Sprague v. Caldwell Transportation Inc. , 116 Idaho 720 ( 1989 )

BISTLINE, Justice.

The Commission concluded that claimant’s medical treatment occurring subsequent to April 10, 1985, was not “reasonable,” and therefore the surety was not obligated to pay such costs under I.C. § 72-432(1). We reverse.

A.

Claimant Gary Sprague suffered a back injury on June 5, 1984, which arose out of and in the course of his employment with Caldwell Transportation Company. While fueling a vehicle, Sprague fell backward from the third step of a gasoline tank when his feet got tangled in a gasoline hose. He fell about three feet, landing on his back and head. Sprague immediately consulted with Dr. John Downey, a chiropractic physician from Caldwell.

Dr. Downey diagnosed Sprague’s injury as a compression fracture of the 12th thoracic vertebrae and a subluxation complex of the lumbar spine. Dr. Downey treated Sprague on a frequent basis, submitting periodic reports and billings to the surety, Aetna Casualty. In September 1984, the surety arranged for a consultation with Dr. Floyd Johnson, an orthopedic surgeon. The surety subsequently notified Dr. Downey and claimant Sprague that further chiropractic treatment would not be authorized because Dr. Johnson indicated that Sprague should not receive manipulative treatment, but only passive treatment {e.g., ultrasound and traction). However, Dr. Johnson later reported that chiropractic treatment would be appropriate. Sprague continued to receive treatment from Dr. Downey.

The surety subsequently arranged consultation with another orthopedic surgeon, Dr. Keith Taylor, in April of 1985. Dr. Taylor concluded Sprague had received enough chiropractic therapy and that Sprague should engage in back exercises. Thereafter, the surety requested that Dr. Downey send his final report and bill. On April 15, 1985, Dr. Downey sent a report stating the “patient has been finalized and has reached his MMI” (maximum medical improvement). The surety paid all of Dr. Downey’s charges through April 10, 1985, in the total amount of $5108.71.

Sprague nevertheless returned to Dr. Downey a week later for further treatment of back pain. This appeal focuses on the treatment received after April 10, 1985. Sprague received 34 additional treatments in 1985 and 13 in 1986. The bill for this treatment totalled $1,848.96. The referee found that during the period of treatment after April 10, 1985, Sprague “made gradual improvement.” The referee further found that the post April 10, 1985, “charges were fair, reasonable and similar to others in the same profession.” Surprisingly, however, the referee also concluded that the treatment was not reasonable under I.C. § 72-432(1), and therefore the surety was not obligated to make payment therefor. The Commission adopted the Findings of Fact, Conclusions of Law, and Order of the referee in their totality.

B.

Our scope of review in appeals of this kind is well established. The Idaho Constitution mandates that review of the Industrial Commission is limited to questions of law. Idaho Const, art V, § 9. The findings of the Commission will not be disturbed on appeal when supported by substantial and competent evidence. Nenoff v. Culligan Soft Water, 97 Idaho 243, 542 P.2d 837 (1975).

The provisions of the Worker’s Compensation Law are to be liberally construed in favor of the employee. Jones v. Morrison-Knudsen Co., 98 Idaho 458, 567 P.2d 3 (1977); Burch v. Potlatch Forests, Inc., 82 Idaho 323, 353 P.2d 1076 (1960). Liberal construction in favor of the worker is required to enable the act to serve the humane purposes for which it was promulgated, “leaving no room for narrow, technical construction.” Hattenburg v. Blanks, 98 Idaho 485, 485, 567 P.2d 829, 829 (1977).

C.

The sole issue presented on this appeal is whether the treatment Sprague received from his physician subsequent to April 10, 1985, was “reasonable” under I.C. § 72-432(1). In pertinent part, that code provision states:

“The employer shall provide ... reasonable medical ... treatment ... as may be required by the employee’s physician____”

(Emphasis added.)¹ The clearly expressed intent of the legislature must be given effect; there is no occasion for construction where language is unambiguous. Ottesen v. Bd. of Comm’rs of Madison Co., 107 Idaho 1099, 695 P.2d 1238 (1985). Thus, the mandate of the statute requires the employer to pay for the costs of reasonable medical treatment required by the employee’s physician. Chiropractic physicians are recognized and acceptable professionals able to provide treatments for industrial accidents. See I.C. § 72-102(20) (“ ‘Physician’ means medical physicians and surgeons, ... chiropractic physicians.”). Furthermore, chiropractic is a licensed profession the practice of which without a license is illegal. See I.C. § 54-702. Our review requires an examination of the record.

First, as noted, the Commission found that “during the period of treatment by Dr. Downey subsequent to April 10, 1985, Sprague made gradual improvement.² (Emphasis added.) Second, the uncontradicted evidence establishes that Dr. Downey was of the unequivocal opinion that in his judgment the medical treatment Sprague received was required.³ Third, the Commission found that the treatment Sprague received “was within the standard of the practice of chiropractic. The charges were fair, reasonable and similar to charges of others in the same profession.”⁴ These facts are beyond cavil or dispute.

The Commission determined, however, in the conclusions of law that the chiropractic treatment was “unreasonable” under I.C. § 72-432(1) and therefore the surety was not obligated to make payment therefor. While we do not disturb findings of fact supported by the evidence, whether the conclusions of law are supported by the facts presents a question of law over which we exercise free review. As stated in O’Loughlin v. Circle A Construction, 112 Idaho 1048, 739 P.2d 347 (1987):

But here the pertinent facts are uncontroverted. Instead, the issues turn upon the proper application of the law to the undisputed [or found] facts____ Hix v. Potlatch Forests, Inc., 88 Idaho 155, 159, 397 P.2d 237, 241 (1964), citing Johnston v. A. C. White Lumber Co., 37 Idaho 617, 217 P. 979 (1923); Ybaibarriaga v. Farmer, 39 Idaho 361, 228 P. 227 (1924). The standard is one of free review. The Honorable Donald L. Burnett, Jr., of our Court of Appeals, has written: ‘An appellate court is expected to declare the law and may substitute its view for that of a trial court or agency upon a legal issue.’ Standards of Appellate Review in State and Federal Courts, § 3.2, p. 3-3, Idaho Appellate Handbook (Idaho Law Foundation, Inc., 1985).

112 Idaho at 1051, 739 P.2d at 350.

The Commission’s finding that Sprague’s accident and injury “did not necessitate the type of care provided to [Sprague] by Dr. Downey subsequent to April 10, 1985” incorrectly focuses on the necessity of the treatment, rather than on whether it was reasonable and was required by Sprague’s physician. I.C. § 72-432(1) obligates the employer to provide treatment, if the employee’s physician requires the treatment and if the treatment is reasonable. It is for the physician, not the Commission, to decide whether the treatment is required. The only review the Commission is entitled to make of the physician’s decision is whether the treatment was reasonable. Here, the Commission’s attempt to premise a conclusion that the treatment was not reasonable on a finding that it was not necessary exceeded the Commission’s authority.

Under the circumstances of this case, there is no dispute that: a) the claimant made gradual improvement from the treatment received; b) the treatment was required by the claimant’s physician; and c) the treatment received was within the physician’s standard of practice the charges for which were fair, reasonable and similar to charges in the same profession. We hold that in light of these facts a legal conclusion that the treatment was unreasonable under I.C. § 72-432(1) cannot stand. Accordingly, we reverse and remand to the Commission to enter an order consistent with this opinion.

Reversed. Costs to claimant; no attorney fees on appeal.

SHEPARD, C.J., and HUNTLEY and JOHNSON, JJ. concur.

1 . Idaho Code § 72-432(1) provides in full:

The employer shall provide for an injured employee such reasonable medical, surgical or other attendance or treatment, nurse and hospital service, medicines, crutches and apparatus, as may be required by the employee’s physician or needed immediately after an injury or disability from an occupational disease, and for a reasonable time thereafter. If the employer fails to provide the same, the injured employee may do so at the expense of the employer.

(Emphasis added.) Note that the disjunctive “or” categorizes treatment into two kinds: (1) that required by an employee’s physician, and (b) that needed immediately after an injury or disability from an occupational disease, and for a reasonable time thereafter. The term "or" should ordinarily be given its normal disjunctive meaning unless such a construction renders the provision in question repugnant to other provisions in the statute, would involve an absurdity or produce an unreasonable result. Filer Mutual Telephone Co. v. Idaho State Tax Comm’n., 76 Idaho 256, 281 P.2d 478 (1955).

2 . This finding is supported by substantial competent evidence and will not be disturbed on appeal.

3 . Dr. Downey’s testimony in part provides: "Q. Now concerning the care and treatment that was provided to Mr. Sprague in 1985 and in 1986, in your opinion was this care and treatment required for the injury that he suffered in June of 1984? A. Yes.” Tr., at 65. This uncontradicted testimony must be accepted as true. Smith v. Idaho State University Federal Credit Union, 114 Idaho 680, 685, 760 P.2d 19, 24 (1988); Pierstorff v. Gray's Auto Shop, 58 Idaho 438, 477, 74 P.2d 171, 175 (1937). See also Dinneen v. Finch, 100 Idaho 620, 627, 603 P.2d 575, 582 (1979).

4 .Finding of Fact VII, R., at 10-11 (emphasis added). This finding is supported by substantial competent evidence and will not be disturbed on appeal.