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Do I Need “Medical Evidence” Before Requesting Alternate Care Under Workers’ Compensation?

Whiplash

Unlike many other states, In Iowa the workers’ compensation system allows the employer–not the injured employee–to choose the medical care you receive. If you object to the employer’s choices, or you simply believe your injury requires additional care beyond what the employer says it will provide, you can file a petition for “alternate care” with the Iowa Workers’ Compensation Commission. But keep in mind, when filing such a petition the legal burden of proof is on the employee to show the employer’s original choice of medical care was “unreasonable,” given the particular facts surrounding the injury.

Court of Appeals: No “Bright-Line” Rule Requiring Medical Evidence

The Iowa Court of Appeals recently issued an important decision, Huff v. CST Expedited, Inc., which addressed on aspect of the employee’s burden of proof in alternate-care petitions: Is it absolutely essential for the employee to present “medical evidence” in support of a request for alternate-care benefits?

Here are the facts of the case. The petitioner is a former truck driver who worked for the defendant. In April 2016, the petitioner was involved in a truck accident that occurred in the course of his employment, a fact that the employer did not dispute. Unfortunately, the plaintiff’s injuries included a crushed leg that left him wheelchair bound. On top of this, the plaintiff was homeless at the time of the accident. He was actually living out of his truck. After the accident, he moved in with his son in his college apartment in Georgia, but he was later evicted. Indeed, the petitioner’s attorney later told Iowa workers’ compensation officials that his client “was now difficult to contact.”

In any case, the petitioner requested several forms of alternate care under workers’ compensation, including a “handicap accessible” residence near his doctors in Georgia, an accessible van or other means of transportation, and home healthcare assistance. The Workers’ Compensation Commission denied all of these requests, noting that none of the petitioner’s “current medical providers have opined that [the plaintiff] needs an accessible apartment, accessible van, or home health aide services at this time.”

The petitioner appealed the Commission’s ruling to the Polk County District Court. The district judge reversed the Commission, holding that “evidence from a medical provider” was not necessary to support the petitioner’s requests and that accessible housing and transportation, as well as in-home assistance, were all allowable “appliances” or “services” under Iowa workers’ compensation laws.

The employer appealed the district court’s ruling. The Court of Appeals’ decision did not entirely favor either side. The appeals court agreed with the district judge that “the absence of medical evidence cannot be a bright-line, legal bar to an award of alternate care.” However, the district court went a step too far in effectively ordering the Commission to allow the petitioner’s requests. The Court of Appeals said, “The district court’s findings improperly rely on factual determinations the agency never made.” In other words, the Commission needs to reconsider the petitioner’s requests in light of the correct legal standard articulated by the Court of Appeals.

Speak with an Iowa Workers’ Compensation Lawyer Today

The Court of Appeals’ ruling is nevertheless good news for injured workers throughout the state who may be entitled to alternate-care arrangements. If you have been injured in a workplace accident, it is in your best interests to consult with an experienced Southeast Iowa workers’ compensation attorney to learn more about your rights. Contact the Noyes Law Office, P.C., if you need immediate legal assistance.

Source:

scholar.google.com/scholar_case?case=18440538563068781381

https://www.noyeslawoffice.com/does-signing-an-employment-application-mean-im-covered-by-workers-compensation/

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