In a case out of the Iowa Court of Appeals, it was determined that a worker could still be eligible for alternate care even if they had refused an IME to determine whether the requested treatment was related to a compensable injury.

Justin Botkin worked for Harris Steel Group, Inc. when he injured his right shoulder at work in June of 2015. His employer authorized him to receive treatment from Dr. Tuvi Mendel, who performed shoulder surgery in November 2015. When he returned for a follow-up one year after surgery, he said that his pain had increased slightly.

He tried to schedule an appointment again with Dr. Mendel but since it had been two years since his injury, Dr. Mendel said he needed to get authorization from Harris. He scheduled Botkin for an IME to take place December 2017 but Botkin refused to go. Then Harris failed to respond to authorization requests for additional treatment with Dr. Mendel.

Botkin submitted a claim for alternate medical care and the workers’ comp commissioner said that his request for continued treatment was reasonable and ordered Harris to authorize it. The employer applied for a rehearing saying that their denial was based on his refusal to go to an IME, and their application was denied.

The court affirmed the earlier opinion. His request for alternate care was reasonably suited to treat his injury and he was entitled to continue care with Dr. Mendel as long as he indicated that the care he provides is related to his work injury. Once an employer chooses the injured worker’s care (as they had in sending him to Dr. Model), “the employer shall hold the employee harmless for the cost of care until the employer notifies the employee that the employer is no longer authorizing all or any part of the care and the reason for the change in authorization.” Since they never told him they were no longer authorizing care with Dr. Mendel, they must hold Botkin harmless for the cost of any treatment related to his original injury.

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