Court Opinion

ID: 9697952
Source: CourtListenerOpinion
Date Created: 2023-08-25 19:38:02.256613+00
Date Added: 2024-06-11T18:20:37.279427
License: Public Domain

CAPPY, Justice,
dissenting.
I must respectfully dissent to the decision of the Majority. I believe that the decision is not consistent with the plain language or the intent of the statute, nor is it factually supported by the record. Finally, I do not believe that the *449decision provides any workable framework for determining when an employee is entitled to payment for medical services.
First, I agree with the Commonwealth Court that the 1978 amendment to section 306(f)(1) of the Pennsylvania Workmen’s Compensation Act, Act of June 2, 1915, P.L. 736, as amended, 77 P.S. § 531(1), intended to limit the selection of health care providers to the province of the employer. The plain language of the statute provides that:
(1) The employer shall provide payment for reasonable surgical and medical services, services rendered by duly licensed practitioners of the healing arts, medicines, and supplies as and when needed: Provided, if a list of at least five designated physicians or other duly licensed practitioners of the healing arts or a combination thereof is provided by the employer, the employe shall be required to visit one of the physicians or other practitioners so designated and shall continue to visit the same or another physician or practitioner for a period of fourteen days from the date of the first visit. Subsequent treatment may be provided by any physician or any other duly licensed practitioner of the healing arts or a combination thereof, of the employe[’]s own choice, and such treatment shall be paid for by the employer.
77 P.S. § 531(1) [Emphasis added]. I believe the language is clear that the employee is required to visit one of the health care providers designated by the employer for the first fourteen days of treatment. The employee is not prevented from seeking treatment from a practitioner that he or she deems preferable; he or she simply must pay for that choice.
I also view the Majority’s reliance on Workmen’s Compensation Appeal Board v. Overmyer Mold Co., 473 Pa. 369, 374 A.2d 689 (1977), to be clear bootstrapping. Overmyer is simply inapposite to this case. In Overmyer, the Court interpreted the version of § 306(f) prior to the 1978 amendments. In that version, § 306(f) permitted the employee to select a treatment provider unless at least five physicians were desig*450nated by the employer, in which case the employee was required to choose from the five physicians. The Court interpreted § 306(f) to mean that only the choice of physicians was limited. The Court stated: “If the Legislature had intended to restrict the employee’s rights to choose ‘any practitioner of the healing arts,’ it could have limited that choice by allowing the employer to designate certain ‘practitioners of the healing arts’ from which the employee was to choose.” 473 Pa. at 375, 374 A.2d at 691-692. The 1978 amendments to § 306(f) made it clear, to my mind, that the Legislature intended to restrict the employee’s right to choose a health care provider.1,2 The Majority’s reliance on Overmyer is simply an attempt to graft an interpretation of a previous version of a statute onto an amended version which has been materially altered.
Nor does the Majority’s argument that if the statute were not construed to permit Appellant to visit a chiropractor, an “absurd” result would occur, lend credence to its interpretation of § 306(f). The factual record in this case simply does not play out the purported “absurdity” of the statute, since there was no evidence that a physician was unable to handle Appellant’s medical complaint. Here, the Majority states that *451the Appellant’s injury of a possible disc herniation is “routinely treated by chiropractic manipulation and physiotherapy.” The Majority then makes the leap, which I believe to be unwarranted, that a chiropractor is the only competent treatment provider of back injuries, and that the Appellant’s injury required chiropractic care. For example, the Majority implies that in this case, Appellant would be prevented from “obtaining appropriate care____”, Maj. op. at 444. The Majority goes on to assert:
[Wjhen an employer fails to include on the designated list those physicians or practitioners required by the injured employee for proper treatment of a particular job-related injury, we see nothing in the statute that prevents the employer from being required to pay for the employee’s treatment by the physician or practitioner which the employee’s injury dictates---- [W]e see no evidence in the statute’s amendment of legislative intent to take away an employee’s right to use the type of practitioner of the healing arts needed when none are in the list designated by the employer.
Maj. op. at 1303 [Emphasis added]. The problem with these assertions is that in this case, there is simply no evidence of record that any of the physicians listed on the employer’s list were incompetent to treat Appellant or were an inappropriate treatment provider.3,4 Surely the Majority is not suggesting that medical doctors are unqualified to treat herniated discs!5 In this regard, I note that the referee’s finding that the *452treatment received by Appellant was reasonable and “necessary” does not translate into a finding that chiropractic treatment was the only treatment that was adequate for Appellant. In other words, merely because the referee found that treatment itself was “necessary,” ie., Appellant’s injury required some treatment, does not mean that the manner of treatment, ie. chiropractic manipulation, was necessary to the exclusion of all other medical treatment.
Finally, I note that the Majority’s decision provides no guidelines or legal principles for determining when the list of physicians and practitioners submitted by an employer is insufficient to treat an injured employee. Who is to determine what is the appropriate care required — the employee? If that is the intent of the Majority, why even have a statute that provides the employer with the opportunity to select suitable health care providers? Moreover, how many kinds of practitioners must an employer include in the list? I believe § 306(f) plainly vests discretion in the hands of the employer in a workable manner; the Majority’s interpretation creates ambiguity and confusion where none need exist. Therefore, I must conclude that the Majority has interpreted § 306(f) in a manner not only in derogation of the language and intent of the statute, but in also in a manner that is wholly unworkable. Accordingly, I dissent.
CASTILLE and MONTEMURO, JJ., join this Dissenting Opinion.

. I would also note that although the statute is remedial in nature and therefore is to be construed in favor of the injured worker, we are not permitted to ignore a rational plan adopted by the Legislature to govern the selection of health care providers in favor of perceived policy considerations and imagined horrors. Appellant's brief focuses repeatedly on the issue of “freedom of choice’’ with regard to health care providers, perhaps in an attempt to echo the recent national debate on this issue. However, the issue of freedom of choice and whether that is desirable or undesirable is simply not before this Court now. Rather, we are faced with interpreting a scheme that has already been adopted by the Legislature, not With judicially legislating what we may perceive to be the more desirable system.

. I note that the Legislature again amended § 306(f) in 1993. The latest amendments require the employee to visit an employer-designated health care provider "[pjrovided an employer establishes a list of at least six designated health care providers, no more than two of whom may be a coordinated care organization and no fewer than three of whom shall be physicians....” Clearly, the Legislature continues to indicate its legislative preference to provide the employer with control over the medical services initially obtained by an employee.

. The only evidence presented by Appellant was testimony by the treating chiropractor that treatment for disc herniation by a medical doctor was different than that of a chiropractor, but not improper (R.R. at 64a); and testimony from the Deputy Director for the Foundation for Chiropractic Education and Research that chiropractic treatment was generally less expensive than that of a medical doctor (R.R. at 75a-76a).

. Moreover, unlike in Overmyer, Appellant was not told by any of the designated physicians that Appellant’s condition was not treatable by a medical doctor.

. I believe this is the clear logical implication of the Majority’s holding, and demonstrates the danger of the type of result-oriented analysis in which the Majority engages.