B-120283, AUGUST 30, 1954, 34 COMP. GEN. 107

B-120283, AUGUST 30, 1954, 34 COMP. GEN. 107

MEDICAL TREATMENT - PRIVATE - DISTRICT OF COLUMBIA POLICE AND FIREMAN - DIAGNOSTIC STUDIES - APPROPRIATION AVAILABILITY DISTRICT OF COLUMBIA APPROPRIATION," COMPENSATION AND RETIREMENT FUND EXPENSES," WHICH, UNDER SECTION 12 OF THE ACT OF SEPTEMBER 1, 1916, MAY NOT BE USED TO PAY THE COST OF PRIVATE MEDICAL TREATMENT OF POLICE AND FIREMEN UNLESS THE INJURY OR DISEASE FOR WHICH THE TREATMENT IS GIVEN WAS INCURRED IN THE ACTUAL DISCHARGE OF DUTY MAY BE REGARDED AS AVAILABLE TO PAY THE COSTS OF PRIVATE DIAGNOSTIC STUDIES UP TO THE POINT OF DEFINITE DETERMINATION THAT THE DISEASE OR INJURY WAS OR WAS NOT INCURRED IN THE ACTUAL DISCHARGE OF DUTY.

ACTING COMPTROLLER GENERAL KELLER TO THE PRESIDENT, BOARD OF COMMISSIONERS OF THE DISTRICT OF COLUMBIA, AUGUST 30, 1954:

REFERENCE IS MADE TO YOUR LETTER OF MAY 26, 1954, WITH ENCLOSURES, REQUESTING A DECISION AS TO WHETHER SECTION 12 OF THE ACT OF SEPTEMBER 1, 1916, 39 STAT. 718, D.C. CODE, SECTION 4-506, AUTHORIZES THE USE OF DISTRICT OF COLUMBIA FUNDS FOR PAYMENT OF THE COSTS OF PRIVATE DIAGNOSTIC, MEDICAL, SURGICAL, AND HOSPITAL STUDIES OF POLICEMEN AND FIREMEN UP TO THE POINT OF A DEFINITE DETERMINATION THAT THE INJURY OR DISEASE CONTRACTED WAS OR WAS NOT INCURRED IN THE ACTUAL DISCHARGE OF DUTY.

THE CIRCUMSTANCES GIVING RISE TO THE QUESTION PRESENTED FOR DECISION STEM FROM A DIFFERENCE BETWEEN THE INTERNAL AUDIT OFFICE AND THE BOARD OF POLICE AND FIRE SURGEONS OF THE DISTRICT OF COLUMBIA IN THEIR INTERPRETATIONS OF SECTION 12 OF THE ACT OF SEPTEMBER 1, 1916, AND THE DECISION REPORTED IN 18 COMP. GEN. 963, RELATIVE THERETO. SAID SECTION 12 PROVIDES IN PERTINENT PART:

WHENEVER ANY MEMBER OF THE POLICE DEPARTMENT OR THE FIRE DEPARTMENT OF THE DISTRICT OF COLUMBIA SHALL BECOME TEMPORARILY DISABLED BY INJURY RECEIVED OR DISEASE CONTRACTED IN THE ACTUAL DISCHARGE OF HIS DUTY, TO SUCH AN EXTENT AS TO REQUIRE MEDICAL OR SURGICAL SERVICES OTHER THAN SUCH AS CAN BE RENDERED BY THE BOARD OF POLICE AND FIRE SURGEONS OF SAID DISTRICT, OR TO REQUIRE HOSPITAL TREATMENT, THE EXPENSES OF SUCH MEDICAL OR SURGICAL SERVICES, OR HOSPITAL TREATMENT, SHALL BE PAID FROM THE POLICEMAN AND FIREMEN'S RELIEF FUND, DISTRICT OF COLUMBIA, PROVIDED FOR IN THIS ACT; BUT NO SUCH EXPENSES SHALL BE PAID EXCEPT UPON A CERTIFICATE OF THE SAID BOARD OF POLICE AND FIRE SURGEONS, OR TWO MEMBERS THEREOF, SETTING FORTH THE NECESSITY FOR SUCH SERVICES OR TREATMENT AND THE NATURE OF THE INJURY OR DISEASE WHICH RENDERED THE SAME NECESSARY, AND UPON THE APPROVAL OF THE SAID CERTIFICATE BY THE SUPERINTENDENT OF THE METROPOLITAN POLICE OR THE CHIEF ENGINEER OF THE FIRE DEPARTMENT, AS THE CASE MAY BE, AND THE APPROVAL OF THE COMMISSIONERS OF THE DISTRICT OF COLUMBIA.

IN THE CITED DECISION AT PAGE 966 IT WAS STATED:

THE STATUTE CLEARLY AND DEFINITELY AUTHORIZES THE USE OF THE FUND TO PAY THE COST OF PRIVATE MEDICAL, SURGICAL, AND HOSPITAL TREATMENTS OF MEMBERS OF THE POLICE DEPARTMENT OR THE FIRE DEPARTMENT OF THE DISTRICT OF COLUMBIA ONLY WHEN THE INJURY OR DISEASE WAS "CONTRACTED IN THE ACTUAL DISCHARGE OF HIS DUTY," AND WHERE SUCH SERVICES COULD NOT BE PERFORMED BY THE BOARD OF POLICE AND FIRE SURGEONS. THE STATUTE FURTHER REQUIRES IN SUCH CASES A CERTIFICATE BY THE BOARD OF POLICE AND FIRE SURGEONS, OR TWO MEMBERS THEREOF,"SETTING FORTH THE NECESSITY FOR SUCH SERVICES OR TREATMENT AND THE NATURE OF THE INJURY OR DISEASE WHICH RENDERED THE SAME NECESSARY," AND THAT THE CERTIFICATE BE APPROVED BY THE SUPERINTENDENT OF THE METROPOLITAN POLICE, AND BY THE COMMISSIONERS OF THE DISTRICT OF COLUMBIA. HOWEVER, SUCH A CERTIFICATE, EVEN THOUGH APPROVED BY THE SUPERINTENDENT OF POLICE AND THE COMMISSIONERS, CONSTITUTES NO PROPER BASIS FOR PAYMENT OF THE COST OF PRIVATE MEDICAL AND HOSPITAL TREATMENT FROM THE POLICEMEN AND FIREMEN'S FUND IN A CASE IN WHICH THERE HAS BEEN NO FINDING THAT THE INJURY OR DISEASE WAS CONTRACTED IN THE ACTUAL DISCHARGE OF DUTY.

YOU STATE THAT IN THE COURSE OF AN AUDIT BY THE INTERNAL AUDIT OFFICE OF THE POLICEMEN AND FIREMEN'S RELIEF FUND, A QUESTION WAS RAISED AS TO THE PROPRIETY OF A NUMBER OF VOUCHERS CERTIFIED BY THE BOARD OF POLICE AND FIRE SURGEONS AND APPROVED BY THE COMMISSIONERS COVERING PAYMENTS FOR DIAGNOSTIC STUDIES OF POLICEMEN AND FIREMEN PERFORMED BY OTHER THAN THE BOARD MEMBERS. APPARENTLY THE QUESTIONED VOUCHERS COVERED SITUATIONS WHERE THE DIAGNOSES DISCLOSED THAT THE DISEASE OR INJURY COMPLAINED OF WAS NOT CONTRACTED "IN THE ACTUAL DISCHARGE OF HIS DUTY.' IT APPEARS TO BE THE POSITION OF THE INTERNAL AUDIT OFFICE THAT THE EXPENSES OF PRIVATE DIAGNOSTIC STUDIES MADE IN CONNECTION THEREWITH SHOULD NOT BE CHARGED TO THE FUND BECAUSE THEY ARE BEYOND THE SCOPE OF THE CONDITION IMPOSED BY THE CONGRESS ON THE USE THEREOF, I.E., INJURY OR DISEASE CONTRACTED "IN THE ACTUAL DISCHARGE OF HIS DUTY" AND THAT SUCH EXPENSES SHOULD BE BORNE BY THE INDIVIDUAL POLICEMAN OR FIREMAN.

THERE ACCOMPANIED YOUR LETTER AN EXTENSIVE STATEMENT FROM THE CHAIRMAN, BOARD OF POLICE AND FIRE SURGEONS, TO YOU, AND STATEMENTS OF CONCURRENCE THEREIN BY THE CHIEF OF POLICE AND THE FIRE CHIEF RELATIVE TO THE MATTER. IT IS STATED THEREIN THAT THE CITED STATUTE AND THE OFFICE DECISION PLACED UPON THE PHYSICIANS THE RESPONSIBILITY FOR DEFINITELY DETERMINING WHETHER A DISEASE IS CONTRACTED OR AN INJURY IS RECEIVED IN THE ACTUAL DISCHARGE OF DUTY AND THAT, IN ORDER TO CARRY OUT SUCH RESPONSIBILITY EFFECTIVELY, IT IS A NECESSARY AND COMMON MEDICAL AND SURGICAL PRACTICE FIRST TO MAKE AND ESTABLISH A DIAGNOSIS OF THE CONDITION INVOLVED. IT IS EXPLAINED THAT SUCH DIAGNOSIS ENTAILS THE SECURING OF COMPLETE MEDICAL DATA, SUCH AS HISTORY, PHYSICAL EXAMINATION, LABORATORY STUDIES INCLUDING BLOOD STUDIES, X-RAY STUDIES AND MANY OTHER TECHNICAL STUDIES WHICH FREQUENTLY REQUIRE THE USE OF FACILITIES NOT AVAILABLE AT THE BOARD'S CLINIC. ALSO, CONSULTATIONS WITH OTHER PHYSICIANS SPECIALIZING IN FIELDS OUTSIDE THE SCOPE OF THE WORK OF THE BOARD MEMBERS ARE OFTEN REQUIRED. IT IS FURTHER STATED THAT WHEN IT IS DETERMINED FROM A DIAGNOSIS THAT THE CONDITION PRESENT WAS NOT RECEIVED OR CONTRACTED IN THE ACTUAL DISCHARGE OF DUTY THE INDIVIDUAL POLICEMAN OR FIREMAN IS THEN NOTIFIED THEREOF AND THAT ANY FURTHER EXPENSES IN CONNECTION THEREWITH ARE PERSONAL TO HIM. IT IS POINTED OUT, HOWEVER, THAT THE ESTABLISHED DIAGNOSTIC PROCEDURES MUST BE FOLLOWED--- IRRESPECTIVE OF THE ULTIMATE FINDING OF THE RELATIONSHIP BETWEEN A DISEASE OR INJURY AND THE DISCHARGE OF DUTY--- IN ORDER TO MAKE THE DETERMINATION REQUIRED BY THE STATUTE, AND IT IS URGED THAT THE EXPENSES OF THE DIAGNOSTIC STUDIES IN QUESTION ARE CORRECT AND JUST OBLIGATIONS OF THE DISTRICT GOVERNMENT.

THE QUOTED PROVISIONS OF THE ACT OF SEPTEMBER 1, 1916--- BY ITS SPECIFIC TERMS--- PLACED UPON THE BOARD OF POLICE AND FIRE SURGEONS THE RESPONSIBILITY FOR DETERMINING, AS A CONDITION TO THE USE OF THE POLICEMEN AND FIREMEN'S RELIEF FUND FOR PAYMENTS OF THE SPECIAL MEDICAL, SURGICAL AND HOSPITAL SERVICES PROVIDED FOR THEREIN--- PAYMENTS OF THAT CHARACTER NOW BEING PROVIDED FOR UNDER THE APPROPRIATION " COMPENSATION AND RETIREMENT FUND EXPENSES"--- THAT THE INJURY OR DISEASE CONTRACTED WAS "IN THE ACTUAL DISCHARGE OF ITS DUTY.' THERE CAN BE NO DOUBT THAT DIAGNOSTIC STUDIES ARE A PRIMARY REQUISITE FOR THE PROPER PERFORMANCE BY THE BOARD MEMBERS OF SUCH FUNCTIONS.

IT IS A SETTLED RULE THAT WHERE AN APPROPRIATION IS MADE FOR A PARTICULAR OBJECT IT CONFERS BY IMPLICATION AUTHORITY TO INCUR EXPENSES WHICH ARE NECESSARY OR PROPER OR INCIDENT TO THE PROPER EXECUTION OF THE OBJECT, UNLESS THERE IS ANOTHER APPROPRIATION WHICH MAKES MORE SPECIFIC PROVISION FOR SUCH EXPENDITURES OR UNLESS THEY ARE PROHIBITED BY LAW. SEE 29 COMP. GEN. 419; 32 ID. 360. HAVING REGARD FOR THE NATURE OF THE DUTIES IMPOSED UPON THE BOARD, IT REASONABLY APPEARS THAT THE EXPENSES FOR PRIVATE DIAGNOSTIC STUDIES ARE NECESSARY AND INCIDENT TO THE PROPER EXECUTION THEREOF AND OF THE BASIC OBJECT OF THE STATUTE IN QUESTION, IRRESPECTIVE OF WHETHER IT IS DETERMINED THAT THE INJURY OR DISEASE CONTRACTED DID NOT RESULT IN THE ACTUAL DISCHARGE OF DUTY.

ACCORDINGLY, AND IN ANSWER TO YOUR SPECIFIC QUESTION, I HAVE TO ADVISE THAT THE APPROPRIATION " COMPENSATION AND RETIREMENT FUND EXPENSES" MAY BE REGARDED AS PROPERLY AVAILABLE FOR EXPENSES OF PRIVATE DIAGNOSTIC STUDIES UP TO THE POINT OF DEFINITE DETERMINATION THAT THE DISEASE OR INJURY WAS OR WAS NOT INCURRED IN THE ACTUAL DISCHARGE OF DUTY.

IT MAY BE FURTHER STATED THAT IT APPEARS FROM THE CERTIFICATE IN THE REPRESENTATIVE CASES OF PRIVATE DIAGNOSTIC STUDIES ATTACHED TO YOUR LETTER THAT MEMBERS OF THE BOARD OF POLICE AND FIRE SURGEONS, IN CERTIFYING THE PAYMENT OF EXPENSES THEREFOR, UTILIZE FORMS F.D. 39 REV. AND P.D. 52 IN CASES WHERE IT HAS BEEN DETERMINED THAT THE DISEASE OR INJURY WAS NOT CONTRACTED IN THE ACTUAL DISCHARGE OF DUTY. SINCE THE PRINTED STATEMENT APPEARING ON SUCH FORMS, DISEASE OR INJURY "WAS CONTRACTED IN THE ACTUAL DISCHARGE OF DUTY" OBVIOUSLY DOES NOT ACCORD WITH THE SUBSEQUENTLY DETERMINED FACTS, AND SINCE THAT FACT IS NOT A CONDITION PRECEDENT TO PAYMENT, THERE APPEARS NO NECESSITY FOR INCLUDING IT WITHIN ANY CERTIFICATION THAT MAY BE MADE IN SUCH CASES.