A-30372, MARCH 18, 1930, 9 COMP. GEN. 408

A-30372: Mar 18, 1930

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ONLY WHERE APPROPRIATE AUTHORITY THEREFOR IS OBTAINED IN ADVANCE. PROCURES CIVILIAN MEDICAL AND HOSPITAL TREATMENT ON HIS OWN INITIATIVE FOR DISEASE OR ILLNESS ALLEGED TO HAVE HAD ITS INCEPTION DURING HIS PERIOD OF ACTIVE DUTY. HE IS NOT ENTITLED UNDER THE PROVISIONS OF THE ACT OF APRIL 26. 1930: THERE ARE BEFORE THIS OFFICE FOR CONSIDERATION AND SETTLEMENT. WHILE A COPY OF LIEUTENANT GREENE'S ORDERS IS NOT FURNISHED. THE OFFICER WAS ON ACTIVE DUTY AT FORT BRADY. THAT HE WAS TREATED BY HIS DOCTOR FROM JULY 29. IN MY OPINION IT IS DOUBTFUL IF THIS ILLNESS WAS CAUSED BY INOCULATION.'. ANY RIGHTS THESE CLAIMANTS MAY HAVE ACCRUED UNDER THE ACT OF MARCH 4. WHEN HOSPITAL TREATMENT IS NECESSARY FOR APPROPRIATE TREATMENT OF SUCH INJURY OR DISEASE.

A-30372, MARCH 18, 1930, 9 COMP. GEN. 408

MEDICAL TREATMENT - PAY AND ALLOWANCES - MEMBER OF OFFICERS' RESERVE CORPS CIVILIAN MEDICAL AND HOSPITAL TREATMENT MAY BE PROCURED BY MEMBERS OF THE OFFICERS' RESERVE CORPS AT GOVERNMENT EXPENSE UNDER THE PROVISIONS OF THE ACT OF APRIL 26, 1928, 45 STAT. 461, ONLY WHERE APPROPRIATE AUTHORITY THEREFOR IS OBTAINED IN ADVANCE. WHERE A MEMBER OF THE OFFICERS' RESERVE CORPS, WHO HAS RETURNED TO HIS HOME AFTER RELEASE FROM ACTIVE DUTY, PROCURES CIVILIAN MEDICAL AND HOSPITAL TREATMENT ON HIS OWN INITIATIVE FOR DISEASE OR ILLNESS ALLEGED TO HAVE HAD ITS INCEPTION DURING HIS PERIOD OF ACTIVE DUTY, BUT THE FIRST SYMPTOMS OF WHICH BECAME EVIDENT AFTER ARRIVAL AT HOME, HE IS NOT ENTITLED UNDER THE PROVISIONS OF THE ACT OF APRIL 26, 1928, 45 STAT. 461, TO PAY AND ALLOWANCES FOR THE PERIOD OF MEDICAL AND HOSPITAL TREATMENT.

DECISION BY COMPTROLLER GENERAL MCCARL, MARCH 18, 1930:

THERE ARE BEFORE THIS OFFICE FOR CONSIDERATION AND SETTLEMENT, CLAIMS PRESENTED BY (1) PAUL CHURCHILL GREEN, FIRST LIEUTENANT, OFFICERS' RESERVE CORPS, FOR PAY AND ALLOWANCES WHILE UNDERGOING MEDICAL AND HOSPITAL TREATMENT DURING THE PERIOD JULY 30, 1930, 1929, TO AUGUST 13, 1929, AFTER RETURN TO HIS HOME FROM ACTIVE DUTY; (2) ST. AGNES HOSPITAL IN THE SUM OF $72 FOR HOSPITAL SERVICES RENDERED LIEUTENANT GREEN DURING THE PERIOD AUGUST 2 TO 13, 1929; (3) DR. E. L. SHEPARD IN THE SUM OF $67 COVERING TRANSPORTATION OF LIEUTENANT GREEN TO AND FROM ST. AGNES HOSPITAL AND PROFESSIONAL SERVICES RENDERED THE OFFICER DURING THE PERIOD JULY 29 TO AUGUST 14, 1929; AND (4) DR. REGINALD L. PREES (CAPTAIN, MEDICAL RESERVE), IN THE SUM OF $4 FOR PROFESSIONAL SERVICES RENDERED LIEUTENANT GREENE AT ST. AGNES HOSPITAL ON AUGUST 8, 1929.

WHILE A COPY OF LIEUTENANT GREENE'S ORDERS IS NOT FURNISHED, IT APPEARS THAT PURSUANT TO SPECIAL ORDERS NO. 150, HEADQUARTERS, SIXTH CORPS AREA DATED JUNE 26, 1929, THE OFFICER WAS ON ACTIVE DUTY AT FORT BRADY, MICH., DURING THE PERIOD JULY 16, 1929, TO JULY 29, 1929; THAT HE RECEIVED TRIPLE TYPHOID VACCINE INOCULATIONS ON JULY 17, 1929, JULY 22, 1929, AND JULY 27, 1929; THAT ON JULY 29, 1929, AT THE TERMINATION OF HIS TOUR OF ACTIVE DUTY, HE SIGNED A CERTIFICATE IN LIEU OF A PHYSICAL EXAMINATION AS PROVIDED BY PARAGRAPH 32 A, ARMY REGULATIONS 140-5, TO THE EFFECT THAT THERE HAD BEEN NO MATERIAL CHANGE IN HIS PHYSICAL CONDITION DURING HIS TOUR OF ACTIVE DUTY; THAT PRIOR TO HIS RELEASE FROM ACTIVE DUTY, HE MADE NO MENTION OF FEELING ILL; THAT AFTER ARRIVAL AT HIS HOME AND WITHOUT NOTIFYING THE ARMY AUTHORITIES OF HIS CONDITION OR REQUESTING MEDICAL TREATMENT IN A GOVERNMENT HOSPITAL OR BEING SPECIFICALLY AUTHORIZED TO PROCURE SUCH SERVICES ELSEWHERE, HE SOUGHT PRIVATE MEDICAL ATTENTION BECAUSE HE RAN A HIGH TEMPERATURE; THAT DOCTOR SHEPARD, HIS OWN PHYSICIAN, ON AUGUST 2, 1929, TOOK HIM TO ST. AGNES HOSPITAL, FOND DU LAC, WIS., WHERE HE REMAINED UNTIL AUGUST 13, 1929, WHEN HIS DOCTOR TOOK HIM HOME; THAT HE WAS TREATED BY HIS DOCTOR FROM JULY 29, 1929, TO AUGUST 14, 1929; THAT ON AUGUST 8, 1929, DOCTOR PREES CALLED AT THE HOSPITAL INSTEAD OF DOCTOR SHEPARD; THAT THE DOCTORS DIAGNOSED LIEUTENANT GREEN'S ILLNESS AS A SEVERE REACTION FROM INOCULATION AGAINST TYPHOID-PARATYPHOID FEVERS, ADMINISTERED AT FORT BRADY WHILE ON ACTIVE DUTY; THAT BY LIEUTENANT GREENE'S LETTER OF AUGUST 15, 1929, TO THE COMMANDING OFFICER, SIXTH CORPS AREA, HE STATED THAT ON JULY 28, 1929, HE RAN A HIGH FEVER AS A RESULT OF TYPHOID INOCULATION ON JULY 27, 1920, AND REQUESTED THAT HIS ACTIVE DUTY BE EXTENDED FROM JULY 29 TO AUGUST 13, 1929; AND THAT BY FIFTH INDORSEMENT OF AUGUST 30, 1929, FROM STATION HOSPITAL, FORT BRADY, MICH., TO THE COMMANDING OFFICER, FORT BRADY, MICH., THE SURGEON STATED: ,IN MY OPINION IT IS DOUBTFUL IF THIS ILLNESS WAS CAUSED BY INOCULATION.'

ANY RIGHTS THESE CLAIMANTS MAY HAVE ACCRUED UNDER THE ACT OF MARCH 4, 1923, 42 STAT. 1508, AS AMENDED BY THE ACT OF JUNE 3, 1924, 43 STAT. 364, AND APRIL 26, 1928, 45 STAT. 461, WHICH, IN SO FAR AS HERE MATERIAL, PROVIDES AS FOLLOWS:

THAT * * * MEMBERS OF THE OFFICERS' RESERVE CORPS * * * OF THE ARMY WHO SUFFER PERSONAL INJURY OR CONTRACT DISEASE IN LINE OF DUTY WHILE ON ACTIVE DUTY UNDER PROPER ORDERS; * * * SHALL, UNDER SUCH REGULATIONS AS THE PRESIDENT MAY PRESCRIBE, WHEN HOSPITAL TREATMENT IS NECESSARY FOR APPROPRIATE TREATMENT OF SUCH INJURY OR DISEASE, BE ENTITLED TO HOSPITAL TREATMENT, INCLUDING MEDICAL TREATMENT, AT GOVERNMENT EXPENSE, UNTIL THE DISABILITY RESULTING FROM SUCH INJURY OR DISEASE CAN NOT BE MATERIALLY IMPROVED BY FURTHER HOSPITAL TREATMENT, AND DURING THE PERIOD OF HOSPITALIZATION, TO THE SAME PAY AND ALLOWANCES WHETHER IN MONEY OR IN KIND THAT THEY WERE ENTITLED TO RECEIVE AT THE TIME SUCH INJURY WAS SUFFERED OR DISEASE CONTRACTED, AND TO TRANSPORTATION TO THEIR HOMES AT GOVERNMENT EXPENSE WHEN DISCHARGED FROM HOSPITAL; THEY SHALL ALSO BE ENTITLED TO SUCH FURTHER MEDICAL TREATMENT FOR SUCH INJURY OR DISEASE AS IS REASONABLY NECESSARY AFTER ARRIVAL AT THEIR HOMES UNDER SUCH REGULATIONS AS MAY BE PRESCRIBED BY THE PRESIDENT. * * *

THIS ACT AS AMENDED, WAS PUBLISHED TO THE ARMY BY BULLETIN NO. 18 W.D., MAY 12, 1928. (SEE ARMY REGULATIONS 140-5, PARAGRAPH 72, CHANGE 1, DATED APRIL 30, 1929, AND ARMY REGULATIONS 35-3420, PARAGRAPH 2 A (7), DATED DECEMBER 10, 1929.) BY THE ADJUTANT GENERAL'S CIRCULAR, DATED JULY 3, 1928, A.G. 240 (6-9-28) MISC., ENTITLED "CARE AND TREATMENT OF MEMBERS OF THE CIVILIAN COMPONENTS OF THE ARMY WHO SUFFER PERSONAL INJURY OR SICKNESS IN LINE OF DUTY," PROVISION IS MADE FOR CIVILIAN MEDICAL AND HOSPITAL SERVICE AS FOLLOWS:

3D. WHEN TREATMENT IN ARMY HOSPITALS OR BY MILITARY PERSONNEL IS NOT AVAILABLE, CIVILIAN MEDICAL AND HOSPITAL SERVICE MAY BE EMPLOYED AS OUTLINED IN AR 40-505, PAR. 3A, SUBJECT TO RESTRICTIONS IN AR 40 505, PAR. 3B, RESPECTING EMPLOYMENT OF SPECIALISTS AND CONSULTANTS. ACCOUNTS FOR CIVILIAN MEDICAL AND HOSPITAL SERVICE WILL BE ALLOWED AT REASONABLE RATES APPROVED BY THE CORPS AREA COMMANDER. WHEN CIVILIAN MEDICAL AND HOSPITAL SERVICE IS NECESSARY, THE CORPS AREA COMMANDER WILL BE THE FINAL AUTHORITY IN DETERMINING WHEN THE DISABILITY CAN NOT BE MATERIALLY IMPROVED BY FURTHER HOSPITAL TREATMENT AND SUCH TREATMENT AT PUBLIC EXPENSE SHALL THEN TERMINATE. SIMILARLY, IN THE CASE OF PATIENTS TREATED IN THEIR HOMES, THE CORPS AREA COMMANDER WILL DECIDE WHEN SUCH TREATMENT AT PUBLIC EXPENSE SHALL TERMINATE AS HAVING BEEN ALL THAT WAS REASONABLY NECESSARY.

EXCEPT IN EMERGENCY, AUTHORITY OF THE CORPS AREA COMMANDER WILL BE SECURED BEFORE ANY GOVERNMENT FUNDS ARE OBLIGATED FOR MEDICAL CARE UNDER THE PROVISIONS OF THIS ACT. WHEN IN EMERGENCY MEDICAL CARE HAS BEEN SECURED WITHOUT AUTHORITY, IMMEDIATE REPORT OF THE FACT AND CIRCUMSTANCES CONNECTED THEREWITH WILL BE FORWARDED TO THE CORPS AREA COMMANDER.

PROVISION IS ALSO MADE IN THIS CIRCULAR FOR HOSPITAL CARE AND MEDICAL TREATMENT AT CAMP AND FURTHER MEDICAL TREATMENT AFTER RETURN HOME UNDER INSTRUCTIONS RELATIVE THERETO BY LOCAL AUTHORITIES WHEN DEEMED ADVISABLE IN EACH CASE THROUGH GOVERNMENT FACILITIES. WHERE SUCH TREATMENT EXTENDS BEYOND THE DATE OF COMPLETION OF ACTIVE DUTY, IT IS PROVIDED THAT THE INDIVIDUALS WILL BE BROUGHT BEFORE BOARDS OF MEDICAL OFFICERS FOR FINAL DISPOSITION WHEN HOSPITAL TREATMENT IS NO LONGER DEEMED NECESSARY.

PARAGRAPH 6 OF THE CIRCULAR PROVIDES:

AS CLAIMS WILL UNDOUBTEDLY ARISE AS A RESULT OF DISEASE, THE INITIAL SYMPTOMS OF WHICH HAVE NOT APPEARED UNTIL AFTER THE INDIVIDUAL HAS QUIT THE TRAINING POINT, SURGEONS WILL INCLUDE IN THEIR SPECIAL SANITARY REPORT COVERING THE TRAINING PERIOD THE EPIDEMIOLOGICAL FEATURES OF SUCH COMMUNICABLE DISEASE AS MAY HAVE EXISTED.

IT WILL BE OBSERVED THAT PAY IS AUTHORIZED DURING HOSPITALIZATION WHICH ORIGINATED WHILE ON ACTIVE DUTY. WHERE THE OFFICER IS RELIEVED FROM ACTIVE DUTY IN APPARENT GOOD HEALTH, THERE IS NO RIGHT TO PAY WHILE UNDERGOING "FURTHER MEDICAL TREATMENT * * * AFTER ARRIVAL AT THEIR HOMES" WHETHER OR NOT SUCH FURTHER MEDICAL TREATMENT INCLUDES HOSPITALIZATION, A- 27659, JUNE 27, 1929. THE CLAIM FOR PAY IS ACCORDINGLY DISALLOWED.

THE STATUTE CONTEMPLATES THE FURNISHING OF MEDICAL AND HOSPITAL TREATMENT BY OR THROUGH GOVERNMENTAL MEDICAL AGENCIES, AND ONLY WHEN SUCH AGENCIES HAVE BEEN FOUND NOT TO BE AVAILABLE IN ANY PARTICULAR CASE IS THERE AUTHORITY FOR THE PROCUREMENT OF CIVILIAN MEDICAL OR HOSPITAL TREATMENT. THE REGULATIONS ARE ADDRESSED TO SUPERVISORY ARMY OFFICERS AND LIMIT AND CONTROL THEIR AUTHORITY TO PROCURE CIVILIAN MEDICAL AND HOSPITAL TREATMENT AT GOVERNMENT EXPENSE FOR BENEFICIARIES OF THE STATUTE. NEITHER THE STATUTE NOR THE REGULATIONS CONTEMPLATE THAT THE INDIVIDUAL SHALL OBLIGATE THE GOVERNMENT TO PAY FOR MEDICAL AND HOSPITAL CARE AND TREATMENT WITHOUT REFERENCE TO OR AUTHORITY FROM RESPONSIBLE OFFICERS OF THE ARMY. THE STATUTE DOES NOT GIVE A RIGHT TO EVERY MEMBER OF THE OFFICERS' RESERVE CORPS, AFTER A PERIOD OF ACTIVE DUTY, TO PROCURE MEDICAL AND HOSPITAL TREATMENT AT THE EXPENSE OF THE UNITED STATES IF CIVILIAN MEDICAL PRACTITIONERS CAN DIAGNOSE THE ILLNESS AS RELATED TO A RECENT PERIOD OF ACTIVE DUTY. THE STATUTE REQUIRES, AND THE REGULATIONS PROVIDE THAT THE ARMY AUTHORITIES SHALL CONTROL THE MATTER OF FURNISHING MEDICAL ATTENDANCE. UNLESS A REPORT OF THE ILLNESS AND THE BASIS FOR BELIEVING IT TO BE CONNECTED WITH A RECENT TOUR OF ACTIVE DUTY IS MADE TO THE PROPER ARMY AUTHORITY AND OPPORTUNITY AFFORDED TO PROVIDE ARMY OR GOVERNMENT FACILITIES FOR THE TREATMENT, AND AUTHORITY GIVEN BY SUCH RESPONSIBLE OFFICIAL, THERE IS NO AUTHORITY IN THE STATUTE TO PAY FOR CIVIL MEDICAL TREATMENT PROCURED ON THE RESPONSIBILITY OF THE OFFICER HIMSELF. SEE, ALSO, THE APPROPRIATION UNDER "ORGANIZED RESERVES," 45 STAT. 1370. THE CLAIMS OF ST. AGNES HOSPITAL, DR. E. L. SHEPARD AND DR. REGINALD L. PREES, REPRESENTING SERVICES NOT PROCURED BY OR BY AUTHORITY OF THE CORPS AREA COMMANDER, WILL BE DISALLOWED.