Appeal from Mobile Circuit Court. (CV-92-0003047.51).
Crawley, Judge. Robertson, P.j., and Thigpen, Yates, and Monroe, JJ., concur.
The opinion of the court was delivered by: Crawley
This is a workmen's compensation action seeking payment of medical expenses. The trial court entered a judgment for the plaintiff, Charles R. Poston (the "worker"), and GAF Corporation (the "company") appeals.
The payment of medical expenses regarding the medical treatment rendered and prescribed by Dr. Rodning is the only issue on appeal. All other issues were reserved for further action by the trial court. The trial court entered an order pursuant to Rule 54(b), A.R.Civ.P., making its order regarding the medical expenses final.
The issues are (1) whether the worker was excused from obtaining authorization for medical treatment, (2) whether the injury was work-related, (3) whether the company must pay medical expenses already paid by the worker's private health insurance plan, and (4) whether the evidence supports the amount of medical expenses awarded by the trial court.
The worker's injury occurred in August 1991. The review of this case is governed by Ala. Code 1975, § 25-5-1 et seq., the Workmen's Compensation Act, as it was in effect before the amendments of May 19, 1992.
Under the Workmen's Compensation Act, the standard of appellate review is a two-step process. Initially, the reviewing court will look to see if there is any legal evidence to support the trial court's findings. If such evidence is found, then the reviewing court determines whether any reasonable view of that evidence supports the trial court's judgment. Ex parte Eastwood Foods, Inc., 575 So. 2d 91, 93 (Ala. 1991). Where one reasonable view of the evidence supports the trial court's judgment, the judgment must be upheld, even if another, perhaps better reasoned, view of the evidence might have dictated a different outcome. Ex parte Veazey, 637 So. 2d 1348 (Ala. 1993).
The worker suffered an on-the-job injury, a hernia on the right side. He was treated by several physicians and underwent several operations, for which the company paid.
The worker continued to have pain and was dissatisfied with his previous physicians. The worker's family physician referred him to Dr. Rodning, who performed surgery.
The company contends that the worker was not authorized to obtain the medical treatment from Dr. Rodning and was not justified in proceeding in the absence of authorization from the company. In Combustion Engineering, Inc. v. Walley, 541 So. 2d 560 (Ala. Civ. App. 1989), this court stated:
"Pursuant to Ala. Code (1975), § 25-5-77(a) (1986 Repl. Vol.), an employer is not liable for medical or surgical treatment obtained by the employee without justification or notice to the employer. Kimberly-Clark Corp. v. Golden, 486 So. 2d 435 (Ala. Civ. App. 1986). However, the appellate courts of this state have set out several instances of justification for not obtaining authorization from the employer before incurring medical expenses. Among such instances are (1) where the employer has neglected or refused to provide the necessary medical care, (2) where notice of and request for alternative care would be futile, and (3) where other circumstances exist which justify the selection of alternative care by the employee. Kimberly-Clark Corp., 486 So. 2d 435.
"Here, the record is clear that on numerous occasions the employee was in contact with the employer or its insurance carrier and requested authorization of certain medical treatment. The record is also clear that the employer did not grant such authorization, contending that the requested treatment was not due to a work-related injury. Further, the employer stated in the record that, ...