Hansen-Smith v. West Des Moines Community School District, 010920 IAWC, 19700676.01

• Case Date: January 09, 2020
• Court: Iowa

SONJA HANSEN-SMITH, Claimant v. WEST DES MOINES COMMUNITY SCHOOL DISTRICT, Employer, and, SFM MUTUAL INSURANCE COMPANY, Insurance Carrier, Defendants. No. 19700676.01 Iowa Workers Compensation Before the Iowa Workers' Compensation Commissioner January 9, 2020          HEAD NOTE: 2701           ALTERNATE MEDICAL CARE DECISION           MICHAEL J. LUNN DEPUTY WORKERS’ COMPENSATION COMMISSIONER          On December 20, 2019, claimant filed an original notice and petition for alternate medical care under Iowa Code section 85.27, invoking the provisions of rule 876 I.A.C. 4.48. Defendants filed an answer accepting that claimant sustained injuries to the head and neck on May 16, 2019, which arose out of and in the course of her employment. Defendants noted that they denied liability for further medical care for claimant’s alleged head injury if claimant refused to present for a follow-up appointment with Steven Adelman, D.O.          This alternate medical care claim came on for hearing on January 3, 2020, at approximately 10:50 a.m. The proceedings were recorded digitally and constitute the official record of the hearing.          Prior to hearing, defendants were asked to clarify their seemingly conditional acceptance of claimant’s head injury. After a lengthy discussion regarding the undersigned’s inability to accept a conditional acceptance, defendants provided that for purposes of the alternate care proceeding they would be accepting liability for the alleged head injury.          The record consists of Claimant’s Exhibits 1 through 6, which include a total of 10 pages. Defendants offered Exhibits A through D, which include a total of 10 pages. Ms. Hansen-Smith was the only witness to provide testimony. Counsel for both parties provided argument.          ISSUE          The issue presented for resolution is whether claimant is entitled to alternate medical care consisting of recommendations for care contained in a report from Shawn Spooner, M.D. Claimant also seeks the removal of Steven Adelman, D.O., and Daphney Myrtil, M.D., as authorized physicians due to breakdowns in the physician-patient relationship.          FINDINGS OF FACT          Having considered all evidence and testimony in the record, the undersigned finds:

On May 16, 2019, Sonja Hansen-Smith injured her head, neck, and back while attempting to break up a fight outside of her classroom. In the process of breaking up the fight, Ms. Hansen-Smith’s head came into contact with a brick wall several times. (Claimant’s Testimony; see Exhibit C, page 1).

         Defendants authorized treatment through Daphney Myrtil, M.D. (See Ex. C, p. 2). Claimant received conservative treatment consisting of diagnostic imaging, medication, and physical therapy. Despite seeing improvement in her neck condition, claimant continued to experience persistent headaches and issues with balance. Claimant reported the same to her physical therapists, Catherine Mitchell, P.T. and Thomas Rodemyer, P.T.          According to claimant, Mr. Rodemyer was concerned with claimant’s persistent headaches and issues with balance. Claimant subsequently contacted defendants and requested additional treatment to address the same. Claimant testified defendants told her they would not pursue additional treatment for her complaints until she had completed physical therapy for her neck. When defendants did not immediately authorize additional treatment for her headaches, Mr. Rodemyer recommended she pursue treatment through her primary care physician.          Claimant’s primary care physician diagnosed her with a concussion and referred her on to Shawn Spooner, M.D. for further treatment. (Claimant’s Testimony; see Ex. 1, p. 1; see also Ex. C, p. 3). Defendants did not authorize claimant’s treatment with Dr. Spooner. Dr. Spooner is board-certified in sports medicine and family medicine. Dr. Spooner has been acting in a primary role of managing posttraumatic head injuries, including complex concussion injuries, for the past 7 years. He has led multidisciplinary teams for the United States military and now in a civilian role for UnityPoint Clinic. His focus is on the recognition and appropriate management of head and neck injuries, with an additional focus on management of co-morbidities. (Ex. 1, p. 1).          Claimant initially presented to Dr. Spooner on July 24, 2019. (See Ex. C, p. 3). Dr. Spooner diagnosed claimant with post-traumatic head and neck injuries, including a concussion, based on cognitive changes in addition to symptoms involving persistent headaches, functional vision dysfunction, and functional impaired postural stability or impaired balance. (See Ex. 1, p. 1). Dr. Spooner also commented on what he considered to be claimant’s extensive pre-existing co-morbidities, such as migrainous headaches, fibromyalgia, anxiety and depression, and ADHD, and how such co-morbidities impacted his diagnoses. (See Ex. 1, p. 1).          To address claimant’s ongoing symptoms, Dr. Spooner proposed a multidisciplinary approach consisting of appropriate vestibular and cervicogenic physical therapy, speech-language pathology for cognitive coping techniques, and cognitive rehabilitation. Dr. Spooner also recommended claimant present for an evaluation by neuro-optometry for what appeared to be substantial functional vision impairment. (See Ex. 1, p. 1).          Claimant subsequently produced Dr. Spooner’s report and recommendations to Dr. Myrtil. (See Ex. 2, p...