Duncan v. Fidelity & Casualty Co.

250 F. Supp. 907, 1966 U.S. Dist. LEXIS 6454
CourtDistrict Court, S.D. Texas
DecidedFebruary 11, 1966
DocketCiv. A. No. 64-C-48
StatusPublished

This text of 250 F. Supp. 907 (Duncan v. Fidelity & Casualty Co.) is published on Counsel Stack Legal Research, covering District Court, S.D. Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Duncan v. Fidelity & Casualty Co., 250 F. Supp. 907, 1966 U.S. Dist. LEXIS 6454 (S.D. Tex. 1966).

Opinion

GARZA, District Judge.

The Plaintiff, Leona Duncan, appealed to this Court from a final award of the Industrial Accident Board of June 2, 1964, terminating her Workmen’s Compensation payments after Defendant Insurer had paid a total of fifty-eight (58) weeks compensation to the Plaintiff.

The Plaintiff suffered a back injury as the result of a fall on April 11, 1963, at the cafe where she was employed as a waitress. The parties have stipulated that she received an accidental injury in the course of her employment on that date; that while the matter was pending before the Industrial Accident Board, the Defendant admitted liability for the payment of Workmen’s Compensation benefits, and filed written demand for surgery upon the Plaintiff; that the Board ordered an examination of the Plaintiff by Dr. Herbert Burns; that Dr. Burns made a report of his examination to the Board; that the Board issued its unanimous order directing the Plaintiff to submit to surgery within twenty (20) days from April 30, 1964, the date of the order; that on May 1, 1964, the Plaintiff, through her attorney, advised the Board that she would not comply with its order; and that Defendant paid fifty-eight (58) weeks compensation to the Plaintiff from April 12, 1963, to May 21, 1964.

In the pretrial stipulation submitted through their attorneys, the parties agreed that the issues in controversy were as follows:

“1. Will surgery upon Leona Duncan materially benefit and improve her condition?
“2. Is such surgical operation more than ordinarily unsafe?
“3. Did Leona Duncan have any total disability from and after 58 weeks from the date of her alleged injury?
“4- Did Leona Duncan have any partial disability from and after 58 weeks from the date of her alleged injury?
“5. What is Leona Duncan’s average weekly wage?”

The case was tried before a jury upon the theory that the Defendant had fully complied with the statutory requirements of the Texas Workmen’s Compensation Law so as to allow it to prove the benefits of surgery upon the Plaintiff and [909]*909that the operation would not be more than ordinarily unsafe.

The case was submitted to the jury on special interrogatories inquiring, first, if from a preponderance of the evidence it would have been more than ordinarily unsafe for the Plaintiff to have submitted to the operation on her back on April 30, 1964. The jury was next asked if from a preponderance of the evidence surgery upon the Plaintiff would have materially benefited and improved her condition on said date. The remaining interrogatories inquired as to the nature and duration of Plaintiff’s disability as a result of her accidental injury, and further asked for the difference between her average weekly wage before the injury and her average weekly wage earning capacity during any partial disability which might be found.

The jury returned its verdict, finding that the back operation would not have been more than ordinarily unsafe, that it would have benefited and improved the Plaintiff’s condition, and that the injury was a producing cause of total and permanent disability.

Since § 12b and § 12e, Article 8306, Vernon’s Ann.Tex.Civ.St., limit compensation to a period of one year for an employee who refuses to submit to an operation unanimously ordered by the Board after examination, and since the Defendant has paid the Plaintiff fifty-eight (58) weeks of compensation; the Defendant Insurer moves for judgment on this verdict that the Plaintiff take nothing and that costs be assessed against the Plaintiff.

Plaintiff has also filed a motion for judgment awarding compensation for total and permanent disability, contending that the answers to the interrogatories inquiring about the advisability of surgery should be ignored and the judgment based upon the jury findings of total and permanent disability.

In support of this position Plaintiff for the first time raises the point that the interlocutory order of the Board directing the Plaintiff to submit to surgery was void because of noncompliance with §§ 12b and 12e of Article 8306, and because the final award of the Board superseded the order directing surgery and found no further disability.

Section 12e, Article 8306, sets forth the steps to be taken in determining the advisability of a surgical operation and the consequences of refusing to submit to surgery when ordered by the Board. This section incorporates by reference some of the provisions of § 12b which is the hernia statute.

Plaintiff contends that one of the provisions in § 12b which is incorporated by § 12e is the requirement that the physician’s report of examination be signed and sworn to, and that the report of Dr. Burns recommending a laminectomy and disc removal, upon which the Board ordered the Plaintiff to submit to surgery, was not sworn to as required by the hernia statute, § 12b.

Defendant contends that § 12e, which relates to all other injuries, makes no such requirement either specifically or by reference to § 12b.

It is well recognized that the rights and obligations of parties to a Workmen’s Compensation suit are entirely controlled by the statute, since the Act is in derogation of the common law, and that every step provided therein must be taken in the manner directed, and no other. Truck Insurance Exchange v. Seelbach, 1960, 161 Tex. 250, 339 SW.2d 521.

Section 12e provides that an operation may be ordered by the Board only when there has been (1) a demand in writing to the Board by either party, (2) an order by the Board for a medical examination as provided in § 12b, (3) an examination, report of facts and opinions of experts, “all reduced to writing and filed with the board,” showing that such operation is advisable and will relieve the condition of the injured employee or will materially benefit him; (4) a written statement to that effect by the Board; and (5) the unanimous order of the Board in writing directing the employee to submit to the operation, [910]*910a copy of which shall be directed to the employee and the association. Section 12e concludes, “The results of such operation, the question as to whether the injured employé shall be required to submit thereto and the benefits and liabilities arising therefrom shall attach, be treated, handled and determined by the board in the same way as is provided in the case of hernia in this law.”

Section 12b provides in the case of hernia, that surgery shall be provided and if refused the Board shall order an examination and report which must be signed and sworn to, stating whether the operation is advisable and not more than ordinarily unsafe. If the Board finds the operation advisable and not more than ordinarily unsafe, and orders the employee to submit thereto, then upon refusing the operation his compensation is limited to a maximum of one year.

The cases relied upon by the Plaintiff involve attempts by the insurer to prove the beneficial effects of surgery at trial where it has not been tendered to the claimant or ordered by the Board.

In Garcia v. Travelers Insurance Co., S.Ct. of Tex., 1963, 365 S.W.2d 916, the employee declined surgery when the insurer first demanded it, and although the Board directed the employee to submit to an examination, it never ordered him to submit to an operation.

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Related

American General Insurance Company v. Quinn
277 S.W.2d 223 (Court of Appeals of Texas, 1955)
Garcia v. Travelers Insurance Company
365 S.W.2d 916 (Texas Supreme Court, 1963)
Industrial Accident Board of Texas v. Hudson
246 S.W.2d 715 (Court of Appeals of Texas, 1952)
Truck Insurance Exchange v. Seelbach
339 S.W.2d 521 (Texas Supreme Court, 1960)
Heard v. Texas Compensation Ins.
87 F.2d 30 (Fifth Circuit, 1936)

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Bluebook (online)
250 F. Supp. 907, 1966 U.S. Dist. LEXIS 6454, Counsel Stack Legal Research, https://law.counselstack.com/opinion/duncan-v-fidelity-casualty-co-txsd-1966.