Case Title: Clements v. Diamond State Port Corp.

Citation: 

Docket Number: 51, 2003

State: delaware

Court: Delaware Supreme Court

Date: 2003-08-14T00:00:00Z

Document:
IN THE SUPREME COURT OF THE STATE OF DELAWARE 
 
DAVID CLEMENTS, 
 
 
§ 
 
 
 
 
 
 
 
§ 
No. 51, 2003 
 
Appellant Below,  
 
§ 
 
 
Appellant,  
 
 
§ 
 
 
 
 
 
 
 
 
 
 
§ 
Court Below – Superior Court   
 
v. 
 
 
 
 
§ 
of the State of Delaware,  
 
 
 
 
 
 
§ 
in and for New Castle County  
DIAMOND STATE PORT CORP.,  §  
C.A. No. 02A-04-008  
 
 
 
 
 
§ 
 
Appellee Below,  
 
§ 
 
Appellee. 
 
 
 
§ 
 
Submitted:  May 20, 2003  
Decided:  August 14, 2003  
 
Before VEASEY, Chief Justice, HOLLAND and STEELE, Justices. 
 
 
Upon appeal from the Superior Court.  Affirmed in part, Reversed in 
part, and Remanded. 
 
Glenn C. Ward, Esquire, of Ramunno, Ramunno & Scerba, P.A., 
Wilmington, DE, for Appellant.  
 
Francis X.D. Nardo, Esquire and Susan A. List, Esquire, of Tybout, 
Redfearn & Pell, Wilmington, Delaware, for Appellee.  
 
 
 
 
 
 
HOLLAND, Justice: 
 
2 
 
This is an appeal from a judgment of the Superior Court.  That 
judgment affirmed a decision of the Industrial Accident Board (the 
“Board”).  The Board terminated the total disability benefits of David 
Clements (the “Claimant”) retroactive to the date that Diamond State Port 
Corporation (the “Employer”) filed a Petition to Terminate Benefits.  
Nevertheless, the Board did award the Claimant partial disability and expert 
witness fees. 
 
The Claimant raises four issues for review on appeal to this Court. 
First, that the Board erred, as a matter of law, in concluding that the 
Employer’s medical expert was better qualified than his treating physician to 
determine if the Claimant was risking further neurological damage by 
returning to work within restrictions.  Second, that the Board’s finding that 
the Claimant misled the treating physician regarding his condition and, 
therefore, the Claimant could not rely on the treating physician’s total 
disability order constitutes an error of law and is not supported by 
substantial competent evidence.  Third, that the Board erred, as a matter of 
law, when it terminated the Claimant’s total disability benefits retroactive to 
the date the Employer’s termination petition was filed.  Fourth, in the 
alternative, that the Board’s decision to terminate the Claimant’s total 
 
3 
disability benefits retroactive to the date of the filing is not supported by 
substantial competent evidence. 
Board Proceedings 
 
On September 24, 2001 (“date of filing”), the Employer filed a 
Petition to Terminate Benefits.  The petition alleged that the Claimant’s total 
disability had ceased and that he was capable of returning to work in some 
capacity.  At the time of the Petition to Terminate, the Claimant was 
receiving total disability payments pursuant to an agreement with the 
Employer. Such an agreement is legally equivalent to an award by the 
Board.1 
On January 23, 2002, the Board held a hearing on the Employer’s 
petition and rendered its decision on February 4, 2002.  The Board 
terminated the Claimant’s total disability benefits retroactive to the date of 
filing by the Employer.  Nevertheless, the Board did award the Claimant 
partial disability benefits and expert witness fees.2 
The Board determined that the Employer had met its burden of 
showing that the Claimant is not completely incapacitated and that the 
                                        
1 Del. Code Ann. tit. 19, § 2347.  “Compensation payable to an employee, under this 
chapter, shall not terminate until and unless the Board enters an award ending the 
payment of compensation after a hearing upon review of an agreement or award . . .” 
(emphasis added).  See Hamilton v. Trivits, 340 A.2d 178 (Del. Super. 1975) 
2 Clements v. Diamond State Port Corp., Board Hearing No. 1141580 (Feb. 4, 2002) at 
13. 
 
4 
Claimant’s total disability terminated as of September 24, 2001, the filing 
date of the Employer’s petition.3  Relying on the testimony of Dr. 
Townsend, who performed a medical examination o
f the Claimant at the 
Employer’s request, the Board held that “the Claimant is physically capable 
of working within the restrictions set forth by Dr. Townsend.”
4  Based on the 
Claimant’s education and work experience, the Board concluded that the 
Claimant “appears employable on a prima facie basis, even with his physical 
restrictions.”  Because the Claimant had made no efforts to locate suitable 
employment, the Board determined that the Claimant was not actually 
displaced.5 
 
The Board further held that the Claimant “clearly has physical 
restrictions that could affect his earning capacity,” and thus is partially 
disabled.6  The Board received testimony from Robin L. Subers, a vocational 
counselor employed by Carter Works, Inc., concerning a labor market 
survey of prospective jobs within the Claimant’s physical capabilities as 
described by Dr. Townsend.  The Board held, pursuant to title 19, section 
2325 of the Delaware Code, that the “Claimant’s compensation rate for 
                                        
3 Id. at 8-9. 
4 Id. at 10. 
5 Id. at 10-11. 
6 Id. at 11. 
 
5 
partial disability is $141.07 per week, effective from the date his total 
disability terminated.”7   
Upon examination of the Employer’s pre-hearing written settlement 
offer, the Board concluded that the settlement offer equaled the amount 
awarded by the Board.  Therefore, pursuant to section 2320, the Board ruled 
that the Claimant was not entitled to an award of attorney’s fees.8  The 
Board awarded the Claimant medical witness fees, however, in accordance 
with section 2322(e).9 
 
The Claimant moved for reargument of the Board’s decision.  The 
Board denied the Claimant’s motion for reargument finding “no basis to 
change its decision.”10  The Claimant filed a timely appeal with the Superior 
Court, which affirmed the Board’s judgments.  The Claimant has raised the 
same issues on appeal to this Court that were presented to the Superior 
Court. 
Compensation Agreement 
 
On August 8, 1997, the Claimant suffered a back injury, consisting of 
a low back strain and sprain and a herniated disc, while working for the 
                                        
7 Id. at 12. 
8 Id. at 12-13. 
9 Id. at 13. 
10 Clements v. Diamond State Port Corp., Board Hearing No. 1141580 (April 4, 2002) at 
4. 
 
6 
Employer.  Following that accident, the Claimant and Employer entered into 
an agreement as to total disability benefits.  On March 15, 1999, the 
Claimant’s total disability was terminated.  The parties agreed that the 
Claimant was capable of working in some capacity and entered into an 
agreement as to partial disability benefits.  On February 21, 2001, the 
Claimant underwent back surgery and resumed total disability status by 
further agreement of the parties.   
On June 28, 2001, Dr. Vaccaro, the Claimant’s surgeon, issued a 
“return-to-work physical capacities sheet” indicating the Claimant could 
return to light duty work.  Without returning to work, however, the Claimant 
consulted with his other treating physician, Conrad K. King, Jr., M.D., a 
pain management specialist.  Dr. King determined that the Claimant 
remained totally disabled following the surgery by Dr. Vaccaro.  Therefore, 
the Claimant continued to received total disability payments pursuant to the 
agreement with the Employer.   
Claimant’s Physician-Total Disability Opinion 
 
Dr. King testified before the Board by deposition on behalf of the 
Claimant.  Dr. King first saw the Claimant in February 1999 and has seen 
him periodically since that time.  Dr. King testified that on November 5, 
2001, the Claimant appeared without an appointment. Prior to that, he had 
 
7 
last seen the Claimant on January 18, 2001.  Dr. King stated that on 
November 5, 2001, the Claimant related that he had disc surgery on 
February 21, 2001 performed by Dr. Alexander Vaccaro.  The Claimant told 
Dr. King that, since the surgery, he continued to experience significant low 
back pain and ongoing right-lower extremity radicular symptoms.   
Upon examination, Dr. King observed that the Claimant’s “[r]ange of 
motion of the lumbar spine was limited to approximately 75 percent of 
normal in all planes.  He had moderate spasm of the lumbar paraspinal 
muscles.  Straight leg raising was negative at 75 degrees on the left, but 
positive at 60 degrees on the right.”  Dr. King testified that these results 
were better than at any time he had seen the Claimant since February 1999.  
Based on the objective findings after the physical examination, Dr. King 
ordered a repeat MRI. Dr. King testified that: 
The MRI performed on November 21, 2001, revealed a large 
right lateral disc herniation at L5-S1 partly surrounded by 
postoperative fibrosis.  It revealed marked pressure on the dural 
sac in the right S1 nerve root.  And the reviewing radiologist 
compared it to a previous study of August 2nd, 1999, and 
indicated that it represented significant worsening since the last 
exam performed on 8-2-99. 
 
Dr. King testified that the same radiologist reviewed the August 1997 MRI, 
the August 1999 MRI and the November 2001 MRI. 
 
8 
 
Dr. King next saw the Claimant on December 31, 2001.  At that time, 
Dr. King issued a disability note stating, “[the Claimant] was totally disabled 
until he saw [Dr. King] in follow-up on February 25th.”  Based on both 
objective and subjective findings, Dr. King classified the Claimant’s low 
back condition as severe and characterized it as failed back syndrome.   
Dr. King opined that the Claimant would require another surgical 
procedure.  He testified that he “made arrangements to have [the Claimant’s] 
records sent to Dr. James Campbell who is a noted neurosurgeon at Johns 
Hopkins” and that it is “Dr. C
ampbell’s procedure to review records and 
make a decision on whether or not he’s willing to see a patient . . . .”  Dr. 
King stated that if the Claimant were to ignore his instructions and return to 
work, in any capacity, he would risk further complications and a worsening 
of his condition.  Dr. King testified that the wrong type of activity could 
cause his condition to “progress to cauda equina syndrome which led to his 
initial surgery back in 2001.”   
Dr. King was “unaware of whether [the Claimant] was taking any 
prescription medication during the period of time” after June 28, 2001 or if 
the Claimant had received any medical treatment from June 28, 2001 to 
November 2001.  Dr. King testified that at the time of examination the 
Claimant was not suffering from sexual or urological dysfunction.  At that 
 
9 
time, the claimant did not require any assisting device such as a cane, a 
wheelchair or a walker.   
Employer’s Physician-Partial Disability Opinion 
 
John B. Townsend, III, M.D., a Board certified neurologist, t
estified 
by deposition on behalf of the Employer before the Board.  Dr. Townsend 
saw the Claimant for the first time on February 25, 1998.  After the 
performance of a MRI, Dr. Townsend diagnosed a large central and right 
lateral disc herniation at the level of L5-S1 and recommended that the 
Claimant undergo low back surgery at that time.   
 
Dr. Townsend next saw the Claimant on February 15, 1999.  Upon 
examination, with regard to the low back, Dr. Townsend observed that the 
Claimant had restricted ranges of motion and muscle tenderness in the right 
sacroiliac region.  Dr. Townsend testified that the Claimant told him “he 
couldn’t lie down and do [the] Patrick’s maneuver or straight leg raising at 
that time.”  Dr. Townsend testified that on this occasion he p
erformed a 
neurologic examination and that the Claimant: 
. . . had normal strength in the upper and lower extremities.  He 
could do heel and toe walking, but did so very slowly.  He had 
normal deep tendon reflexes, except that he had a one plus right 
ankle jerk compared to two plus on the left.  And he had some 
diminished sensation to pin-prick and temperature in the L5 
distribution. 
 
 
10
Dr. Townsend concluded that the Claimant was capable of doing sedentary 
to light-duty work, with the opportunity to change positions on an hourly 
basis and that at the time the Claimant was still a candidate for surgery. 
 
Dr. Townsend last examined the Claimant on January 2, 2002.  Dr. 
Townsend testified that based on a physical exam and a range of motion test 
performed by a digital dual inclinometer, the Claimant’s range of motion 
was slightly improved, but still limited.  Dr. Townsend observed that the 
Claimant was able to lie down for the Patrick’s maneuver and had no 
difficulty doing the heel walk; but the Claimant did complain of difficulty 
when walking on his toes.   
Dr. Townsend noted that the Claimant had an absent ankle jerk reflex 
and diminished sensation to a pinprick in the right foot.  At this time, Dr. 
Townsend stated that the Claimant had no urinary or bladder complaints and 
did not require any type of aid to walk.  Dr. Townsend opined, based on his 
clinical findings, that the Claimant continued to suffer from mild S1 
radiculopathy as evidenced by mild weakness, some loss of sensation and 
some pain complaints. 
 
Dr. Townsend testified that the Claimant had improved to some extent 
since the February 1999 examination but that he was still a surgical 
candidate.  According to Dr. Townsend, the Claimant’s condition in January 
 
11
of 2002 was similar to his condition in February of 1999, and Dr. Townsend 
believed, as he did then, that the Claimant could work in a light to sedentary 
capacity with restrictions.   
Upon review of a labor market survey prepared by the Employer, Dr. 
Townsend opined that from a physical standpoint each of the ten (10) 
employment positions identified were suitable for the Claimant to perform 
on a full-time basis.  Furthermore, when asked whether he had an opinion 
whether the Claimant would have continuously been able to work in a 
sedentary to light-duty capacity since June 28, 2001, Dr. Townsend testified 
that, 
. . . based on the fact that [the Claimant] did have a release to 
work at that time there would be no reason why he couldn’t 
have worked in a light sedentary capacity.  And, again, at least 
after my evaluation, given that he looked quite similar to the 
way he did when I released him previously, I saw no ongoing 
reason why he still couldn’t work in that capacity. 
 
Claimant’s Testimony 
 
The Claimant testified that he is thirty-five years old and has a
 high 
school education.  He feels that he is articulate and has leadership skills.  He 
stated that he participates in a study-discussion group concerning the 
principles and concepts of the political economy.  The Claimant’s job 
experience includes:  a forklift truck operator, a field administrator 
performing data entry for Guardian Environmental Group, and sales and 
 
12
management encompassing a three state territory for 21st Century Concepts.  
The Claimant testified since his operation he has 
. . . been experiencing extreme chronic pain in the lower back 
radiating and coming up into [his] legs which is a symptom that 
has increased that [he] didn’t have the problems before 
radiating into [his] left leg.  [He has] experienced additional 
numbness into [his] right foot and subsequently [he has] 
chronic pain on a daily basis . . . .  [He is] experiencing 
difficulty with erectile dysfunction and chronic pain in the 
testes. 
 
Increasingly, he feels a urinary urgency but with no actual result.  This 
symptom existed prior to the surgery, went away after surgery, but has 
returned.   
The Claimant testified that he did not tell Dr. King in November or 
December 2001 that he was experiencing erectile and urinary dysfunction.  
He could not recall telling Dr. King about the pain radiating down his left 
lower extremity.  The Claimant stated that he sleeps for about forty-five 
minutes at a time and experiences spasm and numbness if he rolls over onto 
his back. 
 
The Claimant testified that the pain interferes with his daily activities. 
He explained that tasks such as brushing his teeth and putting on his shoes, 
socks and pants are difficult because of the pain.  In addition, the Claimant 
explained that he lives alone and basic housekeeping tasks such as doing 
laundry or taking out the garbage required the aid of friends and neighbors. 
 
13
 
The Claimant testified that he is awaiting confirmation of a scheduling 
date with a specialist in Baltimore.  If the doctor recommends surgery, he 
initially avowed to “absolutely follow the doctor’s recommendation” but 
later testified that he couldn’t rule out getting a second opinion.  The 
Claimant testified that before his first surgery he was told by a neurosurgeon 
to explore all the possibilities and to get other opinions.  The Claimant 
explained that before he submitted to the first surgery, because of the risk of 
paralysis or loss of sexual function, he tried several types of rehabilitation 
including chiropractic care, physical therapy and aquatic therapy. 
 
When asked if he felt capable of returning to work at this time, the 
Claimant stated “[n]ot at this time.”  The Claimant testified that physically 
he: 
. . . would be unable to be in a position for 8 hours or 4 hours 
being subjected to a work place environment and not continuing 
to try and rehabilitate myself and put myself in a position to 
recoup that presents a situation for me where I could further my 
injury along and I would not want to be doing something that 
would be inconsistent with the recommendation of the doctor . . 
. . 
 
The Claimant stated that his last visit to Dr. Vaccaro was in March 2001 and 
that he did not learn that Dr. Vaccaro had released him to work in June 2001 
until six months later.  He agreed that he received the Employer’s 
termination petition in September 2001.   
 
14
The Claimant testified that he had not seen another doctor until he 
went to see Dr. King in November 2001.  In explanation as to why he never 
went back to see Dr. Vaccaro the Claimant stated “if I were experiencing 
some type of difficulty I would have been back to [Dr. Vaccaro] or possibly 
a different neurosurgeon.”  During the time period from March 2001 to 
November 2001, the Claimant testified that he took no prescription 
medication, only over-the-counter medications when needed.  The Claimant 
classified his visit to Dr. King in November 2001 as an “emergency 
situation” because he felt his condition had worsened. 
Conflicting Medical Expert Opinions 
The Claimant’s first contention on appeal challenges the Board’s 
decision to accept Dr. Townsend’s medical opinion that the Claimant was 
only partially disabled rather than Dr. King’s opinion of total disability.  
According to the Claimant, the Board erred, as a matter of law, in 
concluding that Dr. Townsend was better qualified than Dr. King to 
determine if the Claimant was risking further neurological damage by 
returning to work within restrictions.  The Claimant argues that the 
“[Board’s] rejection of Dr. King’s total disability opinion because it 
determined Dr. Townsend was ‘better qualified’ to assess the risk of further 
potential worsening of the Claimant’s disc” “violated the statutory and 
 
15
absolute right of the Claimant to treat with and follow the advice of a 
physician of his own choosing.”  Alternatively, the Claimant asserts that 
there exists no substantial evidence to support the Board’s conclusion that 
Dr. Townsend was ‘better qualified’ than Dr. King.  We have concluded that 
both of those contentions are without merit.   
In this case, there were two competing expert opinions.  Dr. King, the 
treating physician and a pain management specialist, testified on behalf of 
the Claimant.  Dr. Townsend, a neurologist, testified on behalf of the 
Employer.  The Board concluded that the opinion of the neurologist, Dr. 
Townsend, was more persuasive than that of the pain management specialist, 
Dr. King.   
 
Under Delaware law, “an experienced practicing physician is an 
expert, and it is not required that he be a specialist in the particular malady at 
issue in order to make his testimony as an expert admissible.”11  The weight 
to be given to the expert testimony of a treating physician, however, is for 
the Board to determine, as the trier of fact.12  In the absence of agreement 
between medical experts, the Board properly relied on all the record 
evidence to reach its determination to accept Dr. Townsend’s opinion.   
                                        
11 DiSabatino Brothers, Inc. v. Wortman, 453 A.2d 102, 106 (Del. 1982) (citations 
omitted). 
12 Board of Public Ed. in Wilmington v. Rimlinger, 232 A.2d 98, 100 (Del. 1967). 
 
16
The Board explained its reasons for accepting the expert opinion of 
Dr. Townsend, rather than that of Dr. King, as follows:  first, “Dr. King, a 
pain management specialist, opined that the Claimant should be considered 
totally disabled until he had seen a neurosurgeon.  Dr. Townsend, on the 
other hand, is a neurologist.”  Second, “[Dr. Townsend] examined the 
Claimant and was aware of the results of the November 2001 MRI” and had 
evaluated the Claimant in 1999.  Third, “Dr. Townsend is better qualified to 
determine if the Claimant is risking further neurological damage by 
returning to work within the restrictions he listed.” 
This Court has consistently held that it is the Board’s function to 
resolve conflicts in medical testimony.13  The Board did not err, as a matter 
of law, in concluding that Dr. Townsend was better qualified than Dr. King 
to determine if the Claimant was risking further neurological damage by 
returning to work within restrictions.  The Board set forth the factual basis 
for its conclusion that Dr. Townsend’s testimony was more persuasive.  
Those factual findings are supported by the record.14  Accordingly, we have 
determined that the Claimant’s first argument is without either legal merit or 
factual record support. 
                                        
13 Carey v. H & H Maintenance, Inc., 2001 WL 985114, at *2 (Del. Super.) (citing 
Lindsay v. Chrysler Corp., Del. Super., C.A. No. 94A-04-005, Barron, J. (Dec. 7, 1994)). 
14 See Carey v. H & H Maintenance, Inc., 2001 WL 985114 at *2 (Del. Super.) (citing 
Lindsay v. Chrysler Corp., Del. Super., C.A. No. 94A-04-005, Barron, J. (Dec. 7, 1994)). 
 
17
Claimant’s Reliance Proper 
As a general rule, “[t]he credibility of the witnesses, the weight of 
their testimony, and the reasonable inferences to be drawn therefrom are for 
the Board to determine.”15  It was also within the discretion of the Board to 
evaluate the credibility of the Claimant’s testimony.   In this case, the Board 
determined that the Claimant was not entirely credible because the 
symptoms he described to the Board were not the same symptoms he had 
related to either Dr. King or Dr. Townsend.  The Board also noted that the 
Claimant had not taken any prescription medication from March 2001 to 
November 2001 and had not sought medical care.   
It is well established that the Board cannot substitute its judgment to 
nullify the objective findings of a medical expert that fully support the 
claimant’s subjective complaints.16  Where a medical expert’s opinion 
depends primarily upon the credibility of the claimant’s subjective 
complaints, however, and the Board determines that those subjective 
complaints are not credible, the Board may reject the medical expert’s 
                                        
15 Coleman v. Dept. of Labor, 288 A.2d 285, 287 (Del. Super. 1972). 
16 Pusey v. Natkin & Co., 428 A.2d 1155 (Del. 1981) (holding that competent unrebutted 
medical evidence cannot be ignored by the board). 
 
18
conclusion.17  Nevertheless, the claimant is entitled to rely upon the medical 
expert’s opinion until it is rejected by the Board.   
In this case, Dr. King characterized the Claimant’s condition as failed 
back syndrome with objective and subjective evidence of ongoing problems.  
Although the Board could not nullify the objective findings of Dr. King, it 
could evaluate the credibility of the Claimant and the weight to be accorded 
to Dr. King’s opinion in reliance on the Claimant’s subjective complaints.  
The Board found that the Claimant’s subjective complaints and incomplete 
medical history misled Dr. King regarding his condition.  Consequently, the 
Board held that the Claimant could not rely on Dr. King’s “no work” total 
disability order.  This finding resulted in the Board’s determination that the 
Claimant was not a displaced worker.  Thus, according to the Board, the 
Claimant should have been looking for work with restrictions 
notwithstanding Dr. King’s no work order and the total disability agreement 
between the parties. 
 
The Claimant argues that the Board’s finding that the Claimant’s 
subjective complaints misled Dr. King regarding his condition, and therefore 
the Claimant could not rely on Dr. King’s total disability order, constitutes 
                                        
17 Breeding v. Contractors-One-Inc., 549 A.2d 1102, 1104 (Del. 1988); Sears, Roebuck 
& Co. v. Farley, 290 A.2d 639, 641 (Del. 1972) citing DeBernard v. Reed, 277 A.2d 684 
(Del. 1971). 
 
19
an error of law.  We agree that holding by the Board constituted an error of 
law because in Gilliard-Belfast, this Court held “that a person who can only 
resume some form of employment by disobeying the orders of his or her 
treating physician is totally disabled, at least temporarily, regardless of his or 
her capabilities.”18  The rationale for this Court’s holding in Gilliard-Belfast 
was based upon the operative fact that, in the medical opinion of the 
claimant’s treating physician, the claimant was totally disabled. 
 
That rationale is directly applicable to this case.  Medical doctors must 
always make a diagnosis on the basis of all available data, including the 
patient’s subjective complaints, as measured whenever possible by objective 
findings that are available upon physical examination and testing.  Although 
there are exceptions, treating physicians are not easily misled into making a 
medical determination of total disability by malingerers or patients with 
exaggerated subjective complaints that defy confirmation by an objective 
physical examination or test. 
The Claimant’s general right to rely upon his treating physician’s total 
disability opinion, especially while a Board award or agreement is in effect, 
means that the Claimant had no obligation to either return to work on a 
limited basis with the Employer or to look for other employment until the 
                                        
18 Gilliard-Belfast v. Wendy’s, Inc., 754 A.2d 251, 254 (Del. 2000). 
 
20
Board makes that determination.  Accordingly, the Board erred, as a matter 
of law, in concluding that the Claimant’s failure to look for work was 
relevant to the displaced worker issue.  The Claimant was required only to 
return to work on a restricted basis or to seek other employment following a 
Board determination that he was no longer totally disabled. 
The Board’s holding that the Claimant could not rely on the no work 
order of his treating physician would place the Claimant in the same position 
that this Court held was untenable in Gilliard-Belfast.  The Claimant would 
have to either disregard the no work order of the treating physician at the 
risk of personal injury or follow the advice of the treating physician with the 
risk of losing benefits retroactively.  Once again, we hold that when the 
treating physician renders a no work order – even if the employer’s 
physician disagrees with the order – the claimant is totally disabled for the 
purpose of the Delaware Workers’ Compensation statute until the Board 
resolves that issue in favor of the employer.   
It is not unusual for medical experts to have a legitimate difference of 
opinion about a claimant’s total disability even if both medical experts agree 
about the subjective complaints, objective physical findings, and test results.  
If the treating physician adheres to the view that the claimant is totally 
disabled, then as this Court held in Gilliard-Belfast, “a person who can only 
 
21
resume some form of employment by disobeying the orders of his or her 
treating physician is totally disabled, at least temporarily regardless of his or 
her capabilities.”19  It is then incumbent upon the employer to file a Petition 
to Terminate with the Board, as the employer did in this case.   Until the 
issue of total disability is resolved by the Board, however, the claimant is 
entitled to follow the no work instructions of the treating physi
cian.  
Consequently, the Board’s determination that the Claimant was not a 
displaced worker should have been reversed by the Superior Court and 
remanded for reconsideration. 
Employer’s Protective  Statutory Rights 
 
When an employer disputes a total disability determination from the 
claimant’s treating physician, as in this case from Dr. King, the statute 
requires a claimant to submit to a separate medical examination, at the 
employer’s request.20  The employer’s statutory right to request a separate 
medical examination provides the employer with a form of double 
protection.  First, it provides the employer with an opportunity to submit the 
claimant’s subjective symptoms to enhanced objective scrutiny by another 
medical expert.  Second, it permits the employer to ascertain whether there 
is a genuine divergence of opinion between the medical experts with regard 
                                        
19 Id. 
20 Del. Code Ann. tit. 19, § 2343.  
 
22
to the claimant’s total disability status, even if they are in agreement about 
the subjective and objective manifestations of the claimant’s condition.  If 
the medical expert selected by the employer concludes that the claimant is 
not totally disabled, as Dr. Townsend did in this case, the basis for that 
medical conclusion should be made known to the treating physician.  If the 
treating physician adheres to his or her original determination of total 
disability, after being advised of the employer’s medical expert’s reasons for 
reaching a different opinion, the employer must file a Petition to Terminate 
Benefits and the matter must be resolved by the Board.   
Thereafter, although the Claimant’s right to receive total disability 
benefits continues after the petition to terminate is filed, those benefits are 
then paid by the Secondary Fund rather than the Employer.   
[A]n employee is entitled to compensation until there is a 
finding that he is no longer entitled to it, was implemented by 
providing for the continuation of the employee’s compensation 
during the pendency of the proceedings to be paid out of the 
Fund.  The legislative purpose was to assure continued 
compensation to the injured employee until he is found not to 
be entitled to receive it, and the burden of bearing the cost of 
such compensation if the employee is ultimately determined not 
to be entitled to it was placed upon the Fund.  Of course, it 
provided for reimbursement to the Fund by the employer if it is 
ultimately determined that the employee is still entitled to 
compensation.21   
 
                                        
21 Hamilton v. Trivits, 340 A.2d 178, 179-80 (Del. Super. 1975). 
 
23
If the Board resolves the conflict between the medical experts in favor 
of the employer, the claimant’s total disability status ends on the date of the 
Board’s determination.  That was the Board’s ruling in this case.  If the 
Board determines that the Claimant remains totally disabled, however, the 
Employer must reimburse the Secondary Fund for payments made after the 
date of filing.   
In this case, the Board’s decision that it had the statutory authority to 
terminate the Claimant’s total disability status as of the date of filing was 
correct, as a matter of law.  The statutory scheme is consistent with this 
Court’s holding in Gilliard-Belfast because it contemplates that the Claimant 
will follow the no work order of a treating physician but relieve the 
successful employer from the cost of paying total disability retroactively to 
the date of filing. 
Evidence Supports Retroactive Termination 
 
The Claimant’s last argument is that the Board’s decision to terminate 
the Claimant’s total disability benefits retroactive to the date of the filing is 
not supported by substantial competent evidence.  The Claimant asserts that 
Dr. Townsend did not examine the Claimant until January 2, 2002, and 
therefore, that date provides the earliest competent evidence of the 
Claimant’s work capabilities.  The Claimant also argues that Dr. Vaccaro’s 
 
24
June 2001 release for work cannot be considered, as evidence for the 
purpose of fixing a termination date because it was not moved into evidence 
and Dr. Vaccaro was not called as an expert to testify.   
The 
Board 
noted 
that 
“[w]hile 
contemporaneous 
medical 
examinations would have been preferable, ‘medical evidence is not the only 
evidence the Board may rely on in making its factual determinations with 
respect to the Claimant’s injury.’”  According to the Superior Court, the 
evidence before the Board indicated “(1) the Claimant received no medical 
treatment at all between March 2001 and November 2001; (2) the Claimant 
required no prescriptions during this time; (3) Dr. Townsend testified that 
the Claimant could have worked at least sedentary duty given that he 
presented similarly, if not better than, he had when Dr. Townsend examined 
him in 1999; (4) Dr. King testified that the Claimant’s physical examination 
was improved in November of 2001 as compared to when he saw him in 
1999 and when he opined that the Claimant was able to work in a sedentary 
to light duty capacity.”  Based upon that evidence, the Superior Court held 
that the Board’s decision to terminate the Claimant’s total disability benefits 
retroactive to the date of the filing was supported by substantial evidence.  
This Court has concluded that the Superior Court’s determination is 
supported by the record and is the product of a rational deductive process.   
 
25
Conclusion 
 
The judgments of the Superior Court are affirmed except for the 
judgment affirming the Board’s determination that the Claimant was not a 
displaced worker.  That issue must be remanded to the Board for 
reconsideration in accordance with this opinion.  Jurisdiction is not retained.