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Showing posts with the label Ramirez-Trujillo v. Quality Egg

Supreme Court Reverses Court of Appeals, Concludes that Section 85.27(4) Does Not Automatically Require Continuation of Medical Benefits Before Notice from Employer

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...

Court of Appeals Affirms Denial of Benefits, Holds Claimant Harmless for Certain Medical Expenses

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...