Case Title: Ex Parte Moncrief

Citation: 627 So. 2d 385

Docket Number: 1911603

State: alabama

Court: Alabama Supreme Court

Date: 1993-05-14T00:00:00Z

Document:
627 So. 2d 385 (1993)
Ex parte Tracy MONCRIEF.
(Re Tracy MONCRIEF
v.
RUSSELL CORPORATION).
1911603.

Supreme Court of Alabama.
May 14, 1993.
*386 William M. Cunningham, Jr. of Burns, Cunningham & Mackey, Mobile, for petitioner.
Randall S. Haynes of Morris, Haynes & Ingram, Alexander City, for respondent.
KENNEDY, Justice.
Tracy Moncrief appeals from a judgment of the Court of Civil Appeals affirming the denial of workers' compensation benefits. Moncrief worked as a manual laborer for Russell Corporation; he claimed to have sustained a back injury while on the job.
The issues are (1) whether the Court of Civil Appeals erred in affirming the trial court's denial of temporary total disability benefits to Moncrief during his convalescence following unauthorized surgery; and (2) whether the Court of Civil Appeals erred in affirming the trial court's holding that the employer did not have to pay unauthorized medical expenses.
The Court of Civil Appeals set out the facts in Moncrief v. Russell Corp., 627 So. 2d 383 (Ala.Civ.App.1992). However, we feel it necessary to recite the facts as found by that court in order to better present the issues in this case.
627 So. 2d  at 384.
The trial court found that the employee had sustained a lower back injury as a result of an accident in the course of his employment. It found that the employer had paid for certain authorized medical expenses, but held that it was not liable for unauthorized medical treatment. The court determined that the employee had suffered a 10% loss of ability to earn, and it awarded benefits accordingly. The court also found that the employee had been paid temporary total disability benefits for 10 weeks and 4 days spent recuperating from the authorized treatment, but that the employee was not entitled to temporary total disability benefits for the time he spent recuperating from the unauthorized surgeries. The Court of Civil Appeals affirmed the judgment of the trial court.
The first issue is whether the Court of Civil Appeals erred in affirming the trial court's holding that the employee was not entitled to temporary total disability benefits for the time that he spent recuperating from the unauthorized surgeries. Temporary total disability refers to "the healing period during which an employee is recovering and unable to work." Haywood v. Russell Corp., 611 So. 2d 365, 367 (Ala.Civ.App.1992). "It has *388 repeatedly been held that the `time of temporary total disability' is the recovery period that lasts until maximum medical recovery is reached." Haywood, 611 So. 2d  at 367, citing Ex parte DCH Regional Medical Center, 571 So. 2d 1162 (Ala.Civ.App.1990). Temporary total disability is ordinarily established by direct evidence of actual wage loss. Defense Ordinance Corp. v. England, 52 Ala.App. 565, 295 So. 2d 419 (1974);[*] § 25-5-57(a)(1), Ala.Code 1975.
The Court of Civil Appeals held in this case that the trial court did not err in limiting the employee's medical costs to those incurred for authorized treatments and, therefore, that it properly denied temporary total disability benefits for the periods of recovery following the unauthorized surgeries. We disagree. Nowhere in the Workers' Compensation Act is there a requirement that temporary disability be awarded solely for authorized surgeries. First, for an injury to be compensable under the Workers' Compensation Act, the employee must establish both legal and medical causation. Hammons v. Roses Stores, Inc., 547 So. 2d 883 (Ala.Civ. App.1989). Once legal causation has been established, i.e., once it has been established that an accident arose out of and in the course of employment, medical causation must be established, i.e., that the accident caused the injury for which recovery is sought. Hammons. Second, the test for total disability is whether the employee is unable to perform his trade or to obtain reasonably gainful employment; the employee need not be absolutely helpless or be entirely physically disabled in order to obtain temporary total disability benefits. Price's Bar-B-Que, Inc. v. Carter, 541 So. 2d 38 (Ala. Civ.App.1989).
The employee now seeks recovery in the form of temporary total disability benefits for the back surgeries that were necessary due to the injury. It is undisputed that the employee's injury arose out of his work and in the course of his employment with the employer. It is also undisputed that the employee was unable to work while he was recuperating from the two back surgeries. Therefore, the employee is entitled to temporary total disability benefits from the periods when he was recuperating from the unauthorized surgeries.
The second issue is whether the Court of Civil Appeals erred by affirming the trial court's holding that the employer did not have to pay medical expenses for unauthorized surgeries.
Under Alabama's workers' compensation laws, unless there is an emergency the employee must notify his employer when he wishes to consult another physician. Ex parte Grantham, 514 So. 2d 1385 (Ala.1987). In United States v. Bear Brothers, Inc., 355 So. 2d 1133 (Ala.Civ.App.1978), the Court of Civil Appeals set out exceptions for obtaining unauthorized, nonemergency treatment: (1) where the employer has neglected or refused to provide the necessary medical care; (2) where the employer has consented to the employee's choice of physicians; (3) where notice of and request for alternative care would be futile; and (4) where other circumstances exist to justify the selection of alternative care by the employee.
The Workers' Compensation Act clearly provides that an employer is not liable for medical or surgical treatment provided without notice to the employer or justification. The trial court found that no justification existed for the employee's failure to notify the employer. Appellate review in workers' compensation cases is a two-step process. Initially, the reviewing court will look to see if there is any legal evidence to support the trial court's findings; if it finds such evidence, it then determines whether any reasonable view of that evidence supports the trial court's judgment. Ex parte Eastwood Foods, Inc., 575 So. 2d 91 (Ala. 1991). A reasonable view of the evidence in *389 this case supports the trial court's finding that there was no notification and no justification to require the employer to pay for the unauthorized medical expenses.
The judgment of the Court of Civil Appeals is affirmed in part and reversed in part, and the cause is remanded for an order or proceedings consistent with this opinion.
AFFIRMED IN PART; REVERSED IN PART; AND REMANDED.
HORNSBY, C.J., and MADDOX, SHORES and ADAMS, JJ., concur.
[*]  [Reporter of decisions' note: Although the opinion cited is styled Defense Ordinance Corp. v. England and the appellate record indicates that style, the correct style probably should have been Defense Ordnance Corp. v. England. The secretary of state's records indicate the January 19, 1971 incorporation of a company in Etowah County named "Defense Ordnance Corporation." The secretary of state's records show no incorporation under the name of "Defense Ordinance Corporation."]