Chaples v. Gilco, Inc.

280 A.2d 546, 1971 Me. LEXIS 235
CourtSupreme Judicial Court of Maine
DecidedAugust 13, 1971
StatusPublished
Cited by6 cases

This text of 280 A.2d 546 (Chaples v. Gilco, Inc.) is published on Counsel Stack Legal Research, covering Supreme Judicial Court of Maine primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Chaples v. Gilco, Inc., 280 A.2d 546, 1971 Me. LEXIS 235 (Me. 1971).

Opinion

ARCHIBALD, Justice.

This is an appeal by the Employee from a pro forma decree of the Superior Court approving a decision of the Industrial Accident Commission.

There are only two issues to be decided:

1. Can the Appellees be ordered to pay for necessary diagnostic medical service rendered the Appellant in Boston by a nonresident physician, who is not licensed to practice in Maine?

2. Can the Appellees be ordered to pay the costs of taking the deposition of this Boston doctor for the sole purpose of perpetuating his testimony ?

The facts are . not in dispute. The Appellant was injured in an industrial accident and received medical and surgical treatment in Maine, for which payment was made by the Appellees. Prior to surgery, the Appellant was sent to Boston by ambulance on order of his Maine doctor, who had been selected by the Appellant, for purposes of diagnosis, the expenses being as follows:

New England Medical Center $ 758.20
Warren J. Courville, M.D. 75.00
Ambulance Service 175.00
$1,00820

It was agreed that there was a medical need for this diagnosis and that the total cost therefor, $1,008.20, was fair and reasonable. The Appellees were not given prior notice of the proposed trip to Boston for this purpose.

The Commission concluded: A.) There is no statutory authority for ordering the payment of such medical services obtained from a physician not on the panel selected pursuant to 39 M.R.S.A. § 52; 1 B.) The perpetuation of testimony is not “discovery” and, therefore, not within the provision of 39 M.R.S.A. § 93(3). 2

The law is well settled that reasonable transportation costs necessarily incident to receiving medical treatment are compensable. Newberry v. Youngs, (1956) 163 Neb. 397, 80 N.W.2d 165; Huhn v. Foley Bros., (1946) 221 Minn. 279, 22 N.W.2d 3.

Examination for diagnostic purposes, including hospitalization, falls within the medical services for which there may be payment under the Workmen’s Compensation Act. Travelers Insurance Co. v. Hernandez, (5 Cir. 1960) 276 F.2d 267.

In the instant case the referring Doctor was on the panel of physicians selected by the Industrial Accident Commission, as required by the Statute (see n. 1), but the Diagnostician was not. In order that the Maine Doctor might render proper surgical treatment he felt it necessary to have the opinion of Dr. Courville, and there is nothing in the record to suggest any error in this medical judgment. We consider this diagnosis to be within the “proper medical, * * * and hospital services” to which the Employee is entitled under the Act. We, *548 therefore, hold that a physician on the panel is not limited to other medical experts on the same panel from whom he may obtain diagnostic advice. This, of course, is limited by the necessities of a given case and the reasonableness of the charges, over which the Commission has discretionary supervision.

Neither Party has furnished us any specific authority to support, or negate, this conclusion. However, we note the provisions of the Council of State Governments Draft, § 12(b) which require the employer to maintain a “Panel of Physicians” from whom the employee may make his selection and which also contains this provision: “The physician selected under this paragraph may arrange for any consultation, referral, extraordinary or other specialized medical services as the nature of the injury shall require. * * * ” Larson on Workmen’s Compensation Law, § 61.12 at 88.234, n. 34.

The Workmen’s Compensation Act does not limit the authorized panel to resident Maine physicians but only to physicians “authorized to practice as such under the laws of the State,” there being no residence requirement in 32 M.R.S.A. § 3252 under which physicians and surgeons may be examined, registered and licensed to practice in Maine. Nor do we feel that the Legislature meant to restrict a licensed panel physician to one similarly situated when, to render the medical and surgical services required by the patient, the diagnostic services of a non-licensed physician become necessary.

The Appellees urge a .narrow construction of the Act by this argument: “If the employee is to have carte blanche to go wherever and to whomever he may wish at employer’s expense, there would be no limit to the amount for which the employer could be held accountable. Why stop at Boston? Why not a flight to the West Coast or Europe for hospitalization and an examination by any specialist that might be recommended to employee?”

In Ward v. Dixie Shirt Co., (1953) 223 S.C. 448, 76 S.E.2d 605, 610, the South Carolina Commission had, over the objection of the employer’s insurance carrier, authorized an injured employee to be examined in Atlanta, Georgia, by medical experts on the advice of his local attending physician, and it was held:

“It is stated in appellants’ brief: ‘The statute merely allows the Commission to send the claimant to a doctor, but the statute cannot be extraterritorial in nature and could only embrace the jurisdiction of the State of South Carolina.’ It is contended that there are competent neurosurgeons in South Carolina and to send claimant to Atlanta, Georgia, for examination adds unnecessarily to the liability of appellants for medical expenses and that the Atlanta physicians could not be compelled to attend court in South Carolina. These certainly constitute very cogent reasons why ordinarily claimants should be examined by South Carolina physicians. But we find nothing in the Workmen’s Compensation Act restricting the Commission to the selection of South Carolina physicians. We wquld not be warranted in holding that under no circumstances may physicians from other states be used in workmen’s compensation cases. The argument is made that if the Commission may send a claimant to Atlanta, it could send them to distant points and thereby impose an undue hardship on insurance carriers. But if the Commission- should abuse its discretion in this respect, such abuse is subject to correction by the courts." (Emphasis added.)

We adopt this reasoning, and note that the Commission has discretionary supervision over both the necessity for medical services and the reasonableness of the charges therefor.

39 M.R.S.A. § 52 (see n. 1) allows the injured employee to select his physician from the panel for needed medical or surgical services, but the Act does not *549 limit the medical judgment of the physician thus selected, nor does it restrict him in doing that which he may consider necessary to treat his patient, provided it meets the tests of necessity and reasonableness.

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280 A.2d 546, 1971 Me. LEXIS 235, Counsel Stack Legal Research, https://law.counselstack.com/opinion/chaples-v-gilco-inc-me-1971.