Martin v. Workmen's Compensation Appeal Board

OPINION OF THE COURT

PAPADAKOS, Justice.

On June 2, 1989, Thomas R. Martin, Appellant, injured his lower back during the course of his employment with Emmaus Bakery, Appellee. Appellant was totally disabled due to the injury which was diagnosed as a possible disc herniation, the type of injury which is routinely treated by chiropractic manipulation and physiotherapy. Appellant immediately began chiropractic treatment with Dr. Gary Tarola, a Board certified specialist in chiropractic orthopedics. As a result of the *444chiropractic treatment and physiotherapy, Appellant was able to return to work on June 9, 1989, seven days after his work-related injury.

Appellee denied payment for the first two weeks of chiropractic care provided by Dr. Tarola to Appellant. The Workmen’s Compensation referee found as fact that the treatment rendered to Appellant during the first fourteen days after his work-related injury was both “reasonable and necessary.” (Referee’s Finding of Fact number 7). However, the referee denied Appellant’s claim petition seeking reimbursement. In rendering his decision, the referee concluded that despite Appellee’s posting of a panel of physicians in accordance with Section 306(f)(1) of the Pennsylvania Workmen’s Compensation Act (the Act) of June 2, 1915, P.L. 736, as amended, 77 P.S. § 531(1), Appellant, instead, elected to seek treatment from a chiropractor, which precluded him from remuneration.

Appellant appealed the referee’s decision to the Workmen’s Compensation Appeal Board (Board) which affirmed, finding that Appellant’s failure to seek treatment from a physician named on Appellee’s designated list removes Appellee’s obligation to pay for treatment within the first fourteen days following the injury.

On appeal, the Commonwealth Court, in affirming the Board’s decision, determined that under the 1978 amendment to Section 306(f)(1) of the Act an employer is required to reimburse only for treatment rendered by practitioners on the designated list. Martin v. Workmen’s Compensation Appeal Board (Emmaus Bakery), 161 Pa.Cmwlth.Ct. 637, 638 A.2d 294 (1994).

Appellant now comes before us in an effort to clarify what appears to be an absurd application of the Act which would limit injured employees from obtaining appropriate care simply because their employer failed to include a suitable practitioner on the designated list. Appellant argues that the Commonwealth Court’s analysis relies heavily on its misinterpretation of our holding in Workmen’s Compensation Appeal Board (Collier) v. Overmyer, 473 Pa. 369, 374 A.2d 689 (1977), *445wherein we reversed the Commonwealth Court which, in turn, had reversed the Workmen’s Compensation Appeal Board’s ruling that chiropractor charges were payable under Section 306(f).

The issue presented in Overmyer was whether, under the pre-1978 version of Section 306(f) of the Act, an employer who had designated a list of five physicians, was responsible for treatment rendered by a licensed practitioner of the healing arts.

In concluding that the chiropractic services were reimbursable, we noted:

If the legislature had intended to restrict the employee’s rights to choose “any practitioner of the healing art,” it could have limited that choice by allowing the employer to designate certain “practitioners of the healing arts” from which the employee was to choose ... we believe the legislature intended only to limit the employe’s choice as to “physicians,” if the employe desired to be treated by a “physician,” and if the employer had designated five “physicians” in accord with the statute.

Overmyer, 473 Pa. at 375, 374 A.2d at 691-92.

Following our decision in Overmyer, the legislature amended Section 306(f) by repealing certain language and enacting new Section 306(f)(1) which permits employers to include both physicians and other practitioners on their designated lists.

The 1978 version of Section 306(f)(1) is at issue here: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 the employer and the employer’s representative by agreement, in which instance the employe *446shall select a physician from among those designated] 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 employe[’Js own choice, and such treatment shall be paid for by the employer.

77 P.S. § 531(1) (Emphasis added).

Appellee argues that under amended Section 306(f)(1) an employer should not be responsible to pay medical benefits to a particular type of provider not included on the employer’s designated list for treatment sought within the first fourteen days following a work-related injury because this would place an unreasonable burden upon employers in terms of both time and money and would require employers “to locate and evaluate the qualifications of innumerable duly licensed practitioners of the healing arts.” (Appellee’s brief, p. 15).

The Commonwealth Court was apparently persuaded with this reasoning and concluded that in Section 306(f)(1), the General Assembly decided to require employers to reimburse claimants only for treatments rendered by practitioners contained on the list during the statutory fourteen day period ■without regard to whether those physicians or practitioners would be of any help to an injured employee.

Because we agree with Appellant that the Commonwealth Court’s interpretation of Section 306(f)(1) is overly narrow, we now reverse.

We begin by noting that our scope of review in workmen’s compensation matters is limited to determining whether there has been a constitutional violation, an error of law, or a violation of Appeal Board procedure, and whether necessary findings of facts are supported by substantial evidence. St. *447Joe Container Company v. Workmen’s Compensation Appeal Board (Staroschuck), 534 Pa. 347, 633 A.2d 128 (1993).

Our basic premise in workmen’s compensation matters is that the Workmen’s Compensation Act is remedial in nature and is intended to benefit workers and, therefore, the act must be liberally construed in order to effectuate its humanitarian objectives. Peterson v. Workmen’s Compensation Appeal Board (PRN Nursing Agency), 528 Pa. 279, 597 A.2d 1116 (1991).

The language of Section 306(f)(1) before us requires an employer to provide 1) a list of five designated physicians, or 2) a list of five other duly licensed practitioners of the healing arts, or 3) a combination thereof from which an injured employee can make a choice in being treated. The latitude the employer is given in creating a list of designated physicians and practitioners of the healing arts is obviously designed to afford an employer an opportunity to direct its injured employees, in the first two weeks of an injury, to physicians and practitioners of the employer’s preference. Admittedly, it is impossible to predict all the different types of job-related injuries which can befall an employee, but when an employer fails to include on the designated list those physicians or practitioners required by the injured employee for proper treatment of a particular job-related injury, we see nothing in the statute that prevents the employer from being required to pay for the employee’s treatment by the physician or practitioner which the employee’s injury dictates. Overmyer does not stand for a different proposition and, in fact, as in Overmyer, we see no evidence in the statute’s amendment of legislative intent to take away an employee’s right to use the type of practitioner of the healing arts needed when none are in the list designated by the employer.

Here, Appellant was in need of chiropractic services. He did not need the services of a physician. The referee specifically found that the care given by the two chiropractors (which amounted to $445.00, of which the sum of $296.00 was incurred during the first 14 days following Appellant’s injury) *448were both reasonable and necessary and that finding of fact is not challenged by Appellee. Appellee’s list of designated physicians and practitioners of the healing arts did not include any chiropractors. As a result, Appellant was required to choose his own chiropractor. The Commonwealth Court’s interpretation of Section 306(f)(1), as a practical matter, would force injured workers to wait fourteen days before seeking proper treatment where an employer fails to include a suitable physician or practitioner of the healing arts on its designated list. Under the Commonwealth Court’s ruling, if an injured employee requires the services of a dentist, but the employer’s designated list contains only names of physicians and no dentists, then the employee would either have to wait for fourteen days before seeing a dentist or pay for the first fourteen days of treatment for the work-related injury from his own pocket. We reject such a reading of the Act since it is not harmonious with the humanitarian nature of the Act.

Rather, we interpret the Act to require Appellee to reimburse Appellant for chiropractic treatment where the treatment was necessary and reasonable for the type of injury involved and where no suitable physician or practitioner (in this case a chiropractor) was included on the list of designated physicians of practitioners of the healing arts.

The opinion and order of the Commonwealth Court are reversed and the matter is remanded to the Workmen’s Compensation Appeal Board to enter an order reimbursing Appellant for the chiropractic treatment provided during June 2, 1989 to June 9, 1989.

CAPPY, J., files a Dissenting Opinion in which CASTILLE and MONTEMURO, JJ., join. MONTEMURO, J., is sitting by designation.

. On July 1, 1978, by Act No. 1978-119, the General Assembly deleted the bracketed portion from the 1974 amended section and replaced it with the italicized portion immediately following the last bracket.