Case Title: Cain v. Industrial Commission of Colorado

Citation: 315 P.2d 823

Docket Number: 

State: colorado

Court: Colorado Supreme Court

Date: 1957-09-16T00:00:00Z

Document:
315 P.2d 823 (1957) Charles E. CAIN, Plaintiff in Error, v. INDUSTRIAL COMMISSION OF COLORADO, Macco-Puget Sound, and Travelers Insurance Company, Defendants in Error. No. 18189. Supreme Court of Colorado, En Banc. September 16, 1957. Rehearing Denied October 7, 1957. *824 Hornbein & Hornbein, Roy O. Goldin, Denver, for plaintiff in error. Duke W. Dunbar, Atty. Gen., Frank E. Hickey, Deputy Atty. Gen., Peter L. Dye, Asst. Atty. Gen., Wood, Ris & Hames, William K. Ris, Denver, for defendants in error. MOORE, Chief Justice. Writ of error issued in this action to review the judgment of the district court of the City and County of Denver affirming an award of the Industrial Commission in a proceeding under the Workmen's Compensation Law. Charles E. Cain was injured accidentally on June 18, 1954, when in the course of his employment a rock fell from a conveyor belt striking him on the top of the head. A cervical laminectomy was performed July 26, 1954, and Dr. Stuck who performed the operation found that Cain reached maximum improvement January 6, 1955, and should be considered permanently disabled 15% as a working unit. Five per cent of this disability he attributed to a previous injury and ten per cent to the accident of June 18, 1954. Cain was examined by Dr. Freed who also found the disability attributable to the accident to be 10% as a working unit. The Industrial Commission made an award based on a finding of partial permanent disability of 10% as a working unit. An application for a lump sum settlement was approved by the Commission March 2, 1955, and Cain receipted to the insurance carrier for the amount due under this award. August 29, 1955, Cain petitioned the Industrial Commission to reopen the claim. He alleged that his physical condition had grown worse and requested that the matter be reopened on the Commission's "own motion." The petition was supported by a report from Cain's physician, Dr. Griffin. On August 31, 1955 the Commission ordered, inter alia: The order further fixed a date for the hearing before a referee and stated: On October 11, 1955, a hearing was had before the Referee who ordered a delay in final determination of the matter because of the prospect that treatment which Cain was then undergoing might reduce his disability. May 22, 1956, the matter again *825 came on for hearing. Dr. John G. Griffin, a neurosurgeon whose qualifications as an expert witness were conceded by counsel for the employer and insurance carrier, testified that claimant was unable to return to his former occupation as a heavy equipment operator, and that he had sustained 20% permanent partial disability as a working unit. He also testified that further surgery would not be advisable; that he had previously prescribed heavy neck stretching and physiotherapy and this course of treatment had been faithfully followed. He testified that the course of therapy had not altered claimant's symptoms to any perceptible degree, and that the only treatment he could prescribe at the present time was the wearing of a neck collar and a heavy cervical collar. As to these, Dr. Griffin believed that they would "more or less" keep Cain's condition from getting worse, but that they would not "remedy his original injury." Thereupon counsel for the employer and insurance carrier requested that Cain submit to an examination by Dr. Freed who requested that a cervical myelogram be performed, to which Cain submitted and was hospitalized for three days in connection therewith. On the basis of this myelogram Dr. Freed made a report, which included the following: The insurance carrier, without benefit of an order from the Commission, instructed Cain to submit to the "exploratory surgery" which Dr. Freed wished to perform. Cain's attorney responded to this request by letter dated July 25, 1956, as follows: July 30, 1956, the Commission entered an order in which reference was made to the case history above set forth. This order included the following: In Cain's petition for review, filed by his attorney, he asserted that he was not required to submit to exploratory surgery; that he had the right to follow the advice of his physician; that there was no evidence that the surgery was reasonably essential to his recovery or that it would promote it; and that his then disability as a result of his accident of June 14, 1955 had increased by 5% over what it formerly was. The Commission's order of July 30, 1956, became the final "award", and Cain filed his complaint in the district court, where the action of the Commission was upheld. Counsel for Cain, in his Summary of Argument for reversal of the judgment, asserts the following: "The plaintiff has submitted to every reasonable proposal for medical examination and treatment by the employer and its insurance carrier. There is neither statutory nor judicial authority which gives the defendants the right to *827 operate upon the plaintiff in a search for evidence to bolster their case. Since the evidence is undisputed that plaintiff's permanent partial disability has increased by 5% as a working unit, he is entitled to an award of compensation for such increase in disability." Counsel for the Commission, the employer and the insurance carrier advance no argument in opposition to that presented by counsel for Cain. They assert only that: First: Where an award of the Industrial Commission has become final and thereafter the claimant petitions the Commission "upon its own motion" to reopen the cause for further hearing, and the Commission enters an order that the cause "should be reopened on the Commission's own motion for the purpose of determining whether or not there has been error, mistake or change in condition," and fixes a time for the new hearing before a referee; and where hearings actually were held pursuant to said order and competent evidence received in support of claimant's claim for additional compensation; will the Commission be permitted to dipose of the cause by entry of an order "that claimant's application to reopen this case be and the same is hereby dismissed"? This question is answered in the negative. The authorities cited by counsel for defendants in error fully support the established rule that the Commission's action in refusing to reopen and review a case cannot be set aside by the courts except in case of fraud or a clear abuse of discretion. Kokel v. Industrial Commission, 111 Colo. 188, 139 P.2d 259, and cases there cited. No such issue is presented in the instant case. August 31, 1955, the Commission reopened the case, set a date for hearing, and directed, "That upon conclusion of said hearings the Referee enter his findings and award in the premises." Having thus reopened the case the issues are the same as those presented in any other action for review of a decision of the Commission, namely, whether the award was entered in conformity with the law and supported by competent evidence. Once having reopened a case the Industrial Commission is obligated to decide the issues presented in all respects, as upon original hearing. Second: Where the Industrial Commission has reopened a case on its own motion, held a hearing and taken evidence, will the law uphold an order of the Commission which provides, "That the claimant's application to reopen this case be and the same is hereby dismissed"? This question is answered in the negative. It is clear that the dismissal of Cain's petition was based exclusively upon his refusal to submit to the "exploratory surgery" which Dr. Freed desired to perform. The record shows that Cain submitted to a cervical laminectomy, and, at the request of defendants in error submitted to cervical myelograms on two different occasions. His own physician, and other qualified physicians, advised against surgery. Dr. Freed in his report gave no assurance that the proposed surgery would give relief. Cain's unwillingness to undergo the operation is understandable and completely justifiable. C.R.S.1953, 81-12-12 provides in pertinent part: "If any employee * * * shall refuse to submit to such medical or surgical treatment as is reasonably essential to promote his recovery, the the commission, in its discretion, may *828 reduce or suspend the compensation of any such injured employee." There is nothing in the report of Dr. Freed indicating that the proposed operation was reasonably essential to promote Cain's recovery. Before the Commission would be justified in denying relief to an applicant because of his refusal to submit to treatment or surgery it must appear that the proposed treatment or surgery is such as to be free of unusual risks and calculated to effect a cure. As stated by the Supreme Court of Nebraska in Simmerman v. Felthauser, 125 Neb. 795, 251 N.W. 831, 833: In National Lumber and Creosoting Company v. Kelly, 101 Colo. 535, 75 P.2d 144, 145, where delays in operative treatment were considered as a basis for denial of benefits, this court stated, inter alia: The only evidence before the Commission, which had probative value upon the issue for determination, was that given by Dr. Griffin whose qualifications were admitted by defendants in error. His testimony was that the claimant's permanent, partial disability was 5% more than was determined in the original award. This evidence is not controverted by any testimony. The fact that Dr. Freed stated that it was "very difficult to ascribe what percentage of this claimant's disability is attributable to the various injuries he has allegedly had to his neck," and that he would need the results of an exploratory operation to give an opinion, did not controvert the testimony of Dr. Griffin. Upon the record as made, Cain was entitled to an additional award based on the increased partial permanent disability of 5%. The judgment is reversed and cause remanded with directions to the trial court to order the additional compensation in harmony with the views above expressed. FRANTZ, Justice (specially concurring). A definitive decision requires us to discountenance language in National Lumber & Creosoting Co. v. Kelly, 101 Colo. 535, 75 P.2d 144, indicating that the Commission, in its discretion, may order invasions of the body of a claimant by surgery or puncture as part of a physicial examination. C.R.S. '53, 81-12-12, in part provides: "Whenever, in case of injury, the right to compensation under this chapter would exist in favor of an employee, upon the written request of his employer, or the insurer carrying such risk, he shall submit himself from time to time, to examination by a physician or surgeon, * * * and he shall likewise submit to an examination from time to time by any regular physician selected and paid for by said commission, or a member or examiner thereof. * * * If any employee * * * shall refuse to submit to such medical or surgical treatment as is reasonably essential to promote his recovery, the commission, in its discretion, may reduce or suspend the compensation of any such injured employee." It is to be noted that this provision of the Workmen's Compensation Act provides for two things: (1) an examination by a physician or surgeon, and (2) medical or surgical treatment reasonably essential to promote recovery. Exploratory surgery may be a phase, under the circumstances present here, of examination. Such an operation may be defined as the opening of any body cavity or tissues for the purpose of examining the *829 contents thereof and the structures related thereto, to determine the nature of the pathological processes present, if any, and the treatment thereof, if such be amenable to treatment. In a civil suit the ruling of the trial court court refusing to require a spinal puncture was sustained in Riss & Co., Inc., v. Galloway, 108 Colo. 93, 114 P.2d 550, 551, 135 A.L.R. 878, the court saying that "it would have been an invasion of plaintiff's rights, and beyond the court's authority without plaintiff's consent." Only when a claimant consents may an exploratory operation be undertaken. Other cases holding to like effect are United States Fidelity & Guaranty Co. v. Wickline, 103 Neb. 681, 173 N.W. 689; Burns v. Aetna Life Insurance Co., 95 Mont. 186, 26 P.2d 175.