Opinion
CASE NO. 107 CRD-7-81
AUGUST 29, 1984
The Claimant-Appellant was represented by Robert B. Adelman, Esq.
The Respondents-Appellees were represented by the law firm Gillooly, McGrail Carroll and brief submitted by Bruce M. Killion, Esq., from the same firm.
This Petition for Review from the November 17, 1981 Dismissal of Claim by the Commissioner for the Seventh District was argued April 29, 1983 before a Compensation Review Division Panel consisting of the Commission Chairman, John Arcudi and Commissioner Rhoda Loeb and Frank Verrill [Verrilli].
OPINION
This matter relates to payment for the services of a licensed clinical psychologist. It is undisputed that claimant Kiley suffered a compensable injury January 2, 1980 when he fell a distance of some thirty feet during the course of his employment with the employer-respondent Executone. He was first treated at the Norwalk Hospital by the orthopedist, Dr. Jens Herman. Thereafter an orthopedist in the Bridgeport area, Dr. MacEllis Glass became the authorized treating physician.
Neither Dr. Herman or Dr. Glass referred the claimant to Dr. Reid J. Daitzman, Ph.D., the clinical Psychologist the payment for whose services is at issue here. But claimant did consult and receive treatment from Dr. Daitzman beginning January 29, 1980 and continuing for an entire year until January 1981. The bill in dispute is $20,977.00.
During the course of his treatment with Dr. Daitzman claimant also continued to be treated by the Bridgeport Orthopedic Group of which Dr. Glass was a member. The other members of the group at that time were Dr. Donald S. Dworken and Dr. Jerold M. Perlman. At the hearing before the Seventh District Commissioner there was introduced in evidence a May 22, 1980 letter from Dr. Perlman to claimant's attorney.
The letter stated:
"In response to your letter of May 15, 1980, I feel that a large portion of Mr. Kiley's problem is psychological. I strongly feel that he should continue his treatment with the clinical psychologist that he has been seeing . . ."
Exercising his statutory authority, the Commissioner below found the entire treatment of Dr. Daitzman to be unauthorized and therefore dismissed the claim for payment of those services, Bowen v. Stanadyne, 232 CRD-1-83 (June 19, 1984). But the Commissioner made no finding concerning Dr. Perlman's May 22, 1980 letter in evidence. Section 31-294 C.G.S. not only obligates the employer to provide a competent physician or surgeon but also obligates him to furnish such other medical or surgical aid which the treating physician deems reasonable or necessary. This section of the statute has been the traditional justification for considering as authorized all treatment resulting from referrals by the original physician. Here Dr. Perlman was part of that original authorized group, and his letter of May 22, 1980 would make any treatment by Dr. Daitzman authorized after that date.
But it does not necessarily follow from our holding in that regard that the $12,638.00 for services after that date are payable. Under Section 31-298, C.G.S. it must be established that those charges are reasonable and necessary. For a discussion of the criteria to be applied see Bowen v. Stanadyne, supra. Therefore our holding here is that the Commissioner's decision denying the entire $20,977.00 charge is modified. That part of his decision denying payment for. the $8,339.00 charges before May 22, 1980 is affirmed. As to the remaining charges the matter is remanded for further findings as to the reasonableness of charges after May 22, 1980 and as to whether the symptoms treated were causally related to the compensable injury.
The decision of the Commissioner is modified and the matter is remanded for further findings and award or dismissed to comply with this opinion.
Commissioners Loeb and Verrilli concur in this opinion.