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Ralyea v. KF Environmental Tech2/28/2005
the requirements of 19 Del. C. ยง 2322(b) because he did not first request medical treatment from the employer before seeking treatment on his own.
Section 2322(b) permits the employee to seek medical treatment on his own only after the employer "upon application made to the employer, refuses to furnish the services." The language of Section 2322(b) states the general principle that "the employee should ordinarily not incur medical expenses without first giving the employer a reasonable opportunity to furnish such services, and an employee who does so will be liable for that expense."
The purpose behind this notice requirement is to protect the employer against unreasonable charges and possible fraudulent claims. The employer must have "some knowledge of accompanying facts connecting the injury or illness with the employment, and indicating to a reasonably conscientious manager that the case might involve a potential compensation claim."
The employee need not give formal notice in order to recover as long as the employer has "sufficient knowledge of the injury ." Once the employee has "furnished the employer with the facts of the injury" the employer must then instruct the employee on how to seek treatment.
Section 2322(b) was part of the original workers' compensation statute which required the employer to pay the employee's medical expenses during only the first 30 days after the accident, and provided that upon the employer's refusal to do so, the employee could obtain medical treatment and recover the cost thereof from the employer. The Board, upon application, was authorized to require the employer to furnish medical treatment for an additional period of time. Section 2322(b) does not expressly say that a claimant who fails to obtain a prior refusal from the employer is barred from recovering for reasonable and necessary medical treatment. Here the employer was aware of the work-related injury and had paid some workers' compensation benefits. I have carefully reviewed the record below, including the arguments of counsel for the employer, and I find nothing to indicate that the reasonableness of the medical expenses or their relationship to the compensable injury was in question. I think that where the record shows that the employer was aware that a work-related injury had occurred, and the employer relies upon section 2322(b) as a basis for refusing to pay for the employee's treatment, the employer should identify some prejudice, or some knowing failure of the employee to follow company policy, or some other circumstances sufficient to justify relieving it of the obligation to pay for the employee's medical treatment. No such prejudice or other circumstances are alleged here, and I find that on the record in this case, Section 2322(b) is not a defense to the claimant's petition.
CONCLUSION
For the foregoing reasons, the decision of the Board is reversed, and the case is remanded to the Board for further proceedings consistent with this opinion.
IT IS SO ORDERED.
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