the matter is left open. Under the Ohio law the industrial commission ruled that benefits are a vested right after an award, and a widow remarrying is entitled to their payment according to the original award, citing the Munding case above. The New Jersey court of common pleas, on the other hand, held that as the law is for the benefit of dependents, payments would cease on the remarriage of a widow, as it would be presumed that she was no longer a dependent, and it was not fair to burden industry for the benefit of such persons. It may be noted that since this decision the law of that State has been amended so as to bar payments after marriage.

Under the law of Maryland, benefits to a widow cease on her remarriage, other beneficiaries receiving benefits for eight years. Under this provision, the accident commission of the State held that the award to a sister became a vested right on its being made, so that her marriage would not terminate it, which is an obvious inconsistency of legislation.

The mutual exclusiveness of classes of awards was passed upon by a compensation commissioner of Connecticut in a case in which the disabled workman received compensation during the period of his incapacity, and on his subsequent death the claim was made that this amount should be deducted from the compensation awarded the widow; this contention the commissioner rejected, saying that the rights of the widow are separate and distinct from the rights of the deceased, and the two forms of compensation should be kept separate.

The law of Michigan is construed by a recent decision of the supreme court of the State (Foley v. Detroit United Ry., 157 N. W. 45), in which it was held that an approval by the State board of an agreement between employer and employee covering the period of total incapacity was no bar to a reopening of the case to determine what was a proper award for permanent partial incapacity, and the release given by the injured man as a full discharge against the employer, at the end of total disability payments, not having been approved by the board, was no bar to the claim. So also of a release by an injured man who subsequently died of the injury, the Supreme Court of Wisconsin holding that this was no bar to the widow's claim, which was an independent right, not in being during her hushand's lifetime, and not capable of being affected by his acts, and her claim was allowed accordingly. (Milwaukee Coke & Gas Co. v. Industrial Commission, 151 N. W. 245.)

The industrial accident board of Michigan ruled that the employer had no power to regulate the contract for burial expenses under the provision of the law of that State, which limits such expenses to $200 in cases in which the injured man left no dependents, the board pointing out that he could not be required to pay more than

$200, but had no right to undertake the control of matters that properly belonged to the next of kin or the relatives or friends.

A very common provision of the laws arranges for the commutation of payments to a lump sum. Under the Massachusetts statute it was held that this matter rested with the parties affected, and in the absence of a submitted agreement the court had no power to act, though it might approve or reject any proposition made by the parties. A case involving this question was before the Supreme Court of Kansas. (McCracken v. Missouri Valley Bridge & Iron Co., 150 Pac. 832.) There had been an award for death, and the court took the view that the insurer was seeking to prevent commutation and continue periodical payments with the hope that the death of the beneficiary would end the obligation before it was completely discharged. It was said that the insurer was not entitled to raise such an objection, ruling that the mode of payment is in the discretion of the trial court under the law of that State.

The Texas statute authorizes lump-sum settlements in cases of death or of total permanent disability, and the accident board of the State rules that such settlements for temporary or partial disabilities are null as outside the scope of the act.

The compensation commission of Pennsylvania took the view that lump-sum payments should not be favored, refusing its sanction in a case where a widow with children had secured the consent of her former husband's employer to pay in a lump the amount of $6,015 in settlement of an award, which sum she wished to invest. Installment payments as provided by the law were ordered, since "it is well to protect her against herself and an uncertain investment."

The status of an award in case of bankruptcy was decided by a Federal court (Wood v. Camden Iron Works, 221 Fed. 1010), in a ruling to the effect that compensation payments were a charge against the operation of the business, to be paid the same as wages.

MEDICAL TREATMENT.

What is a sufficient compliance with the law requiring medical treatment to be furnished was considered by the California commission in a ruling that set forth that (1) The physician most quickly obtainable should be summoned; (2) the employer should furnish instruction as to further treatment; (3) if insured, the insurer should furnish the employer with definite instructions to be followed in case of accident. It was also said that the commission will not favor the policy of procuring the cheapest physician. A request by the employee is not required, as the duty of an active compliance with the law rests upon the employer; if he has knowledge of an injury and a reasonable opportunity to furnish the needed service, that is sufficient to charge him with the reasonable expense of any service obtained by

the employee in default of the employer's action. Where, however, the employee has secured emergency treatment, and the employer afterwards offers the services of his physician, they must be accepted, as a general proposition, and subsequent services rendered by the employee's physician will be at his risk and cost; but if there has been a capital operation, the physician originally taking charge will not be dismissed unless shown to be wholly unfit to continue the treatment.

In a case in which there was a wrong diagnosis of an injury, this commission ruled that the mistaken advice of the employer's physician could not be used to deprive the injured man of his rights, but was rather an injury to the employer himself. However, where the wrong diagnosis was not corrected until after the expiration of the 90 days during which medical aid was to be furnished, it was held too late to require such treatment, though disability payments must be made; but if the employer tender the necessary treatment, the employee must accept it or forfeit such payments. Where a man suffered from a hernia and chose to take a truss, not desiring an operation at the time for family reasons, he asked to have an award in order to hold the case open for future review. This the commissión declined to do, as there had not been a disability of 14 days' duration; it ruled, however, that as hernia was a permanent disability, an award would be considered on that basis unless an operation was tendered, together with temporary disability payments for the time required for recovery therefrom, saying that a cure offers the best service to the community, and accords with the purpose of the law. The discontinuance of medical service was held not to be warranted by the disobedience of hospital rules by an injured man who absented himself without permission and drank several glasses of beer during his absence.

An opinion by the Supreme Court of Massachusetts declares that the mere posting of lists of physicians to whom injured men may go is not a compliance with the requirement to furnish treatment, and in the absence of positive instructions as to the proper course to be taken, the employee may select his physician, and the board will have jurisdiction of the question of the employee's right to recover the costs of the treatment. (In re Panasuk, 105 N. E. 368.) In a case in which the injured man had been furnished a physician, but called in his own doctor on account of pain during the first night, and continued to have him, the accident board of the State allowed the payment of a fee for the call for relief during the first night, but held that as the employer had furnished a physician, resort should have been had to him for subsequent treatment, and bills therefor were disallowed; and so generally where the employer is

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prompt to make provision, it can not be rejected unless for sufficient cause shown, except at the employee's own cost.

The question of the expense of medical and surgical services was involved in the case of City of Milwaukee v. Miller (144 N. W. 188), in which the surpreme court disallowed a claim for services rendered by a physician employed by the claimant, Miller, who gave no notice to the city of his desire for medical attendance, and continued the employment of his physician after the city had voluntarily offered the services of a competent physician. The time during which the claimant could properly employ a physician was held to be limited to such reasonable time as necessarily intervened between his injury and reasonable opportunity, after due notice, for the city to exercise its privilege of furnishing a physician. The injury was a comparatively slight one, and the industrial commission had regarded the charges as quite large, but accepted the attending physician's evidence as controlling in the matter, on account of his greater experience as compared with the city's physician, who had testified that practically one-fourth the amount of the claim would have been adequate as the cost of medical attendance. As to balancing the evidence in such a case the court said that where there were great doubts as to the amount, and the truth of the matter rested solely on the word of the interested party, opposed by the evidence of a competent witness who had little or no interest in the result, there should be much hesitation and generally a refusal to decide the matter wholly against the defendant; adding that one who, by reason of special knowledge, might be competent to give opinion evidence might deal in such exaggerations, especially when they favor his selfish interests, as in this case, as to render his evidence of little or no value. It was also said that it did not devolve upon the city to exercise active vigilance to discover the necessities of injured employees, since the language, "neglect or refusal seasonably to do so," was held to necessarily imply that reasonable notice should be given of the employee's needs and of his desire for treatment.

It was held, therefore, that the act did not authorize the payment of medical and surgical costs incurred under the circumstances, and the compensation awarded was confirmed only as to the actual compensation benefits approved by the industrial commission, plus the cost of bandages and supplies.

To the same effect was a decision of the Supreme Court of New York, appellate division, in a case (Keigher v. General Electric Co., 158 N. Y. Supp. 939) holding that where suitable provision of medical service is made by the employer, the employee can not refuse the same and claim payment for a physician of his own choosing.

Where the employee refuses to accept or act on the advice of the physician the question of actual or estimated consequences comes up for consideration. Thus where the neglect of a fracture led to infection and amputation the commission of California reckoned that recovery would have taken place in five weeks with proper care and allowed compensation only for a temporary total disability for that period and nothing for the loss of the limb. If a probably advantageous operation of comparatively inconsiderable risk is refused, that the commission may bar absolutely all claims for compensation for the remaining disability was the ruling in another case, while in a third payments were suspended until the injured man should consent to undergo a minor operation which medical testimony indicated to be necessary to a recovery of the use of the injured member.

Such also was the position of a commissioner of Connecticut in a case where an operation was indicated for the recovery of the use of a fractured limb; but where the testimony was only as to a possible benefit and the injured man declined, it was held that he would not be penalized for the refusal. So also in a case that was before the Supreme Court of Massachusetts, an operation was not required where the evidence of prospective benefit was said to be too slight to warrant an insistence thereon. (Floccher v. Fidelity & Deposit Co., 108 N. E. 1032.) Serious danger attendant on the operation was held to be ground for a refusal to undergo it, especially as the result might not be of curative effect in the case in hand (accident board of Massachusetts); though in a case where there was no such risk the man was required to decide within a period of six days what course he would pursue, at the end of which time, if refusal persisted, compensation would be suspended during its continuance. The industrial commission of Oklahoma also ruled that refusal to observe instructions, leading to the prolongation of disability, did not afford a basis for the extension of the compensation period; and in a case before the industrial commission of Wisconsin the refusal of an injured man to accept the advice of both his employer's and his own physician, causing, as was alleged, a prolongation of the term of incapacity, was held to warrant the rejection of his claim for such excess of time. The industrial board of Illinois ruled similarly where neglect prolonged the period of disability of a man suffering from an injury to the eye.

The effect of deferring consent to a serious surgical operation was before the Supreme Court of Michigan in Jendrus v. Detroit Steel Products Co. (144 N. W. 563), the physician employed in the case having urged an immediate operation as offering the only opportunity for saving the injured man's life. Assent was refused, but given the next day. The injury was to the intestines, and peritonitis