The plaintiff-appellant, Donald Feeley, a veteran of the United States armed forces, sustained severe physical injuries while engaged in overseas combat. These injuries culminated in a medical discharge for a mental disorder; psychoneurosis, anxiety reaction. This service-connected disability has resulted in ’Feeley’s being rated as 50% permanently ■disabled by the Veterans’ Administration, entitling him to disability benefits. Prior to July 7, 1960, Feeley frequently sought medical care for this condition, which he received free of charge from the Veterans’ Administration.
The district court 1 found that on July 5, 1960, the plaintiff, while working for the City of Philadelphia, was injured in Philadelphia by a United States Post Office truck through the negligence of an employee of the United States Government. Feeley suffered injury tо his right knee and leg and also an aggravation of his pre-existing service-connected psychoneurosis. In June of 1961, the plaintiff, while playing basketball, injured his right ankle. The evidence was in dispute :as to whether or not this injury was the result of a weakened condition caused by the knee injury.
After these injuries, Feeley, realizing that his mental illness was worsening, sought further hospital and medical care from the Veterans’ Administration, which he received free of charge.
The plaintiff then instituted this action under the Federal Tort Claims Act, 28 TJ.S.C. § 1346(b), to recover for the damages sustained by the negligence of the ■driver of the Post Office vehicle. The •court below, sitting without a jury, found in favor of the plaintiff. Although the .government does not contest the finding of negligence, it appeals from that part of the judgment which allowed the plaintiff, as a part of his damages, the reasonable value of the medical care furnished free by the Veterans’ Administration and the award for future medical care. The appellant also claims that the trial court failed to make adequate findings of fact as required by Rule 52(a), Fed.R.Civ. Proc., 28 U.S.C., in respect to the amount of damages.
I. VALUE OF SERVICES PROVIDED BY VETERANS’ ADMINISTRATION HOSPITAL.
In awarding damages, the district court included an amount of $2055.-20, which it calculated to be the reasonable value of the medical care which the plaintiff received from the Veterans’ Administration Hospital. There is no doubt that Feeley did not pay for this service, has not incurred any future liability for it, and that the service was rendered free of charge under Title 28, U.S.C.A. Nonetheless, Feeley argues that the trial court properly awarded damages to him for this gratuitous service under the collateral source rule. While it is well established that a plaintiff’s recovery under the ordinary negligence rule is limited to damages which will make him whole, the collateral source rule allows a plaintiff further recovery under certain circumstances even though he has suffered no loss. See Restatement, Torts § 920, Comment e. The collateral source rule may be described as “the judicial refusal to credit to the benefit of the wrongdoer money or services received in reparation of the injury caused which emanate from sources other than the wrongdoer.” 2 Under the collateral source rule a “plaintiff who has been рaid his salary or a pension during disability, or had his medical expenses paid by another, or out of the proceeds of an accident insurance policy, may still recover full damages for *927 these items from a defendant who is liable for the injury. To this extent, plaintiff may get double payment on account of the same items. The defendant wrongdoer should not, it is said, get the benefit of payments that come to the plaintiff from a collateral source.” 3 However, where the defendant has been the source of the payment, the damages, generally, cannot include the benefit conferred by the defendant. 4 But in instances in which the United States is the payer-defendant, this general rule has sporadically succumbed to a proliferation of judicial decisions attempting to accommodate the collateral source rule to the unique position of the federal government with its many separate branches and agencies, each independent of the other. 5
The case at bar arises under the Federal Tort Claims Act, 28 U.S.C.A. § 2674, which provides that, “The United States shall be liable, respecting the provisions of this title relating to tort claims, in the same manner and to the same extent as a private individual under like circumstances * * *.” Under this provision, the applicable state law, not federal law controls, in the first instance,
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in determining the computation of damages. Richards v. United States,
It is incorrect to analyze the ambit or boundaries of the collatеral source rule in the context of a search for a single applicable rule. The application or non-application of the rule encompasses many different situations and each one must be *928 analyzed separately. 7 There are some basic considerations which must be kept in mind in deciding whether a plaintiff should be allowed to recover from both the defendant and the collateral source. In some circumstances, there may be no double recovery at all because the plaintiff may be legally obligated to repay his original source of reimbursement, under the doctrine of subrogation. At other times, one can justify a double recovery where the original source was supplied by the plaintiff, himself, out of resources that would otherwise have been available to him for other purposes, or where the source was the result of a gift to the plaintiff, in which there is an actual or presumed donative intent with no thought given by the donor to compensate the plaintiff. See 2 Harper & James, supra, note 3 at 1348.
With these basic principles in mind, we turn now to an examination of Pennsylvania state law. We can find no Pennsylvania case and plaintiff has cited none presenting the fact situation that we have hypothesized, a situation in which the plaintiff has received free government medical and hospital care and is seeking the value of these services as damages against a private defendant. We note, however, that the majority view would allow recovery in this situation. Rayfield v. Lawrencе,
Recent dictum by the Pennsylvania Supreme Court would seem to indicate that Pennsylvania law follows a broad collateral source rule. Thus, in Boudwin v. Yellow Cab Co.,
An analogous situation to the case at bar is the situation in which the injured plaintiff claims damages for lost wages,
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even though he has been paid his full wages by his employer.
8
The collateral source problem arises because there has been no actual loss of wages thus presenting baldly the double recovery problem. This question was first before the Pennsylvania Supreme Court in Quigley v. Pennsylvania R. Co.,
Kite did not prevent the court, in Layman v. Doernte,
In summing up Pennsylvania law under this line of cases the best that can be said from the plaintiff’s point of view is that where the payment is a true gift by the employer, there can be double recovery. From the defendant’s standpoint, on the most recent holding, Kite v. Jones, supra, it might well be argued that there can be no double recovery for lost wages. Regardless of which position is correct, or, indeed, even if neither is correct and some intermediate position is the correct one, a full-blown collateral source rule approach would, in all cases, treat the employer’s payment as a gift, 9 thus allowing double recovery. It is clear that Pennsylvania does not go that far, but looks, at the least, for a true donative intent on the part of the employer before it will allow a double recovery, although it is not quite clear what facts will sustain a finding of donative intent. By looking for a true donative intent instead of settling for a fictional one, if it allows a double recovery at all, the Pennsylvania courts seem to recognize that the idea of a gift embodies the generous intention that the benefit be in addition to all other compensation and does not, in itself, embody notions of compensation for the injury.
Perhaps as further indicative of the general reluctance in Pennsylvania to adopt a broad double recovery rule is Antonelli v. Tumolo,
None of the Pennsylvania decisions involving pensions and disability insurance establish a broad collateral source rule. In Littman v. Bell Tel. Co.,
In the pension cases, either the benefits consisted entirely of funds committed by the plaintiff, Kline v. Thornton,
Clearly, Pennsylvania allows no diminishment in damages for workmen’s ■compensation recoveries. Boudwin v. Yellow Cab Co.,
There is also, however, some indication in Lengle that an additional reason for .allowing full recovery from the tortfeasor is because workmen’s compensation recoveries do not fully compensate for the injury. This reasoning seems ill-considered, however, because the right of subrogation negates any double-recovery. Were this the true reason for allowing full recovery in workmen’s compensation cases, rather than the fact that the compensation carrier is subrogated to the rights of the injured plaintiff against the tortfeasor, the plaintiff would get a full recovery merely by deducting the ■compensation award from his tort dam•ages. It would seem, then, that the collateral source rule in workmen’s compensation cases is for the protection of the insurance carrier and not for the protection of the plaintiff. Nevertheless, the Superior Court, in Blatt v. C. C. Davis Constr. Co.,
It is clear that Pennsylvania does allow double recovery where the collateral sourсe is unemployment insurance. Lobalzo v. Varoli,
The cases of public and private benevolence involving medical care are also on point. In Norristown v. Moyer,
A case we find very much in point is Gaydos v. Domabyl,
However, even if we are wrong on the result that state lav/ would reach here, the plaintiff has two additional obstacles to overcome. First, he must show that this payment is from a collateral source. Secondly, proving that much, he must, also show that the Federal Tort Claims-Act, which is a compensatory scheme, would allow recovery here.
In the determination of whether or not-the payment was from a collateral source, state law, even if it applies, is likely to be of little help. Most cases involving the-United States as a defendant will be litigated in a federal forum and, certainly, all Federal Tort Claims Act cases will be in the federal courts. 28 U.S.C.A. § 1346(b). Perhaps useful analogies-could be found in state cases in which the-state is a defendant, but none has been found by this court bearing on the problem at bar. Therefore, we need not decide whether it is federal or state law *933 thаt controls in deciding whether a payment by the United States is a payment from a collateral source, since we have no choice but to look to other federal decisions to help guide us toward the correct result.
The question now before us is one of first impression in this circuit, having been expressly left open by us in Knecht v. United States,
On remand, the Court of Appeals for the Fourth Circuit, United States v. Brooks,
This argument ignores the distinction made by the Supreme Court in Feres v. United States,
We are of the view that the decision of the Court of Appeals in Brooks, supra, is correctly decided and should be followed. The defendant United States has provided free hospital care for these specific injuries. While it is true that the plaintiff became entitled to the bene
*934
fits beсause of his status as a veteran and his pre-existing service-connected disability, and not because he was the victim of a tort committed by a federal employee, the fact is that the United States has paid for the hospital care here in dispute, while the plaintiff has paid nothing for the care. To allow the plaintiff to recover for this item in his damages would not only result in a double-recovery for him, but also a double-payment out of the general treasury by the United States. We are careful, however, to limit this result to the facts of this case. This decision casts neither approval nor disapproval on such possibly distinguishable situations as where the payment is out of a specially funded source, see United States v. Harue Hayashi,
Neither do we disagree with the case on which plaintiff places his primary reliance, United States v. Gray,
Since we hold that the plaintiff cannot recover the value of the free hospital care rendered by the government under either of the alternative grounds we have discussed, we need not decide now whether a collateral source recovery, which seems to embody elements of punitive damages in some situations, is repugnant to the Federal Tort Claims Act which exempts the United States from liability for punitive damages. See note 6, supra.
II. FUTURE MEDICAL DAMAGES.
The district court awarded the plaintiff Twelvе Thousand Dollars ($12,000) for future psychiatric medical expenses.
However, acceptance of the government’s position would result in forcing the plaintiff, financially speaking, to seek only the available public assistance. *935 Private medical care would be obtained at the plaintiff’s own expense. We think that this is an unconscionable burden to place on the plaintiff. A victim of another’s tort is entitled, we think, to choose, within reasonable limits, his own doctor and place of confinement, if such care is necessary. To force a plaintiff to choose between accepting public aid or bearing the expense of rehabilitation himself is an unreasonable choice. The plaintiff may not be satisfied with the public facilities; he may feel that a particular private physician is superior; in the future because of over-crowded conditions he may not even be able to receive timely care. These are only a few of many considerations with which an individual may be faced in selecting treatment. The plaintiff’s past use of the government facilities doеs not ensure his future use of them. He will now have t the funds available to him to enable him to seek private care. He should not be denied this opportunity.
It is true that if the plaintiff should decide to seek care from the Veterans’ Administration, the defendant may well be paying twice for the same element of damages. However, this is dependent on whether the government can refuse to render free care. This factor, however, should not be a consideration in awarding damages under the Federal Tort Claims Act, but rather is a policy judgment to be made in the administration of veterans’ benefits.
III. SUFFICIENCY OF THE DISTRICT COURT’S FINDINGS OF FACT.
The government contends that the District Court did not make sufficient findings of fact, in accordance with Rule 52(a) of the Rules of Civil Procedure.
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Rule 52(a) is intended to provide the аppellate court and the litigants with a clear understanding of the trial court’s judgment. I. C. C. v. Cardinale Trucking Corp.,
The government’s position is that the trial court failed to meet this standard in that it did not apportion the damages between those attributable to the plaintiff’s pre-existing mental condition and those attributable to aggravation of that condition by the 1960 accident. It is evident, however, that the district court only awarded damages to compensate the plaintiff for the aggravation of his pre-existing condition: “This ease involves an aggravation of plaintiff’s pre-existing psychoneurosis. Therefore, in аddition to the pain and suffering resulting from the injury to his knee, he is entitled to an award for the unusual amount of mental suffering due to the psychoneurosis, anxiety reaction, which occurred here. * * * The amount allocated to future psychiatric care is that amount necessary to return the plaintiff to the condition he was in prior to the accident.”
However, the government quite correctly argues that the trial judge made no findings of fact of a causal relationship between the defendant’s negligence and the later basketball injury to the plaintiff’s ankle. Our mathematical calculations leаd us to the conclusion that the district court perhaps did not include in the plaintiff’s damage award the Hahnemann Hospital bill for treatment to the plaintiff’s ankle. This would lead one to believe that the district court perhaps did not find the requisite causal connec *936 tion. However, there apparently was included in the damage award the bill from Dr. Kaplan in the amount of $481.-<00. Dr. Kaplan testified that he treated the plaintiff for both injuries, yet there is no indication in the record whether his bill was for both injuries or only for the knee injury. If it encompassed treatment for both injuries the district court’s judgment would be inconsistent.
We are also troubled by additional problems involving the subsequent ankle injury, although not raised by the government. There is some testimony by Dr. Kaplan which would tend to estаblish that treatment of the knee injury was further complicated by the ankle injury. We feel it is necessary for the district court to determine, if it first finds no causal connection between the defendant’s negligence and the subsequent ankle injury, whether any part of the cost of treatment for the knee was due to the subsequent basketball injury. In addition, we find some testimony indicating that perhaps the plaintiff’s mental condition was worsened by the subsequent ankle injury. If the district court finds no causal connection between the ankle injury and the defendant’s negligence, it must then determine whether the ankle injury further aggravated the plaintiff’s mental condition so that a part of the amount of money necessary to restore the plaintiff to his pre-1960 condition also included damages fоr this additional aggravating circumstance. In this connection, it will be necessary for the trial court to re-examine the amounts awarded by it for pain and suffering and to make proper findings of fact and conclusions of law in respect thereto in accordance with this opinion and Rule 52(a). It is clear, as we have stated, that the trial court must deduct from the amount awarded as damages the value of the hospital and medical care rendered to Feeley without charge by the Veterans’ Administration.
Accordingly, the judgment of the court below will be vacated and the cause will be remanded with directions to proceed in accordance with this opinion.
. The district court was, of course, bound by its own circuit court’s decision in Brooks.
Notes
. Feeley v. United States,
. Maxwell, Tlie Collateral Source Rule in tlie American Law of Damages, 46 Minn.L.Rov. 669, 670-71 (1962); see generally Note, Unreason In the Law of Damages: The Oollaterial Source Rule, 77 Harv.L.Rev. 741 (1964) ; 48 Cornell L.Q. 353 (1963).
. Harper & James, Tlie Law of Torts 1343-1344 (1956).
. Note, 63 Harv.L.Bev. 330, 333 (1950).
. See Maxwell, supra note 2 at 689-692; United States v. Price,
. If the state law of damages is punitive, then the state law will not apply and the federal court will adopt a compensatory standard for damages. Massachusetts Bonding & Ins. Co. v. United States,
. See generally authorities cited at notes 2-4, supra. Compare Drinkwater v. Dinsmore,
. Tins situation must be distinguished from the claim for impairment of future earning power, since in that case the plaintiff’s future earning power may be impaired even though there has been no diminisbment in Ms current wages. See Messer v. Beighley,
. “Often of course the intent was never even thought out by the donor, certainly not expressed. In these eases of private generosity the best solution seems to be a rule of thumb that would give greatest scope to the donor’s generosity.”
2 Harper & James, op. cit. supra note 3 at 681; see Note, 77 Harv.L.Rev., supra note 2 at 743-744.
. Maxwell, supra note 2 at 679-680; Note, 77 Harv.L.Rev., supra note 2 at 744.
. See Nelson v. Federal Mogul Service, 27 Pa.Dist. & Co. R.2d 222 (Phila.1962).
. Emphasis added.
. Brooks v. United States,
. The district court’s findings of fact and conclusions of law are unreported. Gray v. United States, No. 3147 (D.Col. Oct. 20, 1951).
. See Gray v. United States, No. 3147 (D.Col. April 20, 1953) (Unreported).
. Hule 52(a) provides, in part, “In all actions tried upon the facts without a jury * * * the court shall find the facts specially and state separately its conclusions of law thereon * *
