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Clay v. Department of Education11/20/2000
Appeal from the Iowa District Court for Polk County, Linda R. Reade, Judge.
The petitioner appeals from the district court's ruling on judicial review affirming the industrial commissioner's review-reopening decision denying the petitioner additional worker's compensation benefits. The petitioner claims that: (1) the commissioner's decision which denied the award of additional benefits for an alleged increase in industrial disability was not supported by substantial evidence, (2) she was entitled pursuant to Iowa Code section 85.27 (1995) to have a prescription charge account for medicine needed for her treatment allegedly related to her work-related injury and for the payment of unpaid charges for such medication, and (3) the district court abused its discretion in refusing to remand the case pursuant to Iowa Code section 17A.19(7) for the hearing of additional evidence by the commissioner.
AFFIRMED.
Helen Clay appeals from the district court's ruling on judicial review affirming the industrial commissioner's review-reopening decision denying her additional workers' compensation benefits. Clay contends: (1) the commissioner's decision denying the award of additional benefits for the alleged increase in industrial disability was not supported by substantial evidence; (2) she was entitled to have a prescription charge account for medication needed for the treatment of the alleged work-related injury and for the payment of unpaid charges for such medication, pursuant to Iowa Code section 85.27; and (3) the district court abused its discretion in refusing to remand the case for the commission to hear additional evidence, pursuant to Iowa Code section 17A.19(7). We affirm.
I. BACKGROUND FACTS AND PRIOR PROCEEDINGS
Helen Clay was employed as secretary and administrative assistant for Respondent-Appellee the Iowa Department of Education. In August of 1990 she fell on a wet floor at work and sustained a back injury . Clay applied for workers' compensation benefits. In an arbitration decision filed February 3, 1994 Clay was awarded healing period benefits, 125 weeks of permanent partial disability, based on a twenty-five percent industrial disability, medical costs and alternate medical care. The deputy commissioner found that the fall had aggravated a pre-existing degenerative disc disease in her back. The decision was affirmed and adopted as final agency action by the commissioner on June 23, 1994.
Clay tried a number of treatments with several different doctors for her back, however she felt none of them were giving her sufficient relief. All of the physicians agreed she is not a candidate for surgery. In addition to her back problems, it is undisputed that Clay had several other health and medical problems, including a long-standing history of severe obesity, arthritis in her hands, knees and ankles, and diabetes. Eventually Clay began to see Dr. Marc Hines, a neurologist in Ottumwa, Iowa, in August of 1993. Although Dr. Hines was not "authorized" as a physician by the State of Iowa, the State paid for Clay's treatment by Dr. Hines pursuant to the order in the arbitration decision which thereby, in effect, made Dr. Hines an "approved" physician under Iowa Code section 85.27. Prior to treatment by Dr. Hines the State had directly paid for medication used in Clay's treatment through a prescription charge account. However, with her change to an "unapproved" physician, the State required Clay to pay for any medication prescribed herself, with subsequent reimbursement by the State after its review of the charge.
Clay filed a review-reopening petition on January 8, 1996, seeking to increase her award of industrial disability. Clay arg
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