This section contains the nature of the case and procedural background.

P suffered catastrophic injuries in an industrial accident while working for D. P was nineteen years old and, lost both his legs at the hip joint, as well as his buttocks, rectum, and a testicle. He has undergone numerous surgeries, including skin grafts and colon resections. P suffers from chronic phantom limb pain. P is very sensitive to temperature due to his extensive skin grafts and scaring. He is forced to spend most of his time in seclusion in his room at Opportunities Unlimited where the temperature can be kept cooler. P is often unable to use his wheelchair because his skin problems prevent him from sitting. Therefore, he uses a 'prone cart' that permits him to lie on his stomach and chest. P suffers from post-traumatic stress disorder and other psychological injuries as a result of the accident. He has lived in a medically supervised environment from the time he was injured in April 1997. P had no education or training beyond high school. He did not own a computer. D's worker's compensation carrier provided P with a laptop computer in October 1997. P completed ten hours of college course work. The computer died and could not be repaired. P filed an application for alternate medical care pursuant to Iowa Code section 85.27, on August 30, 2000. P requested that D be required to provide him with a laptop computer, including adaptations that would facilitate his use of it in his wheelchair and the prone cart. P needed a computer to assist him in his educational and rehabilitation pursuits. P called two employees of Opportunities Unlimited who supported his claim: a computer teacher who was certified by Microsoft, and a licensed occupational therapist. D argued that a computer did not qualify as medical care under section 85.27 and therefore D had no obligation to provide one. The deputy industrial commissioner concluded the computer and adaptive devices were appropriate expenses under section 85.27. The deputy stated that 'the computer is, in this case[,] an appliance because of the rehabilitative and therapeutic use it provides in an occupational therapy setting to increase [P's] vocational and personal independence, which were lost as a result of his injuries.' This ruling was affirmed by the district court on judicial review but was reversed by the court of appeals. P appealed.

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