EMPLOYEE CAN REFUSE PSYCH TREATMENT AND STILL BE CONSIDERED PERMANENTLY AND TOTALLY DISABLED
Ex Parte Saad’s Healthcare Services, Inc.:
On April 3, 2009, the Alabama Supreme Court released this opinion which addressed a trial court’s ability to find an employee permanently and totally disabled when the employee has refused psychological and psychiatric treatment. The case arose out of an unfortunate incident in which a licensed practical nurse was stabbed 47 times by a patient’s relative. She received treatment for both physical and mental injuries. At trial, evidence was introduced that the employee refused psychological/psychiatric treatment. As a result, the trial judge applied the Ala. Code § 25-5-57(a)(4)d exclusion which states that an employee cannot be found permanently and totally disabled when he or she refuses to undergo physical or vocational rehabilitation. The case was appealed twice. The first appeal resulted in the Alabama Court of Civil Appeals reversing the trial court on the grounds that the exclusion set forth in Ala. Code § 25-5-57(a)(4)d only applied to refusals taking place after the employee reached maximum medical improvement (MMI). The matter was appealed to the Alabama Supreme Court where the petition was quashed without opinion. When the matter was returned to the trial court, it was learned that the employee had continued to refuse psychological/psychiatric treatment after being placed at MMI by refusing to take her antidepressant medication. Despite this new evidence, the trial court held the employee to be permanently and totally disabled. In support of this finding, the court noted that the Ala. Code § 25-5-57(a)(4)d exclusion did not apply since psychological/psychiatric treatment did not constitute "physical or vocational rehabilitation" as required by the statute. The employer appealed this decision and the Alabama Court of Civil Appeals agreed with the trial court. The Alabama Supreme Court subsequently granted the employer’s petition for certiorari review and held that, because the post-MMI treatment refused by the employee was not offered for the purpose of restoring her physical function or her ability to engage in gainful employment, but was instead offered to treat her mental impairments, the treatment was not "physical or vocational rehabilitation" within the meaning of the Ala. Code § 25-5-57(a)(4)d exclusion.
If you are facing a similar situation then you will want to read the 11 page dissenting opinion authored by Justice Parker quoting extensively from Justice Moore’s partial dissent in the underlying Court of Civil Appeals opinion.