Alfonzo Penny v. Whirlpool
16-0495
| Iowa Ct. App. | Feb 8, 2017Background
- Penny, a Whirlpool employee, injured his back at work on April 1, 2015 and was treated by Whirlpool-authorized physicians Dr. Peter Matos and neurosurgeon Dr. Chad Abernathey.
- MRI showed a disc contusion and annular tear contacting portions of a nerve root; doctors favored conservative care and ordered further testing and pain-clinic management.
- Whirlpool scheduled appointments and transportation, but Penny did not attend, believing Whirlpool considered the injury nonwork-related.
- On June 2, 2015 Penny petitioned the Iowa Workers’ Compensation Commission for authorization to transfer care to an alternate neurosurgeon (Dr. Darin Smith); the commission denied the petition.
- Penny sought rehearing and then judicial review; the district court affirmed the commission, and Penny appealed to the Court of Appeals.
- The Court of Appeals reviewed only the record from the June 2, 2015 petition and affirmed, finding substantial evidence the authorized physicians — not Whirlpool or its insurer — made medical decisions and that authorized care was not unreasonable.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the commission erred in denying Penny's request for alternate medical care under Iowa Code §85.27(4) | Penny argued Whirlpool and its carrier controlled his specific medical treatment and thus the commission should authorize alternate care | Whirlpool argued it merely authorized providers and arranged appointments/payment; treating physicians made care decisions and authorized care was reasonable | Court held commission did not err; substantial evidence shows doctors made treatment decisions and authorized care was reasonable, so denial affirmed |
| Whether the commission misinterpreted §85.27(4) (legal error) | Penny contended the commission applied the statute incorrectly by allowing employer control over specific treatments | Whirlpool and commission maintained statutory framework was properly applied: employer may select providers but cannot bar reimbursement for necessary unauthorized care; commissioner correctly assessed reasonableness | Held no erroneous legal interpretation; decision consistent with statute |
| Whether the commission departed from its precedent or policy | Penny claimed the decision conflicted with prior commission precedent about employer control over care | Whirlpool asserted consistency with precedent and statutory balancing of interests between employer selection of providers and employee remedies | Held decision not inconsistent with precedent |
| Whether the commission’s factual findings lack substantial evidence | Penny argued record does not support finding that doctors — not employer/carrier — directed treatment and that authorized care was reasonable | Whirlpool pointed to record showing physicians ordered testing, pain management, and conservative treatment; failure to attend appointments by Penny undermined his claim | Held factual findings supported by substantial evidence |
Key Cases Cited
- Mary v. Iowa Dep’t of Transp., 382 N.W.2d 128 (Iowa 1986) (judicial review limited to the agency record)
- Neal v. Annette Holdings, Inc., 814 N.W.2d 512 (Iowa 2012) (standards for district court review of agency action)
- Jacobson Transp. Co. v. Harris, 778 N.W.2d 192 (Iowa 2010) (grounds for relief on judicial review tied to statutory subsections)
- Ramirez-Trujillo v. Quality Egg, L.L.C., 878 N.W.2d 759 (Iowa 2016) (explaining Iowa Code §85.27(4) balance between employer selection of providers and employee's right to necessary care)