State News : Iowa

Finley Hospital v. Charles Stokes, No. 2-381 / 11-2024 (Iowa Court of Appeals)

The Claimant, Charles Stokes, sought alternate medical care by way petition to the workers’ compensation commissioner. Claimant’s first application was made in February of 2011 and was subsequently denied by the deputy workers’ compensation commissioner. In issuing the denial, the deputy found that the Claimant had expressed dissatisfaction with his current care in October of 2010 by way of a letter from his counsel. However, the employer had extended the offer to return the Claimant to Dr. Pearson and the deputy did not find this unreasonable. The deputy also found that the employer scheduled an appointment with Dr. Pearson for the Claimant on March 17, 2011. Further the employer represented that it would abide by Dr. Pearson’s treatment recommendations.

The Claimant filed another application for alternate medical care on April 14, 2011. At hearing of the matter, the Claimant testified that he attended the March 17, 2011 appointment with Dr. Pearson, who was unaware of the reason for the visit. The Claimant explained he had ongoing symptoms for which he had been seeing Dr. Tebbe for chiropractic relief. He then asked Dr. Pearson for treatment and a referral to Dr. Tebbe. Dr. Pearson suggested an MRI, but noted he would need prior authorization for this. He then stated he would not make a referral for chiropractic care, stating “I don’t treat pain.” Nothing was offered by Dr. Pearson in the way of treatment.

The Claimant then introduced correspondence from his counsel dated April 12, 2011, stating that Claimant’s counsel had written to the employer’s counsel on March 22, 2011 requesting a copy of Dr. Pearson’s notes or report and that to date Claimant’s counsel had heard no reply. The letter continued to express Claimant’s dissatisfaction with Dr. Pearson’s care. On April 21, the employer’s counsel replied providing Dr. Pearson’s medical notes. Another letter was sent by the employer’s counsel on April 25, the day before the alternate medical care hearing, authorizing an MRI with Dr. Pearson.

At hearing, the deputy determined that the employer failed to timely provide medical care to the Claimant. The deputy then granted the Claimant’s request for chiropractic care with Dr. Tebbe. On appeal to the district court, the Court found that there was substantial evidence to support the deputy’s findings that the care the employer offered the Claimant by way of Dr. Pearson was not offered promptly. The court also stated there was substantial evidence that the treatment made available to the Clamiant was not ‘reasonably suited to treat the injury without undue inconvenience to the employee,’ as required by section 85.27(1). The employer then appealed to the Court of Appeals.

The employer first challenged the deputy’s decision on the grounds that Claimant’s counsel’s letter in October of 2010 did not convey dissatisfaction of authorized care. The Court concluded that the deputy was correct in finding the letter substantially complied with Iowa law and communicated the Claimant’s dissatisfaction.

Next the employer challenged the decision of the deputy on the grounds that the designated care provider, Dr. Pearson, remained available to provide care. The Court dismissed this argument, as well, finding that while Dr. Pearson did perform an evaluation of the Claimant, he made no recommendations for ongoing care.

The Court ultimately found that after the Claimant expressed his dissatisfaction with the care provided, nearly six months had expired, and three petitions for alternative care had been filed, although the first petition was dismissed. During that time the only ongoing care ultimately authorized by the employer was an MRI test. However, that authorization came one day before the hearing on the third petition and as noted, Dr. Pearson’s medical notes only state that it “may” be needed.

The Court ultimately found that the deputy’s decision was supported by substantial evidence and affirmed the ruling of the district court upholding the deputy’s granting of alternate medical care.

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