Case Name: Brewer-Strong v. HNI Corporation
Filed: June 8, 2018, Supreme Court of Iowa (No. 16-1364)
Subject matter: Employer’s right to control medical care after initially denying liability for workers’ compensation claim and standard for reimbursement of, and healing period benefits following, employee’s receipt of unauthorized care.
Facing an issue of first impression as to whether an employer can “regain control of the employee’s medical care” after denying liability, the Supreme Court held that “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 it amended its answer to acknowledge compensability for her injury.” The Court reasoned: “Holding otherwise would run contrary to the very purpose of Iowa Code chapter 85 to resolve ‘workplace-injury claims with minimal litigation’ by forcing employers to reach a conclusion about their liability for an employee’s injury without thoroughly performing their duty to investigate the claims, potentially creating more litigation and expenses in the process.”
The Court also reaffirmed the standard set out in Bell Bros. Heating & Air Conditioning v. Gwinn, 779 N.W.2d 193 204 (Iowa 2010), establishing that an employer can be ordered to pay for unauthorized care received by the employee only if the employee “prove[s] ‘by a preponderance of the evidence that such care was reasonable and beneficial’ under the totality of the circumstances,” with “beneficial” defined as “provid[ing] a more favorable medical outcome than would likely have been achieved by the care authorized by the employer.” The Court rejected the employee’s claim that the burden of proof set an impossible standard, concluding the burden “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. The mere fact that this creates a heightened burden for the employee does not require a modification of the test. This is all part of the balancing found within our workers’ compensation statute.” Justice Hecht dissented on this point, and would have overruled the Bell Bros. standard as “an impractical legal standard requiring parties, witnesses, and the commissioner to engage in sheer speculation.”
The Court also held that an employer is not required to pay healing period benefits when an employee is off due to unauthorized care. Recognizing that “Iowa Code section 85.34(1) does not explicitly state that an employee cannot receive healing period benefits for unauthorized care,” the Court nonetheless concluded that “[a]n interpretation that requires an employer to provide injured employees with healing period benefits for their unauthorized care when they knowingly abandoned the protections of Iowa Code section 85.27 would be inconsistent with the overall intent of the statute.”