Abf Freight System, Inc. and Ace American Insurance Co. v. Marvin Veenendaal, 16-0653

Martin Veenendaal sustained a compensable work-related back injury in October 2006; compensability was established in earlier proceedings.
He was scheduled for back surgery in 2008 but the claims administrator (Gallagher Bassett) denied coverage based on Dr. Abernathey’s opinion that the L4–L5 herniation was not work-related, so surgery did not occur.
Veenendaal later sought review-reopening relief, requesting increased compensation and medical benefits (surgery) under Iowa Code §85.27; he testified repeated requests for authorization were ignored by the employer/insurer.
A deputy commissioner found a substantial change in condition for disability (later reversed on that point) but found the need for surgery was related to the 2006 injury and ordered ABF to authorize surgery promptly; the commissioner affirmed the surgery order.
The district court affirmed the agency’s final decision ordering ABF to authorize surgical care; ABF appealed only the question whether Veenendaal met his burden to show the requested care was causally related and reasonable.
The Court of Appeals held the commissioner’s findings that the alternate (surgical) care was reasonable and necessary were supported by substantial evidence and affirmed.

Issue	Veenendaal's Argument	ABF's Argument	Held
Whether claimant met burden to obtain authorization for back surgery (alternate care) under §85.27	Surgery is related to the 2006 compensable injury; employer ignored repeated requests so alternate care should be authorized	Surgery is not shown to be causally related/necessary; agency applied wrong burden (initially argued)	Held: Claimant met burden; commissioner’s finding that surgery is reasonable and related is supported by substantial evidence; order to authorize surgery affirmed
Whether review-reopening justified increased compensation under §86.14(2)	Claimed substantial change in condition warranting increased benefits	Employer disputed causal proof for increased disability	Held: Commissioner denied increased benefits (no appeal of that denial); issue not before court on this appeal

Simonson v. Snap-On Tools Corp., 588 N.W.2d 430 (Iowa 1999) (standard for reopening awards to increase compensation)
Williamson v. Wellman Fansteel, 595 N.W.2d 803 (Iowa 1999) (claimant must prove post-award impairment proximate to original injury for reopening)
R.R. Donnelly & Sons v. Barnett, 670 N.W.2d 190 (Iowa 2003) (where compensability is not disputed, commissioner may order alternate care if claimant proves necessity)
Kohlhaas v. Hog Slat, Inc., 777 N.W.2d 387 (Iowa 2009) (res judicata principles limit relitigation of impairment/earning capacity in reopening)
Bell Bros. Heating & Air Conditioning v. Gwinn, 779 N.W.2d 193 (Iowa 2010) (disputes over diagnosis/treatment are questions of reasonable medical care, not compensability)