Harsha v. Maremont Corp.

1989 OK 164, 784 P.2d 1070, 1989 Okla. LEXIS 197, 1989 WL 155053
CourtSupreme Court of Oklahoma
DecidedDecember 26, 1989
DocketNo. 70846
StatusPublished
Cited by3 cases

This text of 1989 OK 164 (Harsha v. Maremont Corp.) is published on Counsel Stack Legal Research, covering Supreme Court of Oklahoma primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Harsha v. Maremont Corp., 1989 OK 164, 784 P.2d 1070, 1989 Okla. LEXIS 197, 1989 WL 155053 (Okla. 1989).

Opinions

OPALA, Vice Chief Justice.

The dispositive issues on certiorari are: (1) Is the trial tribunal’s decision against the physician so legally flawed that the claim must be remanded for reconsideration? and (2) Did the Court of Appeals err in assessing the physician’s counsel fees and costs against the employer? We answer both questions in the affirmative.

William N. Harsha, M.D. [physician or medical claimant] sought to recover pay[1072]*1072ment from Maremont Corporation [employer] for medical services claimed to have been rendered to an injured employee. At the hearing the medical claimant’s lawyer offered as proof of the claim copies of the physician’s Form 19, an itemized bill and the statement authorizing legal representation.

During the same proceeding other health providers as well sought payment from the employer by offering similar documents. Defense counsel objected to one of the latter claims on three specific grounds: lack of notice, authorization and necessity. To Dr. Harsha’s bill the objection interposed was on the sole ground that “it represents a totally unauthorized change of doctors.” The trial judge “noted” the employer’s objection and accepted for consideration all of the medical claimant’s documents.

In further defense of the physician’s claim the employer offered several medical reports that had been used as evidence in earlier proceedings pressed by the employee. Those papers were admitted without objection.

Dr. Harsha’s claim met with denial based on the finding

“[t]hat the Form 19’s of Dr. ... J. ... and Dr. William Harsha were not necessary or authorized medical treatment, and are therefore not ordered to be paid.”

On appeal, a three-judge panel affirmed the claim’s denial as one that “was not against the clear weight of the evidence nor contrary to law.” The Court of Appeals vacated the order and directed that the physician’s claim be paid on remand. That court noted:

“[There is] nothing in the record prior to the trial court’s determination of claimant’s injury and compensation to indicate Dr. Harsha’s treatment was not necessary or unreasonable, nor is there any objection to the treatment, although respondent [employer] had adequate notice and time prior to trial to object.”

In short, the appellate court viewed the employer’s proof as having failed “to indicate that Dr. Harsha’s treatment was unreasonable and unnecessary.” Upon the employer’s petition, certiorari is now granted.

I.

THE ANATOMY OF FORM 19 PROCEEDINGS

The pattern of proof to be adduced in a Form 19 proceeding is governed by Rule 26,1 Workers’ Compensation Court Rules. That rule provides that anyone seeking payment for health-related services rendered to a compensation claimant may use a “verified or declared report” to establish the claim. The health care provider must, in any event, show: 1) the charges were reasonable (or “based upon the rates prevailing in the community”), 2) the services rendered were necessary and 3) either the notice requirements of 85 O.S.1981 § 142 were met or the treatment was authorized.

II.

THE CLAIM MUST BE REMANDED FOR RECONSIDERATION

The trial tribunal found that the medical services for which the physician sought an [1073]*1073award were “not necessary or authorized medical treatment.” (emphasis added). This finding leaves us in doubt whether the trial judge’s denial was intended to be rested on his finding that the treatment was “not necessary” and hence should be regarded as one that could not be legally authorized for payment by the employer, or whether the rendered treatment was viewed as unnecessary because it had not been authorized prior to its inception.

Assuming the trial judge’s critical finding means that the medical services were both unnecessary and unauthorized, the order denying the claim is nonetheless vulnerable to vacation. The first component of the finding is not responsive to the issues raised at the hearing and the second is plainly contrary to the law in effect when the services began. The finding that the medical treatment rendered by Dr. Har-sha was unnecessary clearly is unresponsive to the defense issues tendered before the trial judge. The only objection the employer had advanced regarding Dr. Harsha’s claim was based on lack of authorization, not lack of necessity.

The question whether a claim for medical expenses should be disallowed because a compensation claimant had changed physicians without authorization was clearly settled in Iwunoh v. Maremont Corp.3 There, we held that a claimant need not obtain the court’s or the employer’s approval before changing physicians; the employer need only have been provided with the notice prescribed by the terms of 85 O.S.1981 § 14 within a reasonable time after the change had occurred.4 Although § 14 has since been amended,5 at the time Dr. Harsha claims to have begun treating the employee, there was no statutory requirement for prior court authorization. It is not disputed here that (a) the physician’s bill covers the period from June 1986 to June 1987 and (b) the employer had timely notice of the Harsha treatment’s inception.6 The amended version of §■ 14 did not become effective until November 1, 1986.

In sum, the employer’s lack-of-authorization objection does not constitute a defense against Dr. Harsha’s claim, which is governed by the provisions of § 14 prior to its 1986 amendment. The trial tribunal’s finding that the medical services were “not authorized” is hence clearly contrary to law.

This claim cannot be remanded for entry of an award. Although the employer did not raise the defense of unnecessary treatment, we are nonetheless left in doubt by the appellate record before us whether Dr. Harsha himself proved that his services were necessary. His affidavit stating that they were medically needed has, at best, a [1074]*1074clouded evidentiary status.7 We must accordingly remand this proceeding for reconsideration consistent with the views expressed in this opinion.8

III.

THE COURT OF APPEALS HAD NO AUTHORITY TO AWARD THE PHYSICIAN HIS COUNSEL FEES AND COSTS AGAINST THE EMPLOYER

After the Court of Appeals had rendered its decision for the doctor, he moved in that court for an assessment against the employer of costs and attorney’s fees incurred in this review proceeding. In support of his quest Dr. Harsha relies upon 12 O.S. 1981 § 9789 and 20 O.S.Supp.1982 § 15.1.10 The employer argues here that neither statute is applicable. We agree.

Section 978 deals with the cost regime for cases that come on appeal from the district courts. Even if it did apply to workers’ compensation claims, costs do not include attorney’s fees unless they are explicitly included by the text of a statute.11

The provisions of 20 O.S.Supp.1982 § 15.1 are patently inapplicable to this case. Under this section counsel fees may be recovered

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Wilson v. Glancy
1995 OK 141 (Supreme Court of Oklahoma, 1996)
TRW/Reda Pump v. Brewington
1992 OK 31 (Supreme Court of Oklahoma, 1992)

Cite This Page — Counsel Stack

Bluebook (online)
1989 OK 164, 784 P.2d 1070, 1989 Okla. LEXIS 197, 1989 WL 155053, Counsel Stack Legal Research, https://law.counselstack.com/opinion/harsha-v-maremont-corp-okla-1989.