LYNCH LIVESTOCK, INC. and NATIONWIDE AGRIBUSINESS INS. CO., Plaintiffs-Appellants,
KENNETH BURSELL, Defendant-Appellee.
from the Iowa District Court for Polk County, Scott D.
Livestock appeals a district court order affirming final
agency action in a workers' compensation proceeding.
REVERSED AND REMANDED WITH INSTRUCTIONS.
Jeffrey W. Lanz of Huber, Book, Lanz, McConkey & Finch,
P.L.L.C., West Des Moines, for appellant.
M. Livingston and Rick D. Crowl of Stuart Tinley Law Firm
LLP, Council Bluffs, for appellee.
by Vogel, C.J., and Vaitheswaran and McDonald, JJ.
appeal arises out of a drawn-out workers' compensation
proceeding. Lynch Livestock appeals from the order of the
district court affirming the agency's decision that Lynch
Livestock should pay certain medical expenses incurred by
Kenneth Bursell for treatment of a work-related injury. On
appeal, Lynch Livestock contends it was error for the agency
to order Lynch Livestock to pay for the medical expenses.
fully address the issue of whether Lynch Livestock should
have to pay the challenged medical expenses, some background
is necessary. This is the second time the parties have been
before this court regarding Bursell's workers'
compensation claim. In the first appeal, this court reviewed
an alternate-medical-care decision. See Lynch Livestock,
Inc. v. Bursell, No. 14-1133, 2015 WL 2394143, at *1
(Iowa Ct. App. May 20, 2015). Our prior opinion recited the
relevant facts and procedural posture as follows:
In December 2008, Bursell sustained a sprained left ankle
while employed with Lynch Livestock, Inc. The employer
accepted the compensability of injury and paid for the care
Bursell selected. Bursell underwent two tarsal tunnel
decompressions to alleviate the pain, one in January and one
in July 2009. When the pain in Bursell's ankle did not
resolve, he was referred to John E. Cook, M.D., medical
director of Siouxland Surgery Center Pain Clinic. The
employer accepted the referral to Dr. Cook and paid for the
treatment provided, including injections to control pain.
Bursell was diagnosed with complex regional pain syndrome,
and Dr. Cook recommended he undergo a laparoscopic lumbar
sympathectomy for long-term relief and resolution of his
pain, referring him to Dr. Kelly, a vascular surgeon. On
February 11, 2010, Dr. Patrick Kelly, M.D., recommended
conservative treatment, opining a lumbar sympathectomy would
be a "last ditch effort/option." The employer had
Bursell evaluated by other physicians who concluded Bursell
does not have complex regional pain syndrome and would not
benefit from the sympathectomy. Instead, these physicians
recommended conservative treatment including physical therapy
and psychiatric referrals.
When the employer did not authorize the sympathectomy,
Bursell filed an application for alternate medical care on
April 7, 2010. The matter came before the deputy workers'
compensation commissioner on April 19, 2010. In granting the
alternate care, the deputy commissioner concluded Dr.
Cook's opinion recommending the surgery was
"reasonable and necessary." The deputy commissioner
ordered the employer to "provide and pay for the surgery
recommended by Dr. Cook including any referrals he makes and
any medication he prescribes to treat [Bursell's] work
The employer filed a petition for judicial review with the
district court on June 16, 2010. After holding oral
arguments, the district court issued its decision on June 16,
2014, reversing the agency's decision to grant the
treatment recommended by Dr. Cook. The district [court]
concluded the agency failed to apply the correct legal test
to Bursell's alternate care request as the agency failed
to decide whether the care authorized by the employer was
"unreasonable." The district court found the
agency's decision wholly unjustified and reversed the
Id. (footnote omitted).
prior opinion, we affirmed the district court's
judicial-review decision but remanded the case to the
district court for remand to the agency to apply the correct
legal standard to the petition for alternate medical care.
See id. at *4. In our prior opinion, we also noted