Davis v. Christiana Care Health Servs., C.A. No. N14A-05-012 (Del. Super. Feb. 27, 2015).
The Superior Court holds that an approved Medical Only Agreement specifying that an injury has resolved does not preclude a claimant from seeking benefits that may arise in the future.
The claimant, Kenneth Davis, sustained a compensable injury to his low back when he slipped and fell in the scope of his employment on August 21, 2012. The employer agreed to acknowledge the work accident and recognize a “lumbar spine contusion, resolved” pursuant to a medical only agreement and a final receipt that were filed with the Board. Eight months later, the claimant filed a Petition to Determine Additional Compensation Due, seeking permanent impairment benefits for the injury to the lumbar spine. The Board granted the employer’s motion to dismiss the permanency petition and concluded that the medical only agreement precluded a later permanency claim by providing that the lumbar spine contusion had “resolved.”
The claimant appealed the decision to the Superior Court. The Superior Court examined the language of the settlement correspondence between the parties as well as the agreement, itself, and held that it was unreasonable for the Board to broadly interpret “resolved” to mean that the claimant was precluded from raising any and all future claims for work-related benefits. The Court referred to 19 Del. C. § 2358(a)’s commutation provision as the only appropriate mechanism to achieve a resolution of the entirety of a workers’ compensation claim. The Court further held that the Board was required to hear medical evidence regarding whether Claimant suffered permanent impairment as a result of the work accident. In support of that holding, the Court opined that the permanency determination was separate and apart from the reasonable, necessary and related determination applicable to medical treatment and that the permanency issue had never been litigated and was not barred by the doctrines of res judicata or collateral estoppel. Lastly, the Court found Chavez v. David’s Bridal, 979 A.2d 1129, 1134 (Del. Super.), aff’d, 950 A.2d 658 (Del. 2008), to be inapposite to and distinguishable from the facts of the instant case.
Ultimately, the Court held that, besides in the commutation context, the Workers’ Compensation Act “does not contemplate closing the door on a claimant’s ability to seek benefits to which he may be entitled to receive before his claim for said benefits ripens.” The Board’s decision was reversed and remanded.