Relying on Delaware Superior Court memorandum opinion that determined the Industrial Accident Board correctly decided to terminate total disability benefits following a total knee replacement, Delaware Supreme Court affirms Boards’ decision.
The claimant suffered from rheumatoid arthritis for approximately 20 twenty years and required biological medications to treat pain, swelling and stiffness in his joints. Despite these symptoms, he was able to perform his job as a construction worker. On July 26, 2017, the claimant fell at work and tore the meniscus in his left knee. He developed a staph infection after undergoing an aspiration and injection of the knee, resulting in several surgeries. He also had to discontinue his biological medications in order to take antibiotics. He underwent total knee replacement surgeries of the right knee in October 2022 and left knee in January 2023. Initially, the employer denied that the total knee replacements were related to the work accident. The claimant filed a petition that sought compensability of the surgeries and ongoing total disability benefits after the procedures. Before the hearing, the employer accepted the left knee surgery.
The Industrial Accident Board decided that the right total knee replacement was compensable. However, the Board also accepted the testimony of the employer’s medical expert that the claimant could return to work in a sedentary duty capacity. It was determined that the claimant was no longer entitled to total disability benefits and would receive temporary partial disability benefits beginning July 28, 2023, with the rate based on a labor market survey from the employer’s vocational expert. The claimant challenged the decision to terminate total disability.
On appeal, the Superior Court held that the Industrial Accident Board acted within its legal authority when it accepted the opinions of the employer’s medical expert over those of the claimant’s two medical experts’. It emphasized that the claimant’s experts had not seen him after his surgeries, unlike the employer’s expert. Moreover, the treating surgeon (who did not testify) documented improvement and the rheumatologist’s decision to not resume orthobiologic medications was indicative of overall improvement following the surgeries. The claimant, himself, testified that he felt pretty good and able to perform several activities of daily living. All of this was sufficient to show that the Board’s decision, that the claimant was able to return to sedentary work, was supported by substantial evidence.
The decision was affirmed by the Delaware Superior Court and again by the Supreme Court for the reasons outlined in the Supreme Court’s opinion.
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