California, United States of America
The following excerpt is from Brotherton v. Workmen's Compensation Appeals Bd., 273 Cal.App.2d 451, 78 Cal.Rptr. 70 (Cal. App. 1969):
In McCoy v. Industrial Acc. Com., 64 Cal.2d 82, 48 Cal.Rptr. 858, 410 P.2d 362, the defendants had provided the applicant with some medical treatment following an industrial injury. They subsequently informed her, on the advice of a physician, that they would furnish no further treatment as it was unnecessary. After hearing on her claim, the commission found that further treatment was not required. Some time later applicant wrote the insurance carrier advising that her condition had become worse and she was in need of further treatment. Two doctors who had previously examined her [273 Cal.App.2d 457] on behalf of the insurer re-examined her and found her condition remained permanent and stationary. Relying on their opinions, the carrier again refused further treatment. She requested a hearing by the commission. Both parties sought additional time for further medical investigation. In the meantime, applicant's self-procured physician diagnosed a ruptured disc and recommended hospitalization for further tests. While she was undergoing the tests under his supervision, defendants wrote advising her that they had arranged for her to be examined by another doctor in ten days. Her doctor proceeded to perform surgery during which he found and removed a ruptured disc. The commission issued an award for further disability but denied reimbursement for the self-procured medical, surgical and hospital expense on the ground that defendants were not given reasonable notice, nor a reasonable opportunity to furnish surgery. Affirming the award in other respects, the court remanded the cause to the commission with instructions to award reimbursement for the reasonable cost of the self-procured medical care and temporary disability.
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