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Workers' Compensation

No "Lunacy" Here in Delaware: Employer's Payment of Medical Bills Does Not Create an "Implied Agreement" for Statute of Limitations Purposes

Today is post is compliments of Nancy Chrissinger Cobb.  And spoiler alert-- this case is boring.   Not your usual Harlequin romance of a workers comp scenario..... But that said, it was authored by Chief Hearing Officer Baum and that alone makes it worth perusing.  It's not his fault that the facts were pedestrian

But back to Nancy -

"Here is a decision on the SOL.  Chris Baum writes a nice decision (and not just cause I won) in which he notes that the focus of an "implied Agreement" argument is on the Employer/Carrier's belief.

So what we have is the proposition that not all payment of medical bills by the employer is binding in the sense of enlarging the statute of limitations ["SOL"] of 19 Del. Code Section 2361 from two years to five years.  The case in point is Jose Luna v. Turf Pro, IAB# 1368492 (10/4/110) (ORDER).  As most of you are aware, the SOL is expanded if there is an "implied Agreement" and an "implied Agreement" is created where payment is made by an employer or carrier under "a feeling of compulsion".  And that refers to the feeling that the claim is compensable.

In this case, the facts were dispositive.  Claimant was injured on March 13, 2009, employer reportedly was not aware that the injury was work-related, claimant did not have the money to pay for medical treatment, and in a spirit of cooperation and possibly benevolence, the employer paid the bills.  At that juncture the bills were in collections. The employer then recouped what it termed a "loan" by subsequent payroll deductions from claimant's paycheck.  A DCD Petition was filed by the claimant on May 27, 2011, five months after he was laid off by Turf Pro.

The compulsion issue was analyzed by the Board.  There was a clear understanding between the parties that the medical bill payments were a loan and in fact that was noted on the memo of the checks that were issued to the providers.  The claimant testified that he agreed to this arrangement and to having the funds repaid out of his wages.

The Board also rejected the claimant's argument that this payment was a "payment without prejudice" under Section 2322(h) which failed, for which the remedy was treating the payment as though it were made under a feeling of compulsion. (Now that's a creative argument!)

I applaud Nancy's victory here.   But I don't really see how there ever was a colorable claim of "compulsion."  In fact it would seem that these facts were less disputed than most.  Moreover, this employer testified that it had a practice of assisting its workers with bills in arrears -- such as Sprint, Verizon and Comcast.  Props to Nancy anyway, along with her opponent Joe Jachetti-- they managed to take something about as interesting as a cup of Wawa coffee and give it the Starbucks treatment.

Irreverently yours,
Cassandra Roberts

Delaware Detour & Frolic   Visit Delaware Detour & Frolic, a law blog by Cassandra Roberts

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