Barnes v. Newell


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Docket Number: 2005-WC-01602-COA
Oral Argument: 08-22-2006
 

 

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Court of Appeals: Opinion Link
Opinion Date: 10-17-2006
Opinion Author: SOUTHWICK, J.
Holding: Reversed and Remanded

Additional Case Information: Topic: Workers’ compensation - Temporary move - Mileage reimbursement - Commission General Rule 9 - Reasonable and necessary medical treatment
Judge(s) Concurring: KING, C.J., LEE AND MYERS, P.JJ., IRVING, CHANDLER, GRIFFIS, BARNES, AND ISHEE, JJ.
Non Participating Judge(s): ROBERTS, J.
Procedural History: Admin or Agency Judgment
Nature of the Case: CIVIL - WORKERS' COMPENSATION

Trial Court: Date of Trial Judgment: 07-26-2005
Appealed from: WAYNE COUNTY CIRCUIT COURT
Judge: Robert Bailey
Disposition: REVERSED ORDER FOR PAYMENT OF TRAVEL EXPENSES
Case Number: CV-2005-80(B)

  Party Name: Attorney Name:  
Appellant: HUGH EARL BARNES




JOHN HUNTER STEVENS



 

Appellee: W. S. NEWELL, INC., EMPLOYER, AND THE MISSISSIPPI ASSOCIATED GENERAL CONTRACTORS WORKERS’ COMPENSATION FUND, INC., CARRIER WILLIAM D. BLAKESLEE  

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Topic: Workers’ compensation - Temporary move - Mileage reimbursement - Commission General Rule 9 - Reasonable and necessary medical treatment

Summary of the Facts: Hugh Barnes sustained an on-the-job injury while in the employ of W. S. Newell, Inc. Under the procedures for determining workers’ compensation benefits, Barnes’s injury was found to have caused the total loss of use of his left leg. Barnes was entitled to reasonable medical treatment. Barnes moved to Louisiana and then temporarily, to Kansas. Barnes filed a motion to compel payment for mileage expenses he incurred in traveling from Kansas to Hattiesburg so that he could receive continuing treatment for the same injury from his orthopedist. An administrative judge ordered payment of the Kansas-Mississippi travel expense. The Commission confirmed. The Wayne County Circuit Court reversed the Commission’s decision, and Barnes appeals.

Summary of Opinion Analysis: The employer and carrier accept that the current residence of Barnes is in Kansas. Therefore, the Court will not analyze whether a temporary move to a distant state will cause the new location to be considered the claimant’s residence. The language of the order of the administrative judge, adopted by the Commission, indicates that the mileage from Kansas to Hattiesburg was only authorized as reasonable for one year. The circuit court reversed because it found that the Hattiesburg doctor was not reasonably convenient to Barnes’ residence in Kansas when he could receive similar competent treatment in Kansas. The parties accept that if Barnes had permanently moved to Kansas, then he would have been required to obtain treatment from a physician local to his new residence. That concession is inconsistent with the order adopted by the Commission, since the holding appears to have been that a physician convenient either to the claimant’s residence – which can change – or the fixed place of injury could be insisted upon by a claimant because Commission General Rule 9 establishes a choice. However, the same order emphasized that the distant residence was temporary. If convenience to place of injury is a sufficient basis to permit selection of a physician, then the temporary nature of the claimant’s distance from the place of injury should not matter. The Commission’s interpretation of the options under Rule 9 is unclear. The concept of reasonableness is found in Commission General Rule 9 in two different situations. A treating physician must be “reasonably convenient” to the place of injury or residence of the injured party. There is no evidence that adequate medical treatment could not be obtained near Barnes’ residence in Kansas. However, Rule 9 applies reasonableness in another context: “medical services shall be reasonably suited to the nature of the injury.” This means that the treatment must be “reasonable and necessary.” What is clear from the record is that Barnes was not receiving specialized treatment that would only be available through his doctor or in Hattiesburg. Barnes’ doctor was of the opinion that it was better for Barnes to return to Hattiesburg because of the length of their physician-patient relationship and the temporary nature of the Kansas residence. There is little evidence that Barnes would medically benefit from continuing his treatment in Hattiesburg versus treatment in Kansas. Patient preference alone does not meet the reasonable and necessary standard. Thus, the Commission applied an incorrect legal standard. The circuit court is reversed since it rendered judgment denying reimbursement. It may be possible to sustain the Hattiesburg treatment on the basis of what was medically necessary and reasonable.


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