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[T] Pella Corp. v. Fogle11/17/2003
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Relying on Fogle's testimony and the medical opinion of Dr. Koontz, a deputy workers' compensation commissioner concluded that the care currently being offered was not reasonably suited to treat Fogle's injury, and ordered that Fogle's medial care be transferred to Dr. Koontz. Pella filed a petition for judicial review, and the district court upheld the agency's decision. While noting that Drs. Boarini, Bahls and Thurston had provided Fogle appropriate medical care, the court concluded Fogle had presented substantial evidence that the authorized care was not reasonably suited to treat her injury. Pella appeals.
Scope of Review
Our review is limited to the correction of errors at law. Aluminum Co. of America v. Musal, 622 N.W.2d 476, 478 (Iowa 2001). The agency's decision is upheld unless it prejudiced Pella's substantial rights. Iowa Code § 17A.19(10) (2001). Invalidity of agency action can be demonstrated in a number of ways, including proof the action was legally erroneous, arbitrary or capricious, or unsupported by substantial evidence in the record when that record is viewed as a whole. Id. Pella bears the burden of demonstrating both the invalidity of the agency's action, and resulting prejudice. Id.; § 17A.19(8)(a).
Discussion
If Fogle established that the authorized medical care provided by Pella was not offered promptly, was not reasonably suited to treat her injury, or was unduly inconvenient to her, then the agency was authorized to order alternate medical care. See Iowa Code § 85.27(4); R.R. Donnelly & Sons v. Barnett, ___ N.W.2d ___ (2003). The agency apparently concluded that Pella had failed in all three regards. However, we agree with Pella that the record did not contain substantial evidence that the authorized treatment was not provided promptly or was unduly inconvenient. Fogle was almost immediately seen by Dr. Thurston, and was promptly referred to specialists. She was not forced to travel great distances to obtain this care, nor is there any indication that she was otherwise unduly inconvenienced by the authorized care.
These conclusions are not fatal to the agency's decision, however, if the record contains substantial evidence that the authorized treatment was not reasonably suited to treat Fogle's injury. The standard to be applied in such cases was discussed in Pirelli-Armstrong Tire Co. v. Reynolds, 562 N.W.2d 433, 437 (Iowa 1997):
The burden is on the employee to show that the care chosen by the employer is not reasonably suited to treat the injury. Reasonableness, of course, is a fact question.
...
hen evidence is presented to the commissioner that the employer-authorized medical care has not been effective and that such care is"inferior or less extensive" than other available care requested by the employee, the commissioner is justified by section 85.27 to order the alternate care.
(citations omitted).
In assessing the adequacy of the authorized care, we agree with Pella that Fogle's testimony about a general lack of improvement, increased pain, and "things... getting worse" does not constitute substantial evidence that treatment provided by Drs. Thurston and Bahls actually caused Fogle's medical condition to deteriorate. Nevertheless, the testimony of Fogle and the opinion of Dr. Koontz, supported by the testing of Dr. Iqbal, provides substantial evidence that the conservative treatment had not been effective to treat Fogle's condition, and that surgery would offer superior treatment and pain management. See Sherman v. Pella Corp., 576 N.W.2d 312, 321 (Iowa 1998) (noting agency may accept or reject medical opinion in whole or in part, and as f
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