Workers’ Compensation: What Is Alternate Medical Care?

May 2014

If you have sustained a work-related injury, you probably have a lot of questions, including how you obtain medical care through your workers’ compensation benefits. The Iowa Workers’ Compensation Act gives employers and their insurance carriers the right to choose the doctors and other health care professionals who provide medical care to their injured workers. In some situations, however, you may be dissatisfied with the level or quality of care offered by an employer-selected provider. If your employer doesn’t permit you to seek alternate care, you have the option to apply to the Iowa Workers’ Compensation Commissioner for alternate medical care.

Workers’ Compensation Medical Disputes

If you are unhappy with the care provided by the doctor selected by your employer, you can file a Form 100C Petition for Alternate Medical Care. Before you do so, however, you must first inform your employer in writing that the level of care provided by the employer’s physician is unreasonable and provide specific reasons to support your claim. The Iowa Workers’ Compensation Commissioner has repeatedly stated that workers must provide specific grounds to support a claim of unreasonableness – merely stating that you are displeased with the care is not enough to warrant a grant of alternate medical care.

Common examples of acceptable grounds for unreasonable care include:

  • A lengthy delay in care
  • Care that does not adequately treat the injury
  • Care that fails to meet the standard of care available from other providers
  • Ineffective care; improper diagnosis
  • Care that is inconvenient for the worker (such as an unreasonable geographic distance between the injured employee and the physician)

Additionally, injured workers must sometimes fight to receive further care or treatment recommended by a workers’ compensation physician. This situation frequently arises when a workers’ comp doctor recommends additional testing or refers an injured worker to a specialist. If the employer disagrees with the doctor’s recommendations, it may refuse to pay for the treatment or procedure. For example, the employer might resist paying for the injured worker to undergo arthroscopy to provide a more accurate diagnosis.

Iowa Workers’ Compensation Law Firm

If you believe the physician your employer chose to treat your work-related injury has provided unreasonable care, you may be able to obtain permission to seek alternate medical care from the Iowa Workers’ Compensation Commissioner. Because the injured worker has the burden to prove that the employer’s designated health care provider has not provided reasonable care, it is very important to consult with an experienced workers’ compensation attorney before submitting your alternate care petition. Contact Attorney Ed Keane today at (712) 234-3088 to discuss your case.

This website has been prepared by Keane Law Firm for informational purposes only and does not, and is not intended to, constitute legal advice. The information is not provided in the course of an attorney-client relationship and is not intended to substitute for legal advice from an attorney licensed in your jurisdiction.