Martin v. Workmen's Compensation Appeal Board

638 A.2d 294, 161 Pa. Commw. 637, 1994 Pa. Commw. LEXIS 54
CourtCommonwealth Court of Pennsylvania
DecidedFebruary 4, 1994
StatusPublished
Cited by3 cases

This text of 638 A.2d 294 (Martin v. Workmen's Compensation Appeal Board) is published on Counsel Stack Legal Research, covering Commonwealth Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Martin v. Workmen's Compensation Appeal Board, 638 A.2d 294, 161 Pa. Commw. 637, 1994 Pa. Commw. LEXIS 54 (Pa. Ct. App. 1994).

Opinions

KELTON, Senior Judge.

Thomas R. Martin (Claimant) petitions for review of the September 17, 1992 order of the Workmen’s Compensation Appeal Board (Board) affirming the Referee’s decision denying reimbursement to Claimant for chiropractic services which Claimant received during the first fourteen days after he suffered a work-related injury.1 We affirm.2

Claimant presents the following issues on appeal: (1) whether the Supreme Court’s decision in Workmen’s Compensation Appeal Board v. Overmyer Mold Co., 473 Pa. 369, 374 A.2d 689 (1977) authorizes an injured employee to obtain and be reimbursed for chiropractic treatment which he received during the first fourteen days after his injury, where the employer does not include the name of the non-physician licensed practitioner of the healing arts on the employer’s posted list of “at least five physicians or practitioners of the healing arts,” pursuant to Section 306(f)(1) of The Pennsylvania Workmen’s Compensation Act (Act);3 and (2) whether the Board capriciously disregarded unrefuted testimony offered by Claimant’s medical and scientific witnesses.

The facts as found by the Referee are as follows. Claimant suffered a work-related injury to his lower back while working for Emmaus Bakery (Employer). As a result, he was totally disabled from June 2 to June 9, 1989. At the time Claimant suffered that injury, Employer had posted a list of five health care providers. That list contained the names of physicians only; it did not include names of any chiropractors.

Immediately after his injury, Claimant received treatment for his injuries by two licensed chiropractors. The chiropractors rendered a bill for $445.00 to Claimant for their services, $296.00 of which related to the first fourteen days after the injury. Claimant received reimbursement for chiropractic services which he received after the first fourteen days following his injury.

Claimant filed a claim petition for the payment of the chiropractic services that he received for his work-related injury during the first fourteen days after the injury. In support of his claim, Claimant presented the testimony of his treating chiropractor, Dr. Gary Taróla, and the testimony of a research expert, Steven Wolk, Ph.D.

The Referee found that the treatment which Claimant received from the two chiropractors was reasonable and necessary. He also found that Claimant elected not to seek treatment from any of Employer’s posted list of physicians, but chose instead to seek chiropractic treatment from Dr. Tarola. The Referee dismissed Claimant’s petition as to payment of chiropractic treatment which Claim[296]*296ant received during the first fourteen days after his injury.

Reimbursement for Services Rendered During the First Fourteen Days After The Injury by a Healing Art Practitioner Not Included on Employer’s Posted List:

The 1978 version of Section 306(f)(1) is at issue here:4

(1) The employer shall provide payment for reasonable surgical and medical services, services rendered by duly licensed practitioners of the healing arts, medicines, and supplies, as and when needed: Provided, That [the employe may select a duly licensed practitioner of the healing arts of his own choice, unless at least five physicians shall have been designated by the employer or by the employer and the employe’s representative by agreement, in which instances the employe shall select a physician from among those designated]5 if a list of at least five designated physicians or other duly licensed practitioners of the healing arts or a combination thereof is provided by the employer, the employe shall be required to visit one of the physicians or other practitioners so designated and shall continue to visit the same or another physician or practitioner for a period of fourteen days from the date of the first visit. Subsequent treatment may be provided by any physician or any other duly licensed practitioner of the healing arts or a combination thereof, of the employees oum choice, and such treatment shall be paid for by the employer.

77 P.S. § 531(1) (Emphasis added).

Claimant argues that, under the pre-1978 Section 306(f)(1), as interpreted by the Supreme Court in Overmyer, an employee may select a non-physician health care practitioner from whom he may obtain treatment, and for which he may receive reimbursement from the employer, where the employer does not include on its list of “physicians or practitioners of the healing arts” any non-physician licensed practitioners.

In Overmyer, the Supreme Court noted that Section 306(f)(1) makes reference to “practitioners of the healing arts,” and to “physicians.” The Court distinguished the two terms which have different statutory definitions. “Healing art” is “the science of diagnosis and treatment in any manner whatsoever of disease or any ailment of the human body.” 1 Pa.C.S. § 1991 (Emphasis added.) On the other hand, 1 Pa.C.S. § 1991 defines a physician as an individual licensed to engage in the practice of medicine and surgery under the laws of the Commonwealth. Id. at 372, 373, 374 A.2d at 690, 691.

The Court held that, where an employer designated five “physicians” on a posted list to treat a claimant’s compensable injuries, and the claimant chose instead to consult a chiropractor — a practitioner of the healing arts — the claimant was entitled to receive reimbursement for the chiropractic treatment. In other words, the Court construed the pre-1978 Section 306(f) to mean that the employer’s designation of five physicians did not bar claimant from receiving reimbursement because he chose to consult a chiropractor.

When the Court decided Overmyer, the pre-1978 Section 306(f)(1) stated in relevant part:

The employer shall provide payment for reasonable surgical and medical services, services rendered by duly licensed praeti-[297]*297tioners of the healing arts, medicines, and supplies, as and when needed; Provided, That the employe may select a duly licensed practitioner of the healing arts of his own choice, unless at least five physicians shall have been designated by the employer and the employe’s representative by agreement, in which instance the employe shall select a physician from among those designated....

Id. at 372, 374 A.2d at 690, (emphasis by Supreme Court).

Although it is true that Overmyer has never been overruled, the statute at issue herein and the one at issue in Overmyer are simply not comparable. For example, the employer’s list in Overmyer could only consist of five physicians, there was no fourteen-day proviso and there was no provision regarding the reimbursement for treatment rendered subsequent to the fourteen-day period by a health care practitioner not on the list.

ACF Industries, Inc. v. AMCAR-Division v. Workmen’s Compensation Appeal Board (Brown), 80 Pa.Commonwealth Ct. 206, 471 A.2d 173

Free access — add to your briefcase to read the full text and ask questions with AI

Related

In Re: D.A.G., a Minor
Superior Court of Pennsylvania, 2018
Martin v. Workmen's Compensation Appeal Board
652 A.2d 1301 (Supreme Court of Pennsylvania, 1995)

Cite This Page — Counsel Stack

Bluebook (online)
638 A.2d 294, 161 Pa. Commw. 637, 1994 Pa. Commw. LEXIS 54, Counsel Stack Legal Research, https://law.counselstack.com/opinion/martin-v-workmens-compensation-appeal-board-pacommwct-1994.