Opinion ID: 430490
Heading Depth: 3
Heading Rank: 1

Heading: Dr. Gordon's Alleged Refusal to Provide Treatment

Text: 21 We consider first the ALJ's finding that Dr. Gordon did not refuse to provide further treatment to Mr. Lloyd. Dr. Gordon testified that when he released Mr. Lloyd from treatment on January 28, 1976, he remained available to perform any follow-up treatment that Mr. Lloyd should request. Dr. Gordon further testified that he told Mr. Lloyd that he could call and come back if he had any further trouble. It was not until over a year and a half later, on August 22, 1977, that Mr. Lloyd first sought treatment from Dr. Schuster. The record supports the conclusion that Dr. Gordon's prior conduct did not indicate that he would have refused treatment had Mr. Lloyd requested it at that time. In Shahady, in contrast, the claimant testified that he actually did request further treatment from the employer's physician, and that the physician told him that [h]e was fine, there was nothing wrong with [his] leg, and to come back and see him in a year. 682 F.2d at 969. Within a few months of this discharge the claimant independently procured treatment. Id. at 970. In Shahady, therefore, the record clearly established that, at the time when the employee independently procured treatment, he had ample reason to believe that the employer's physician would have refused to provide any treatment. In the present case, however, we conclude that the ALJ's finding that Dr. Gordon did not refuse to provide further treatment to Mr. Lloyd is supported by substantial evidence in the record considered as a whole and is conclusive. 22 The Board's basis for rejecting the ALJ's finding on this point is meritless. The Board concluded that Dr. Gordon's actions were tantamount to a mistaken diagnosis. 4 In James Washington, 3 BEN.REV.BD.SERV. (MB) 474, 479 (May 10, 1976), the Board held that a mistaken diagnosis can be equivalent to a refusal of treatment by the employer. In Washington, the employer's doctors diagnosed the claimant's symptoms as arthritis, while the claimant's own physician correctly diagnosed the condition as two degenerated discs. In the present case, in contrast, the Board admits that Dr. Gordon and Dr. Schuster did not actually diagnose claimant's ailments differently. Each found back pain complicated by accompanying emotional problems. 5 The Board concluded, however, that Dr. Gordon's method of treatment was tantamount to a mistaken diagnosis because it differed considerably from Dr. Schuster's method of treatment, which subsequently was found by an administrative law judge to be reasonable and necessary. 6 23 The Board's conclusion follows from its premises only if there is exactly one right method of treatment. But that, of course, is not the case. Capable doctors can and frequently do disagree about what course of treatment will most benefit the patient. We do not foreclose the possibility that a demonstrably improper method of treatment might constitute a refusal to provide treatment. In the present case, however, the record is devoid of any evidence that Dr. Gordon's method of treatment was medically unacceptable. Indeed, we find no evidence even to indicate that Mr. Lloyd's recovery would have been less successful had he remained under Dr. Gordon's care. 24