Iowa Workers' Compensation

In Lynch Livestock v. Bursell , No. 17-1629 (Iowa App. March 6, 2019), claimant was awarded medical expenses for unauthorized care premised on a beneficial care theory. In an earlier appeal, the court of appeals had remanded the claim to the agency, finding that if alternate care had not been correctly ordered based on the correct legal standard, claimant must prove the treatment was reasonable and beneficial. On remand, the agency denied the petition for alternate medical care because claimant had not exhausted conservative care before obtaining surgery.  Following the alternate care hearing, an arbitration hearing was held and claimant was awarded medical care, finding that the deauthorization of certain previously authorized physicians was inappropriate and that claimant's care with these doctors was reasonable and beneficial. At the district court level, the employer argued that claimant had not met the Bell Brothers  standard.  the district court agreed, holding ...

In a 6-1 decision, the Iowa Supreme Court affirmed their earlier ruling in Bell Bros. v. Gwinn , 779 N.W.2d 193 (Iowa 2010) and held that in order to take advantage of the beneficial care rule, claimant must prove that care that was unauthorized is reasonable and beneficial and provides a more favorable medical outcome than the care authorized by the employer.  Brewer-Strong v. HNI Corp., No. 16-1364 (Iowa June 8, 2018).  The court also concluded that a an employer who initially denies liability of a claim, can later find that the claim is work-related and regain control of the claim, including authorization of medical care.  Finally, the court held that if care is provided to claimant outside of the workers' compensation process, healing period benefits may be lost if claimant does not prove that the care obtained provided a more favorable outcome than that offered by the employer. Claimant suffered carpal tunnel problems, which were thought to be work-related by her i...

Catholic Health Initiatives v. Hunter , No. 14-0202 (Iowa App. Nov. 26, 2014) involved questions of causation, healing period benefits, permanency benefits and medical care.  The Court of Appeals affirmed the commissioner's award of benefits. Claimant had systemic lupus and was receiving social security disability benefits, but returned to work after those benefits were terminated.  She suffered a traumatic injury to her left wrist, hip and knee, and also complained of headaches as a part of this injury.  Following this incident, claimant had a fall at home and visited the doctor following that fall.  Claimant's symptoms had largely resolved when she slipped and fell again at work on March 3, 2010 (the earlier injuries were in 2009).  She was placed on work restrictions following this fall. Claimant was offered light duty work during the day, but could not perform that work because of family obligations.  No light duty work was available at night. ...

In Mercy Hospital Iowa City v. Goodner , No. 12-0186 (Iowa App. Jan. 9, 2013), the Court of Appeals affirmed the finding of the commissioner that claimant was permanently totally disabled.  The court also concluded that defendants were judicially estopped from contesting liability for the claim, and that defendants were responsible for paying for one half of the cost of family therapy sessions for claimant.  The court reversed the finding of the agency that payment for bariatric surgery for claimant should be paid by the defendants. Claimant, a doctor was exposed to mononucleosis as a result of her work.  She later developed depression and chronic fatigue syndrome.  Defendants' doctors indicated that she may not have had mononucleosis, but did have fatigue and memory loss.  Claimant's doctors indicated that she had developed mononucleosis and this was one of a multitude of triggers for chronic fatigue syndrome.  Following these developments, claimant bega...

In Verizon Business Network Serv., Inc. v. McKenzie , No. 11-1845 (Iowa App. Oct. 17, 2012), the court grappled with issues involving review reopening and the commencement date of such benefits, and also concluded that weight loss surgery was not related to the work injury. The case had previously been remanded by the court in November of 2010, to be reconsidered under the review-reopening standard set forth in Kohlhaas .  Claimant had initially been found to have a 25% industrial loss as a result of her back injury, and the commissioner had concluded on the initial review reopening that she was permanently and totally disabled.  The court also indicated that the commissioner should reconsider payment for the bypass surgery under Bell Bros. v. Gwinn .  Finally, the agency was to redetermine the correct date for commencement of benefits. On remand, the commissioner found that claimant was unable to work due to her spine injury.  The commencement date for benefits ...

In Verizon Business Network Services, Inc. v. McKenzie , No. 0-685 (Iowa App. Nov. 24, 2010), the Iowa Court of Appeals wrestled with issues involving review-reopening proceedings that had been addressed in Kohlhaas v. Hog Slat , 777 N.W.2d 387 (Iowa 2009).  The question raised in the case was whether the commissioner had used the correct standard in determining whether the claimant was entitled to an increase in benefits. Claimant suffered a back injury, and was awarded 25% industrial disability benefits at the initial arbitration hearing.  Following the hearing, claimant continued to have difficulties with her back, although she had gastric bypass surgery to reduce her weight in the interim.  She filed a review-reopening petition, and at the arbitration and appeal levels was found to be permanently and totally disabled.  There was a great deal of emphasis in these decisions on whether claimant's continuing problems had been anticipated at the time of the original...

On March 5, 2010, the Supreme Court issued a decision in Bell Brothers Heating and Air Conditioning v. Gwinn , 779 NW2d 193 (Iowa 2010). The case involved the proof required by the employee to establish a claim for benefits and expenses on account of medical care obtained by the employee, but not authorized by the employer or the commissioner. Mr. Gwinn had obtained non-authorized care (surgery) a week before the arbitration hearing. The court noted that the employer generally had the right to control care (the so-called authorization defense), but that the statute allowed the employee to choose care in certain emergency situations, when the employer and employee agreed to alternate medical care, and when the commissioner approved alternate medical care. The court concluded, however, that the employer's right to select the medical care did not prevent the employee from choosing medical care at his or her own expense under two circumstances. The first circumstance is when the ...