B-147263, DECEMBER 6, 1961, 41 COMP. GEN. 387

B-147263, DECEMBER 6, 1961, 41 COMP. GEN. 387

OFFICERS AND EMPLOYEES - HEALTH SERVICES - DESENSITIZATION, IMMUNIZATION, ETC. MEDICAL TREATMENT TO DESENSITIZE A DEPARTMENT OF AGRICULTURE HORTICULTURIST FROM BEE AND WASP STINGS BECAUSE OF THE SEVERE REACTION FROM SUCH STINGS, THE DANGER TO HIS HEALTH AND, AS A PREVENTIVE, TO AVOID FUTURE ILLNESS FROM STINGS WITH THE RESULTANT LOSS OF WORK TIME MAY BE REGARDED AS MEDICAL TREATMENT FOR THE BENEFIT OF THE GOVERNMENT RATHER THAN THE EMPLOYEE, EVEN THOUGH OTHER EMPLOYEES ENGAGED IN SIMILAR WORK ARE NOT SEVERELY AFFECTED BY THE STINGS; THEREFORE, FEES FOR SUCH MEDICAL TREATMENT MAY BE PAID FROM APPROPRIATED FUNDS PROVIDED THAT AN ADMINISTRATIVE DETERMINATION IS MADE THAT THE MEDICAL TREATMENT IS NECESSARY TO CARRY OUT THE PURPOSES OF THE APPROPRIATION, AND THAT IF PUBLIC FACILITIES--- GOVERNMENT, STATE OR LOCAL--- ARE AVAILABLE FOR SUCH MEDICAL TREATMENT WITHOUT CHARGE THEY WILL BE UTILIZED IN FUTURE SIMILAR CASES, AND THAT FUNDS OF THE BUREAU OF EMPLOYEES' COMPENSATION ARE NOT AVAILABLE FOR PREVENTIVE TREATMENT.

TO E. L. STRUTTMANN, UNITED STATES DEPARTMENT OF AGRICULTURE, DECEMBER 6, 1961:

YOUR LETTER OF SEPTEMBER 20, 1961, REQUESTS OUR DECISION WHETHER YOU MAY CERTIFY FOR PAYMENT THE VOUCHER TRANSMITTED THEREWITH IN FAVOR OF DR. ROBERT W. JONES, HORTICULTURIST, FOR $78, COVERING REIMBURSEMENT OF FEES PAID TO A PRIVATE PHYSICIAN FOR DESENSITIZATION TREATMENT AGAINST BEE AND WASP STINGS.

IT APPEARS FROM THE ENCLOSURES ACCOMPANYING YOUR LETTER THAT DR. JONES, WHILE WORKING AT THE U.S. HORTICULTURAL STATION IN FRESNO, CALIFORNIA, HAD BEEN STUNG SEVERAL TIMES BY WASPS AND BEES AND HAD RECEIVED RATHER SEVERE REACTIONS FROM THE STINGS. HIS PHYSICIAN RECOMMENDED THAT HE TAKE DESENSITIZATION TREATMENT TO ALLEVIATE ILLNESS FROM FUTURE STINGS SINCE THE DANGER THEREOF IS SO PREVALENT IN HIS WORK.

DR. JONES REPORTED THE MATTER TO MR. J. H. HEMPSTEAD, REGIONAL PERSONNEL OFFICER, AGRICULTURAL RESEARCH SERVICE, BERKELEY, CALIFORNIA, REQUESTING TO BE INFORMED WHETHER FEDERAL FUNDS COULD BE USED TO PAY FOR THE DESENSITIZATION TREATMENT AS A PREVENTIVE MEASURE TO PRECLUDE SUBSEQUENT MEDICAL EXPENSE WHEN STINGS WERE INCURRED. MR. HEMPSTEAD THEN COMMUNICATED WITH DR. LEE K. BUCHANAN, CHIEF, HEALTH DIVISION, DEPARTMENT OF AGRICULTURE, REGARDING THE MATTER AND REQUESTED HIS AUTHORIZATION TO EXPEND FEDERAL FUNDS FOR THE TREATMENT. IN SUPPORT OF THE REQUEST IT WAS POINTED OUT THAT THE EMPLOYEE'S HEALTH MIGHT BE IMPAIRED WITHOUT THE TREATMENT, AND ALSO, THAT THE DEPARTMENT WOULD LOSE THE SERVICES OF A VALUABLE EMPLOYEE BECAUSE OF ILLNESS CAUSED BY THE STINGS.

DR. BUCHANAN APPROVED THE REQUEST TO EXPEND FEDERAL FUNDS FOR THE MEDICAL SERVICES, AND A BLANKET PURCHASE ORDER WAS ISSUED TO DR. JONES AUTHORIZING THE EXPENSE OF THE DESENSITIZATION TREATMENT DURING THE PERIOD MARCH 1 THROUGH JUNE 30, 1961. SUBSEQUENTLY, THE PURCHASE ORDER WAS CANCELED BECAUSE OF THE QUESTION RAISED BY THE CROPS RESEARCH DIVISION ADMINISTRATIVE OFFICER AT BELTSVILLE, MARYLAND, AND REPRESENTATIVES OF THE FISCAL MANAGEMENT BRANCH, BUDGET AND FINANCE DIVISION, AGRICULTURAL RESEARCH SERVICE, CONCERNING THE AVAILABILITY OF APPROPRIATED FUNDS FOR SUCH PURPOSES. THEIR DOUBT IN THE MATTER IS ATTRIBUTED TO THE VIEW THAT THE DESENSITIZATION TREATMENT IS PRIMARILY FOR THE BENEFIT OF DR. JONES, AND THAT WHILE APPARENTLY NECESSARY IT IS REQUIRED BECAUSE OF HIS PHYSICAL CONDITION RATHER THAN CONSTITUTING A TREATMENT REQUIRED IN THE INTEREST OF THE GOVERNMENT FOR ALL EMPLOYEES PERFORMING SIMILAR DUTIES.

IN YOUR LETTER YOU SAY THAT THE AGRICULTURAL RESEARCH SERVICE REALIZES THAT THE DANGER OF BEE AND WASP STINGS IS PREVALENT IN DR. JONES' WORK, AND THAT THE DESENSITIZATION TREATMENT WAS A PRECAUTIONARY MEASURE TAKEN FOR THE PURPOSE OF PREVENTING SERIOUS ILLNESS AND CONSEQUENT LOSS OF MANPOWER. HOWEVER, YOU QUESTION THE PROPRIETY OF AUTHORIZING REIMBURSEMENT OF THIS EXPENSE BECAUSE SUCH TREATMENT, WHILE NECESSARY, WOULD APPEAR TO HAVE BEEN REQUIRED PRIMARILY BECAUSE OF THE EMPLOYEE'S CONDITION, THE SERIOUSNESS OF THE HAZARD OF THE STINGS APPEARING TO BE A SECONDARY FACTOR RATHER THAN CONSTITUTING A TREATMENT REQUIRED FOR ALL PERSONNEL PERFORMING LIKE DUTIES.

THE QUESTION OF FURNISHING MEDICAL TREATMENT TO CIVILIAN EMPLOYEES OF THE GOVERNMENT--- FOR ILLNESS NOT DIRECTLY RESULTING FROM THE NATURE OF THEIR EMPLOYMENT--- HAS BEEN CONSIDERED IN NUMEROUS DECISIONS OF OUR OFFICE AND THE GENERAL RULE HAS BEEN ESTABLISHED THAT SUCH EXPENSES ARE PERSONAL TO THE EMPLOYEE AND THAT THE PAYMENT THEREOF FROM APPROPRIATED FUNDS IS UNAUTHORIZED UNLESS PROVIDED FOR IN THE CONTRACT OF EMPLOYMENT OR BY STATUTORY ENACTMENT OR VALID REGULATION. HOWEVER, EXCEPTIONS TO THE RULE HAVE BEEN RECOGNIZED IN CIRCUMSTANCES WHEN THE MEDICAL ATTENTION TO THE EMPLOYEE, BY REASON OF THE CONDITIONS OF EMPLOYMENT, MAY BE CONSIDERED AS A REGULATORY MEASURE PRIMARILY FOR THE BENEFIT OF THE GOVERNMENT RATHER THAN THE EMPLOYEE, IN WHICH EVENT THE EXPENSE THEREOF PROPERLY MAY BE PAID FROM APPROPRIATED FUNDS. SEE DECISION TO THE SECRETARY OF AGRICULTURE DATED JULY 15, 1947, B-67192, AND 22 COMP. GEN. 32; 23 ID. 888; 30 ID. 387; AND 33 ID 231, CITED IN YOUR LETTER. ALSO, SEE 32 COMP. GEN. 52. CF. 15 COMP. GEN. 20.

THUS, THE QUESTION FOR CONSIDERATION IS WHETHER THE EXPENSE OF THE DESENSITIZATION TREATMENT, WHICH WE INFORMALLY LEARNED IS PROPOSED TO BE CHARGED TO THE APPROPRIATION " SALARIES AND EXPENSES, AGRICULTURAL RESEARCH SERVICE, 1961," MAY BE REGARDED AS A NECESSARY AND INCIDENTAL EXPENSE TO THE ACCOMPLISHMENT OF THE PURPOSES OF THE APPROPRIATION, AND WHETHER THE GOVERNMENT OR THE EMPLOYEE RECEIVES THE PRINCIPAL BENEFIT RESULTING THEREFROM.

IN THE CASE HERE PRESENTED, IT APPEARS THAT BEE AND WASP STINGS ARE OCCUPATIONAL HAZARDS EXISTING IN CONNECTION WITH DR. JONES' WORK AS A HORTICULTURIST WHICH PRESENT A DANGER TO HIS HEALTH. THE FACT THAT OTHER PERSONS ENGAGED ON SIMILAR WORK ARE NOT SEVERELY AFFECTED BY SUCH STINGS DOES NOT LESSEN THE DANGER. IT FURTHER APPEARS THAT THE CHIEF MEDICAL OFFICER OF THE DEPARTMENT OF AGRICULTURE HAVING KNOWLEDGE OF THE NATURE OF DR. JONES' EMPLOYMENT, AND THE FACT THAT HE IS SUBJECT TO SEVERE REACTION FROM BEE AND WASP STINGS AUTHORIZED THE EXPENDITURE OF APPROPRIATED FUNDS FOR DESENSITIZATION TREATMENT AS A PREVENTATIVE TO AVOID ILLNESS, THE EXPENSE OF MEDICAL TREATMENT BY REASON OF THE EMPLOYMENT, AND THE CONSEQUENT LOSS OF WORK TIME THAT OTHERWISE WOULD RESULT IN HIS CASE.

IN LIGHT OF THE FOREGOING COMMENTS, THERE IS A REASONABLE BASIS FOR CONCLUDING THAT THE MEDICAL TREATMENT IN QUESTION IS PRIMARILY FOR THE BENEFIT OF THE GOVERNMENT, RATHER THAN FOR THE BENEFIT OF THE EMPLOYEE. THEREFORE, IF IT BE FOUND SO ADMINISTRATIVELY AND DETERMINED NECESSARY TO CARRY OUT THE PURPOSES OF THE APPROPRIATION, OUR VIEW IS THAT THE APPROPRIATION REFERRED TO IS AVAILABLE FOR EXPENDITURE FOR SUCH PURPOSES. SEE A-32786, DATED AUGUST 8, 1930. IN THAT CONNECTION, WE POINT OUT THAT IF THERE ARE PUBLIC FACILITIES--- GOVERNMENT, STATE OR LOCAL--- AVAILABLE WHERE SUCH MEDICAL TREATMENT CAN BE OBTAINED WITHOUT CHARGE TO THE APPROPRIATION, SUCH FACILITIES SHOULD BE USED IN THE FUTURE. ALSO, WHILE THE RECORD DOES NOT SO STATE, WE ASSUME THAT THE BUREAU OF EMPLOYEES' COMPENSATION IS OF THE VIEW THAT ITS FUNDS ARE NOT AVAILABLE FOR THE PREVENTIVE TREATMENT.