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Bocalbos v. Kapiolani Medical Center for Women and Children

3/9/2000

related accident, simply required more complex treatment in this case because of Bocalbos's pre- accident status.


Nevertheless, the Board sought to apportion medical treatment coverage afforded by HRS § 386-21 between a "pre-existing" dental condition and the accident-induced TMJD upon the unstated assumption that treatment for Bocalbos's injury could be so divided. We note that there is no statutory authority granted to the Board to apportion medical treatment in such a manner. The relevant question under HRS § 386-21 is whether the medical treatment proposed is necessitated by the nature of the injury. In this case, the substantial evidence in the record indicates that this is so. If so, then the employer is required to provide compensation for "all" medical treatment required.


B.


We also recognize that a contrary interpretation of HRS § 386- 21 would conflict with the liberal construction to be given the workers compensation statute in light of its "broad humanitarian purpose." DeFries v. Association of Owners, 999 Wilder, 57 Haw. 296, 304, 555 P.2d 855, 856 (1976); see Akamine v. Hawaiian Packing & Crating Co., 53 Haw. 406, 409, 495 P.2d 1164, 1166 (1972). Such an apportionment may unjustifiably result in an employee foregoing needed treatment, as was held in Granado v. Workmen's Compensation Appeals Bd., 445 P.2d 294 (Cal. 1968).


There, an employee appealed the decision of the Workmen's Compensation Appeals Board that apportioned the cost of his medical treatment between his employer and himself because of an uncompensable neck injury suffered prior to an industrial neck injury. The prior neck injury was "asymptomatic and [the employee had been] able to work between the injury . . . and the [subsequent neck] injury." Id. at 299.


In reviewing a statute similar to HRS § 386-21, the court concluded that the medical payments were not apportionable between the employee and the Board:


There can be no doubt that medical expense is not apportionable. Section 4600 of the Labor Code states that the employer shall provide such treatment which is reasonably required to cure or relieve from the effects of the injury , and section 4601 of the code provides that "All" of the doctor treatment shall be at the expense of the employer. . . . So long as the treatment is reasonably required to cure or relieve from the effects of the industrial injury, the employer is required to provide the treatment, and treatment for non-industrial conditions may be required of the employer where it becomes essential in curing or relieving from the effects of the industrial injury itself. Id. (emphases added).


In explaining its ruling, the California Supreme Court pointed out that an apportionment rule could result in delaying treatment or in precluding treatment altogether if an employee were not able to pay for his or her share of the required treatment:


If medical expenses reasonably necessary to relieve from the industrial injury were apportionable, the working[person] who is disabled may not be able to pay his [or her] share of the expenses and thus forego treatment. Moreover, the uncertainties attendant to the determination of the proper apportionment might cause the employers to refuse to pay their share until there has been a hearing and decision on the question of apportionment, and such delay in payment may compel the injured working[person] to forego prompt treatment to which he [or she] is entitled. Id. (emphases added).


We agree with the foregoing rationale and therefore, under the circumstances, we regard the apportionment of medical treatment benefits as erroneous and wrong.


VII.


F

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