Appeal from the Iowa District Court for Polk County, Eliza J. Ovrom, Judge.
The opinion of the court was delivered by: Mullins, J.
An injured employee appeals from the district court's decision affirming the agency's denial of workers' compensation benefits. AFFIRMED.
Considered by Doyle, P.J., and Mullins and Bower, JJ.
We consider whether there is substantial evidence to support the workers' compensation commissioner's (commissioner) conclusion that employee Alice Talton's work injury did not cause her arthritis or the pain in her knee and back, that she was not entitled to alternate medical care, and that she was not entitled to additional temporary disability or healing period benefits. The district court affirmed the commissioner's ruling and so do we.
On April 17, 2007, Talton sustained a stipulated work-related injury when a seven-pound can of tomatoes fell about six feet onto her left foot.
Talton's primary care physician referred her to podiatrist Dr. Robert Eells. Dr. Eells evaluated her foot and x-rays, and diagnosed an injury to the first metatarsal head. Talton saw Dr. Eells periodically for about three months. On July 18, 2007, Dr. Eells referred Talton to Dr. Eric Barp, a foot surgeon, for possible removal of a fractured sesamoid.
Talton met with Dr. Barp on July 19, 2007. He diagnosed a fractured fibular sesamoid on her left foot that he believed would heal with conservative treatment. He noted her back and hip pain "should subside once we get her out of the CAM boot. We will get her out of the CAM boot." Dr. Barp's assessment was sesamoiditis and arthritis in her big toe joint. In a November 20 letter to the nurse case manager, Dr. Barp stated he told Talton to stop using the CAM boot that day. The letter indicated he believed she had reached maximum medical improvement and that her left big toe arthritis was unrelated to her work injury.
On January 11, 2008, Talton sought treatment on her own initiative from Dr. Vincent Mandracchia, a podiatrist at Broadlawns Medical Center. Dr. Mandracchia assessed her condition as degenerative joint disease with hallux limitus first metatarsal phalangeal joint, left. Dr. Denise Mandi, a foot surgeon at Broadlawns Medical Center, performed an exostectomy on January 31.
Talton had follow-up appointments with Dr. Mandi on February 26 and March 25, 2008. Talton was recovering well from surgery, but reported that her pain was "about the same." Dr. Mandi suggested hemi-implant surgery to replace the left big toe joint.
Talton saw other doctors throughout 2008 to treat pain in her right knee and lower back. Dr. David Wadle and Dr. Dana Simon of the Mercy Pain Medicine Center treated her for back pain. Dr. Simon indicated Talton's back pain was "probably secondary to the antalgic gait abnormality, maybe somewhat contributory." Dr. Wadle similarly stated that Talton's altered weight bearing activities seem to have aggravated a pre-existing condition in her lower back.
On March 26, 2008, Talton saw Dr. Timothy Kenney from the Iowa Orthopaedic Center for her knee pain. Dr. Kenney believed Talton's altered weight bearing aggravated a pre-existing condition in her arthritic right knee but that this was a temporary condition caused by her altered gait while wearing the CAM boot.
On July 8, 2009, Dr. Mandracchia wrote a letter explaining that he believed the joint disease and cartilage damage in Talton's left big toe directly resulted from her April 2007 work injury and that joint ...