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affirming the Board's denial of claimant's petition even though the Board allegedly failed "to consider whether the payment of medical bills for over four years constituted an implied agreement to provide compensation"
Summary of this case from Bermudez v. PTFE Compounds, Inc.Opinion
C.A. No. 99A-04-011.
Date Assigned: October 4, 1999.
Date Decided: March 16, 2000.
On Appeal from the Industrial Accident Board.
DENIED
Vivian Medinilla Longo, Esquire, Wilmington, DE, Attorney for the Appellant.
Robert N. Ralston, Esquire, Wilmington, DE, Attorney for the Appellee.
OPINION AND ORDER
The matter before the Court concerns an appeal by Neftale Garcia ("Claimant") of the March 19, 1999 decision of the Industrial Accident Board denying the Claimant's petition for additional compensation benefits.
FACTS
At all times relevant to this matter, the Claimant was employed by E. I. DuPont DeNemours Company. (Bd. Hr'g Tr. at 34.) His duties included washing boxes, chaining animals to different cages, clearing the floors, and bleeding animals. (Bd. Hr'g Tr. at 15.) While working at the DuPont Company's Glenolden, Pennsylvania Research Development Laboratory on August 18, 1994, the Claimant injured his right elbow. At that point in time, he had been working at that site for five years. It is undisputed that the DuPont Company paid all medical bills arising out of that accident. (Bd. Dec. at 2.)
The Claimant continued to work at the Glenolden site until December, 1995, when he was transferred to the DuPont Company's Experimental Station in Wilmington, Delaware. On July 22, 1996, the Claimant suffered an injury to his left shoulder while working at that facility. Again, the DuPont Company paid the medical and related expenses which resulted from the accident.
Following the 1994 accident, the Claimant sought medical attention from Dr. Leo W. Raisis for right elbow pain. (Bd. Hr'g Tr. at 56.) He diagnosed the Claimant with right elbow synovitis related to work activities and treated him with injections followed by surgery in December of 1995. (Bd. Hr'g Tr. at 58.) He was released to work as of January 29, 1996, but began seeing Dr. David T. Sowa in August of that year when he started experiencing left shoulder pain following the July, 1996 accident. Id. Dr. Sowa and Dr. Raisis determined that the Claimant suffered from left shoulder impingement syndrome and prescribed surgical treatment which took place in August, 1997.
Dr. Raisis was unavailable at the time. He and Dr. Sowa were associated together in the practice of medicine.
The Claimant was first released by Dr. Raisis to return to work as of January 29, 1996. See (Raisis Dep. at 7.) After his July, 1996 injury, he was allowed to return to work by Dr. Raisis on January 7, 1997. This time, however, he was advised against repetitive use of his right elbow as well as repetitive use of his left shoulder above shoulder level. (Raisis Dep. at 12.) With the exception of one other period of time, from March 31, 1998 until May 6, 1998, the Claimant was deemed able to work by Dr. Raisis, albeit with the aforementioned restrictions.
The Claimant saw Dr. Raisis for recurring symptoms in his left shoulder and right elbow intermittently during the period of time between his 1994 injury through February, 1999. By September, 1998, notwithstanding some improvement, the injuries from both accidents continued to bother him. Shortly thereafter, Dr. Raisis opined that the Claimant had stabilized but a ten percent (10%) permanent impairment of his right upper extremity and a ten percent (10%) permanent impairment of his left upper extremity. (Raisis Dep. at 21.)
The Claimant was also evaluated by Dr. Andrew Gelman, who saw him on two occasions at the behest of the DuPont Company Co. Dr. Gelman also felt that the Claimant was capable of working a "light duty" type job on a full time basis. Lastly, the doctor opined that the Claimant suffered a ten percent (10%) permanent impairment of his right elbow.
On October 9, 1998, the Claimant filed a Petition to Determine Additional Compensation Due based upon the ten percent permanent impairment and disfigurement of his right elbow incurred as a result of the 1994 Pennsylvania accident. The Claimant also sought compensation for an ongoing total disability which commenced on March 31, 1998 arising out of the 1996 injury. The DuPont Company opposed the petition.
The hearing was held on March 19, 1999. The Board found that pursuant to 19 Del. C. § 2303 (b), it lacked jurisdiction over the Claimant's request for permanent impairment and disfigurement benefits arising out of the 1994 work accident because the petition was filed more than two years after that injury. (Bd. Dec. at 5.) The Board also held that there was no evidence that the 1996 injury resulted in or caused whatever disability the Claimant had suffered, if any, as a result of the 1996 injury. As a consequence of those holdings, the Claimant's petition was denied.
In relevant part, Section 2303 reads:
(a) If an employee, while working outside the territorial limits of this State, suffers an injury on account of which the employee, or in the event of the employee's death the employee's dependents, would have been entitled to the benefits provided by this chapter had such injury occurred within this State, such employee, or in the event of the employee's death resulting from such injury the employee's dependents, shall be entitled to the benefits provided by this chapter, provided that at the time of such injury:
(1) The employee's employment is principally localized in this State; or
(2) The employee is working under a contract of hire made in this State in employment not principally localized in any state; or
(3) The employee is working under a contract of hire made in this State in employment principally localized in another state whose workers' compensation law is not applicable to the employee's employer; or
(4) The employee is working under a contract of hire made in this State for employment outside the United States and Canada.
(b) The payment or award of benefits under the workers' compensation law of another state . . . shall not be a bar to a claim for benefits under this chapter, provided that claim under this chapter is filed within 2 years after such injury. . . .
Contrary to what his attorney stated before the Board, the Claimant did not request additional compensation due for a recurrence of a partial disability pursuant to 19 Del. C. § 2325. The Board did not address such a claim presumably for that reason. See Bd. Hr'g Tr. at 4 to 5; and Garcia v. E. I. DuPont DeNemours Co., Hearing No. 1092673, Pet. to Determine Add'l Comp. Due (Oct. 8, 1998).
On August 3, 1999, the Claimant filed the instant appeal citing two errors. First, he argued that the Board erred as a matter of law in applying 19 Del. C. § 2303 (b) by failing to consider whether the payment of medical bills for over four years constituted an implied agreement to provide compensation, thereby tolling the two-year statute of limitations contained therein. Second, the Board erred in requiring him to prove that the 1996 injury was the sole cause of his disability in order to be eligible for an award of total disability benefits. The DuPont Company continued to oppose the Claimant's efforts to obtain compensation, contending that the Board properly interpreted and applied the relevant provisions of the Workmen's Compensation Act.
DISCUSSION
On appeal from a decision of the Industrial Accident Board this Court's review is limited to determining whether there is substantial, competent evidence of record to support the Board's decision, and whether it is free from legal error. Stoltz Management Co. v. Consumer Affairs Bd., Del. Supr., 616 A.2d 1205 (1992); and 29 Del. C. § 10142 (d). On questions of fact, deference is given to the experience and specialized competence of the Board. Id. The Court reviews the entire record to determine if, based on the evidence, the Board could fairly and reasonably have reached the conclusion that it did.National Cash Register v. Riner, Del. Super., 424 A.2d 669, 674-675 (1980).
The Claimant argues that 19 Del. C. § 2361 (b) applies to the case at bar and not 19 Del. C. § 2303 (b) because the DuPont Company elected to pay benefits under Delaware Workers' Compensation laws and not those of Pennsylvania. The DuPont Company has therefore reached an agreement with the Claimant and the five year limitations period of Section 2361 was triggered. Stated differently, he argues that the claim was removed from the bar of the two-year statute of limitations set forth in Section 2303(b) when the DuPont Company began to pay compensation for injuries sustained as a result of the 1994 accident. As a result, the Claimant then had five years to file a claim in Delaware if necessary. He did so in 1998, therefore the Board did have jurisdiction. Cited in support of that proposition here and before the Board were New Castle v. Goodman, Del. Supr., 461 A.2d 1012 (1983); Starun v. All American Engineering Co., Del. Supr., 350 A.2d 765 (1975); and McCarnan v. New Castle County, Del. Super., C. A. No. 858-JL-18, Martin, J. (May 2, 1996). Unfortunately for the Claimant, the Court disagrees.
19 Del. C. § 2361 (b) reads: Where payments of compensation have been made in any case under an agreement approved by the Board or by an award of the Board, no statute of limitation shall take effect until the expiration of 5 years from the time of the making of the last payment for which a proper receipt has been filed with the Department.
The Claimant also argues that the benefits paid fall under the Delaware workers compensation benefits because they would not qualify as Pennsylvania benefits. However, this argument does not make clear how jurisdiction could be waived when the applicable statute indicates that the requirements of Section 2303(a) must be met before the two-year statute of limitations in Section 2303(b) is applicable.
Where a work related injury takes place outside the geographical boundaries of the State of Delaware, an employee can still seek compensation under the Delaware Workers' Compensation Act. However, he or she must meet the requirements of Section 2303(a) (b). Section 2303(a) specifies what conditions have to be met in order to be eligible for benefits in this state. Section 2303(b) states that the fact that an injured employee has received benefits under the workers' compensation laws of another state will not terminate that eligibility where the employee has filed a claim in Delaware within two years of the injury. That subsection also provides a dollar for dollar set off of the out-of-state benefits against any benefits received under the Delaware Workers' Compensation Act, presumably to avoid a double recovery and/or forum shopping. Coen v. Ambrose-Augusterfer Corp., Del. Supr., 463 A.2d 265 (1983); and 19 Del. C. § 2303. However and again, eligibility for benefits where the injury occurs out of state must first be established via Section 2303(a).
(a) If an employee, while working outside the territorial limits of this State, suffers an injury on account of which the employee, or in the event of the employee's death the employee's dependents, would have been entitled to the benefits provided by this chapter had such injury occurred within this State, such employee, or in the event of the employee's death resulting from such injury the employee's dependents, shall be entitled to the benefits provided by this chapter, provided that at the time of such injury:
(1) The employee's employment is principally localized in this State; or
(2) The employee is working under a contract of hire made in this State in employment not principally localized in any state; or
(3) The employee is working under a contract of hire made in this State in employment principally localized in another state whose workers' compensation law is not applicable to the employee's employer; or
(4) The employee is working under a contract of hire made in this State for employment outside the United States and Canada.
(b) The payment or award of benefits under the workers' compensation law of another state . . . shall not be a bar to a claim for benefits under this chapter, provided that claim under this chapter is filed within 2 years after such injury . . . 19 Del. C. § 2303.
At first glance, this dispute appears to be more complicated than it in fact is, if the respective positions of the parties and the decision of the Board are to be accepted regarding one critical conclusion. Specifically, all seem to agree that the Claimant did not meet the threshold requirements of Section 2303(a). That being the case and the Court having examined the record and unable to come to a different conclusion, it follows that the Board did not have jurisdiction over the 1994 injury since it took place in Pennsylvania. It therefore does not matter why or pursuant to whose schedule of benefits the DuPont Company paid the resultant expenses if the petition could not be filed here in any event. Stated differently, unless the Claimant complied with Section 2303(a), he had no recourse under the Delaware Workers' Compensation Law for that injury.
The record indicates that the Claimant never attempted to establish jurisdiction under Section 2303(a) at the hearing before the Board.
Unless a statute is ambiguous or subject to interpretation, this Court is bound by the plain language of the statute. State v. Cooper, Del. Supr., 575 A.2d 1074, 1075 (1990). "It is fundamental that the courts ascertain and give effect to the intent of the General Assembly as clearly expressed in the language of the statute. There is judicial discretion to construe a statute when its language is obscure and ambiguous, but when no ambiguity exists, and the intent is clear from the language of the statute, there is no room for statutory interpretation or construction." Giuricich v. Emtrol Corp., Del. Supr., 449 A.2d 232, 238 (1982).
Section 2303 is clear on its face and does not allow either side to ignore its commands. The cases relied upon by the Claimant, as the Board found, are not applicable to this dispute. Those cases involved injuries which took place in Delaware and over which the Board had jurisdiction. The Board therefore reached the correct result as a matter of law, although its opinion seemed to be more focused on Section 2303(b) than Section 2303(a), when the Board ruled that it lacked jurisdiction over the Claimant's petition for permanent impairment and disfigurement benefits arising out of the 1994 work accident. (Bd. Dec. at 5 to 6.)
The Claimant also argues that the Board erred as a matter of law in holding that the Claimant was required to prove through expert medical testimony that any total disability he might have suffered was "causally related to the 1996 work related injury", and that he did not meet his burden of proof in this regard. (Bd. Dec. at 6.) At first glance, this argument has some appeal. However, a more sustained examination reveals that it is not persuasive.
First, it is a correct statement of the law that in order for the Claimant to establish his entitlement to compensation, he must prove that he suffered a compensable injury which in turn proximately caused him to be totally disabled. State v. Steen, Del. Supr., 719 A.2d 930, 935 (1998). And, he must establish the existence of the disability as well as the nexus between it and the injury by means of expert medical testimony. Id. In this case, the only injury for which compensation was available was the 1996 injury. Consequently, the Claimant was required to demonstrate what resulted from that injury.
Second, the record reflects the testimony of Drs. Raisis and Gelman, who attribute the resulting limitations to both the 1994 and 1996 injuries. However, neither doctor indicated that the Claimant was totally disabled as a result of the 1996 injuries. Indeed, the most favorable testimony was provided by Dr. Raisis in that regard when he indicated that the Claimant was unable to work from March 31 to May 6, 1998, but did not differentiate between the causal effects of either set of injuries. Dr. Gelman, on the other hand, saw the Claimant on November 28, 1997 and January 19, 1999. At both points in time he felt that the Claimant could engage in light duty work. The Board was free to accept or reject the testimony in whole or in part of either physician. See Holden v. State, Del. Super., C.A. No. 93A-07-021, Bifferato, J. (March 1, 1994) at 5 to 6. It apparently did so.
Based upon the record, the Court must find that there was substantial evidence to support the Board's decision and it correctly applied the applicable law when it found that the Claimant failed to prove his total disability was caused by or resulted from the 1996 accident and injury. While the decision may not have used the most artful language ever employed in resolving a claim for such benefits, it is sufficient for present purposes.
CONCLUSION
For the reasons stated above, the Court must conclude that there is substantial evidence to support the findings of the Board and that the Board did not err as a matter law. The Industrial Accident Board's decision must therefore be affirmed.
IT IS SO ORDERED.