Opinion ID: 1816435
Heading Depth: 2
Heading Rank: 3

Heading: Issue: Whether Dr. Perez's Treatment of Hernandez Was Authorized and Reasonable

Text: Petroleum contends that Dr. Jose Francisco Magana Perez, one of numerous physicians who treated Hernandez for her injury, was unauthorized pursuant to the dictates of Mississippi Workers' Compensation General Rule 9: SELECTION OF MEDICAL. The employer shall select competent physicians, hospitals, and other attendance or treatment and immediately furnish such services including all emergency services to the injured employee. The injured employee shall have the right to accept the services furnished by the employer or, in his discretion, to select a competent physician of his choosing to administer medical treatment. Such physician selected by the employer or the employee shall be located in an area reasonably convenient to the place of the injury or the residence of the injured employee, and the physician's services shall be reasonably suited in the nature of the injury. A competent physician shall mean a licensed medical doctor. See WORKERS' COMPENSATION LAW OF MISSISSIPPI 39-40 (1984) (emphasis added by Petroleum). Specifically, Petroleum contends that, because Perez is licensed to practice medicine in Mexico and not in the United States, his treatment of Hernandez was violative of General Rule 9. Moreover, because Perez's office is located in Tijuana, Mexico, and not near Hernandez's residences [2] or the place of injury, securement of his services was violative of Rule 9's convenience requirement. And finally, Petroleum contends that Perez's treatment of Hernandez was not reasonable under the terms of the Act. These contentions are unpersuasive. Rule 9 does not expressly prohibit treatment of an employee's injury by a physician who is licensed to practice medicine in countries other than the United States. That some injuries may require treatment by a specialist located outside the United States is not inconceivable. Literally interpreted, the rule merely requires that the physician be licensed. This rule, however, should not be liberally construed to mean that Mississippi's doors are hereby opened wide to any physician so long as he is licensed somewhere in the world. Once licensure is established, the focus should turn, if necessary, to establishment of the physician's competence. Contrary to what the last line of Rule 9 implies, competence is not interchangeable with licensure. For example, the Commission or a trial court could determine that a licensed general surgeon was not competent to provide treatment for an injury, or to render an opinion on a matter, requiring the expertise of a dental surgeon. In addition, a physician licensed in one state could, nonetheless, be found incompetent on the basis that he was de-licensed in three other states for committing egregious acts of malpractice. Once competence of the selected physician is established, the focus should then turn, if necessary, to the issue of reasonableness of employing a physician allegedly located outside the realm of convenience. The boundaries of the realm of convenience can only be determined on a case-by-case basis. For example, the Commission may conclude in one case that the boundary reasonably extended over seven hundred miles to Charleston, South Carolina, where a renowned hospital specializing in treatment of burn victims is located. In another case, the Commission may find that a competent specialist could have been located in Mississippi and, therefore, the boundary line should not have extended beyond the State's border. In the case sub judice, Perez's licensure and competence are not issues of dispute. The record reveals that Perez is a general surgeon licensed to practice medicine in Mexico. His educational background and work experience in medicine is extensive. His studies and specialties deal with, or have dealt with, trauma and orthopedics  which are relevant to Hernandez's injuries. Contrary to Petroleum's contention, the Rule 9 realm of convenience test was met. The Commission found that Hernandez was unable to obtain an appointment to be examined by a competent physician in Natchez, Mississippi. Therefore, she returned to her original hometown of Los Angeles, California  to which Perez's Tijuana office was not determined by the Commission to be inconvenient. [3] Probably, the realm of convenience test was delineated for the protection of the employee  not the employer. The test insures employees against potential devious-minded, vindictive employers who may furnish the services of a physician who is not conveniently located. And finally, whether Perez's treatment of Hernandez was reasonable as required by the Act is an issue not addressed by Petroleum in its brief. Petroleum had an affirmative duty to specifically address the issue and provide authoritative support for its position. Brown v. State, 534 So.2d 1019, 1023 (Miss. 1988); Shive v. State, 507 So.2d 898 (Miss. 1987); Read v. Southern Pine Elec. Power Ass'n, 515 So.2d 916 (Miss. 1987); Devereaux v. Devereaux, 493 So.2d 1310 (Miss. 1986); Pate v. State, 419 So.2d 1324 (Miss. 1982). In light of Petroleum's failure, this Court is under no obligation to consider th[e issue]. Brown, 534 So.2d at 1023; see also Clark v. State, 503 So.2d 277 (Miss. 1987); Kelly v. State, 463 So.2d 1070 (Miss. 1985); Redmon v. State, 457 So.2d 1344 (Miss. 1984); Smith v. State, 430 So.2d 406 (Miss. 1983); Nelson v. Clanton, 263 So.2d 787 (Miss. 1972). Procedural bar aside, examination of the record reveals an absence of evidence supportive of Petroleum's contention. In addition, the Commission did not find Perez's treatment of Hernandez to be unwarranted, and without evidence to the contrary, this Court is without authority to reverse the order for payment of Perez's fees. See MISS. WORKER'S COMPENSATION GEN. R. 12; MISS. CODE ANN. § 71-3-15 (1972); V. DUNN, MISSISSIPPI WORKMEN'S COMPENSATION §§ 340-41 (1982) (These three sources deal with the Commission's authority to assess medical costs against an employer). In sum, Rule 9 instills a right in an injured employee to accept the services [of a physician] furnished by the employer or, in his [the employee's] discretion, to select a competent physician of his choosing. In the case sub judice, the record provides no indication that Petroleum offered to furnish Hernandez with a physician. This notwithstanding, the rule empowered Hernandez with the discretionary right to select her own competent physician  which she did. The evidence in the record provides reasonable uncontradicted support for her decision to secure Perez's services. This Court finds no violation of Rule 9 by Hernandez. Admittedly, Rule 9 is constructed with broad terminology. This Court, however, should not fill in between the lines of the rule unless necessitated in order to avert a fundamentally unfair result. The Commission is advised to exercise its authority to clarify Rule 9. See MISS. WORKER'S COMPENSATION GEN. R. 2 (The rules of the Commission are subject to amendment at any time, and the Commission will adopt additional rules whenever ... changes [or clarification] is advisable.).