr. Mathew was an appropriate treater and affirmed the decision of the district court.