Quintero v. Pillsbury Co.

811 P.2d 843, 119 Idaho 918, 1991 Ida. LEXIS 75
CourtIdaho Supreme Court
DecidedMay 15, 1991
Docket18755
StatusPublished
Cited by6 cases

This text of 811 P.2d 843 (Quintero v. Pillsbury Co.) is published on Counsel Stack Legal Research, covering Idaho Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Quintero v. Pillsbury Co., 811 P.2d 843, 119 Idaho 918, 1991 Ida. LEXIS 75 (Idaho 1991).

Opinion

*919 McDEVITT, Justice.

Petra Quintero (“Quintero”) was employed by the appellant, Pillsbury Company (“Pillsbury”), as a sanitation worker. On November 21, 1985, she suffered an on-the-job accident that injured her back and required treatment at the Idaho Falls Regional Medical Center Emergency Room. The treating physician diagnosed Quintero’s problem as a probable mild back strain.

On December 13, 1985, Quintero was examined by Dr. Hume, an orthopedic surgeon. Quintero was much better and she returned to work on December 14, 1985. Ten (10) months later, on October 17, 1986, Quintero returned to the medical center complaining of lower back pain and leg pain.

On January 5, 1987, Quintero again visited Dr. Hume. Quintero reported that she did not feel well and that she was experiencing leg pains. In October of 1987, Quintero visited Dr. VanGenderen, an associate of Dr. Hume, again complaining of back and leg pain. An Electromyogram was performed on October 22, 1987. Everything appeared normal, but a slight irritation of the lower back was diagnosed. Dr. VanGenderen again examined Quintero and referred her to a human performance institute for a work hardening program. Dr. VanGenderen released Quintero from work beginning November 9, 1987, through March 7, 1988, to allow her to participate in the work hardening program.

Quintero returned to work on March 27, 1988. Quintero then requested a referral from Dr. VanGenderen in order to seek treatment from Dr. Maraño. Dr. VanGenderen gave Quintero the requested referral. Dr. Maraño was unable to help alleviate Quintero’s pain. Pillsbury objected to Quintero receiving treatment from Dr. Maraño and refused to pay for his services.

In the fall of 1988, Quintero, on the advice of her attorney, visited Dr. Whitenack. After several diagnostic visits, Dr. Whitenack determined that Quintero was a prime candidate for his pain clinic. In order to participate in this pain clinic, Quintero needed a release from work. Dr. Whitenack gave Quintero a note to give to her employer when she asked for time off to participate in the pain clinic. Quintero delivered the note to her employer and informed her employer of her intent to undertake the program at the clinic. Pillsbury gave Quintero the requested time off to participate in the clinic, but refused to pay for Dr. Whitenack’s services.

After returning to work from the pain clinic, Quintero moved to another job within Pillsbury. Because of Pillsbury’s refusal to pay Doctors Maraño and Whitenack, Quintero sought an administrative hearing. The Hearing Commissioner found that both Dr. Marano’s and Dr. Whitenack’s services were compensable and ordered Pillsbury to pay for their services. From that order, Pillsbury appeals. We affirm.

In their brief, the defendants state the issue on appeal as follows:

Can a claimant’s attorney send his client to a physician, without a referral from the client’s treating physician, without any indication from the treating physician that the client requires additional medical care, without notice to the employer or surety, or without a petition to the Industrial Commission for a change of physicians, and thereby obligate the employer and surety under Section 72-432, Idaho Code, for payment of medical expenses related to the physician’s treatment?

It is apparent from the statement of the issues on appeal and the argument in their brief, that the defendants take exception to the fact that Quintero sought treatment from Dr. Whitenack on the advice of her attorney. Defendants assert that only the treating physician can refer an employee to another physician for treatment. Without a referral, the employee would be liable for any expenses incurred in seeking other necessary medical treatment. Defendants characterize this as an employer controlled system as opposed to an employee controlled one.

Idaho Code § 72-432 governs the procedure by which an employee can seek medical treatment. Both the employer and the employee must follow the legislative man *920 dated requirements of this section. This statute provides several different avenues that an injured employee may use to seek necessary medical treatment without a referral from the treating physician, to be paid at the employer’s expense. Pertinent to our discussion is I.C. § 72-432(4) which states:

The employee upon reasonable grounds, may petition the commission for a-change of physician to be provided by the employer, however, the employee must give notice to the employer or surety of his request for a change of physicians to afford the employer the opportunity to fulfill his obligations under this section. If proper notice is not given, the employer shall not be obligated to pay for the services obtained. Nothing in this section shall limit the attending physician from arranging for consultation, referral or specialized care without permission of the employer.

Thus, this statute sets forth a two-step process by which an employee may seek treatment from another physician without a referral from the attending physician. First, the employee must ask the employer or its surety to authorize a change of physicians; upon the denial of that request, the employee can petition the Industrial Commission for permission to change physicians.

The main issue we confront on this appeal is whether the claimant complied with the statutory requirements in obtaining treatment from Dr. Whitenack. Our scope of review is limited to determining whether the Industrial Commission’s findings of fact are based upon competent, although conflicting, evidence. Johnson v. Amalgamated Sugar Co., 108 Idaho 765, 702 P.2d 803 (1985). We will set aside the Commission’s findings only if we determine that the record is devoid of any competent evidence to support them. I.C. § 72-732(1); Paulson v. Idaho Forest Indust., 99 Idaho 896, 591 P.2d 143 (1979).

In determining that Quintero complied with the requirements of I.C. § 72-432(4) the Industrial Commission made the following finding of fact:

VIII.
Claimant’s visits to Dr. Whitenack and his pain clinic present a different set of facts. Claimant’s lawyer suggested she go to a pain clinic in order to help her reduce the pain she had been experiencing for three years. Claimant saw Dr. Whitenack on September 20, 1988, October 28, 1988 and again on November 15, 1988. It was not until after the third visit, Claimant asked Mr. Robert Spanbauer, Safety Coordinator for Defendant Employer, in November 1988 to enroll in Dr. Whitenack’s pain clinic. Mr. Spanbauer then contacted Diane Evans, Senior Claims Examiner, GAB Business Services, Inc., who refused payment, ostensibly because there was no referral from a treating physician. Because it is true there was no physician referral, the Commission must determine whether, alternatively, Claimant gave notice to her Employer or Surety of her request for medical services. We find that Claimant’s request to Mr.

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Cite This Page — Counsel Stack

Bluebook (online)
811 P.2d 843, 119 Idaho 918, 1991 Ida. LEXIS 75, Counsel Stack Legal Research, https://law.counselstack.com/opinion/quintero-v-pillsbury-co-idaho-1991.