Long v. Roberts Dairy Co., 93-1859

• Decision Date: 22 February 1995
• Docket Number: No. 93-1859,93-1859
• Citation: 528 N.W.2d 122
• Parties: Barry LONG, Appellee, v. ROBERTS DAIRY COMPANY, Employer and National Union Fire, Insurance Carrier, Appellants.
• Court: Iowa Supreme Court

Page 122

528 N.W.2d 122

Barry LONG, Appellee, v. ROBERTS DAIRY COMPANY, Employer and National Union Fire, Insurance Carrier, Appellants.

No. 93-1859.

Supreme Court of Iowa.

Feb. 22, 1995.

Stephen W. Spencer and Joseph M. Barron of Peddicord, Wharton, Thune and Spencer, P.C., Des Moines, for appellants.

Dennis L. Hanssen and M. Anne McAtee of Hopkins & Huebner, P.C., Des Moines, for appellee.

Considered by McGIVERIN, C.J., and NEUMAN, SNELL, ANDREASEN, and TERNUS, JJ.

NEUMAN, Justice.

This is a workers' compensation case involving a claim for alternate medical care under Iowa Code section 85.27 (1993). The claimant, Barry Long, became dissatisfied with the employer's decision to have him evaluated and treated at the University of Iowa Hospitals and Clinics, rather than the Mayo Clinic. The industrial commissioner, following hearing, ruled that the employer's decision was reasonable. Long sought judicial review and the district court reversed. Because we find substantial evidence in the record to support the industrial commissioner's decision, we reverse.

The facts are largely undisputed. In March 1991, Barry Long sustained injury to his upper extremities during the course of his employment at Roberts Dairy Company. The dairy and its insurer, National Union Fire, admitted liability and assumed responsibility for Long's medical care. Long was seen by the company doctor, Michael Makowski, who referred Long to Douglas S. Reagan, an orthopedic surgeon. Following surgery, Reagan concluded that Long suffered a permanent partial impairment of his upper extremities.

When Long's pain from the injuries persisted, Dr. Reagan suggested three options: (1) do nothing and continue with work activity as tolerated, (2) seek an additional evaluation either at Mayo Clinic or University of Iowa Hospitals, or (3) consider a pain management clinic. The insurance company's adjuster approved Long's referral to Peter C. Amadio, an orthopedic surgeon at the Mayo Clinic. Before Dr. Amadio would examine Long, however, he insisted on new diagnostic testing at a cost in excess of $5000. The insurer refused to authorize this testing. Instead it arranged for Long to see William F. Blair, an orthopedic surgeon at the University of Iowa Hospitals.

Long was dissatisfied with the insurer's decision and filed an application for alternate medical care under Iowa Code section 85.27. ¹ He supported his petition with a statement from Dr. Makowski that Mayo was the preferred alternative because it might offer a "fresh approach" to Long's injury. The insurer resisted the application.

Following hearing, the industrial commissioner denied Long's application. The ruling concluded that Long had not met his burden of proving that the medical treatment authorized by Roberts was not reasonably suited for Long's injuries. Long then petitioned for judicial review. The district court reversed, concluding that the commissioner's decision was unreasonable, arbitrary, and capricious. This appeal by the dairy and its insurer followed.

I. Our review is for the correction of errors at law, not de novo. Henkel Corp. v. Iowa Civil Rights Comm'n, 471 N.W.2d 806, 809 (Iowa 1991). The commissioner--not the court--weighs the evidence, and we are obliged to broadly and liberally apply those findings to uphold rather than defeat the commissioner's decision. Ward v. Iowa Dep't of Transp., 304 N.W.2d 236, 237 (Iowa 1991). On review, the question is not whether the evidence supports a finding different from the commissioner's but whether the evidence supports the findings the commissioner actually made. Id. at 238. In other words, the commissioner's findings are binding on appeal unless a contrary result is compelled as a matter of law. Id.

II. The ultimate question is whether, in choosing the University of Iowa Hospitals over the Mayo Clinic, the employer met its obligation under Iowa Code section 85.27 "to furnish reasonable services" for the treatment of Long's injuries. Under the statute, the employer is permitted to choose the care. Iowa Code § 85.27; Harned v. Farmland Foods, Inc., 331 N.W.2d 98, 101 (Iowa 1983). By challenging the employer's choice of treatment--and seeking alternate care--Long has assumed the burden of proving that the authorized care is unreasonable. See Iowa R.App.P. 14(f)(5) (burden of proof rests on party seeking relief). Determining what care is reasonable under the statute is a...