Cooksey v. Cargill, Inc.

• Decision Date: 02 October 2013
• Docket Number: No. 3-615 / 12-1729,3-615 / 12-1729
• Parties: JEREMIE J. COOKSEY, Petitioner-Appellant, v. CARGILL, INC., CARGILL MEAT SOLUTIONS CORP., and CARGILL ANIMAL PROTEIN-WAPELLO COUNTY FACILITY, Respondents-Appellees.
• Court: Court of Appeals of Iowa

JEREMIE J. COOKSEY, Petitioner-Appellant, v. CARGILL, INC.,CARGILL MEAT SOLUTIONS CORP.,and CARGILL ANIMAL PROTEIN-WAPELLO COUNTY FACILITY, Respondents-Appellees.

No. 3-615 / 12-1729

COURT OF APPEALS OF IOWA

Filed October 2, 2013

Appeal from the Iowa District Court for Polk County, Eliza J. Ovrom, Judge.

Claimant appeals the district court's decision affirming the agency's dismissal, without a hearing, of his application for alternate medical care pursuant to Iowa Administrative Code rule 876-4.48(7). AFFIRMED.

Philip F. Miller, West Des Moines, and Harry W. Dahl of Harry W. Dahl, P.C., Des Moines, for appellant.

Andrew T. Tice of Ahlers & Cooney, P.C., Des Moines, for appellees.

Heard by Vogel, P.J., and Danilson and Tabor, JJ.

DANILSON, J.

Jeremie Cooksey appeals the district court's decision affirming the Iowa Workers' Compensation agency's dismissal, without a hearing, of his application for alternate medical care pursuant to Iowa Administrative Code rule 876-4.48(7). He contends that his employer, Cargill Incorporated, was judicially estopped from denying its liability after failing to dispute it in previous hearings. He also claims the dismissal of his application without a hearing to determine liability was an interpretation of the rule which was arbitrary, capricious, and an abuse of discretion, and violated his right to due process. Because we conclude that Cargill was not judicially estopped from denying liability and there was no due process violation, we affirm.

I. Background Facts and Proceedings.

On December 30, 2008, Cooksey suffered an alleged injury while working for Cargill. At Cargill's recommendation Cooksey was treated by Dr. David Hatfield. Cooksey filed his first application for alternate medical care, pursuant to rule 4.48(7), on April 12, 2010. Cargill answered the petition and stated, "Respondents do not dispute liability on this claim at this juncture however discovery is continuing." A hearing was held, during which Cargill confirmed it did not dispute liability. However, during the hearing the parties came to an agreement that Cooksey could obtain a second medical opinion from Dr. Chad Abernathy for the purpose of future treatment recommendation. In response, Cooksey agreed to request dismissal of his application for alternate medical care.On April 23, 2010, the deputy approved the request and the application was dismissed without prejudice and without a decision on the merits.

On July 16, 2010, Cooksey filed a second application for alternate medical care. Before Cargill responded, Cooksey filed a motion to dismiss without prejudice. The deputy sustained the motion on July 28, 2010. The order states Cooksey dismissed the application because Cargill authorized Dr. Donna Bahls to evaluate and treat Cooksey's back pain and complaints.

In February 2011, Cargill received reports from two physicians which questioned the causation of Cooksey's symptoms.¹ In August Cargill received a report, at its request, from Dr. Charles Wadle who had performed a mental health examination on Cooksey on August 12, 2011. In it he concluded that Cooksey had no identifiable psychiatric diagnosis.

On August 26, 2011, Dr. Bahls, the physician authorized by Cargill to treat Cooksey at the time, recommended continued treatment for the work-related injuries and advised it would be beneficial for Cooksey to receive alternate evaluation and care through the Spine Clinic of University of Iowa or Mayo Clinic. Soon after Cargill advised Dr. Bahls that she was no longer authorized to provide Cooksey medical treatment.

Cooksey then filed his third and final application for alternate medical care on February 28, 2012. In its answer Cargill disputed liability. The deputy commissioner then dismissed the application pursuant to rule 4.48(7).² In the order dismissing the application the deputy stated: "An application for alternative medical care is only available when defendants do not dispute liability for the medical condition for which care is sought. As defendants deny liability, the original notice and petition concerning claimant's application for alternate medical care must be dismissed." In the order the deputy also barred Cargill from asserting a lack of authorization defense in the future if Cooksey sought to recover costs incurred in obtaining medical care.

Following the dismissal Cooksey filed a request for findings of fact and specific ruling and an amended request based on denial of due process and judicial estoppel. The deputy denied both requests. Cooksey then filed a petition for new trial and hearing and was also denied. Pursuant to Iowa Code section 86.3, the deputy commissioner was delegated the authority to issue the final agency decision on the application.

Finally, Cooksey filed a petition for judicial review with the district court. The court affirmed the agency action. Cooksey appeals.

II. Standard of Review.

On appeal from judicial review, the standard we apply depends on the type of error allegedly committed. Jacobson Transp. Co. v. Harris, 778 N.W.2d 192, 196 (Iowa 2010). Our standard of review depends on the aspect of the agency's decision that forms the basis of the petition for judicial review. Iowa Code § 17A.19(10). If we reach the same conclusions as the district court we affirm, otherwise we reverse. Neal v. Annett Holdings, Inc., 814 N.W.2d 512, 518 (Iowa 2012). Here, Cooksey raises three issues.

He first argues the agency should not have allowed Cargill to deny liability because it was judicially estopped from doing so after admitting liability in previous hearings. "A party challenging agency action bears the burden of proof of proving both the invalidity of the agency's action and resulting prejudice." Winnebago Industries, Inc. v. Haverly, 727 N.W.2d 567, 571 (Iowa 2006). We review for corrections of errors at law. Tyson Foods, Inc. v. Hedlund, 740 N.W.2d 192, 195 (Iowa 2007). We may reverse, modify, or grant other appropriate relief if the substantial rights of the petitioner have been prejudiced. See Haverly, 727 N.W.2d at 571.

Cooksey's second argument is that the agency's interpretation of rule 4.48(7) was beyond the authority delegated to it and arbitrary, capricious, and an abuse of discretion. See Iowa Code § 17A.19(10)(b),(n). The interpretation of workers' compensation statutes and related cases is not clearly vested by a provision of law in the agency. See Finch v. Schneider Specialized Carriers, Inc., 700 N.W.2d 328, 331 (Iowa 2005). We are thus free to review the agency'sinterpretation of law de novo. See id. Deference may be given to an agency's interpretation of an agency rule. Annett Holdings, Inc., 814 N.W.2d at 518.

In a third and related argument, Cooksey argues the agency's interpretation of rule 4.48(7) violated his right to due process and, as such, is unconstitutional on its face or as applied. See Iowa Code § 17A.19(10)(a). It is the role of the judiciary to determine the constitutionality of legislation and rules enacted by other branches of government. ABC Disposal Systems, Inc. v. Dep't of Natural Res., 681 N.W.2d 596, 605 (Iowa 2004). "When a party raises constitutional issues in an agency proceeding, our review is de novo." See id.

III. Discussion.

A. Alternate Medical Care.

This appeal revolves around Cooksey's applications for alternate medical care pursuant to Iowa Code section 85.27(1). Our supreme court has previously explained the purpose and the essence of an employee's right to alternate care and reimbursement for its cost:

An alternate medical care claim brought by an injured worker prior to a final determination of liability of an employer has its roots in the statutory duty of an employer to provide medical care. This duty, however, is imposed only when the employer does not contest the compensability of the injury. See Iowa Code § 85.27 (1). This is an important proposition under the statute because it means the issue of compensability is totally removed from the alternate medical care process. Instead, the commissioner's role under section 85.27 at this stage is limited to determining the reasonableness and necessity of medical care sought by an employee as an alternative to the care furnished by the employer. Thus, if a compensability issue arises in the course of an alternate care dispute, the commissioner cannot order that the alternate care sought by the employee be furnished by the employer prior to a determination of the compensability of the injury in a contested case proceeding or some other proceeding. See Iowa Admin.Code. R. 876-4.48(7) ("Petitions for alternate care where liability of the employer is at issue should be filed pursuant to rule 4.1."). Administrative rule 4.48 is consistent with this approach. See id. r. 876-4.48.

On the other hand, in those cases where compensability of the injury is not at issue and the employer furnishes medical care to the employee, the commissioner is authorized to order the employer to provide alternate care if the employee establishes the alternate medical claim upon reasonable proof of necessity for the care. Iowa Code § 85.27(4); see West Side Transp. v. Cordell, 601 N.W.2d 691, 693-94 (Iowa 1999) (commissioner can order alternate care upon sufficient proof). If the commissioner orders alternate care, the employer is required to furnish the care. Of course, if the commissioner finds the employee has failed to establish the necessity for the alternate care, the employer has no responsibility to furnish or pay for such care. Nevertheless, such a finding by the commissioner does not mean the employee may not still choose to obtain the alternate care. It only means the employer will not be responsible for the expense of the care. If the employee chooses to obtain the alternate care after the commissioner has denied a petition for alternate care on its merits, the employee will be responsible for the expense. Thus, the employer's statutory "right to choose the care" under section 85.27(4),

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