Smith v. Old Republic Ins. Co., 1999 MT 88N (unpublished, nonciteable opinion). In an unpublished, nonciteable opinion, the Supreme Court affirmed the WCC's findingclaimant was not entitled to reimbursement for out of state assessment for thoracic outlet syndrome whereno doctor had diagnosed claimant with the syndrome and his treating physician had only referred claimant to the Seattle physician to accommodate claimant's request that he be evaluated for the condition and only after claimant had rejected the doctor's recommendation that he consult one of two in-town physicianswith expertise in the area.

Smith v. Old Republic Ins. Co. [3/4/98] 1998 MTWCC 20, affirmed in Smith v. Old Republic Insurance Company, 1999 MT 88N (unpublished, nonciteable opinion). Claimant is not entitled to reimbursement for out of state assessment for thoracic outlet syndrome where no doctor had diagnosed claimant with the syndrome and his treating physician had only referred claimant to the Seattle physician to accommodate claimant's request that he be evaluated for the condition and only after claimant had rejected the doctor's recommendation that he consult one of two in-town physicians with expertise in the area.

Pasha v. National Union Fire of Pittsburgh [2/26/97] 1997 MTWCC 5 Out-of-state evaluation for claimant's chronic neck and arm pain, and headaches, is medically reasonable and necessary where three different physicians recommended the evaluation, several additional tests have been recommended by various physicians, physicians treating claimant have expressed uncertainty as to the nature of her condition, and treatment to date has been largely ineffective. Also relevant is the Court's impression that claimant will never return to work unless effective treatment is found and that evaluation at the Mayo Clinic, even if it provides no better diagnosis and treatment, will provide closure to the medical investigation. If the only reason for the referral to the Mayo Clinic were claimant's desire for the evaluation, the Court would not order the evaluation.