In this blog post I am going to talk about two recent Iowa work comp alternate medical care decisions, and some related strategy advice.


  1. Be polite. The recent October 2, 2018 Alternate Medical Care Decision in the case of Stewart v. Hy-Vee, Inc. and EMC Property and Casualty Company involved an accepted left knee injury.  During the course of the case the claimant moved from Iowa to Lake Charles, Louisiana. The Defendants arranged care with an orthopedic surgeon at the Imperial Health Center located in Lake Charles, Louisiana.


The claimant was late for her first appointment with the orthopedic surgeon.  The claimant said she was 30 minutes late, and the doctor’s office said she was 90 minutes late.  The appointment had to be rescheduled.


At the second appointment the claimant was again late, and there was also a dispute about whether the claimant was rude and disruptive when she arrived.  The orthopedic surgeon refused to see or treat the claimant under any circumstances.


I always tell my clients that it is very possible that we will not agree with every doctor, doctor’s opinion, but it is very important to be polite to all medical care providers and their staff.  Part of the reason that I recommend politeness is it helps move the case towards resolution.  All Iowa work comp cases have to go through certain steps:


  1. The injured workers have to see medical care providers chosen by the defendants.


  1. Eventually the defense physicians will say the injured worker has reached maximum medical improvement. The defense physicians will also give opinions on whether work restrictions are necessary and the extent of functional impairment from the injuries.  As I mentioned above, it is entirely possible that we will disagree with those defense medical opinions, but we need to get to the point of the defense doctors giving their final opinions.


  1. Once we have the defense opinions, we can then exercise our right to an independent medical exam and get opinions from a physician of our choice.


  1. Once we have our expert opinions, we are ready to take the case to trial and attempt to prove that the medical opinions of our medical experts should be followed.


Giving defense medical care providers a hard time will not change their opinions, and will only delay getting the case to trial or settlement.


  1. Be willing to travel for medical care. The recent October 3, 2018 Alternate Medical Care Decision in the case of Laurie v. Agriland FS and EMC Insurance Company addresses an issue that comes up fairly frequently.


The claimant suffered an accepted knee injury.  The defendants authorized treatment for the injury including physical therapy, medications, injections, diagnostic exams, and multiple surgeries.


Nonetheless, the claimant continued to have problems with his knee and needed further assessment and care.


The defendants contacted at least four different orthopedic surgeons to see if they would be willing to provide treatment for the claimant, and all of those surgeons declined to get involved in the case.


It is frequently hard to find doctors that want to get involved in a case with a difficult injury and a history of other doctors not being able to successfully treat the problem.  Sometimes the defendants will argue they cannot find a doctor.


In those situations I have begun to directly contact doctors in Chicago, Minneapolis and Kansas City to find physicians that are willing to get involved in the case.  I have been provided this list of willing doctors to the defendants.  In some situations the defendants have used the out-of-state doctors, and in other situations the defendants have convinced previously reluctant Iowa doctors to provide medical care.


Please be sure to contact our office if you have any questions about medical care disputes or other issues in Iowa work comp cases.