Opinion
C.A. 03A-10-001 PLA.
Submitted: September 24, 2004.
Decided: October 6, 2004
Upon Appeal from a Decision of the Industrial Accident Board Affirmed.
Fred Barakat, Esquire, Wilmington, Delaware, Attorney for Employee-Appellant.
Francis X. Nardo, Esquire, Tybout, Redfearn Pell, Wilmington, Delaware, Attorney for Employer-Appellee.
ORDER
On this 5th day of October, 2004, it appears to the Court that:
1. This is an offshoot of a litigation saga that has reappeared before this Court, in one form or another, several times over the last decade. In 1995, Appellant David Clark was injured while working for Appellee Corporate Interiors of Delaware ("CI"). The parties agree that Clark fell between a loading dock and a defective dock plate, exacerbating an injury to his right hip. The hip was already damaged at the time of the accident due to Clark's lifelong battle with sickle cell disease and a car accident that he had a few months before. The sickle cell disease had caused bone necrosis in Clark's hip, meaning that the bone had begun to die inside of him for lack of oxygen, becoming brittle and frail.
2. Clark originally sued several parties for product liability, premises liability, and negligence ("Prior Action"). Through an astounding combination of his attorney's lack of preparation and his own contempt for the judicial process, Clark earned himself a dismissal in that case. His only possible avenue for relief thus became a workmen's compensation claim against CI before the Industrial Accident Board ("IAB" or "Board").
Clark v. E.I. Dupont de Nemours and Company, et. al., 2001 WL 1482831 (Del.Super.), aff'd, 795 A.2d 667 (Del. 2002).
In 1997, rather than defend the claim before the IAB, CI entered a "Commutation Agreement" to settle with Clark for $85,000. This settlement represented a substantial discount of Clark's likely total disability entitlement (estimated at $200,000) in exchange for an upfront payment. The Commutation Agreement contains a clause, the meaning of which the parties dispute. It reads:
The parties agree that the above settlement does not relieve the workmen's compensation carrier [CI] of responsibility for paying medical expenses that are reasonable, necessary, and related to claimant's work injury. Causation with respect to the condition in the right hip is accepted by the carrier.
CI believes this clause reserved its right to challenge whether any individual medical procedure was reasonably related to the accident. Clark believes this clause admits that any problem with the right hip was legally caused by the accident (under the "eggshell skull plaintiff" doctrine), and therefore that any procedure on the right hip is uncontestable. The IAB approved the Commutation Agreement, including the disputed clause.
3. Clark underwent an elective hip replacement in 2001. Clark attempted, in various ways, to tack the bill for the surgery onto the Commutation Agreement, but the Board refused to allow him to do so. Instead, the Board conducted a hearing to determine whether the surgery was reasonably related to the workplace accident. In doing so, the Board adopted CI's reading of the Commutation Agreement.
The elective nature of this surgery and Clark's reasons for choosing to do at that particular time are thoroughly explored in this Court's opinion in the Prior Action.
The Board heard extensive testimony at the hearing from Drs. Dawson, Bodenstab, and Geller. Drs. Dawson and Bodenstab agreed that the accident had seriously exacerbated Clark's existing hip injury, and thus caused the need for hip replacement surgery. Dr. Geller, who was hired by CI, opined that the sickle cell disease caused the "need" for the hip replacement, and would have done so regardless of the accident. The Board found that the opinions of Drs. Dawson and Bodenstab were credible. The Board was "less impressed" with the testimony of Dr. Gelman, which it ultimately rejected. The Board therefore ordered CI to pay the nearly $20,000 hospital bill for the surgery, as well as fees. CI has not appealed this order.
Appellee's Ans. Br. Ex. B, Tr. of Petition to Determine Additional Compensation Due, Industrial Accident Board Hearing No. 1093762 ( hereinafter "Tr. at ___") at 7.
Id.
4. More significant to this case, however, are two other actions by the Board. The first has already been mentioned: the Board accepted CI's reading of the Commutation Agreement and ordered a hearing about the hip replacement surgery. Clark believes that CI's demand for a hearing repudiated the Commutation Agreement, and that it should therefore be rescinded. Clark also argues that rescission will entitle him to the $200,000 that he bargained away at settlement, although he never explains why that would be.
Clark's second complaint is that the IAB refused to consider numerous other bills that are allegedly related to the surgery. The Board explained itself as follows: "the Board feels Claimant submitted insufficient, disorganized evidence as to any other physician or medical bills." The Board later repeated its dissatisfaction with Clark's attorney's preparation by refusing to grant his requested fee award, saying "it is noted that the Claimant's case was presented in a somewhat disorganized fashion which ( sic) weighs against a twenty-four hour preparation award." Clark believes that it is unfair that the Board did not comb through his jumbled submission to compensate him for these other bills.
Id. at 8.
Id. at 9.
5. Each of Clark's claims lack merit. The Commutation Agreement does not amount to a blank check for Clark's medical treatment, so long as "right hip" is written in its subject line. There is no conceivable purpose for including the qualifiers "reasonable, necessary, and related to claimant's work injury" in the Commutation Agreement if the parties intended that all of Clark's future medical bills would be CI's responsibility. The Board's interpretation of the Agreement is not only reasonable and supported by substantial evidence, it is the only one that would not write the qualifying language out of the contract.
Nor do I accept the argument that the phrase "[c]ausation with respect to the condition in the right hip is accepted" provides carte blanche to Clark to pursue any medical treatment he chooses, without review by any judicial body. Under that interpretation, CI could be responsible for bills for aroma therapy, massage, or sundry quack treatments, with no recourse. Instead, I interpret the above quoted language to mean that CI accepts that it is legally responsible for Clark's injury, and must compensate him for treatments, but only those that are reasonably related to it.
6. I also cannot conclude that the Board erred as a matter of law in refusing to consider Clark's other medical bills. Finders of fact have broad discretion as to what evidence to admit. Moreover, this Court has no power to review IAB determinations of credibility, or to make its own factual findings.
Kumho Tire Company v. Carmichael, 526 U.S. 137, 151 (1999).
Johnson v. Chrysler Corp., 213 A.2d 64, 66-67 (Del. 1995).
Clark submitted a stack of twelve one-page bills from Good Samaritan Hospital in Elkton, MD, totaling about $5800. The bills themselves contained no explanation as to how they were related to the surgery. Eleven of the twelve bills appear to be hospital documents meant for purely internal use, in that they list only a price, date of service, and numerical code for the procedures, without any explanation of what the codes signify. This information is mistyped over other text on four of these bills, making them practically illegible. The bills also contain numerous minor typographical errors such that the dollar amounts for the line items do not reconcile with the totals. Dr. Dawson apparently made a blanket statement that all of the bills were reasonably related to the surgery, but only half of the bills had come through his office. The Board found that this evidentiary submission was not sufficiently credible to justify requiring payment by CI.
Clark does not offer any explanation as to why he submitted the bills in this indecipherable fashion. Clark offered one bill from the same hospital that is actually usable, stating in plain English the procedure to which it applied, i.e. an X-ray of Clark's hip. If the hospital had this one bill available in an external-use format, it almost certainly could have printed out similar bills for the remaining procedures, all of which were performed at the same hospital around the same time.
It appears that Clark's attorney asked either his client or the hospital for the wrong documentation, and then tried to shift the responsibility for this mistake onto the Board. Clark implies that the Board was too lazy to consider his relevant, understandable evidentiary submission. The record simply does not support this charge. A far more plausible explanation is that Clark's attorney did not adequately prove his case. Indeed, the Board made an express finding to that effect when it reduced his requested fee award. In any event, the credibility of the bills was an issue within the sole discretion of the Board, and I cannot, and will not, disturb it.
Appellants Reply Br. at 8 ("The Board rejection of the unopposed damages testimony and evidence because 12 one page bills were too burdensome form the Board to consider was abuse of discretion and plain error of law.")
See e.g. Johnson, 213 A.2d at 66.
7. For these reasons, the decision of the Industrial Accident Board is AFFIRMED.