Kim Branch Harris v. VA Beach General Hosp. ( 1999 )


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  •                      COURT OF APPEALS OF VIRGINIA
    Present:    Judges Bray, Annunziata and Frank
    KIM BRANCH HARRIS
    MEMORANDUM OPINION *
    v.       Record No. 0700-99-1                       PER CURIAM
    SEPTEMBER 14, 1999
    VIRGINIA BEACH GENERAL HOSPITAL AND
    MANUFACTURERS ALLIANCE INSURANCE COMPANY
    FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION
    (Jeffrey C. Flax; Kelberg, Childress & Flax,
    P.C., on brief), for appellant.
    (Richard E. Garriott, Jr.; Clarke, Dolph,
    Rapaport, Hardy & Hull, P.L.C., on brief),
    for appellees.
    Kim Branch Harris (claimant) appeals from a ruling of the
    Workers' Compensation Commission suspending claimant's benefits
    on the ground that she unjustifiably refused medical treatment.
    Upon reviewing the record and the briefs of the parties, we
    conclude that this appeal is without merit.      Accordingly, we
    summarily affirm the commission's decision.      See Rule 5A:27.
    On appeal, we review the evidence in the light most
    favorable to the prevailing party below.    See R.G. Moore Bldg.
    Corp. v. Mullins, 
    10 Va. App. 211
    , 212, 
    390 S.E.2d 788
    , 788
    (1990).    "Factual findings by the commission that are supported
    by credible evidence are conclusive and binding upon this Court
    *
    Pursuant to Code § 17.1-413, recodifying Code
    § 17-116.010, this opinion is not designated for publication.
    on appeal."    Southern Iron Works, Inc. v. Wallace, 
    16 Va. App. 131
    , 134, 
    428 S.E.2d 32
    , 34 (1993).
    So viewed, the evidence proved that claimant sustained a
    compensable back injury on December 31, 1991.   Claimant's
    primary treating physician, Dr. Nasrollah Fatehi, subsequently
    diagnosed claimant with Reflex Sympathetic Dystrophy (RSD).    In
    April 1997, Dr. Sidney Mallenbaum evaluated claimant and
    recommended that she be examined by physiatrist Dr. Lisa Barr.
    On May 19, 1997, Dr. Fatehi indicated that he did not object to
    claimant being evaluated by Dr. Barr, and wrote that "[i]f I
    agree with [Dr. Barr's] recommendation, I will encourage
    [claimant] to comply."
    After examining claimant on July 10, 1997, Dr. Barr
    recommended:
    [A] coordinated, interdisciplinary approach
    to treatment through an outpatient
    Spineworks program. This would also include
    a series of selective right S1 nerve root
    blocks and osteopathic manipulation, the use
    of trigger point injections, and a
    coordinated approach of reconditioning that
    will also incorporate dural stretching, gait
    training, functional activities, and lumbar
    stabilization.
    In her July 10, 1997 report, Dr. Barr indicated that she did not
    believe that claimant had RSD.    She further opined that
    claimant's condition included "some degree of symptom
    magnification."
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    Claimant was upset that Dr. Barr questioned Dr. Fatehi's
    RSD diagnosis.   She reported Dr. Barr's diagnosis to Dr. Fatehi
    who, on August 11, 1997, nevertheless "encouraged [claimant] to
    make an appointment with Dr. L. Barr for discussion regarding
    the proposed treatment and . . . told her to go along with Dr.
    L. Barr's recommendation."
    Claimant returned to see Dr. Barr on September 9, 1997.
    Dr. Barr wrote that claimant reported "with an agenda and a very
    defensive posture."    Claimant indicated that she did not trust
    Dr. Barr and that she was not interested in Dr. Barr's
    recommended program.   Claimant testified that Dr. Barr's
    recommended program seemed like physical therapy, that she had
    previously undergone physical therapy, and that physical therapy
    had worsened her condition.
    Kathy Farrahar contacted claimant the following day and
    extended claimant an offer from Dr. Barr to see one of two other
    physiatrists in Dr. Barr's office.      Claimant did not, however,
    return to Dr. Barr's office.   Thereafter, the employer, Virginia
    Beach General Hospital, filed an application for hearing
    alleging that claimant had unjustifiably refused medical
    treatment.
    In a January 13, 1998 letter to claimant's attorney, Dr.
    Fatehi wrote that, "in [his] opinion, (especially in view of the
    failure of the previous trials of physical therapy) [he did] not
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    feel that [claimant] would benefit from this sort of treatment."
    Dr. Fatehi specifically disagreed with Dr. Barr's conclusion
    that claimant was not suffering from RSD.
    Following a hearing, the deputy commissioner suspended
    benefits on the ground that claimant had unjustifiably refused
    medical treatment.   The full commission affirmed, finding that
    Dr. Fatehi had specifically recommended that claimant follow Dr.
    Barr's plan of treatment.   The commission discounted Dr.
    Fatehi's subsequent change of heart.
    Code § 65.2-603(B) provides for the
    suspension of benefits if a claimant
    unjustifiably refuses medical treatment.
    "Once a physician is selected, it is well
    settled that an employee who is referred for
    additional medical services by the treating
    physician must accept the medical service or
    forfeit compensation for as long as the
    refusal persists."
    Schwab Constr. v. McCarter, 
    25 Va. App. 104
    , 109, 
    486 S.E.2d 562
    , 564-65 (1997) (quoting Biafore v. Kitchin Equipment Co., 
    18 Va. App. 474
    , 479, 
    445 S.E.2d 496
    , 498 (1994)).   In addressing
    this issue, "[t]he question is not whether the recommended
    procedure was justified, but whether the patient's refusal to
    submit to it was justified.   The matter of justification must be
    considered from the viewpoint of the patient and in the light of
    the information which was available to him."   Holland v.
    Virginia Bridge & Structures, Inc., 
    10 Va. App. 660
    , 662, 
    394 S.E.2d 867
    , 868 (1990).
    - 4 -
    The record reflects that claimant's primary treating
    physician recommended that claimant undergo Dr. Barr's proposed
    treatment regimen.    And although claimant testified that she did
    not think that Dr. Barr's treatment would help, the record also
    reflects that claimant had a conflict with Dr. Barr because of
    Dr. Barr's conclusion that claimant was not suffering from RSD.
    Especially considering Dr. Fatehi's August 11, 1997
    recommendation that claimant pursue Dr. Barr's treatment plan,
    there is nothing in the record that tends to support claimant's
    concern that Dr. Barr's proposed course of treatment would be
    counter-productive.   Moreover, sensing a personality conflict,
    Dr. Barr even offered to have claimant see another physiatrist
    in her practice.   Accordingly, we cannot say that the commission
    erred when it held that claimant unjustifiably refused medical
    treatment.
    Affirmed.
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