One of the most important aspects of Iowa workers’ compensation is that your employer must provide you with medical treatment if you are injured on the job. Indeed, the goal of workers’ comp is to encourage employees to promptly report an accident and go to the doctor without stopping to worry about who will pay the bill. Iowa law is quite clear on this point–the employer has the obligation to pay.
But a question our Des Moines workers’ compensation lawyers often get from clients is, “Can I choose my own doctor?” Many workers understandably want to direct their own treatment, which includes selecting a doctor who will provide care. Unfortunately, the nature of Iowa workers’ compensation law often makes that difficult.
The Employer Gets to Decide–But You Can Fight Back
Let’s start with the law itself. Iowa Code Section 85.27 is the principal statute dealing with medical care under workers’ compensation. The statute provides that in the event of a job-related accident, the employer “is obliged to furnish reasonable services and supplies to treat an injured employee, and has the right to choose the care.” So in simple terms, your employer has the right to select your doctor as it relates to medical treatment covered by workers’ compensation.
That is not, however, the end of the matter. If you are “dissatisfied with the care offered,” you can notify your employer and propose alternate care that is “reasonably suited” to treat your injury. Ideally, you and your employer would come to an agreement on such alternate care. But if an agreement proves impossible, you can submit the matter to the Iowa Workers’ Compensation Commissioner.
Now, the Commissioner will not allow you to select your own provider just because you disagree with the treatment chosen by your employer. The statute requires the Commissioner to first determine whether your employer’s chosen treatment was not “offered promptly” or “reasonably suited” to your case. Alternatively, the Commissioner can find the employer’s proposed treatment would cause “undue inconvenience” to you. The critical thing to understand here is that you, as the employee, need to prove your employer’s chosen treatment is not reasonable or would cause such undue inconvenience.
ADM Litigates Worker’s Request for Seeking Non-Surgical Treatment of Head, Knee Injuries
A recent decision by the Iowa Court of Appeals, Midland v. Tuttle, illustrates the uphill climb a worker can face when proposing a course of treatment that diverges from that proposed by their employer. This case involved a man, John Tuttle, who worked for one of Iowa’s best-known employers, Archer Daniels Midland (ADM).
ADM hired Tuttle in 2015 to work as a maintenance mechanic. He suffered an on-the-job injury to his left knee in 2018, which forced him to miss work for a period of time. He later returned to his job but sustained a second work-related injury in 2022 when he “struck his head on a metal pipe, fell, and lost consciousness,” according to court records.
Following both accidents, ADM selected Tuttle’s treatment. For the 2018 knee injury, ADM designated the University of Iowa Hospitals and Clinics (UIHC) as the treatment provider. After nearly three years of treatment, UIHC recommended Tuttle undergo a left-knee replacement operation.
Tuttle decided to get a second opinion on his own from a doctor at the Mayo Clinic. The Mayo doctor agreed that Tuttle would eventually need a knee replacement. But she also determined that the operation could be delayed several years if Tuttle received regular injections of a drug cocktail to treat his chronic knee pain. UIHC did not offer this non-surgical option.
As for the 2022 head injury, shortly after the accident, an ADM supervisor told Tuttle’s wife to take her husband to an urgent care clinic. She did that, and the clinic in turn sent Tuttle to the emergency room. The ER staff performed a head CT and determined he sustained a mild traumatic brain injury (i.e., a concussion). The ER then discharged Tuttle with instructions for him to follow-up with his own primary care doctor.
Tuttle did as instructed. ADM, however, later said Tuttle had to see its chosen provider, WorkWell, for further treatment of his head injury. Tuttle complied, but when he arrived for his appointment at WorkWell, there was no doctor available to see him. ADM rescheduled the appointment, but Tuttle instead decided to continue treatment with his primary care doctor, who eventually referred him to a specialist. The specialist recommended a course of human growth injections (HGH) to treat his chronic symptoms, particularly his “mood swings” and “balance issues” following the blow to his head.
ADM refused to pay for either the alternate head or knee injury treatments. This led to extensive litigation before the Workers’ Compensation Commissioner and later the Iowa courts. This past May, the Iowa Court of Appeals weighed in on the case.
The appellate court decided to split the difference. It allowed Tuttle’s alternate treatment for his knee injury but not his head injury. Regarding the head injury, Tuttle argued that since ADM initially allowed him to seek treatment from his own primary care doctor, that in turn allowed her referral to the specialist for additional treatment. But as the Court of Appeals noted, ADM effectively “revoked” that authorization when they directed him to seek treatment from WorkWell instead. And there were grounds to find ADM’s selected head injury treatment “unreasonable.”
With respect to the knee injury, however, the Court agreed with Tuttle that UIHC’s proposed treatment–immediate knee replacement surgery–was “ineffective and inferior or less extensive” than the non-surgical option offered by the Mayo Clinic. The Court therefore upheld a lower court’s ruling allowing Tuttle to seek alternate treatment for his knee injury.
Contact a Des Moines Workers’ Compensation Lawyer Today
When it comes to workers’ compensation, employer-provided medical care often comes with the caveat that the injured employee’s options for seeking treatment may be limited. One way that you can assert your rights under the law is to work with an experienced Des Moines workers’ compensation attorney. Contact Ball, Kirk & Holm, P.C., today at 319-419-4279 to schedule a free consultation. We have offices in Waterloo and Iowa City and are available to travel to our client’s location when necessary.