B-145962, AUG. 1, 1961

B-145962: Aug 1, 1961

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NATIONAL GUARD BUREAU: REFERENCE IS MADE TO 9TH INDORSEMENT OF MAY 23. FOR A DISEASE (HERNIA) SUBSEQUENTLY DETERMINED TO HAVE BEEN INCURRED IN LINE OF DUTY. WAS REQUIRED TO PERFORM A TOUR OF ANNUAL ACTIVE-DUTY TRAINING BY ATTENDING SUMMER FIELD TRAINING SCHEDULED FOR HIS UNIT AT FORT STEWART. WAS ADMITTED ON THAT DATA BY A MEDICAL DOCTOR TO THE POST ARMY HOSPITAL AT FORT STEWART WHERE HIS CONDITION WAS DIAGNOSED AS A RIGHT INDIRECT INGUINAL HERNIA. FOR THE PERFORMANCE OF AN OPERATION AT THE POST HOSPITAL WAS REFUSED AND PURSUANT TO MAJOR JONES' SUBSEQUENT RECOMMENDATION FOR FURTHER TREATMENT SERGEANT STABLER WAS RETURNED TO HIS HOME STATION ON AUGUST 15. WHERE SHORTLY THEREAFTER HE WAS ADMITTED TO A CIVILIAN HOSPITAL AND A HERNIA OPERATION WAS PERFORMED BY A CIVILIAN DOCTOR.

B-145962, AUG. 1, 1961

TO CHIEF, NATIONAL GUARD BUREAU:

REFERENCE IS MADE TO 9TH INDORSEMENT OF MAY 23, 1961, WRITTEN IN YOUR BEHALF, CONCERNING THE PAYMENT OF TWO VOUCHERS (DA FORM 8-9) IN THE TOTAL AMOUNT OF $539.10 FOR MEDICAL SERVICES COVERING CIVILIAN HOSPITALIZATION AND TREATMENT DURING THE PERIOD AUGUST 23 TO SEPTEMBER 6, 1960, IN THE CASE OF SERGEANT DAVID E. STABLER, 24 600 809, ALABAMA ARMY NATIONAL GUARD, FOR A DISEASE (HERNIA) SUBSEQUENTLY DETERMINED TO HAVE BEEN INCURRED IN LINE OF DUTY.

THE FILE REFLECTS THAT SERGEANT STABLER, AS A MEMBER OF BATTERY D, SECOND AUTOMATIC WEAPONS BATTALION, 278TH ARTILLERY, ALABAMA ARMY NATIONAL GUARD, MONROEVILLE, ALABAMA, WAS REQUIRED TO PERFORM A TOUR OF ANNUAL ACTIVE-DUTY TRAINING BY ATTENDING SUMMER FIELD TRAINING SCHEDULED FOR HIS UNIT AT FORT STEWART, GEORGIA, DURING THE PERIOD AUGUST 6 TO 21, 1960. WHILE PARTICIPATING IN A CREW GUN DRILL EXERCISE WITH HIS UNIT ON AUGUST 11, 1960, HE FELT A PAIN AFTER JUMPING TO THE GROUND FROM A TANK. HE REPORTED ON SICK CALL AUGUST 13, 1960, AND WAS ADMITTED ON THAT DATA BY A MEDICAL DOCTOR TO THE POST ARMY HOSPITAL AT FORT STEWART WHERE HIS CONDITION WAS DIAGNOSED AS A RIGHT INDIRECT INGUINAL HERNIA. IT APPEARS THAT A REQUEST BY MAJOR JONES, MC, ALABAMA ARMY NATIONAL GUARD, FOR THE PERFORMANCE OF AN OPERATION AT THE POST HOSPITAL WAS REFUSED AND PURSUANT TO MAJOR JONES' SUBSEQUENT RECOMMENDATION FOR FURTHER TREATMENT SERGEANT STABLER WAS RETURNED TO HIS HOME STATION ON AUGUST 15, 1960, WHERE SHORTLY THEREAFTER HE WAS ADMITTED TO A CIVILIAN HOSPITAL AND A HERNIA OPERATION WAS PERFORMED BY A CIVILIAN DOCTOR. IT APPEARS THAT THE OPERATION WAS NOT PERFORMED AT THE FORT STEWART POST HOSPITAL AS IT WAS THERE CONSIDERED THAT SERGEANT STABLER'S MEDICAL HISTORY INDICATED THE DISEASE WAS A HEREDITARY DEFECT. THE SECRETARY OF THE ARMY DETERMINED ON JANUARY 13, 1961, THAT THE DISEASE WAS INCURRED IN LINE OF DUTY AND WAS NOT DUE TO MISCONDUCT.

INASMUCH AS THE EXPENSES FOR THE CIVILIAN MEDICAL CARE WERE IN EXCESS OF $500 THE VOUCHERS WERE FORWARDED TO YOUR OFFICE BY THE OFFICE OF THE U.S. PROPERTY AND FISCAL OFFICER FOR ALABAMA FOR THE NECESSARY APPROVAL FOR PAYMENT AS REQUIRED BY PARAGRAPH 12D, NATIONAL GUARD REGULATIONS 62. THE VOUCHERS WERE RETURNED BY YOUR OFFICE WITHOUT APPROVAL FOR THE REASON THAT THIS WAS NONEMERGENCY TREATMENT IN A CIVILIAN MEDICAL FACILITY AND DID NOT HAVE THE PRIOR WRITTEN APPROVAL OF THE CHIEF, NATIONAL GUARD BUREAU AS REQUIRED BY PARAGRAPH 8A, NATIONAL GUARD REGULATIONS 62. AT THE REQUEST OF THE OFFICE OF THE ADJUTANT GENERAL, STATE OF ALABAMA, THE MATTER WAS RECONSIDERED BY YOUR OFFICE AND THE DECISION WAS AFFIRMED. IN THE INDORSEMENT OF MAY 23, 1961, FORWARDING THE MATTER TO THIS OFFICE, IT IS STATED THAT THE DECISION TO DISALLOW THE MEDICAL EXPENSES WAS BASED ON FAILURE TO COMPLY WITH THE PROVISIONS OF NATIONAL GUARD REGULATIONS 62.

IT IS RECOGNIZED THAT THE NATIONAL GUARD REGULATIONS PROVIDE FOR PRIOR AUTHORIZATION BY THE CHIEF, NATIONAL GUARD BUREAU, FOR MEDICAL TREATMENT IN CIVILIAN FACILITIES EXCEPT IN CASES OF EMERGENCIES. SINCE, HOWEVER, THE DISEASE WAS DETERMINED TO HAVE BEEN INCURRED IN LINE OF DUTY AND THE MEMBER WAS REFUSED TREATMENT IN GOVERNMENT FACILITIES AT FORT STEWART SHORTLY BEFORE SECURING PRIVATE TREATMENT, WE BELIEVE THERE IS SOME BASIS FOR MISUNDERSTANDING AS TO ENTITLEMENT IN THIS CASE. THEREFORE, WE WOULD NOT BE REQUIRED TO OBJECT TO THE PAYMENT ON THE VOUCHERS SHOULD YOU APPROVE THEM FOR PAYMENT AFTER THE USUAL DETERMINATIONS AS TO NECESSITY FOR THE SERVICES, REASONABLENESS OF CHARGES, IMPRACTICALITY OF USING OR UNAVAILABILITY OF GOVERNMENT FACILITIES, ETC. IN THIS RESPECT IT IS NOTED THAT THE DOCTOR'S STATEMENT INDICATES THAT THE OPERATION WAS PERFORMED ON SEPTEMBER 6, 1960, WHICH IS SHOWN IN THE HOSPITAL STATEMENT AS THE LAST DAY OF THE PERIOD OF HOSPITALIZATION. ALSO, THE HOSPITAL CHARGE OF $173.40 FOR SPECIAL DRUGS APPEARS EXCESSIVE IN THE ABSENCE OF AN ITEMIZATION AND A SUPPORTING STATEMENT SHOWING THE NECESSITY THEREFOR.

THE MATTER IS RETURNED FOR YOUR FURTHER CONSIDERATION AND SUCH ACTION AS IS DEEMED APPROPRIATE IN ACCORDANCE WITH WHAT IS STATED ABOVE.