B-4634, JULY 21, 1939, 19 COMP. GEN. 85

B-4634: Jul 21, 1939

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INCURABLE DISEASE ARMY RESERVE OFFICER WHO WAS HOSPITALIZED FOR DISEASE INCURRED WHILE ON ACTIVE DUTY WITH CIVILIAN CONSERVATION CORPS AND WHO HAS OBTAINED MAXIMUM BENEFITS OF HOSPITALIZATION AND TREATMENT. INSOFAR AS REMOVAL OF THE DISABILITY IS CONCERNED. IS NOT ENTITLED. TO FURTHER MEDICINES AND TREATMENT AT PUBLIC EXPENSE WHERE HIS DISEASE IS CHRONIC AND INCURABLE. BEYOND THE DATE WHEN IT IS DETERMINED FURTHER TREATMENT WILL NOT RESULT IN A REMOVAL OF THE DISABILITY. RECORDS OF THE DEPARTMENT SHOW THAT LIEUTENANT PATNAUDE WAS ON ACTIVE DUTY WITH THE CIVILIAN CONSERVATION CORPS FROM OCT. 15. HIS DISABILITY WAS DIAGNOSED AS DIABETES. HE WAS HOSPITALIZED IN ST. WHENCE HE WAS TRANSFERRED NOVEMBER 24TH TO ARMY AND NAVY GENERAL HOSPITAL.

B-4634, JULY 21, 1939, 19 COMP. GEN. 85

MEDICAL TREATMENT - PUBLIC - ARMY RESERVE OFFICER - INDEFINITE TREATMENT OF CHRONIC, INCURABLE DISEASE ARMY RESERVE OFFICER WHO WAS HOSPITALIZED FOR DISEASE INCURRED WHILE ON ACTIVE DUTY WITH CIVILIAN CONSERVATION CORPS AND WHO HAS OBTAINED MAXIMUM BENEFITS OF HOSPITALIZATION AND TREATMENT, INSOFAR AS REMOVAL OF THE DISABILITY IS CONCERNED, IS NOT ENTITLED, AFTER RELIEF FROM SUCH DUTY, TO FURTHER MEDICINES AND TREATMENT AT PUBLIC EXPENSE WHERE HIS DISEASE IS CHRONIC AND INCURABLE, THE ACT OF JUNE 15, 1936, 49 STAT. 507; AUTHORIZING TREATMENT "UNTIL THE DISABILITY RESULTING FROM SUCH * * * DISEASE CANNOT BE MATERIALLY IMPROVED," CONTEMPLATING RESTORATION TO FITNESS FOR FURTHER ACTIVE DUTY, AND NOT INDEFINITE TREATMENT AFTER EXPIRATION OF ACTIVE DUTY, BEYOND THE DATE WHEN IT IS DETERMINED FURTHER TREATMENT WILL NOT RESULT IN A REMOVAL OF THE DISABILITY.

ASSISTANT COMPTROLLER GENERAL ELLIOTT TO THE SECRETARY OF WAR, JULY 21, 1939:

THERE HAS BEEN RECEIVED YOUR LETTER OF JUNE 26, 1939, AS FOLLOWS:

REQUEST HAS BEEN PRESENTED BY ST LIEUTENANT ROBERT E. PATNAUDE, CAV 1RES., AS TO THE PROCEDURE FOR OBTAINING MEDICINES AND PERIODICAL CHECK-UP ON ACCOUNT OF DIABETES MELLITUS CONTRACTED WHILE ON ACTIVE DUTY WITH THE CIVILIAN CONSERVATION CORPS.

RECORDS OF THE DEPARTMENT SHOW THAT LIEUTENANT PATNAUDE WAS ON ACTIVE DUTY WITH THE CIVILIAN CONSERVATION CORPS FROM OCT. 15, 1933, UNTIL MARCH 14, 1939; THAT HE BECAME ILL IN SEPTEMBER 1938, HIS DISABILITY WAS DIAGNOSED AS DIABETES, AND HE WAS HOSPITALIZED IN ST. ANDREW'S HOSPITAL, BOTTINEAU, NORTH DAKOTA, SEPT. 22ND, BEING TRANSFERRED THEREFROM EARLY IN OCTOBER TO THE ARMY HOSPITAL, FORT LINCOLN, NORTH DAKOTA, WHENCE HE WAS TRANSFERRED NOVEMBER 24TH TO ARMY AND NAVY GENERAL HOSPITAL, HOT SPRINGS NATIONAL PARK, ARKANSAS. ON OR ABOUT JANUARY 15, 1939, HE WAS RELEASED FROM THE HOSPITAL AND WAS PLACED ON TERMINAL LEAVE WHICH EXPIRED MARCH 14, 1939, THE DATE OF TERMINATION OF HIS ACTIVE DUTY STATUS.

ACT OF JUNE 15, 1936 (49 STAT 1507), PROVIDES IN PERTINENT PART AS FOLLOWS:

"* * * MEMBERS OF THE OFFICERS' RESERVE CORPS * * * WHO * * * CONTRACT DISEASE IN LINE OF DUTY WHILE ON ACTIVE DUTY UNDER PROPER ORDERS IN TIME OF PEACE * * * SHALL, UNDER SUCH REGULATIONS AS THE PRESIDENT MAY PRESCRIBE, BE ENTITLED, AT GOVERNMENT EXPENSE, TO SUCH HOSPITALIZATION, REHOSPITALIZATION, MEDICAL, AND SURGICAL CARE, IN HOSPITAL AND AT THEIR HOMES, AS IS NECESSARY FOR THE APPROPRIATE TREATMENT OF SUCH * * * DISEASE, UNTIL THE DISABILITY RESULTING FROM SUCH * * * DISEASE CANNOT BE MATERIALLY IMPROVED BY FURTHER HOSPITALIZATION OR TREATMENT, * * *.'

UNDER THE TERMS OF THE STATUTE QUOTED, LIEUTENANT PATNAUDE IS ENTITLED TO TREATMENT AT PUBLIC EXPENSE UNTIL THE DISABILITY RESULTING FROM THE DISEASE CANNOT BE MATERIALLY IMPROVED BY FURTHER HOSPITALIZATION OR TREATMENT.

THE SURGEON GENERAL STATES THAT THIS OFFICER HAS RECEIVED HOSPITALIZATION AND TREATMENT TO THE EXTENT OF PRESENT MAXIMUM BENEFIT; THAT HIS DISEASE IS CHRONIC AND OF SUCH A NATURE THAT IT CANNOT BE CURED, BUT THAT IT CAN BE KEPT UNDER CONTROL BY DIETARY AND INSULIN REGIMEN; AND THAT THE OFFICER WILL IN ALL PROBABILITY NEED DAILY MEDICATION, AND PERIODIC CHECK-UP FOR THE REST OF HIS LIFE.

THE CIRCUMSTANCES IN THIS CASE, AS OUTLINED IN THE PRECEDING PARAGRAPH, ARE WITHOUT PRECEDENT, SO FAR AS IS KNOWN TO THE DEPARTMENT, AND THE QUESTION ARISES WHETHER IN VIEW OF THESE CIRCUMSTANCES LIEUT. PATNAUDE IS ENTITLED UNDER THE LAW APPLICABLE TO FURTHER TREATMENT AND MEDICINES AT PUBLIC EXPENSE.

IN THE EVENT LIEUTENANT PATNAUDE IS ENTITLED TO FURTHER TREATMENT AND MEDICINES AT PUBLIC EXPENSE, THE ADDITIONAL QUESTION ARISES WHETHER THE COST THEREOF IS PROPERLY CHARGEABLE TO CIVILIAN CONSERVATION CORPS FUNDS OR TO FUNDS FOR THE ORGANIZED RESERVES. LIEUTENANT PATNAUDE'S SALARY AND THE EXPENSES FOR HIS TREATMENT SO FAR RENDERED WERE CHARGEABLE TO CIVILIAN CONSERVATION CORPS FUNDS AS HE WAS ON CIVILIAN CONSERVATION CORPS DUTY (SEE PARS. 101 AND 112D, CCC REGULATIONS, WAR DEPARTMENT, ISSUE OF DECEMBER 1, 1937). ON THE OTHER HAND, THE SALARIES OF RESERVE OFFICERS ON DUTY WITH THE REGULAR ARMY AND ACCOUNTS FOR THEIR TREATMENT ARE CHARGEABLE TO FUNDS FOR THE ORGANIZED RESERVES. AS INDICATED ABOVE, THE DISABILITY, BECAUSE OF WHICH THIS FURTHER TREATMENT IS REQUESTED BY LIEUTENANT PATNAUDE, WAS INCURRED WHILE ON DUTY WITH THE CIVILIAN CONSERVATION CORPS (NOT WITH THE REGULAR ARMY); BUT THE CIVILIAN CONSERVATION CORPS WAS CREATED AS ONE OF THE EMERGENCY PROJECTS, AND THOUGH IT WAS SEPARATELY ESTABLISHED FOR A PERIOD OF THREE YEARS FROM JULY 1, 1937 ( PUB. NO. 163, 75TH CONG. H.R. NUMBER 6551), ITS CONTINUED EXISTENCE AFTER JUNE 30, 1940 (WITH CONTINUED APPROPRIATION OF FUNDS IN CONNECTION THEREWITH) IS NOT KNOWN AT THIS DATE.

IN VIEW OF THE UNPRECEDENTED CIRCUMSTANCES IN THIS CASE, AS ABOVE OUTLINED, YOUR DECISION IS REQUESTED ON THE FOLLOWING POINTS:

(1) WHETHER UNDER THE LAW LIEUTENANT PATNAUDE IS ENTITLED TO FURTHER TREATMENT AND MEDICINES AT PUBLIC EXPENSE.

(2) IN THE EVENT THE ANSWER TO THE FOREGOING QUESTION IS IN THE AFFIRMATIVE, DECISION IS REQUESTED AS TO THE FUNDS TO BE CHARGED WITH THE EXPENSE INCIDENT TO HIS TREATMENT, I.E., THOSE FOR THE CIVILIAN CONSERVATION CORPS OR THOSE FOR THE ORGANIZED RESERVES.

THE PROVISION CONTAINED IN THE ACT OF JUNE 15, 1936, 49 STAT. 1507, QUOTED IN YOUR LETTER, AUTHORIZING TREATMENT OF MEMBERS OF THE OFFICERS' RESERVE CORPS AT GOVERNMENT EXPENSE FOR DISEASE CONTRACTED IN LINE OF DUTY IN TIME OF PEACE "UNTIL THE DISABILITY RESULTING FROM SUCH * * * DISEASE CANNOT BE MATERIALLY IMPROVED" EVIDENTLY HAS FOR ITS PURPOSE THE FURNISHING OF TREATMENT WITH A VIEW TO RESTORATION TO FITNESS FOR FURTHER ACTIVE DUTY. THERE APPEARS NOTHING IN THE ACT TO INDICATE THAT SAID PROVISION CONTEMPLATES INDEFINITE TREATMENT AT PUBLIC EXPENSE OF CHRONIC DISEASES OR TREATMENT IN ANY CASE, AFTER EXPIRATION OF THE TOUR OF ACTIVE DUTY, BEYOND THE DATE ON WHICH IT IS DETERMINED THAT FURTHER TREATMENT WILL NOT RESULT IN A REMOVAL OF THE DISABILITY--- A RESTORATION TO FITNESS FOR ACTIVE DUTY. HAD SUCH A PURPOSE BEEN INTENDED, LANGUAGE MORE DEFINITE THAN THAT USED IN THE ACT UNDOUBTEDLY WOULD HAVE BEEN EMPLOYED IN DRAFTING THE PERTINENT PROVISION.

UNDER THE FACTS AND CIRCUMSTANCES RECITED IN YOUR LETTER THE OBLIGATION AND LIABILITY OF THE GOVERNMENT TO FURNISH MEDICAL TREATMENT UNDER THE PROVISIONS OF THE ACT OF JUNE 15, 1936, CEASED ON MARCH 14, 1939, THE DATE OF TERMINATION OF THE TOUR OF ACTIVE DUTY, MAXIMUM BENEFITS OF HOSPITALIZATION AND TREATMENT, INSOFAR AS REMOVAL OF THE CAUSE OF DISABILITY IS CONCERNED, HAVING BEEN ATTAINED PRIOR THERETO YOUR FIRST QUESTION IS ANSWERED ACCORDINGLY AND NO ANSWER TO THE SECOND QUESTION IS NECESSARY.