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Employer responsible for injured worker's chiropractor payments: Iowa appeals court


DES MOINES, Iowa—An Iowa hospital must pay for an injured worker's unauthorized chiropractor visits because it failed to provide the man with timely medical care, the Iowa Court of Appeals said Wednesday.

Charles Stokes injured his back in 2004 while working for Finley Hospital in Dubuque, Iowa, court records show. He underwent back surgery in 2005 and received care until October 2006 from an employer-approved physician, identified in court records as “Dr. Pearson.”

Under the physician's direction, Mr. Stokes took Tylenol to reduce his back pain, records show. But he ultimately stopped taking the medication after he was diagnosed with ulcers and later sought out chiropractic care from another doctor for his continued lower back pain.

Mr. Stokes asked Finley Hospital in 2010 to pay for his chiropractic sessions as part of his workers comp claim, records show. However, the hospital denied payment and directed Mr. Stokes several times to return to the employer-approved physician.

While Mr. Stokes visited the employer-approved physician for an evaluation in March 2011, records show he denied a request to refer Mr. Stokes to his current chiropractor, saying “I don't treat pain.” The employer-approved physician suggested an MRI at that time but did not provide any other treatment.

An Iowa workers comp commissioner approved chiropractic treatments for Mr. Stokes in April 2011 after finding that the employer-approved physician had not provided Mr. Stokes with “any active care.” An Iowa district court upheld that ruling after finding that the employer-approved physician's care was not offered “promptly.”


In a unanimous decision, the Iowa appellate court upheld the previous rulings authorizing Mr. Stokes’ chiropractic care. The court found that Mr. Stokes had a right to seek alternate medical care under Iowa workers comp law after he was unable to receive timely treatment from the employer-approved physician.

“After Stokes expressed his dissatisfaction with the care provided, nearly six months had expired, and three petitions for alternative care had been filed, although the first petition was dismissed,” the ruling reads. “During that time the only ongoing care ultimately authorized by Finley was an MRI test. However, that authorization came one day before the hearing on the third petition and as noted, Dr. Pearson’s medical notes only state that it ‘may’ be needed.”