What Constitutes a “Reasonable” Redirection of Care Under Iowa Law?

by | Jun 25, 2013

Under Iowa workers’ compensation law, the employer/insurer has the right and obligation to direct reasonable medical care for accepted work injuries.   Therefore, absent an abandonment of care by the employer/insurer, a claimant does not have the right to select a treating physician.  At times, it may become apparent that the ongoing care is insufficient.  At that time, the insurer/employer may desire to redirect care to another physician.  While an employer/insurer does have the right to select care, the claimant may have the right/ability to contest the redirection of care and have the issue decided by the Iowa Workers Compensation Commission.

The Iowa Workers’ Compensation Commission has indicated that care may be directed away from a treating physician only when reasonable. Typically, when the redirection of care is contested, the reviewing Deputy Commissioner will look to the following factors.

  • Has the claimant treated for a prolonged period of time with the physician from whom the care will be directed away from?
  • Is the physician who is proposed to provide the redirected care qualified and reasonably suited to treat the injury?
  • Is the redirected care offered promptly and in an opportune time?

Oftentimes, the best time to direct care is subsequent to emergency room treatment and/or when a referral is made for a specialist as that does not involve changing physicians during the course of ongoing treatment.  For questions regarding employers’ rights to direct medical care under the Iowa Workers’ Compensation Act, please contact Paul Barta at pbarta@baylorevnen.com.