Padgett v. R&F Metals, Inc.
S20A-11-003 RHR
| Del. Super. Ct. | Jun 30, 2021Background
- Claimant Michael Padgett injured his lower back at work on November 18, 2016; he has undergone five back surgeries since that accident. The first four surgeries were either admitted compensable by Employer or found compensable by the IAB. The fifth surgery (performed June 25, 2020) is the subject of dispute.
- Employer filed a Petition for Review in January 2020 seeking termination of benefits; Claimant filed a Petition to Determine Additional Compensation Due in March 2020 to establish compensability for the planned fifth surgery. Claimant had the fifth surgery before the IAB resolved those petitions.
- The IAB held a hearing on October 15, 2020 and issued a decision on October 28, 2020 finding the June 2020 surgery and related expenses were not reasonable, necessary, or causally related to the 2016 work injury; the IAB also granted Employer’s Petition to Terminate Benefits (that termination ruling was not appealed).
- Key medical testimony: Dr. James Zaslavsky (Claimant’s surgeon) supported the necessity of the fifth surgery; Dr. Stephen Fedder (Employer’s expert) opined Claimant had no identifiable lumbar ‘‘pain generator,’’ appeared neurologically normal after the fourth surgery, and that Claimant’s opiate use was driving his complaints.
- The IAB credited Dr. Fedder and discredited aspects of Claimant’s testimony (including inconsistency about trust in treatment and narcotics weaning), concluding medical evidence did not link the fifth surgery to the 2016 workplace injury.
- The IAB also found intervening accidents after the fourth surgery (a dog-attack fall causing increased back pain and a separate incident where Claimant was run over and injured his leg) sufficiently broke any causal chain from the 2016 work injury to the 2020 surgery.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the June 2020 (fifth) surgery was reasonable, necessary, and causally related to the Nov. 2016 work injury | Padgett: the fifth surgery was compensable as a direct result of the 2016 work injury | R&F Metals: medical evidence shows no lumbar pain generator; opiate dependence and intervening events explain symptoms; surgery not work-related | Court affirmed IAB: surgery not reasonable/necessary or causally related to 2016 injury |
| Whether the IAB applied the proper causation ("but-for") standard | Padgett: IAB failed to apply the but-for causation test | R&F Metals: IAB applied but-for and found intervening accidents broke causation | Court: IAB applied but-for; intervening accidents severed causal link; affirmed |
| Whether the IAB's credibility findings are supported by substantial evidence | Padgett: IAB's conclusion lacks substantial evidence and misweighed medical testimony | R&F Metals: IAB reasonably credited Employer's expert and discounted Claimant and surgeon where inconsistent | Court: substantial evidence supports IAB's credibility determinations; appellate court defers to Board |
Key Cases Cited
- DiSabatino Bros. v. Wortman, 453 A.2d 102 (Del. Supr. 1982) (standard of appellate review of administrative decisions)
- Washington v. Del. Transit Corp., 226 A.3d 202 (Del. 2020) (definition and application of "substantial evidence")
- Clements v. Diamond State Port Corp., 831 A.2d 870 (Del. 2003) (deference to Board on witness credibility and weight of testimony)