The Superior Court recently confirmed a decision that denied a petitioner’s request for increased medical bill payments for ketamine infusions under the theory that the Delaware Fee Schedule doesn’t apply. The petitioner argued that the Board should compel payment of the “reasonable cost” of treatment rather than the limited payment prescribed under the fee schedule. The case, Taylor v. State of Delaware (N22A-09-007 CLS), centered on the treatment of Ms. Taylor’s Complex Regional Pain Syndrome (CRPS).
Ms. Taylor was injured in a compensable work accident on September 16, 2016, and eventually developed CRPS involving her right arm and leg. The injury led to her receiving ketamine infusion treatments that were performed at a surgery center in Pennsylvania. As these treatments are typically expensive, she filed a petition seeking approval for increased payments to cover their cost.
However, the Court upheld the claim denial, maintaining that the provisions of the Delaware Fee Schedule apply. Its affirmation of the decision may set a precedent for future cases where claimants seek approval for increased medical bill payments outside of the stipulated fee schedule.
For more detailed information about the case, the Superior Court’s findings, and its potential implications, check the full court document available at JD Supra.
This case exemplifies the continuous legal debates surrounding workers’ compensation payments, the application of fee schedules, and what constitutes “reasonable cost” in the context of medical treatments. Legal professionals, particularly those dealing with workers’ compensation cases, should pay close attention to such developments as they can have significant implications for their practice and their clients.