Kelly Brewer-Strong filed a workers’ compensation Petition against her employer, HNI Corporation (HNI) alleging that she sustained work-related bilateral carpal tunnel injuries while carrying out her employment duties with HNI. HNI initially denied the alleged injuries in its Answer to Brewer-Strong’s Petition. Brewer-Strong then filed an alternate medical care petition alleging “abandonment of care.” HNI responded to the alternate care petition and denied liability for Brewer-Strong’s injuries. The deputy commissioner dismissed the alternate care petition and stated that HNI would be barred from asserting an authorization defense if Brewer-Strong sought “to recover the charges incurred in obtaining the care for which [HNI] den[ied] liability[.]” Brewer-Strong did not seek any further medical treatment immediately after the dismissal of her alternate care petition. HNI continued its investigation, which included sending Brewer-Strong to Dr. Adams for an evaluation. Dr. Adams determined that Brewer-Strong’s bilateral carpal tunnel injuries were related to her employment at HNI. After receiving Dr. Adams opinion, HNI amended its Answer and accepted Brewer-Strong’s bilateral carpal tunnel injuries as compensable.
After Dr. Adams examined Brewer-Strong, he recommended conservative care. A few months later, Brewer-Strong saw a different physician, Dr. Kreiter, who noted that her condition had worsened since Dr. Adam’s evaluation and suggested surgery. After reviewing Dr. Kreiter’s records, HNI advised Brewer-Strong that Dr. Adams was the authorized treating doctor and scheduled a return visit to Dr. Adams for a reevaluation of Brewer-Strong’s bilateral carpal tunnel. Brewer-Strong refused to attend the appointments with Dr. Adams. HNI subsequently learned that Brewer-Strong planned to undergo surgery for her bilateral upper extremities with Dr. Thomas VonGillern. HNI advised Brewer-Strong once again that Dr. Adams was the authorized treating doctor and that it would not pay the medical expenses or indemnity benefits for her unauthorized treatment with Dr. VonGillern. HNI filed a motion to compel Brewer-Strong to attend an appointment with Dr. Adams. The commissioner granted the motion but the evaluation with Dr. Adams was not scheduled. HNI became aware that Brewer-Strong had scheduled surgery with Dr. VonGillern when she requested a leave of absence for the surgeries. Prior to the surgery, HNI again advised Brewer-Strong that Dr. Adams was the authorized treating doctor and that it would not cover the medical expenses or disability benefits from Dr. VonGillern’s unauthorized treatment.
Brewer-Strong subsequently underwent surgery with Dr. VonGillern and took off from work from May 10, 2013, through July 21, 2013. HNI refused to pay Brewer Strong any healing period benefits during the time she was off work based on these unauthorized surgeries. In its refusal to pay healing period benefits, HNI reiterated that Dr. VonGillern was an unauthorized physician to provide treatment to Brewer-Strong. Dr. VonGillern was deposed prior to the hearing for healing period benefits and he testified that he did not know whether his treatment of Brewer-Strong had a more favorable outcome than the treatment Dr. Adams would have provided. Additionally, Dr. VonGillern testified that if Dr. Adams had reexamined Brewer-Strong, Dr. Adam’s recommendations for surgery likely would have been similar to what Dr. VonGillern performed. At the hearing, Brewer-Strong testified that she still had symptoms in her bilateral upper extremities, but was not sure that they connected to her original injury. “She also testified that she was unsure whether she was satisfied with the results of the surgeries that Dr. VonGillern performed.”
At the hearing, Brewer-Strong argued that she was entitled to healing period benefits. The deputy commissioner found that HNI provided a valid authorization defense and rejected Brewer-Strong’s argument that she was entitled to healing period benefits. The commissioner and district court both affirmed the deputy commissioner’s decision to deny Brewer-Strong healing period benefits and Brewer-Strong appealed. The Iowa Supreme Court retained the appeal and affirmed the decision of the district court.
The Supreme Court held that “the workers’ compensation commissioner and the district court correctly found HNI acquired its authorization defense and the statutory rights and obligations to provide and choose appropriate medical care pursuant to Iowa Code section 85.27 once HNI amended its answer to acknowledge compensability for [Brewer-Strong’s] injury.” When HNI amended its Answer and accepted Brewer-Strong’s injuries as compensable and attempted to provide Brewer-Strong with reasonable medical care through Dr. Adams, HNI obtained the right to assert an authorization defense. The Court noted that it “never held that an employer forever forfeits its rights and obligations under Iowa Code section 85.27 by initially denying liability for an injury[.]” Because HNI accepted Brewer-Strong’s injuries in its Amended Answer, it acquired a valid authorization defense for the medical treatment sought after its acceptance.
Brewer-Strong also urged the Supreme Court to overrule or modify its ruling in Bell Bros. Heating & Air Conditioning v. Gwinn, 779 N.W.2d 193 (Iowa 2010). Specifically, she argued that the “more favorable medical outcome” test in Bell Bros. required claimants to meet “a nearly impossible burden of proof.” The Supreme Court rejected Brewer-Strong’s argument and reaffirmed its decision in Bell Bros. reasoning that Bell Bros. “provides the proper burden of proof for a claimant seeking his or her employer’s payment for unauthorized medical care.” The Court acknowledged that the burden required by Bell Bros. was difficult to meet but stated that it was “not impossible.” The Court noted that the Bell Bros. test “respects the balance between the employer’s rights to control medical care and the employee’s right to seek alternative medical care under the statute.”
Brewer-Strong v. HNI Corp., No. 16–1364, 2018 WL 2746318 (Iowa June 8, 2018).