Court of Appeals Affirms Denial of Alternate Medical Care

Dotts v. City of Des Moines, No. 20-0954 (Iowa App. July 21,  2021) - In this somewhat unusual alternate medical care case, claimant filed for alternate medical care under 85.27 and was denied such care by the agency.  Claimant appealed and on judicial review, the district court considered the record, which did not include a transcript of the agency hearing.  The Court of Appeals noted that they also did not have a transcript of the agency hearing to decide whether substantial evidence supported the decision of the agency.

The court notes that the reasonableness of the care provided by defendant was contingent on claimant's testimony that the doctor refused to see him and concessions allegedly made by the employer during the hearing.  Because the court did not have a transcript to review, the conclusion was reached that there was no ability to review the testimony to determine whether the decision was supported by substantial evidence.  The court notes that party seeking judicial review ahs the responsibility to ensure the agency record is before the district court on judicial review.  Without the transcript, the court was unable to review the agency decision and the denial of alternate care was affirmed.  


Comments

Post a Comment

Popular posts from this blog

Iowa Supreme Court Concludes Vascular Injuries are not Per Se Whole Body Injuries for Fund Purposes; Holds that a Sequella Injury to the Body As. Whole Does Not Automatically Preclude Fund Benefits

  Delaney v. Second Injury Fund , No. 23-0182 ((Iowa May 10, 2024) Claimant suffered an injury to her left leg and 33 years later suffered an injury to her right leg. Following surgery on the right leg, claimant developed lymphedema. She filed for benefits against the Fund and the commissioner concluded that because lymphedema was an unscheduled injury, claimant was not entitled to benefits against the Fund under 85.64. The district court affirmed the decision of the commissioner. The Court of Appeals reversed, finding that even if a second injury resulted in a sequella body as a whole injury, claimant was still entitled to consideration of the second injury under 85.64. The Supreme Court first concludes that the agency erred in concluding that a per se rule for vascular injuries that concluded that such injuries precluded an action against the Fund was erroneous.The Court rejects the reliance of the agency on Blacksmith v. All-American , finding that Blacksmith  did not support the st
Read more

2021 Workers' Compensation Appeal Decisions

  2021 Workers' Compensation Appeals Decisions The following are appeal decisions decided by the commissioner in 2021, by month. December 2021 Carmer v. Nordstrom , No. 1656062.01 (App. Dec. 29, 2021) - Claimant was found to have sustained an injury to her right shoulder and a sequela injury to her left shoulder.  Both of these injuries were found to be scheduled member injuries, but the injuries were found to be industrially compensable under 85.34(2)(v). Claimant was found to have a 70% industrial disability (Palmer). On appeal, the commissioner affirms that there was a sequela injury to the left shoulder, crediting Dr. Segal's report over that of Dr. Milani.  Most importantly, the commissioner affirms the fact that because the two shoulder injuries were the result of a single incident, this injury was to be treated industrially under 85.34(2)(v).  The commissioner notes that "shoulder" injuries were not added to the list of injuries that were to be treated a schedu
Read more

2024 Workers' Compensation Appeal Decisions

  2024 Workers' Compensation Appeal Decisions November 2024 Jimmerson v. Ultimate Auto and SIF , No. 1630457.01 (App. Nov. 7, 2024) - Claimant suffered an injury to his right leg (pre-July 2017), diagnosed as lymphedema.  He filed actions against the employer as well as the Fund, with a first injury to the left leg.  The deputy concluded claimant's lymphedema was a body as a whole injury and awarded a 60% industrial disability due to the lymphedema.  No benefits were awarded against the Fund.  The employer received 30% credit for an earlier (pre-2017) industrial shoulder injury (Fitch). On appeal, claimant argues that the 60% industrial award was appropriate, but also argues that an award against the Fund was merited, based on the first and second injuries, citing Delaney v. SIF , 6 NW3d 714 (Iowa 2024).  The employer argues that the injury for which it was responsible was not an industrial injury, but a scheduled member injury.  The Fund argues that the injury was industrial a
Read more