Section 287.140. RSMo controls with respect to the issue of past medical expenses. This statute provides, in relevant part:
- In addition to all other compensation paid to the employee under this section, the employee shall receive and the employer shall provide such medical, surgical, chiropractic, and hospital treatment, including nursing, custodial, ambulance, and medicines, as may reasonably be required after the injury or disability, to cure and relieve from the effects of the injury. If the employee desires, he shall have the right to select his own physician, surgeon, or other such requirement at his own expense. . .
- The employer shall have the right to select the licensed treating physician, surgeon, chiropractic physician, or other health care provider; provided, however, that such physicians, surgeons or other
Injury No.: 13-098181
Employee: Marleta Boykins-Walls
- 3 -
health care providers shall offer only those services authorized within the scope of their licenses.
As the court held in *Downing v. McDonald's Sirloin Stockade*, 418 S.W.3d 526 (Mo. App. 2014):
> *'[A]n employer's duty to provide statutorily-required medical aid to an employee is absolute and unqualified.' That is, [§ 287.140] requires an employer to provide an injured employee medical care but allows the employer to select the medical provider.' Thus, '[a]n employer is held liable for independent medical treatment incurred only when the employer has notice that the employee needs treatment, or a demand is made on the employer to provide medical treatment, and the employer refuses or fails to provide the needed treatment* (emphasis added).' *Id.* 529.
In this case, the employer admits that on December 6, 2013, the employee sustained an injury arising out of and in the course of her employment. Employer referred the employee to Concentra Medical Center the day of her injury for treatment. Concentra physician Dr. Gary Gray discharged the employee from his care on December 26, 2013.
The employee had an obligation to make reasonable efforts to notify employer of her need for additional medical care after her December 26, 2013, release by Concentra. The employer is not liable if it did not know and reasonably could not have known of the employee's need for additional medical care. Furthermore, brief delays in scheduling appointments other than in emergency situations do not render employer/insurer liable for unauthorized care.
We find that the employee's testimony regarding her attempts to notify employer of her need for additional medical care after her December 26, 2013, release from Concentra is so vague that employer had no liability to provide additional medical treatment until after the employee, through her attorney, filed a claim for compensation on or about January 10, 2014, acknowledged by the Division of Workers' Compensation on January 14, 2014. We find claimant's claim for compensation notified employer of her need for additional medical treatment as of January 15, 2014, by specifically stating, "Employee is in need of and officially demands medical treatment."
On January 28, 2014, employer advised employee's attorney that employer scheduled an appointment for the employee at Concentra Medical Center on Thursday, January 30, 2014, at 1:30 p.m. However, when the employee reported to Concentra forty minutes early for her appointment that day, Concentra refused to provide treatment, citing a lack of authorization from employer to reopen the employee's case.
---
1 *Transcript*, 291.
2 *Id.* Employer and Insurer's Exhibit A, 368-371.
3 *Id.* 370.
4 *Id.* Employee's Exhibit 10, 328.
5 *Id.* 324-325.
| Employee: | Marleta Boykins-Walls | Injury No.: | 13-098181 |
| Employer thereafter provided employee no further medical treatment until February 10, 2014, the date of the employee’s appointment with orthopedic physician Michael J. Milne. |
| Pursuant to employee’s notice of her need for additional medical treatment as of January 15, 2014, we find that treatment of her left knee by Dr. William J. Droege from January 17, 2014, through January 27, 2014, was reasonable and necessary. We note that Dr. Droege’s treatment was consistent with the type of treatment (physical therapy) both Dr. Milne and Dr. Doll recommended and that employer eventually provided beginning March 11, 2014. We defer to the ALJ’s finding regarding the employee’s credibility. Specifically, we find there is no credible evidence of any injury other than referable to the employee’s left knee as of January 7, 2014, or thereafter. |
| Employee testified she sought Dr. Droege’s therapy to help improve the pain in her left knee relating to her work injury of December 6, 2013. Dr. Droege testified that all of the therapy he provided the employee was reasonable, necessary, and related to her December 6, 2013, work injury. ^{6 } |
| The following charges for Dr. Droege’s treatment from January 17, 2014, through January 27, 2014, are documented in the record ^{7 } : |
| Date | Charges |
| January 17, 2014 | $187.00 |
| January 20, 2014 | $149.00 |
| January 22, 2014 | $149.00 |
| January 24, 2014 | $149.00 |
| January 27, 2014 | $149.00 |
| Total: | $783.00 |
| Dr. Droege testified that, as of the date of the hearing, he had not submitted these bills to anyone for payment. These bills therefore remain outstanding. |
| An award of past medical expenses is supported when the record includes: (1) the bills themselves; (2) the medical records reflecting the treatment giving rise to the bills; and (3) testimony from the employee establishing the relationship between the bills and the disputed treatment. Martin v. Mid-America Farm Lines, Inc., 769 S.W.2d 105, 111-12 (Mo. 1989). |
| Employer has not advanced any evidence that would demonstrate that employee is not required to pay the billed amounts, that her liability for the disputed amounts was extinguished, or that the reason such liability was extinguished does not otherwise fall within the provisions of § 287.270 RSMo. See Farmer-Cummings v. Pers. Pool of Platte Cnty., 110 S.W.3d 818 (Mo. 2003), and Maness v. City of De Soto, 421 S.W.3d |
| ^{6 } Transcript, 93. |
| ^{ 7 } Id. 171-173. |
532, 545 (Mo. App. 2014). We conclude employer is liable for charges by Dr. Droege for treatment during the period January 17, 2014, through January 27, 2014, in the amount of $\ 783.00.