Hamilton v. Independent Disposal Service
N16A-06-006 ALR
| Del. Super. Ct. | Feb 15, 2017Background
- In 2002 Hamilton injured his low back at work; Employer accepted the injury and paid benefits, and a 2003 IAB order found Hamilton could perform light/sedentary work and awarded partial disability.
- Hamilton received disability payments pursuant to a 2003 Compensation Agreement through 2009; initial post‑accident imaging showed L5‑S1 normal while L3‑4 had abnormalities.
- In December 2014 Hamilton underwent anterior lumbar fusion for an L5‑S1 annular tear and sought additional compensation for surgery and related disability in a 2015 Petition to the Industrial Accident Board (IAB).
- Employer accepted the surgery as reasonable but disputed causation, offering Dr. Piccioni who testified the L5‑S1 tear did not visualize until 2012 and likely resulted from intervening events or wear‑and‑tear; Hamilton’s experts (Drs. Balu and Zaslavsky) attributed the tear to the 2002 work injury.
- Hamilton also argued an implied agreement/payment‑by‑compulsion theory based on Employer’s past payments for injections targeted to L5‑S1; the IAB found inadequate notice to Employer and, on the merits, insufficient evidence that Employer knowingly paid for L5‑S1 treatment under a feeling of compulsion.
- The IAB denied Hamilton’s petition (Jan. 21, 2016) and motion for reargument (May 13, 2016). The Superior Court affirmed, denied Employer’s motion to strike appellate exhibits, and upheld the IAB’s factual findings and legal conclusions.
Issues
| Issue | Hamilton's Argument | Employer's Argument | Held |
|---|---|---|---|
| Whether the L5‑S1 annular tear/surgery was causally related to the 2002 work injury | The L5‑S1 tear resulted from the 2002 workplace injury and progressively worsened until surgery | The L5‑S1 tear did not appear until 2012 and is attributable to intervening incidents or degenerative change | Court affirmed IAB: substantial evidence supports crediting Employer's expert; causation not proven to reasonable medical probability |
| Whether prior payments created an implied agreement (payment by compulsion) that made L5‑S1 treatment/surgery compensable | Employer’s long history of paying disability and injections shows it accepted liability for L5‑S1 treatment | Payments alone insufficient; records/bills did not clearly notify Employer that payments were for targeted L5‑S1 care | Court affirmed IAB: Hamilton failed to show Employer paid under a feeling of compulsion or had actual knowledge payments targeted L5‑S1 |
| Whether res judicata / collateral estoppel from the 2003 IAB decision barred relitigation of causation in 2015–2016 | The 2003 decision established the work accident as the cause of claimant’s back injury and precludes relitigation | The 2003 proceeding addressed disability status in 2003; later causation for a 2014 surgery involves distinct facts (new evidence/intervening events) | Court: doctrines inapplicable — 2003 and 2016 issues are different; later facts (visualization in 2012, intervening incidents) support reexamination |
| Whether appellate consideration of exhibits not admitted below (motion to strike) was proper | Hamilton asked the court to consider exhibits supporting the implied‑agreement theory that were presented to the IAB or in post‑trial filings | Employer moved to strike exhibits not formally admitted at the IAB, arguing appellate review is limited to the record | Court denied motion to strike: materials were presented to and considered by the IAB during hearing and in post‑trial filings, thus are properly before the Superior Court |
Key Cases Cited
- Glanden v. Land Prep, Inc., 918 A.2d 1098 (Del. 2007) (standard of appellate review: substantial evidence supports agency factfinding)
- LaPoint v. AmerisourceBergen Corp., 970 A.2d 185 (Del. 2009) (elements and transactional approach to res judicata)
- Andreason v. Royal Pest Control, 72 A.3d 115 (Del. 2013) (test for implied agreement/payment by compulsion is fact‑specific; payment under a feeling of compulsion required)
- Starun v. All Am. Eng’g Co., 350 A.2d 765 (Del. 1975) (recognizes implied agreements in workers’ compensation context but payments alone are insufficient)
- Delaware Elec. Co‑op, Inc. v. Duphily, 703 A.2d 1202 (Del. 1997) (appellate courts generally review only matters considered by the trial court; materials considered below may be part of the appellate record)