"the Broken Machine" Mandatory Medical Treatment Under Georgia Workers' Compensation
| Publication year | 2018 |
| Pages | 0018 |
"The Broken Machine" Mandatory Medical Treatment Under Georgia Workers' Compensation
An injured worker is neither a broken machine nor a guinea pig. He is a human being, who should, in consultation with his doctor, have freedom to determine what medical treatment he should, or should not, undergo.
BY CHARLES W. SNYDER
The Georgia's Workers' Compensation Code, from its first enactment in 1920, placed a duty on employers to provide medical care to injured workers, and imposed a reciprocal obligation on employees to accept such medical care, or else risk losing their disability income benefits. In its original version, the pertinent part of the statute reads as follows:
[T]he employer shall furnish or cause to be furnished free of charge to the injured worker, and the employee shall accept such necessary medical attention as the nature of the accident may require ....The refusal of the employee to accept any medical, hospital or surgical service when provided by the employer, or on order by the Industrial Commission [now the State Board of Workers' Compensation, hereinafter "the Board"], shall bar said employee from further compensation until such refusal ceases, and no compensation shall at any time be paid for the period of suspension unless in the opinion of the Industrial Commission the circumstances justified the refusal, in which case the Industrial Commission may order a change in the medical or hospital service.[1]
The requirement that an injured worker might have to submit to potentially harmful forms of medical treatment proved controversial from the outset. In 1928, the Board suspended a disabled worker's income benefits because he refused to submit to an operation involving rebreaking and resetting his fractured leg, a procedure that, according to medical testimony, had only a 50 percent chance of success and involved great risk of infection and even of death. Nonetheless, the Superior Court affirmed the Board's order. The Court of Appeals, however, reversed. Judge Alexander W. Stephens issued an eloquent, if scathing, opinion in Zant v. United States Fidelity & Guaranty Co.:
The Compensation Act, which is designed as a humanitarian measure for the purpose of affording compensation in the nature of insurance to injured employees, does not contemplate that the reduction in compensation, by means of medical or surgical treatment extended by the employer to the injured employee, should be accomplished with reference solely to the material and pecuniary benefits to the employer or to the insurance carrier, and without regard to humanitarian considerations. The injured employee is not a machine which has become broken in the performance of its duties in industry, and which can be torn to pieces and experimented with solely for the purpose of rendering it fit to perform material services and produce pecuniary rewards for the person in whose service he is employed. He is not an animal to be vivisected for some one's material gain. He is not a guinea pig to be experimented upon by doctors. He is a human being, entitled to compensation for his injury, and the right of his employer to have him repaired, so to speak, by giving him medical or surgical treatment, is but an incidental and subsidiary right of the employer by which the compensation payable by the employer might be reduced or minimized, and must necessarily be exercised by the employer with due regard, not only to the injured employee's right to compensation under the act, but with due regard and consideration for the injured employee's right as a human being not to be subjected to, or compelled to undergo, pain and suffering, or to jeopardize his life or endanger his health, merely for the pecuniary advantage of another.[2]
The injured employee is not a machine which has become broken in the performance of its duties in industry. He is a human being, entitled to compensation for his injury, and the right of his employer employer to have him repaired, so to speak, by giving him medical or surgical treatment, is but an incidental and subsidiary right of the employer.
Subsequent cases confirmed and extended the Zant decision. It was even indicated that an injured worker could properly refuse diagnostic testing, such as a myelogram, that might not be 100 percent accurate or that might result in "after effects of a painful nature."[3]
The Georgia General Assembly amended the statute granting the Board authority to suspend income benefits if an injured worker unjustifiably refused to submit to unwanted treatment many times. Its essentials remained unchanged, however, for more than 80 years. For example, the version enacted in 1985 read as follows:
The refusal of the employee without reasonable cause to accept either medical, surgical or hospital care or other treatment, as provided by this Code section, when ordered by the board, shall entitle the board in its discretion to suspend or reduce the compensation otherwise payable to such employee unless in the opinion of the board the circumstances justify the refusal.[4]
Clearly, the terms of the statute did not bar the Board from requiring injured workers to submit to surgery or other intrusive procedures. Nonetheless, over the years, the Board generally refrained as a matter of policy from doing so. An authoritative treatise even stated without qualification that, "as a practical matter, the Board will simply not order an employee to accept medical treatment or hospital care."[5] Possibly, the Board exercised self-restraint in light of court decisions holding it unconstitutional to require a competent adult to submit to unwanted medical treatment. In 1989, the Supreme Court of Georgia held that, "in Georgia, as elsewhere, a competent adult patient has the right to refuse medical treatment in the absence of conflicting state interest."[6]
The right to refuse unwanted medical treatment is also protected under the United States Constitution.[7]
It should not have been surprising, in view of...
To continue reading
Request your trial