Iowa Court of Appeals Orders Employer to Pay for Unauthorized Doctor

Iowa Court of Appeals Orders Employer to Pay for Unauthorized Doctor

In Bell Brothers Heating v. Gwinn, 2008 Iowa App. LEXIS 206, filed in April, the Iowa Court of Appeals took the unusual step of deciding the appeal en banc, even though it was argued to a three-Judge panel. The Court found that an employer could not simply refuse to provide further medical treatment, or provide inadequate treatment, and then avoid having to pay for further medical treatment chosen by the injured worker.
In this case, the injured worker arranged for foot surgery on his own. The Court imposed the normal burden of proof that the employer was unreasonable in refusing to provide further medical care. They found that the refusal in this case was unreasonable.
Iowa law normally protects the employer from paying for unauthorized care; the Court noted in this case that an employer who is providing reasonable medical care to an employee is not responsible to pay for unauthorized medical care. The Court found, however, that the employer's designated orthopedic surgeon missed the diagnosis of torn Achilles tendon, which was found by the doctor chosen by the claimant. As a result, the Workers' Compensation Commissioner and the Iowa Court of Appeals found that the employer's offer to send the worker to their doctor was pointless, since he had missed the diagnosis and refused to accept the evidence of the torn Achilles tendon.

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H. Edwin Detlie
  • 05-27-2008

Is a torn Achilles tendon difficult to diagnose? How could it be missed? Also, does it make a difference if the orthopedic surgeon doesn''t specialize in the foot/ankle but rather specializes in the neck/spine?

H. Edwin Detlie
  • 05-29-2008

The Iowa Court of Appeals did not comment on the question of how one misses a diagnosis of torn Achilles tendon, and there was radiographic evidence of the tear. I won't second-guess the doctor who missed the diagnosis, but I imagine that the case will be cited in future cases where he is the treating orthopaedic specialist, whatever the condition.