Provision of Medical Benefits Under the Iowa Workers’ Compensation System

Under Iowa Code §85.27, an employer is liable for all reasonable surgical, medical and hospital services arising out of a work-related injury which will hasten the employee’s restoration to health or employment and will relieve pain. Many times, the question is whether recommended care in fact is likely to relieve pain or promote and hasten the employee’s actual return to work. As Iowa is an employer-care directed state, often times if care is recommended by an authorized treating physician or a physician in the chain of referral, a reviewing deputy will find that recommended care is de facto reasonable and necessary and thus authorized.

A claimant’s entitlement to medical care continues so long as the referring physician indicates that the care is likely to relieve pain. Many times, an authorized physician will designate that a claimant is at maximum medical improvement. Please note that a designation of maximum medical improvement, standing alone, does not mean that a claimant is entitled to no further medical services. In these circumstances, it is also best to inquire with the authorized treating physician as to whether he or she believes that the claimant is in need of any future medical care and if so, the extent of the same. Depending on the response, this could provide the employer with a reasonable basis to cease provision of further medical services.

For any questions regarding provision of medical care under I.C.A. §85.27, please contact Baylor Evnen attorney Paul Barta at pbarta@baylorevnen.com.