In Iowa workers’ compensation cases the employer and insurance company have the right to choose the medical care providers for the injured worker.
If the worker is unhappy with the medical care they can file a Petition for Alternate Medical Care to have the care changed. The employer’s obligation is to provide reasonable care. The Claimant has the burden of proof to show that the authorized care is unreasonable. Determining what care is reasonable is a question of fact. As a general matter when the evidence shows that the employer-authorized medical care has not been effective, and that the authorized care is inferior to the requested care, the Petition for Alternate Medical Care will be granted.
On April 4, 2018 the Commissioner issued an alternate medical care decision in the case of Bushbaum v. Custom Wood Products which involves a worker’s request for alternate medical care, and also a complaint that the defendants had abandoned providing any medical care. If the Commissioner finds that the defendants have abandoned medical care in a case, then the Commissioner will allow the worker to choose his future medical care.
In the Bushbaum case the Claimant had sustained an accepted back injury on December 12, 2014. The defendants provided limited care through March of 2017.
The Claimant argued that although the doctors agreed that surgery was not the answer, he still had substantial problems that required further treatment.
The defendants argued that they had sent the Claimant to two different surgeons and had paid for three steroid injections.
The Commissioner found that the defendants had a long history of providing medical care only very reluctantly. The Claimant had filed a total of four different alternate medical care petitions to try to move the care forward. The Commissioner also found that there had been a very large lapse in care from October of 2015 until March of 2017; and after some care in March of 2017 the care had ended.
The Commissioner further explained that surgery is not the sole care the defendants are obligated to provide. Iowa workers’ compensation law requires the defendants to “Furnish reasonable services and supplies to treat an injured employee. Further, the treatment must be offered promptly and be reasonably suited to treat the injury without undue inconvenience to the employee.”
The Commissioner found that the past care was not reasonable, and that the defendants were declining to provide any care at the current time such as referral to a pain management specialist, physical therapy, or occupational therapy.
Therefore, the Commissioner ruled that the defendants had abandoned care, and the Claimant had the right to choose his own medical providers going forward for the accepted work injury, and the defendants were required to pay for the medical care chosen by the claimant.
Please be sure to contact us if you have any questions about medical care disputes under Iowa law or any other Iowa work comp issues.