The Iowa Supreme Court reviewed whether the Iowa Court of Appeals correctly applied Iowa Code Section 85.39, as amended in 2017, to limit an employee’s reimbursement for an independent medical examination (IME). The workers’ compensation commissioner awarded the entire $2,020 charged by the physician. The district court affirmed, and the Iowa Supreme Court transferred the employer’s appeal to the Court of Appeals. The Court of Appeals reduced the figure to $500 based on its interpretation of the amendment as limiting reimbursement to the impairment rating alone without the accompanying examination. In the present case, the physician examined and tested the claimant, and also reviewed records. The Iowa Supreme Court held that the employee is entitled to the reasonable cost of the examination accompanying the physician’s determination of the impairment rating and not just the impairment rating itself. Reasonableness is typically based on the fee charged in the locale where the examination is performed. The employee bears the burden to prove the reasonableness of the fee, which is a fact question. Here, the commissioner failed to make a finding required under the 2017 amendment as to the fee typically charged in the locale. Accordingly, the Iowa Supreme Court affirmed in part and remanded to the commissioner to conduct further fact-finding on the issue.
Case No. 22-0471: Mid American Construction LLC and Grinnell Mutual, v. Marshall Sandlin