Garcia v. Travelers Insurance Company

365 S.W.2d 916, 6 Tex. Sup. Ct. J. 334, 1963 Tex. LEXIS 561
CourtTexas Supreme Court
DecidedMarch 13, 1963
DocketA-9293
StatusPublished
Cited by9 cases

This text of 365 S.W.2d 916 (Garcia v. Travelers Insurance Company) is published on Counsel Stack Legal Research, covering Texas Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Garcia v. Travelers Insurance Company, 365 S.W.2d 916, 6 Tex. Sup. Ct. J. 334, 1963 Tex. LEXIS 561 (Tex. 1963).

Opinion

GREENHILL, Justice.

In this workmen’s compensation case, the question is whether the claimant should be limited to a recovery of 52 weeks of compensation because of his refusal to submit to surgery. The trial court, under facts which will be set out, held that he should not be so limited. Judgment was entered for the claimant for total and permanent disability. The Austin Court of Civil Appeals disagreed. It reversed the judgment of the trial court. Since the claimant had already been paid in excess of 52 weeks, it rendered judgment that the claimant take nothing by his suit. 360 S.W.2d 415.

The claimant, Louis Garcia, injured his back when he slipped while carrying 130 pounds of marble. The insurer began to make compensation payments shortly after injury and continued to make them for 82 weeks, up to the time of the Industrial Accident Board’s final award. It also bore the expense of Garcia’s treatment. He was placed in a hospital at Killeen and was moved to a hospital in San Antonio, where he was placed in traction. Both of the doctors who examined Garcia were of the opinion that he had a ruptured interverte-bral disc in the lumbar or lower back region. Both recommended to him and to the insurance company that he have surgery. Garcia at first agreed to surgery, but changed his mind. He was told by the doctors that the odds were SO to 90 per cent *917 in favor of the operation’s being successful; that it would relieve his pain; that it was not regarded as a dangerous operation ; and that he would be benefited materially by it if not cured entirely. But Garcia apparently entertained a fear of paralysis, and the doctors could not guarantee their results. There was testimony that there was some slight chance of infection, of injury from the anesthetic, or of paralysis if the surgery were not carefully done; but that none of this should occur if the operation were conducted by a competent physician. No doctor advised Garcia not to submit to surgery. The insurer tendered Garcia an operation at its expense, but he declined.

So the insurer took other steps set out by the Texas statutes. It admitted liability for the injury, responsibility for the hospital and medical expenses, and demanded in writing that Garcia submit to surgery. The demand was addressed to the Industrial Accident Board. The insurer also wrote Garcia’s attorney of the demand and asked for a reply. Garcia’s counsel declined for Garcia, saying, “My client, at the present time, can receive no assurance that he will not be crippled for the rest of his life if he submits to the operation requested by the insurance company.”

Following the provisions of Sections 12e and 12b of Article 8306, 1 the Board appointed Dr. David Oliver, a physician, to examine Garcia. Dr. Oliver agreed with the diagnosis of the other two doctors, and he too recommended surgery. Garcia told Dr. Oliver he did not wish to be operated upon.

Thereafter the Board entered its final order. It provided that Garcia should be paid $35 per week for 100 weeks. As to the surgery, the order stated, “The Board finds that named insurer filed a Demand for Surgery. Said Demand for Surgery is hereby denied as named employee has declined same.” Notice of appeal to the district court was promptly given.

Trial was to a jury. The claimant made a motion at the outset to exclude any evidence which would refer to the offer of surgery or the benefits to be derived therefrom. The motion was overruled, and that point is not before us. See Hardware Mutual Casualty Co. v. Courtney, Tex., 363 S.W.2d 427 (1963). The evidence from Garcia and the doctors relating to surgery was given before the jury. The jury found that Garcia was totally and permanently disabled, and from these particular findings there is no appeal. The jury also found that Garcia had refused the tendered surgery; that the operation would have effected a cure or would have materially and beneficially improved Garcia’s condition; and that it would not have been more than ordinarily unsafe for Garcia to have submitted to the tendered operation.

The defendant-insurer moved for judgment on the verdict. Its motion was denied. The plaintiff Garcia moved to disregard the answers to the issues as to the operation and for judgment on the rest of the verdict. Garcia’s motion was granted.

While the case was under submission in the Court of Civil Appeals, that Court wrote Garcia through his attorney and asked if he were willing at that time to submit to the operation. Garcia replied that he would, at the time and place selected by the Court, and at the hands of a surgeon selected by the Court, if his compensation payments were accelerated to $105 per week, were paid to date, and upon other conditions. His letter is set out in 360 S.W.2d at 420. The Court of Civil Appeals treated this conditional answer as a refusal to submit to surgery. As stated above, since Garcia had already been paid more than 52 weeks of compensation, the Court of Civil Appeals rendered judgment that Garcia take nothing by his suit.

*918 The rights here involved of both parties are entirely controlled by statute. Truck Insurance Exchange v. Seelbach, 161 Tex. 250, 339 S.W.2d 521 (1960). And, as stated in Seelbach, “Where the statute directs that action be taken in a certain way it may be performed in no other manner..”

Two sections of Article 8306 are determinative of the matter before the Court, and we construe them together. Section 12e deals with surgery in general. It provides that where liability exists for an injury and surgery will cure dr benefit the employee, the employee or the insurer may demand an operation. After a written demand, “the board shall immediately order a medical examination of the employé in' the same manner as is provided for in the section of this law relating to hernia.” [That is Section 12b which will be referred to below.] If it is shown that the operation is advisable and will benefit the employee, “the board shall so state in writing and upon unanimous order of said board m writing * * * [the board] shall direct the employé * * * to submit himself to an operation for said injury. If the board should find that said operation is not advisable, then the employé shall continue to be compensated * * * under the general provisions of this law. If the board shall unanimously find and so state in writing that said operation is advisable, it shall make its order to that effect, stating the time and place when and where such operation is to be performed, naming the physicians * * *.” The article then says that “if the employé refuses to submit to such operation, the board may order or direct the association [the insurer] to suspend the whole or any part of his compensation during the time of said period of refusal.”

The section referred to as dealing with operations for hernia is Section 12b. It says that if the employee refuses to submit to an operation, the board shall order an examination.

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Bluebook (online)
365 S.W.2d 916, 6 Tex. Sup. Ct. J. 334, 1963 Tex. LEXIS 561, Counsel Stack Legal Research, https://law.counselstack.com/opinion/garcia-v-travelers-insurance-company-tex-1963.