Opinion ID: 2234856
Heading Depth: 1
Heading Rank: 5

Heading: authority to order future medical payments

Text: The statutory provisions in effect at the time of Foote's accident and subsequent award in the compensation court are found at Neb.Rev.Stat. § 48-120(1) and (6) (Reissue 1993) and state, in pertinent part: (1) The employer shall be liable for all reasonable medical, surgical, and hospital services ... and medicines as and when needed, which are required by the nature of the injury and which will relieve pain or promote and hasten the employee's restoration to health and employment... subject to the approval of and regulation by the Nebraska Workers' Compensation Court, not to exceed the regular charge made for such service in similar cases. .... (6) The Nebraska Workers' Compensation Court shall have the authority to determine the necessity, character, and sufficiency of any medical services furnished or to be furnished and shall have authority to order a change of physician, hospital, rehabilitation facility, or other medical services when it deems such change is desirable or necessary. Any dispute regarding medical, surgical, or hospital services furnished or to be furnished under this section may be submitted by the parties, the supplier of such service, or the compensation court on its own motion for informal dispute resolution by a staff member of the compensation court or an outside mediator pursuant to section 48-168.... The compensation court may adopt and promulgate rules and regulations regarding informal dispute resolution or the submission of disputes to an independent medical examiner that are considered necessary to effectuate the purposes of this section. We first consider whether the review panel is correct in determining that the workers' compensation trial court lacked the authority to order, as part of a final award, payment of future medical expenses incurred more than 2 years after the date of the last payment, even if the medical expenses are reasonable and necessary and a result of the disabling injury. The operative language of § 48-120(1) pertinent to this issue states that [t]he employer shall be liable for all reasonable medical ... services ... and medicines as and when needed, which are required by the nature of the injury and which will relieve pain or promote and hasten the employee's restoration to health and employment.... Foote argues that in light of the fact that the disabling effects of a permanent disability may continue after an award of permanent partial disability has been entered, the obvious purpose of the statutory scheme is to authorize the Workers' Compensation Court to order, as part of a final award, an employer to pay the costs of the medicines and medical treatment reasonably necessary to relieve the worker from the effects of the injury even though such medical treatment may not be rendered for more than 2 years after the entry of the award. We agree with Foote's argument. The Legislature enacted the Nebraska Workers' Compensation Act in order to relieve injured workers from the adverse economic effects caused by a work-related injury or occupational disease. See, generally, Union Packing Co. v. Klauschie, 210 Neb. 331, 314 N.W.2d 25 (1982); Moise v. Fruit Dispatch Co., 135 Neb. 684, 283 N.W. 495 (1939); Wilson v. Brown-McDonald Co., 134 Neb. 211, 278 N.W. 254 (1938). It is in light of this beneficent purpose that we have consistently given the act a liberal construction to `carry out justly the spirit of the Nebraska Workers' Compensation Act.' Phillips v. Monroe Auto Equip. Co., 251 Neb. 585, 595, 558 N.W.2d 799, 806 (1997). Accord Fite v. Ammco Tools, Inc., 199 Neb. 353, 258 N.W.2d 922 (1977). See, also, Miller v. E.M.C. Ins. Cos., 259 Neb. 433, 610 N.W.2d 398 (2000); Union Packing Co. v. Klauschie, supra . The act is designed to compensate an injured worker for two distinct losses resulting from a work-related injury or occupational disease: the loss of earning capacity based on the concept of disability and medical and other costs associated with the injury or disease. See 4 Arthur Larson & Lex K. Larson, Larson's Workers' Compensation Law § 80.02 (2001). Consistent with this statutory design, the act authorizes an award of permanent disability, either partial or total, as a means of compensating the injured worker for the loss of earning capacity. See, Sherard v. Bethphage Mission, Inc., 236 Neb. 900, 464 N.W.2d 343 (1991); Musil v. J.A. Baldwin Manuf. Co., 233 Neb. 901, 448 N.W.2d 591 (1989). The act also, pursuant to § 48-120, authorizes an award of medical benefits reasonably necessary to relieve the injured worker from the effects of the work-related injury or occupational disease. While both an award of permanent disability and an award of medical benefits are intended to offset the adverse economic consequences sustained by an injured worker, the need for medical treatment does not necessarily cease upon the entry of an award of permanent disability. Grover v. Industrial Com'n of Colorado, 759 P.2d 705 (Colo.1988). Once a worker has reached maximum medical improvement from a disabling injury and the worker's permanent disability and concomitant decreased earning capacity have been determined, an award of permanent disability is appropriate. It is an obvious fact of industrial life, however, that an injured worker can reach maximum medical improvement from an injury and yet require periodic medical care to prevent further deterioration in his or her physical condition. Id. See, also, Little v. Penn Ventilator Co., 317 N.C. 206, 345 S.E.2d 204 (1986). Because the statutes should be broadly construed to accomplish the beneficent purpose of the act, Miller v. E.M.C. Ins. Cos., supra , it is inappropriate to graft onto the statutory scheme a substantial limitation on medical benefits when no such limitation is set forth in the act itself. The only limitation on medical benefits set forth in § 48-120 is that the treatment be reasonable and that the compensation court has the authority to determine the necessity, character, and sufficiency of the treatment furnished. It would be inconsistent with our principles of statutory interpretation set forth above to read another limitation into the statute. In addition to being in accord with the intended purposes of the act, our construction of § 48-120 is consistent with the legislative intent underlying the medical benefits provision, as evidenced by an examination of various amendments adopted by the Legislature over the years following the original enactment of the provision in 1913. As originally enacted in 1913, the statute limited medical benefits to medical and hospital services during the first 21 days after the disability began, with the employer's liability not to exceed $200. See 1913 Neb. Laws, ch. 198, § 20, p. 585-86. Subsequent amendments, however, have greatly expanded the availability of medical benefits: 1917 Neb. Laws, ch. 85, § 6, p. 202 (providing compensation for major medical expenses, not to exceed $200, beyond 21-day period); 1919 Neb. Laws, ch. 91, § 1, p. 228 (eliminating 21-day limit altogether); 1921 Neb. Laws, ch. 122, § 1, p. 520 (eliminating $200 limit); 1965 Neb. Laws, ch. 278, § 1, p. 799 (providing compensation for first prosthetic devices); 1975 Neb. Laws, L.B. 127 (providing compensation for all prosthetic devices, as well as all supplies and treatment required to relieve pain or promote and hasten the employee's restoration to health and employment); and 1978 Neb. Laws, L.B. 529 (providing compensation for plastic or reconstructive surgery). We conclude that the history of the medical benefits provision, from its original enactment in 1913 to the present version applicable here, clearly manifests a legislative intent in § 48-120 to make medical benefits available to a disabled worker without regard to any time limitation measured from the last date of payment (when an award is entered), as long as further medical treatment is reasonably necessary to relieve the worker from the effects of the work-related injury or occupational disease. It is particularly significant to note that the statute, as originally enacted, contained a limitation on the time period during which medical expenses were compensable and that the Legislature later specifically removed that limitation from the statute. Furthermore, the construction we herein adopt accords with the interpretation which other courts have placed on statutory enactments similar to the medical benefits provision of § 48-120. See, e.g., Barnes v. W.C.A.B., 23 Cal.4th 679, 2 P.3d 1180, 97 Cal.Rptr.2d 638 (2000); Lisney v. LIRC, 171 Wis.2d 499, 493 N.W.2d 14 (1992); Grover v. Industrial Com'n of Colorado, 759 P.2d 705 (Colo. 1988); Little v. Penn Ventilator Co., 317 N.C. 206, 345 S.E.2d 204 (1986); Depue v. Barsh Truck Lines, 493 P.2d 80 (Okla. 1972); Eide v. Whirlpool Seeger Corp., 260 Minn. 98, 109 N.W.2d 47 (1961); Plantation Mfg. Co. v. Industrial Comm'n, 294 Ill.App.3d 705, 691 N.E.2d 13, 229 Ill.Dec. 77 (1997). In so construing § 48-120, however, we hasten to emphasize that before an order for future medical benefits may be entered, there should be a stipulation of the parties or evidence in the record to support a determination that future medical treatment will be reasonably necessary to relieve the injured worker from the effects of the work-related injury or occupational disease. The employer, of course, may contest any future claims for medical treatment on the basis that such treatment is unrelated to the original work-related injury or occupational disease, or that the treatment is unnecessary or inapplicable. See § 48-120(6). Where the record has established, however, that future medical treatment will be reasonably necessary, the compensation court is authorized to enter an award of future medical benefits subject to the provisions of § 48-120(6).