## Facts

- Eugene Bolton, a cook employed by Braewood Convalescent Hospital, slipped at work on January 6, 1978, injuring his back and right elbow.
- Bolton was morbidly obese (about 422 pounds) at the time of injury and had a long history of unsuccessful weight-loss efforts.
- Treating and evaluating physicians advised Bolton to lose weight to aid recovery from the industrial back injury; no physician prescribed a specific program.
- The employer paid temporary disability benefits for a period while Bolton received treatment for the back injury but did not offer or agree to fund a weight-loss program.
- With his physician’s support, Bolton enrolled in a closely supervised, live-in obesity program at Duke University Medical Center (out of state) from February to November 1979 and lost about 175 pounds.
- Bolton self-procured the program and sought workers’ compensation reimbursement, temporary disability during participation, and payment for future participation.

## Issues

1. Whether the WCAB may order reimbursement for a self-procured, out-of-state weight-reduction program as medical treatment reasonably required to cure or relieve the effects of an industrial injury.
2. Whether the WCAB may award temporary disability benefits during the employee’s participation in such a program.
3. Whether the WCAB may award medical expenses for future participation in the weight-reduction program.

## Decision

- The California Supreme Court affirmed the WCAB’s award.
- The court held the WCAB acted within its statutory authority in awarding:
  - reimbursement for the self-procured, out-of-state obesity program,
  - temporary disability benefits during the period of participation, and
  - expenses for medically indicated future participation.
- The court relied on substantial medical evidence supporting the WCAB’s finding that weight reduction was necessary to cure or relieve the industrial back injury.

## Legal Principles

- An employer’s duty to furnish medical care includes treatment of a preexisting, nonindustrial condition when that treatment is reasonably required to cure or relieve the effects of the industrial injury.
- A treatment’s nonindustrial target condition does not bar compensation if substantial medical evidence supports the WCAB’s finding that the treatment is part of necessary care for the industrial injury.
- The WCAB may approve reimbursement for self-procured medical treatment when the treatment is reasonable and the employer has not provided adequate care, even if the treatment is obtained out of state.
- Temporary disability benefits may be awarded for periods in which the employee is unable to work due to medically necessary treatment that is reasonably required by the industrial injury.
- The WCAB may award future medical expenses when supported by medical evidence that continuing care is reasonably required to cure or relieve the industrial injury’s effects.

## Conclusion

The court upheld the WCAB’s authority to treat a medically necessary weight-reduction program as compensable care where it was required to relieve the effects of an industrial back injury, and to award related reimbursement, temporary disability during treatment, and future medical expenses.


Braewood Convalescent Hosp. v. Workers’ Comp. Appeals Bd., 34 Cal. 3d 159 (Cal. 1983)