Opinion ID: 867305
Heading Depth: 2
Heading Rank: 2

Heading: Nature of Services Provided

Text: ¶16 Mr. Carbajal received several hours of attendant care each week, for which the Carrier paid. Some services rendered by the attendants, such as dressing and driving Mr. Carbajal, are not medical or curative treatment, but rather constitute palliative care.2 ¶17 The Carrier acknowledges that A.R.S. § 23-1062(A) implicitly covers such palliative care. We agree; by extending compensation for services rendered after a claimant becomes medically stationary, the legislature intended to include coverage for reasonably required palliative care. See 1973 Ariz. Sess. Laws, ch. 133, §§ 30, 32 (1st Reg. Sess.) (extending medical, surgical, and hospital benefits to periods of permanent 2 Palliative care involves managing the claimant’s symptoms or mitigating the effects of the claimant’s injury. See 5 Arthur Larson & Lex K. Larson, Larson’s Workers’ Compensation Law § 94.04 (2008); see also Jackson v. Columbia Pictures, 610 So. 2d 1349, 1351 (Fla. Dist. Ct. App. 1992); O’Donnell v. Workers’ Comp. Appeal Bd., 831 A.2d 784, 791 (Pa. Commw. Ct. 2003). Palliative care differs from curative treatment, which is designed to reduce the level of injury or end the disability. See 5 Larson & Larson, supra, § 94.04. Once a claimant is “medically stationary,” medical care cannot cure or improve the claimant’s medical condition. See Hardware Mut. Cas. Co. v. Indus. Comm’n, 17 Ariz. App. 7, 9-10, 494 P.2d 1353, 1355-56 (1972). Becoming medically stationary demarcates the transition from the period of “temporary disability” to the period of “permanent disability.” Id. Once the claimant is medically stationary, treatment is necessarily palliative rather than curative because, by definition, it cannot improve the claimant’s condition. See id. - 10 - disability). ¶18 Certain services Mrs. Carbajal provided were identical to those rendered by paid attendants. For example, when attendants failed to show up, Mrs. Carbajal performed the services they would have provided, such as bathing and dressing Mr. Carbajal. The Carrier maintains that although Mrs. Carbajal performed some of the services provided by paid attendants, § 23-1062(A) does not require compensation for Mrs. Carbajal’s performance of these duties because she is not a licensed health care provider. We fail to see the connection between licensure and compensation. There is no suggestion that Mrs. Carbajal lacks a required license or is otherwise unqualified to perform the services in question. Nothing in the statute hinges compensability of services to the fact of licensure, even though some services compensable under § 23-1062(A) may only legally be performed by licensed providers.3 Thus licensure of the service provider is not the touchstone for determining the compensability of services. ¶19 The Carrier’s claim that services are compensable when performed by Carrier-provided attendants, but not when performed by Mrs. Carbajal, therefore must turn on her status as Mr. 3 See, e.g., A.R.S. § 32-1455(A)(1) (2008) (making the unlicensed practice of medicine a felony). - 11 - Carbajal’s spouse. Yet the statute creates no such distinction. The statute speaks only in terms of goods and services. The compensability of services inquiry should focus on the nature of the services provided, not on the identity of the service provider. If an injured worker requires services compensable under § 23-1062(A), then the employer must provide them. If the employer fails to do so and thus puts that burden on the injured employee’s spouse, compensation for the necessary services is required by the statute. Those services provided by Mrs. Carbajal that would constitute compensable palliative care if performed by the Carrier-paid attendants are thus compensable.