Dunham v. United Parcel Service, Inc., 022820 IAWC, 5062713.01

• Case Date: February 28, 2020
• Court: Iowa

WALTER J. DUNHAM, Claimant v. UNITED PARCEL SERVICE, INC., Employer, and LIBERTY MUTUAL INSURANCE CO., Insurance Carrier, Defendants. No. 5062713.01 Iowa Workers Compensation Before the Iowa Workers' Compensation Commissioner February 28, 2020          HEAD NOTE: 2701           ALTERNATE MEDICAL CARE DECISION           JAMES F. ELLIOTT DEPUTY WORKERS’ COMPENSATION COMMISSIONER          STATEMENT OF THE CASE          This is a contested case proceeding under Iowa Code chapters 85 and 17A. The expedited procedure of rule 876 I.A.C. 4.48 is invoked by claimant, Walter Dunham.          The alternate medical care claim came on for hearing on February 26, 2020. The proceedings were digitally recorded which constitutes the official record of this proceeding. This ruling is designated final agency action and any appeal of the decision would be to the Iowa District Court pursuant to Iowa Code 17A.          The record consists of Claimant’s Exhibits pages1 – 10, Defendants’ Exhibits pages 1 – 10 and the testimony of claimant and his wife Trina Dunham. Both parties submitted briefs.          ISSUE          The issue presented for resolution is whether the claimant is entitled to alternate medical care. Claimant has alleged:

The employer/carrier has refused to authorize treatment recommended by the authorized treating physician, Dr. Saddler, consisting of physical therapy, chiropractic, acupuncture and massage therapy. In addition, the employer/carrier has delayed and refused to pay for treatment that was authorized, including treatment by Coldstream Health and Dr. Lindsey Lake, causing that clinic to refuse to treat Claimant.

Due to the disruptions in recommended treatment, Claimant is experiencing severe symptoms that have become debilitating. Claimant seeks authorization for a comprehensive evaluation for spine pain management at UIHC to address the recent MRI results and his severe flare in symptoms. Claimant also seeks an order requiring employer/carrier to pay for authorized treatment to date.

(Alternate Care Petition)          FINDINGS OF FACT          The undersigned having considered all of the testimony and evidence in the record finds:          Defendants admitted liability for an injury occurring on March 23, 2015.          Claimant has had two surgeries on his back, a surgery in 2012 and one in 2015. Claimant has not seen an orthopedic surgeon or orthopedic specialist since the surgery in 2015. Claimant testified that he would like to have an orthopedic physician or a neurologist evaluate his MRI. Claimant testified that his pain physician told him that she is not an expert in orthopedic matters.          Trina Dunham testified claimant’s condition is getting worse and that claimant has socking pain in his right leg and his pain has significantly disrupted his sleep.          Defendants have authorized Julie Saddler, M.D., a pain specialist, to provide treatment for claimant’s back pain. Coldstream Health and Lindsey Luke, D.C. has been providing treatment to the claimant since February 28, 2018. (Claimant’s Exhibit 1, p. 4) On September 30, 2019 Dr. Saddler examined claimant. (Defendants’ Exhibit 1, pp. 1- 2) Dr. Saddler noted claimant has had persistent pain in his right leg since his 2015 surgery. Dr. Saddler noted,

He has been managing pain over the past 18 months with chiropractic care, acupuncture and massage therapy, but pain seems to be increasing. He describes a continuous sharp stab and electrical shocks. Pain is in his right buttock, shooting down his right posterior leg into the sole of his right foot with new pain developing into his right lateral leg. He rates his pain 6/10. Pain improves somewhat with water exercises in a hot tub. His best position for comfort varies. Pain increases with standing or sitting too long. His worst position for comfort is standing. Pain interrupts his sleep. He is unable to work a full 8 hours. Pain limits his physical activity and social activity.

(Def. Ex. 1, p. 1) Dr. Saddler discusses the 2015 MRI in this exhibit. On October 21, 2019 Dr. Saddler noted that the recent MRI did not show any significant changes. Dr. Saddler wrote,

Recommend continued massage, chiro, PT. If right leg persists, patient is candidate for SCS consultation with one of my partners. Otherwise, no further pain interventional injections since no benefit from prior

(Def. Ex 1, p. 3)          On December 2, 20191 claimant’s counsel contacted the insurance carrier concerning obtaining medical care. The email noted that Dr. Saddler had recommended continued massage, chiropractic and physical therapy. The email said...