## Facts

- A Kentucky Department of Highways employee suffered a minor, temporary left-foot injury at work.
- After the physical injury, he developed a psychological condition described as psychoneurosis conversion hysteria, characterized by the Board as “compensation neurosis” rather than conscious malingering.
- A psychiatrist recommended a sodium-amytal interview procedure intended to reduce resistance and allow therapeutic suggestion; the psychiatrist testified a cure could occur in two or three sessions if successful.
- The employee refused to undergo the sodium-amytal procedure.
- The employee’s personal physician doubted psychiatric treatment alone would cure him, but did not testify the procedure was incompetent or dangerous.
- The Workmen’s Compensation Board awarded an open-end award for permanent total disability and found the refusal of the procedure was not unreasonable, stating the treatment might deter improvement and would be ineffective if the employee resisted.
- The circuit court upheld the award; the Department appealed.

## Issues

1. Whether, under KRS 342.035, the employee’s refusal to submit to the proposed sodium-amytal psychiatric procedure was an “unreasonable failure” to accept competent medical aid.
2. Whether the Board could deem the refusal reasonable based on speculation about harm or futility unsupported by medical evidence.

## Decision

- The Kentucky Court of Appeals reversed the circuit court judgment upholding the Board’s award.
- The court held the employee’s refusal of the sodium-amytal treatment was unreasonable within the meaning of KRS 342.035.
- The court concluded the Board’s findings that the treatment might be harmful or futile lacked evidentiary support.
- The case was remanded with directions to return it to the Board for further proceedings consistent with the opinion.

## Legal Principles

- Under KRS 342.035, compensation is not payable to the extent disability is aggravated, caused, or continued by an unreasonable failure to submit to competent medical aid or advice.
- An administrative factfinder may not base the reasonableness of refusing treatment on unsupported assumptions about danger or ineffectiveness; findings must rest on record evidence.
- A claimant’s refusal may be treated as reasonable when there is a genuine medical dispute about material risk or efficacy, but a mere physician’s skepticism about cure—without testimony of danger, incompetence, or futility—does not establish such a dispute.
- When a proposed treatment is competent and no medical evidence shows meaningful danger, refusal may be unreasonable where the refusal continues the disabling condition.

## Conclusion

The court held that a workers’ compensation award for disability attributable to compensation neurosis could not stand where the claimant unreasonably refused a competent psychiatric procedure offering a meaningful chance of improvement and the Board’s contrary finding was unsupported by medical evidence.


Commonwealth, Dep’t of Highways v. Lindon, 380 S.W.2d 247 (Ky. Ct. App. 1964)