## Facts

- Luther Earl George worked for Chesapeake & Ohio Railway Company (C&O) for 48 years as a tugboat pilot, paid hourly; he received no company-provided meals or lodging.
- For about 15 years, George experienced recurrent mouth and gum sores and treated them himself.
- In June 1967, while serving aboard a C&O tug, a sore developed that did not respond to his usual treatment; a private specialist’s biopsy showed cancer.
- George reported the condition to C&O as required; C&O sent him to a company doctor and then to the C&O Railway Employee’s Hospital Association hospital at Clifton Forge, Virginia.
- A physician there confirmed cancer and discussed radical surgery versus radiation; because the described surgery would remove a significant portion of his face, George chose radiation.
- Because radiation was unavailable at Clifton Forge, C&O arranged and paid for radiation treatments at a private hospital.
- The cancer later recurred; George underwent surgery at a private hospital based on medical advice that a qualified specialist should perform the procedure.
- C&O refused to pay the private-hospital surgery expenses, contending George could have obtained treatment at a U.S. Public Health Service marine hospital at no cost.
- The evidence showed C&O did not inform George, before the surgery, that a marine hospital was an available alternative or that use of such a facility affected payment.
- George sued under general maritime law for maintenance and cure related to the surgery and sought attorney’s fees as damages for nonpayment.

## Issues

1. Whether C&O was liable for maintenance and cure for George’s private-hospital cancer surgery when it claimed treatment was available at a marine hospital.
2. Whether George’s choice to use private specialist surgical care, rather than employer-associated or government facilities, barred or reduced maintenance-and-cure recovery.
3. Whether C&O’s refusal to pay maintenance and cure justified an award of attorney’s fees based on willful, arbitrary, or callous conduct.

## Decision

- The court held C&O liable for maintenance and cure covering the reasonable medical expenses of George’s private-hospital surgery.
- The court rejected a rule that the mere existence of a marine hospital automatically defeats recovery for private treatment.
- The court found George’s use of private specialist care reasonable given the seriousness of the condition, the need for specialized surgical skill, and his prior use of company-directed care.
- The court denied attorney’s fees, finding the refusal to pay was not shown to be willful, arbitrary, or callous.

## Legal Principles

- A seaman who becomes ill or injured in the service of the vessel is entitled to maintenance and cure until maximum cure is reached.
- Maintenance and cure may include reasonable private-hospital and specialist expenses when such care is medically indicated and not shown to be an unreasonable choice.
- An employer cannot avoid liability by invoking an alternative government facility without showing practical availability and that the seaman had meaningful notice and a reasonable opportunity to use it.
- Attorney’s fees for nonpayment of maintenance and cure require proof of willful, arbitrary, or callous refusal; an incorrect position, without more, does not suffice.

## Conclusion

The court required C&O to reimburse a seaman’s reasonable private-hospital surgical expenses as maintenance and cure where the employer had not timely informed him of any marine-hospital alternative, but it refused fee shifting because the record did not show bad-faith nonpayment.


George v. Chesapeake & Ohio Ry. Co., 348 F. Supp. 283 (E.D. Va. 1972)