Iwunoh v. Maremont Corp.

OPALA, Justice:

The issue presented on certiorari is whether reasonable expenses of claimant’s self-procured medical treatment, found to be necessary, were legally chargeable to the employer even though the services of the physician had been rendered without prior court or employer approval. We answer in the affirmative.

The claimant suffered a back injury while employed at the petitioner’s [employer’s] workplace. The trial tribunal found she had sustained permanent and partial disability. At a later hearing on medical expenses, the employer was directed to pay for necessary treatment by the claimant’s third physician. The order was affirmed by a review panel. The Court of Appeals vacated the order and disallowed the expenses, resting its decision on our pronouncement in Burns v. Southwestern Preferred Properties.¹ On claimant’s petition for certiorari, we now hold that Burns was improperly viewed as a barrier to the award here under review.

The employer contends the medical treatment was not chargeable to the employer ex lege because claimant had changed physicians without prior court approval. The claimant seeks to justify the award in contest as emergency treatment for which the employer is liable in the absence of anterior authorization.²

Factual findings in a compensation proceeding are reviewed by ascertaining if there is any competent evidence reasonably tending to support them.³ It is not the province of the appellate court to weigh the evidence or to determine where the preponderance lies. Factual determinations are binding if supported by any competent evidence. Any evidence in the record on the basis of which the trier could have reached a contrary conclusion is immaterial upon the review of findings in a worker compensation case.⁴

The contested medical expenses were for services rendered by Dr. M. The claimant was initially treated at a clinic by an emergency room physician. She was then treated by Dr. R. at the clinic for a period of three to four weeks, during which time she received no physical therapy for her back injury, but a “normal examination” and medication which the claimant was unable to take. She next went to her lawyer’s personal physician, Dr. C, who treated her and then released her after three weeks. Because she had started going to Dr. C, she canceled an appointment with the doctor listed on her claim form. The month following her treatment by Dr. C, the claimant, on her own initiative, went to a chiropractor, Dr. M, to get relief from recurring pain and discomfort. Dr. M’s treatment covered a seventeen-day period and consisted of ultra sound therapy, adjustments to the back region and diet supplements. At the hearing, approximately six months later, the claimant still complained of pain in her back, numbness on her side and problems with her right leg giving out.

The question of whether medical treatment is necessary for an injured worker is a question of fact for determination by the trial tribunal.⁵ Even though the trial tribunal did not expressly state upon what legal theory the medical expenses were allowed, its action rests on competent proof and is not unauthorized by law.

In the proceeding under review there was no dispute between the parties as to the amount of the charges made for the claimant’s self-procured treatment nor as to its medical necessity. The real issue below and here has been the correctness of the trial tribunal’s adjudication which allows a claim in favor of one who has changed physicians without prior approval. In support of its argument, the employer points to the following portion of § 14:

“ * * * The Court shall have authority on application of employee or employer or its insurance carrier to order a change of physicians at the expense of the employer when, in its judgment, such change is desirable or necessary ...” [emphasis ours]

The employer argues that the claimant’s right to select another physician is restricted because the doctor who first treated the claimant may not be replaced unless advance approval has been given either by the trial tribunal or by the employer. This rationale, the employer asserts, is supported by our pronouncement in Burns.

Burns is clearly distinguishable on the facts and is hence not apposite to the present case. There, neither the claimant nor the treating physician gave any notice to the employer that the claimant, on his own, had selected another physician to provide further treatment. The medical expenses were disallowed because of noncompliance with the statutory prerequisites. This is not the case here. The record shows that the employer received the necessary notice within a reasonable time after treatment had been commenced. The claimant in the case at bar hence met the § 14 notice command.

We do not construe § 14 to be as restrictive as it is urged upon us. The employer’s interpretation of that section fails to consider other important provisions within it:

“ * * * Notwithstanding any other provision of this section, the employee may select a physician of his choice to render necessary medical treatment, at the expense of the employer; provided, however, that the attending physician so selected by the employee shall notify the employer and/or the insurance carrier within a reasonable time after examination or treatment was first rendered. ⅜ * * ’’[emphasis ours]

The quoted language means that an employee has an absolute right to select a physician of his own choice at the employer’s expense when the requisite notice has been given within a reasonable time after examination or treatment.⁶ Whether the self-procured treatment was necessary always presents an issue for the trier of fact. Construing together the cited provisions of § 14, we conclude that retroactive approval of a change of physicians is clearly within the scope of authority conferred by the legislature upon the Workers’ Compensation Court. To hold otherwise would unduly, and without any textual warrant, restrict the powers granted to that tribunal by statute. The primary goal of the compensation law is to rehabilitate injured workers in order that they may be promptly restored to full productive capacity or, if that be impossible, to its highest attainable level.⁷ Medical treatment is the key to seasonable and effective recovery and rehabilitation. Compensation for disability is allowable by the act only for those whose capacity cannot be restored. Absent some explicit legislative language, we are not free to abridge the trial tribunal’s power to achieve the most important objective of the act — that of restoring, as far as possible, the injured worker’s body to its pre-acci-dent condition.

Because (a) there is competent evidentia-ry basis for the order finding that the expenses allowed were reasonable and necessary and (b) the trial tribunal’s power to authorize medical services is not limited by the terms of § 14 to advance, pre-treatment approval of a health care provider’s contemplated replacement, the Court of Appeals’ opinion is vacated and the order of the Workers’ Compensation Court reinstated.

HODGES, LAVENDER, HARGRAVE and WILSON, JJ., concur. BARNES, C.J., and SIMMS, V.C.J., dissent.

1 . Okl., 580 P.2d 986 [1978].

2 . The terms of 85 O.S. 1981 § 14 provide in pertinent part: " * * * the injured employee ... may obtain emergency treatment at the expense of the employer where such emergency treatment is not provided by the employer. * * * ” See also Womack v. Boston Fisheries, Okl., 527 P.2d 1368, 1371 [1974]; Tulsa Linen Service Co. v. Kroth, Okl., 512 P.2d 172, 175 [1973].

3 . ONG v. Williams, Okl., 639 P.2d 1222, 1225 [1981]; Takagi v. Wilson Foods Corporation, Okl., 662 P.2d 308, 309 [1983].

4 . Matter of Death of Sade, Okl., 649 P.2d 538, 540 [1982].

5 . Douglas Aircraft Co. v. Titsworth, Okl., 356 P.2d 365, 367 [1960]; Mayberry v. Walker’s Masonry, Okl., 542 P.2d 510, 512 [1975].

6 . Mayberry v. Walker's Masonry, supra note 5. When Mayberry was decided, the terms of 85 O.S.Supp. 1973 § 14 provided that notice must be given within seven days after treatment. The present version of § 14, amended in 1977, effective July 1, 1978, provides that notice must be given “within a reasonable time after examination or treatment".

7 . McMurtry Bros. v. Angelo, 139 Okl. 236, 281 P. 964, 965 [1929]; Mattingly v. State Industrial Court, Okl., 382 P.2d 125, 128 [1963]; Kerr McGee Corporation v. Croley, Okl., 508 P.2d 1066, 1069 [1973].