Iowa Workers' Compensation

  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 a...

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. M...

In Ramirez-Trujillo v. Quality Egg , No. 14-0640 (Iowa April 15, 2016), the Court wrestled with the meaning of section 85.27(4) of the Iowa Code.  The sentence in issue in this case states that "If the employer chooses the care, the employer shall 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 that change in authorization."  The commissioner concluded that section 85.27(4) required a notice to the claimant in all circumstances if the employer was terminating previously authorized care.  The district court reversed, finding that Quality Egg reasonably believed claimant had recovered from the work injury and did not need to provide notice.  The Court of Appeals agreed with the commissioner and reversed the district court. In a lengthy decision, the Supreme Court reverses the decision of the Court of Appeals and remands the claim to the c...

A series of commissioners has held that when an authorized treating physician recommends treatment that treatment is deemed to be authorized under 85.27(4) of the Iowa Code.  In Lynch Livestock v. Bursell, No. 14-1133 (Iowa App. May 20, 2015), the Iowa Court of Appeals turns this longstanding agency rule on its head and concludes that in the context of an alternate medical care proceeding, the claimant must demonstrate that the care offered by the employer is unreasonable, notwithstanding that the care sought is recommended by the authorized treating physician.  The decision of the court of appeals could well sound the death knell of a large portion of alternate medical care proceedings by destroying the authorized physician rule. In Mr. Bursell's case, Dr. Cook, an authorized treating physician, diagnosed claimant with CRPS and referred him to Dr. Kelly, a vascular surgeon.  Dr. Kelly recommended a lumbar sympathectomy.  Defendants subsequently sent claimant to ot...

The court in Ramirez-Trujillo v. Quality Egg , No. 14-0640 (Iowa App. Feb. 11, 2015) addressed issues of causation and medical expenses, and affirmed the decision of the commissioner on both grounds.  At the appeal level before the agency, the commissioner held that claimant's condition subsequent to September 30, 2009 was not the result of her work injury on August 1, 2009, and that the employer was responsible for reimbursing claimant for out of pocket medical expenses incurred after September 30, 2009, "because the employer failed to notify Ramirez-Trujillo that the care was no longer authorized as required by Iowa Code section 85.27(4)." The district court reversed the commissioner's order with respect to medical expenses and affirmed the decision of the district court on the medical causation question.  The court found that it was reasonable for the employer to deny payment for the medical costs as claimant told the employer that the treatment was for a separat...

Millenkamp v. Millenkamp , No. 11-2068 (Iowa App. April 10, 2013) is a case that has been bouncing back and forth between the agency and the appellate courts since claimant's initial injury in 2001, when claimant suffered a traumatic brain injury while working in his cattle business.  The current dispute concerns a situation where claimant had been treating with a physician who retired from the practice.  That physician recommended that claimant see another physician, Dr. Neiman, who provided treatment to claimant.  Prior to seeing Dr. Neiman, it does not appear as if the employer knew that the authorized treating physician had retired. According to the court, when the employer learned that the authorized treater had retired, it sought to provide care for claimant, first with Dr. Young, who refused to see claimant, and then with Dr. Cullen, who claimant refused to see because he had been hired by the defendants.  Claimant argued that because his treating physician ...