Case Title: Wilson v. Gingerich Concrete & Masonry

Citation: 

Docket Number: 114, 2022

State: delaware

Court: Delaware Supreme Court

Date: 2022-10-03T00:00:00Z

Document:
IN THE SUPREME COURT OF THE STATE OF DELAWARE 
 
 
JOSEPH WILSON,  
 
 
§ 
 
 
 
 
 
 
 
§ 
No. 114, 2022 
 
Appellant Below, 
 
 
§ 
 
Appellant, 
 
 
 
§ 
Court Below:  Superior Court 
 
 
 
 
 
 
§ 
of the State of Delaware 
 
v.  
 
 
 
 
§ 
 
 
 
 
 
 
§ 
C.A. No. K21A-06-002 
GINGERICH CONCRETE &  
 
§ 
MASONRY,  
 
 
 
§ 
 
 
 
 
 
 
§ 
 
Appellee Below, 
 
 
§ 
 
 
Appellee. 
 
 
 
§ 
 
 
Submitted:  September 21, 2022  
Decided:  October 3, 2022 
 
 
Before VALIHURA, VAUGHN, and TRAYNOR, Justices.  
 
On appeal from the Superior Court.  AFFIRMED.   
 
Walt F. Schmittinger, Esquire, Gary E. Junge, Esquire, Schmittinger & Rodriguez, P.A., 
Dover, Delaware for Appellant.   
 
H. Garrett Baker, Esquire, Elzufon, Austin & Mondell, P.A., Wilmington, Delaware for 
Appellee. 
 
 
 
 
 
 
 
 
 
 
 
 
VALIHURA, Justice: 
 
 
 
 
 
 
 
2 
 
I. 
 
BRIEF OVERVIEW 
 
This is an appeal of a March 9, 2022 decision by the Superior Court affirming the 
May 6, 2021 order (the “Order”) of the Industrial Accident Board (the “IAB” or “Board”) 
denying Appellant Joseph Wilson’s (“Wilson”) petition seeking payment for a cervical 
spine surgery.  The parties agree that the treatment Wilson received was reasonable and 
necessary.  The issue we confront is whether the treatment is compensable given that the 
treating physician’s certification under the Delaware Workers’ Compensation Act (the 
“Act”) had lapsed by the time of treatment.  If the treatment is not compensable, as the IAB 
and Superior Court held, then Wilson asks us to anticipatorily resolve the question of 
whether he can be liable for the bill even though no one has asserted such a claim.   
Wilson was injured in a work-related accident on August 1, 2002 while working for 
Appellee Gingerich Concrete and Masonry (“Employer”).  Sometime after the accident, 
Wilson started treatment with Dr. Bikash Bose (“Dr. Bose”), a certified Delaware workers’ 
compensation healthcare provider.  Wilson’s injury necessitated two related cervical 
surgeries.  The first surgery was performed while Dr. Bose was certified under the 
Delaware workers’ compensation system (the “Delaware Certification”) according to the 
requirements set forth in the Act.  Employer’s carrier paid the bills related to Wilson’s first 
surgery.   
But Wilson’s first surgery proved unsuccessful, and Dr. Bose recommended a 
second surgery.  During the time between Wilson’s first surgery and his second surgery, 
Dr. Bose’s Delaware Certification lapsed, and he did not seek re-certification for nineteen 
months.     
 
 
 
 
 
 
 
3 
 
Wilson petitioned the IAB, seeking payment for his second surgery.  The IAB 
scheduled a hearing.1  In order to obtain expert testimony for the hearing, Wilson deposed 
Dr. Bose.  At Dr. Bose’s deposition, Wilson first learned that Dr. Bose’s Delaware 
Certification had lapsed prior to Wilson’s second surgery due to an administrative error, 
but that Dr. Bose corrected the issue shortly after Wilson’s second surgery.   
Employer filed a motion in limine asserting that the lapse in Dr. Bose’s Delaware 
Certification negated Wilson’s right to recover his surgical bills through the workers’ 
compensation health care payment system.  The parties stipulated that Wilson’s surgery 
was reasonable, necessary, and related to Wilson’s workplace injury.   
Relying on 19 Del. C. § 2322D, as well as this Court’s opinion in Wyatt v. Rescare 
Home Care,2 the hearing officer held that Wilson’s treatment was noncompensable solely 
because Dr. Bose lacked certification at the time of Wilson’s second surgery.  The hearing 
officer considered Dr. Bose to be an “uncertified provider” who was required by statute to 
obtain pre-authorization for treatment.  
Wilson appealed the IAB’s decision to the Superior Court, arguing that the IAB 
erred when it equated a lapse in Delaware Certification with a lack of Delaware 
Certification.  In affirming the IAB’s Order, the Superior Court recognized that the IAB 
failed to explain its decision, which conflicted with two prior IAB decisions, namely, 
 
1 In the meantime, Dr. Bose performed the second surgery.  
2 81 A.3d 1253, 1263 (Del. 2013) [hereinafter Wyatt, 81 A.3d at _]. 
 
 
 
 
 
 
 
4 
 
Williams v. State,3 and Zayes v. State.4  Nevertheless, the Superior Court found that this 
Court’s precedent in Wyatt controlled, and that the IAB’s decision was correct as a matter 
of law.  Accordingly, the Superior Court upheld the Board’s denial of Wilson’s petition. 
Wilson raises two issues on appeal.  First, he asserts that the Act should be construed 
liberally and requires a good-faith exception to the certification requirements when there 
is a lapse in certification due to an administrative oversight.   
Second, Wilson asserts that upholding the Board’s decision creates an injustice 
where Wilson might be responsible, through no fault of his own, for medical bills 
associated with reasonable and necessary treatment.  Although no such action has been 
initiated or threatened, he argues that the Act’s plain language expressly permits Dr. Bose 
to commence collection efforts against him after there is a final decision holding that his 
medical bills are noncompensable.   
 
We conclude that Dr. Bose’s lapse rendered him uncertified, and, thus, the disputed 
bills are not compensable under 19 Del. C. § 2322D.  We do not reach Wilson’s second 
issue as it is not ripe.5  
 
3 No. 1282260 (Del. I.A.B. Feb. 6, 2012) [hereinafter Williams, No. 1282260, at _]. 
4 No. 1365817 & 1411306 (Del. I.A.B. Sept. 10, 2015) [hereinafter Zayes, No. 1365817, at _].  We 
note that the IAB caption incorrectly spells the claimant’s name--Ms. Zayas--as “Zayes,” even 
though it spells her name correctly in the decision.  See Zayes, No. 1365817, at 2; see also Zayas 
v. State, 272 A.3d 776, 778 (Del. 2022) (identifying claimant as “Christina Zayas”).   
Because the parties in their briefing refer to this IAB decision as “Zayes,” we do the same here for 
ease of reference.  We intend no disrespect to Ms. Zayas.     
5 There may be various statutory, contractual, or other impediments to holding Wilson responsible 
for the costs due to a lapse that was not his fault.  Employer acknowledged the inequities in such 
an outcome.  See Ans. Br. at 16; id. (stating that “it would be a very heady thing for any physician 
 
 
 
 
 
 
 
 
5 
 
 
For the reasons set forth below, we AFFIRM the decision of the Superior Court. 
II. FACTUAL AND PROCEDURAL HISTORY 
A. Wilson’s Injury and Dr. Bose’s Treatment 
Wilson was injured in a work-related accident while working for Employer on 
August 1, 2002.6  Wilson sustained work-related injuries to his neck and lower back. 
In 2014, Wilson began treating with Dr. Bose, a board-certified neurosurgeon,7 for 
complaints relating to his 2002 work-related injury.  Treatment rendered by Dr. Bose at 
this time was covered by Employer’s carrier.  Wilson also received pain management 
treatment from several other physicians in connection with his work-related injury, but 
Wilson returned to Dr. Bose in 2019 for a reevaluation.   
On February 22, 2019, Dr. Bose performed Wilson’s physical examination, during 
which Wilson expressed complaints of a “burning sensation in his neck which radiated 
down both sides of his neck and into his shoulders and into his arms.”8  “He also 
complained of a feeling of weakness in [his] right arm[.]”9  Dr. Bose found that the pain 
Wilson was experiencing was due to a pinched nerve in his neck, likely caused by a buildup 
of calcium around the nerve.  Dr. Bose ordered Wilson to undergo imaging studies. 
 
to assert that the patient becomes personally responsible for medical care which is not compensable 
by consequence of the physician’s own legal failings.”).  See infra n.70.   
6 B-39 Wilson v. Gingerich Concrete & Masonry, No. 1215102, at 2 (Del. I.A.B. May 6, 2021) 
[hereinafter IAB Decision]; A-003 Wilson v. Gingerich Concrete & Masonry, No. 1215102, at 
3:12 (Del. I.A.B. Apr. 23, 2021) (TRANSCRIPT) [hereinafter IAB Tr.]. 
7 B-4 (Dr. Bose Dep. at 4:19-6:3).  Dr. Bose has been practicing for 35 years.  Id.  The parties do 
not dispute Dr. Bose’s qualifications.  See B-5 (Dr. Bose Dep. at 5:10-13). 
8 B-6-8 (Dr. Bose Dep. at 6:24-7:3, 8:14). 
9 B-7 (Dr. Bose Dep. at 7:3-4). 
 
 
 
 
 
 
 
6 
 
On May 29, 2019, after reviewing Wilson’s results, Dr. Bose discovered that Wilson 
had “multilevel disc disease” in his neck and lower back.  Dr. Bose recommended different 
options for treatment, including a surgical option consisting of a “C3-4 and C5-6 
discectomy.”10  After another visit to further discuss his options, Wilson decided to have 
the surgery.   
Wilson’s cervical surgery took place on July 2, 2019 (the “First Cervical Surgery”).  
According to Dr. Bose, Wilson’s First Cervical Surgery “went as planned[,]”11 and 
Employer’s carrier paid Wilson’s medical bills associated with the surgery. 
Around January 2020, about six months after the First Cervical Surgery, Dr. Bose 
reviewed Wilson’s updated cervical spine X-rays.  The X-rays revealed that Wilson’s 
fusion had not yet solidified.  According to Dr. Bose, an average person should “fuse” by 
six months post-surgery, but a small percentage of people are “slow healers” and may take 
up to a year.12  Dr. Bose continued to monitor Wilson’s recovery.   
On July 17, 2020, Wilson again went to Dr. Bose with updated imaging studies.  Dr. 
Bose found postoperative changes, meaning that Wilson still had not fused even though 
almost a year passed since the First Cervical Surgery.  This essentially rendered Wilson’s 
First Cervical Surgery unsuccessful.  Dr. Bose proposed additional treatment, including 
both surgical and nonsurgical options.   
On August 7, 2020, Wilson returned to Dr. Bose to further discuss the surgical 
 
10 B-10-11 (Dr. Bose Dep. at 10:16-18, 11:5-19).  
11 B-11-12 (Dr. Bose Dep. at 11:20-12:3). 
12 B-13 (Dr. Bose Dep. at 13:19-23). 
 
 
 
 
 
 
 
7 
 
option.  Wilson inquired into the specific procedure and the associated risks.  Before 
committing to another surgery, Wilson wanted to obtain a second opinion. 
On October 20, 2020, Wilson sought a second opinion from Dr. Eppley.13  Dr. 
Eppley agreed with Dr. Bose’s assessment and concluded that there was a “clear nonunion 
at C3-4 and C5-6 with slight loosening of the instrumentation.”14   
Wilson returned to Dr. Bose in order to have the new surgery (the “Second Cervical 
Surgery”), which occurred on February 22, 2021.  Similar to the first surgery, Dr. Bose 
stated that the Second Cervical Surgery “went as planned.”15   
B. Wilson’s Petition for Compensation and the IAB Decision 
On October 1, 2020, Wilson filed a Petition to Determine Additional Compensation 
Due seeking compensability of medical treatment with Dr. Bose, which would include a 
prospective second cervical surgery (the “Second Cervical Surgery”).  A hearing on the 
matter was held on April 23, 2021.  
On April 7, 2021,16 in preparation for the IAB hearing, Wilson took Dr. Bose’s 
deposition.  Dr. Bose testified that both the First Cervical Surgery and the Second Cervical 
Surgery were “reasonable, necessary, and related to [Wilson’s work-related] injury.”17   
 
13 B-19 (Dr. Bose Dep. at 19:9-13).  Dr. Bose’s deposition does not identify Dr. Eppley’s full 
name.   
14 B-19-20 (Dr. Bose Dep. at 19:17-20:2). 
15 B-23 (Dr. Bose Dep. at 23:15-19). 
16 The transcript of Dr. Bose’s deposition is incorrectly dated April 7, 2020.  See B-1 (Dr. Bose 
Dep.).  Dr. Bose’s deposition, however, occurred on April 7, 2021.  See B-40 (IAB Decision at 
3).  
17 B-25-26 (Dr. Bose Dep. at 25:20-26:2). 
 
 
 
 
 
 
 
8 
 
On cross-examination, Employer asked whether Dr. Bose was recertified under the 
Delaware Workers’ Compensation Practice Guidelines.  Dr. Bose testified that he was.  
Employer stated that the Delaware Workers’ Compensation website crossed out Dr. Bose’s 
name on its certification list.18  Dr. Bose explained that “it was,” but that he had “taken 
care of the paperwork.”19  According to Dr. Bose, “[i]t was like the CME was not filed so 
we sent them the paperwork last week so they were going to take it off.  We noticed that.”20  
Dr. Bose further testified that  
I have been certified all along, but with COVID there was some problem with 
communication from their office email and all that and, you know, it fell 
through the cracks so there was some -- we noticed that other providers have 
the same issues and so when it came to our attention, then we filled out the 
paperwork and submitted it to them.  And my office talked to them last week 
or the week before so they said that shouldn’t be a problem.21 
 
Employer questioned exactly when Dr. Bose was recertified, to which he responded that 
the paperwork was sent in around the end of March 2021.  No further questions were asked 
regarding why Dr. Bose lacked Delaware Certification from August 31, 2019 until March 
29, 2021.  However, neither Wilson, nor Wilson’s counsel, knew of Dr. Bose’s lapse in 
Delaware Certification until Dr. Bose’s April 7, 2021 deposition.  
The hearing occurred on April 23, 2021 before an IAB hearing officer.  During the 
hearing, Employer stated that it did not challenge the treatment based on substantive 
 
18 B-28 (Dr. Bose Dep. at 28:4-5).  Counsel for Employer stated: “I have pulled up a copy of their 
website and your name is crossed out.”  Id. 
19 B-28 (Dr. Bose Dep. at 28:6-7). 
20 B-28 (Dr. Bose Dep. at 28:7-9). 
21 B-28-29 (Dr. Bose Dep. at 28:20-29:4). 
 
 
 
 
 
 
 
9 
 
reasons, but rather on “failure to comply reasons”--namely, that Dr. Bose was not certified 
during Wilson’s Second Cervical Surgery because he failed to complete his Delaware 
Certification.22  Thus, the only question before the hearing officer was whether Dr. Bose 
was qualified for compensation under the Act with regard to Wilson’s Second Cervical 
Surgery.   
Employer argued that, in order for treatment to be compensable under the Act, the 
treatment had to be provided either by a Delaware certified provider, or the provider had 
to seek preauthorization.  Relying on this Court’s opinion in Wyatt, Employer pointed to 
only one exception to this rule:  first consultations.23  Dr. Bose was initially certified in 
2008 and recertified four times.  Dr. Bose, however, was not certified from August 31, 
2019 to March 29, 2021, a period of about 19-months.  According to Employer, because 
Dr. Bose was not certified at the time of the Second Cervical Surgery, did not seek 
preauthorization, and the Second Cervical Surgery did not fall within the exception, the 
Second Cervical Surgery was not compensable under the statute.  
Wilson agreed that the only issue was the effect that Dr. Bose’s certification status 
had on compensability.  Wilson further agreed that Dr. Bose was initially certified on April 
30, 2008, recertified four times, and had a lapse in certification from August 31, 2019 to 
March 29, 2021.  Wilson, however, specifically characterized Dr. Bose’s 19-month gap in 
 
22 A-004 (IAB Tr. at 4:1-2). 
23 See A-005 (IAB Tr. at 5:14-18).  During the hearing, Employer correctly identified that Wyatt 
outlined two exceptions to the rule:  first consultation and care provided in the emergency unit of 
a hospital or a pre-hospital setting.  Id.  The emergency exception, however, no longer applies.  
See 19 Del. C. § 2322D(b) (“The provisions of this subsection are limited to the occasion of the 
employee’s first contact with any healthcare provider for treatment of the injury[.]”). 
 
 
 
 
 
 
 
10 
 
Delaware Certification as a “lapse”24 in certification as opposed to a lack of certification.  
Wilson argued that the Act lists requirements for initial certification but does not provide 
“penalties” for a failure to recertify at given intervals.25  Therefore, Wilson argued that Dr. 
Bose “is, and has been, a certified provider and a participant in the worker[s’] 
compensation system[,]”26 such that the Second Cervical Surgery is compensable.   
On May 6, 2021, the hearing officer found that Wilson’s medical expenses were 
“not compensable due to Dr. Bose’s lack of certification and/or failure to obtain pre-
authorization for those expenses.”27  The hearing officer agreed with Employer that Dr. 
Bose’s lapse in certification meant that Dr. Bose was effectively uncertified during the 19-
month period.  Relying on the Act and this Court’s precedent in Wyatt, the hearing officer 
found that uncertified providers who fail to obtain pre-authorization for treatment are not 
entitled to compensation.  Although Dr. Bose testified that his lapse in Delaware 
Certification starting in August of 2019 was “due to an administrative error and/or due to 
the Covid pandemic,” the hearing officer noted that “the Covid pandemic did not begin 
until 2020.”28  Nevertheless, because Dr. Bose did not seek preauthorization for the Second 
Cervical Surgery, and because the Second Cervical Surgery did not fall within the 
exception, the hearing officer concluded that it was not compensable.     
 
24 A-011 (IAB Tr. at 11:9). 
25 A-015 (IAB Tr. at 15:5-9).  
26 A-008 (IAB Tr. at 8:23-24). 
27 B-44 (IAB Decision at 7). 
28 B-41 (IAB Decision at 4). 
 
 
 
 
 
 
 
11 
 
C. Wilson’s Appeal to the Superior Court  
Wilson appealed the Order to the Superior Court.  He argued that the Board erred 
when it equated Dr. Bose’s lapse in certification to a lack of certification.  According to 
Wilson, neither Section 2322D nor the Workers’ Compensation Regulations permitted the 
IAB to find that a medical provider’s certification expired every two years.29  Further, 
Wilson argued that the Board failed to explain its deviation from two prior IAB decisions 
that had described a lapse in Delaware Certification as de minimis.  According to Wilson, 
once Dr. Bose received his Delaware Certification, he remained certified, notwithstanding 
the lapse.  In addition, Wilson challenged the Board’s decision by arguing that the 
Department of Labor (the “DOL”) failed to provide Dr. Bose with notice and a hearing, as 
required by Delaware’s Administrative Procedures Act.   
In response, Employer argued that the Board correctly applied Section 2322D.  
Further, Employer argued that Wilson lacked standing to challenge notice requirements on 
behalf of Dr. Bose.  
The Superior Court affirmed the Board’s decision.  As a threshold matter, the court 
addressed Employer’s argument that Wilson lacked standing to challenge the DOL’s 
alleged failure to provide Dr. Bose notice of his lapse in certification.  The court declined 
to decide this matter for various reasons, including Wilson’s failure to raise the issue before 
the Board.   
Turning to the sole substantive issue in Wilson’s appeal, the court addressed 
 
29 Wilson v. Gingerich Concrete & Masonry, 2022 WL 701632, at *2 (Del. Super. Mar. 9, 2022) 
[hereinafter Wilson, 2022 WL 701632, at _]. 
 
 
 
 
 
 
 
12 
 
whether the Board correctly applied Section 2322D, as well as this Court’s decision in 
Wyatt.  Relying on its common, ordinary meaning, the court described a “lapse” as 
something that occurs when “a right, privilege, or agreement becomes invalid because it is 
not used, claimed or renewed.”30  “In other words, [a lapse occurs when] the right or 
privilege expired.”31  Effectively, the court concluded that a lapse in certification meant 
that Dr. Bose was uncertified during the 19-month period.   
Because Dr. Bose was uncertified during that 19-month period, the Superior Court 
turned to Wyatt and Section 2322D to determine whether an uncertified provider’s 
treatment would be compensable.  The court concluded that both Wyatt and Section 2322D 
required a treating physician to be certified, obtain preauthorization, or fall into the 
exclusive list of exceptions provided in Section 2322D.  Because Section 2322D does not 
permit an additional “good faith” exception, the court declined to judicially craft an 
exception for an administrative error.   
Finally, the Superior Court addressed Wilson’s contention that the Board’s failure 
to follow its own precedent required reversal.  The court considered whether a remand 
would be appropriate to obtain an explanation from the Board as to why its approach 
changed.  But because the issue was one of statutory construction subject to de novo review, 
the court determined that remanding would not be efficient given the court’s view that the 
Board’s decision was correct as a matter of law.   
 
30 Id. at *6 (emphasis in original). 
31 Id. 
 
 
 
 
 
 
 
13 
 
III. 
CONTENTIONS ON APPEAL 
This appeal followed.  The question Wilson presents is whether a lapse in Delaware 
Certification due to an administrative oversight equates to a lack of Delaware Certification 
such that any treatment rendered during that 19-month period would be noncompensable 
under the statute.  Wilson contends that if a lapse in certification equates to a lack of 
certification at the time of his Second Cervical Surgery, then he becomes responsible for 
the medical bills associated with the procedure.   
Employer disagrees and argues that Wilson misreads the statute.  Further, Employer 
states that there is nothing in the record suggesting Dr. Bose has either attempted or 
contemplates holding Wilson personally liable for the medical expenses at issue.  
Accordingly, Employer argues that the Superior Court correctly affirmed the Board’s 
decision by applying Section 2322D, as well as our precedent in Wyatt.   
IV.   STANDARD OF REVIEW 
“The review of an Industrial Accident Board’s decision is limited to an examination 
of the record for errors of law and a determination of whether substantial evidence exists 
to support the Board's findings of fact and conclusions of law.”32  “Substantial evidence is 
‘such relevant evidence as a reasonable mind might accept as adequate to support a 
conclusion.’”33   
 
32 Zayas v. State, 273 A.3d 776, 784-85 (Del. 2022) (citing Roos Foods v. Guardado, 152 A.3d 
114, 118 (Del. 2016)); Sheppard v. Allen Family Foods, 279 A.3d 816, 826 (Del. 2022). 
33 Id. at 785 (citing Roos Foods, 152 A.3d at 118). 
 
 
 
 
 
 
 
14 
 
If the Board decided legal issues, this Court reviews them de novo.34  “Absent errors 
of law, which are reviewed de novo, we review a Board’s decision for abuse of 
discretion.”35  If there is no error of law and substantial evidence supports the Board’s 
findings, “the Board’s decision must be affirmed.”36 
V.   ANALYSIS 
First, we consider the effect of a lapse in certification under Section 2322D of the 
Workers’ Compensation Act. 
A. Section 2322D Requires Providers to be Certified 
“The ‘most important consideration for a court in interpretating a statute is the words 
the General Assembly used in writing it.’”37  “Undefined words are given their ordinary, 
common meaning, and words should not be construed as surplus if a reasonable 
construction will give them meaning.”38  “When the statute is ‘clear on its face and is fairly 
susceptible to only one reading, the unambiguous text will be construed accordingly,’ 
unless the result is an absurdity ‘that cannot be attributed to the legislature.’”39  “In 
 
34 Id. (citing Oceanport Indus., Inc. v. Wilm. Stevedores, Inc., 636 A.2d 892, 899 (Del. 1994)). 
35 Greenville Country Club v. Greenville Country Club, 150 A.3d 1194, 1197 (Del. 2016) (citing 
Person-Gaines v. Pepco Hldgs., Inc., 981 A.2d 1159, 1161 (Del. 2009)). 
36 Zayas, 273 A.3d at 785 (citing Stevens v. State, 802 A.2d 939, 944 (Del. Super. 2002)); Breeding 
v. Contractors-One-Inc., 549 A.2d 1102, 1104 (Del. 1988). 
37 Salzberg v. Sciabacucchi, 227 A.3d 102, 113 (Del. 2020) (quoting Boilermakers Loc. 154 Ret. 
Fund v. Chevron Corp., 73 A.3d 934, 950 (Del. Ch. 2013)).  See also Stream TV Networks, Inc. v. 
SeeCubic, Inc., 279 A.3d 323, 354 (Del. 2022) (citing Salzberg, 227 A.3d at 113).  
38 Wyatt, 81 A.3d at 1260 (citing Progressive N. Ins. Co. v. Mohr, 47 A.3d 492, 495 (Del. 2012)). 
39 Id. at 1260-61 (quoting Mohr, 47 A.3d at 496). 
 
 
 
 
 
 
 
15 
 
interpreting the statute, this Court will read all sections of the statute, ‘in light of all the 
others to produce a harmonious whole.’”40   
Section 2322D(a) provides in full: 
(a)(1) Certification shall be required for a health-care provider to provide 
treatment to an employee, pursuant to this chapter, without the requirement 
that the health-care provider first preauthorize each health-care procedure, 
office visit or health-care service to be provided to the employee with the 
employer or insurance carrier.  Any health-care provider who is not licensed 
by the State of Delaware to provide medical services may elect to become 
certified under this section, and thereby obtain the same rights and 
obligations under this chapter as a certified health-care provider who is 
licensed by the State of Delaware to provide health-care services.  The 
provisions of this subsection shall apply to all treatments to employees 
provided after the effective date of the rule provided by subsection(c) of this 
section, regardless of the date of injury.  A health-care provider shall be 
certified only upon meeting the following minimum certification 
requirements: 
 
a.  
Have a current license to practice, as applicable; 
b.  
Meet other general certification requirements for the specific 
provider type; 
c.  
Possess a current and valid Drug Enforcement Agency 
(“DEA”) registration, unless not required by the provider’s 
discipline and scope of practice; 
d.  
Have no previous involuntary termination from participation in 
Medicare, Medicaid or the Delaware workers’ compensation 
system, which shall be determined to be inconsistent with 
certification under regulations adopted pursuant to subsection 
(c) of this section;41 
e.  
Have no felony convictions in any jurisdiction, under a federal-
controlled substance act or for an act involving dishonesty, 
fraud or misrepresentation, which shall be determined to be 
 
40 Id. at 1261 (quoting Mohr, 47 A.3d at 496). 
41 Subsection (c) provides that “[s]ubject to the foregoing provisions, complete rules and 
regulations relating to provider certification shall be approved and proposed by the Workers’ 
Compensation Oversight Panel.  Regulations arising from the Panel’s work shall be adopted by 
regulation of the Department of Labor pursuant to Chapter 101 of Title 29.”  19 Del. C. § 2322D(c). 
 
 
 
 
 
 
 
16 
 
inconsistent with certification under regulations adopted 
pursuant to subsection (c) of this section; and 
f.  
Provide proof of adequate, current professional malpractice 
and liability insurance. 
 
(2) The certification rules shall require that any healthcare provider to be 
certified agree to the following terms and conditions: 
 
a.  
Compliance with Delaware workers’ compensation laws and 
rules; 
b.  
Maintenance of acceptable malpractice coverage; 
c.  
Completion of State-approved continuing education courses in 
workers’ compensation care every 2 years; 
d.  
Practice in a best-practices environment, complying with 
practice guidance and Utilization Review Accreditation 
Council (“URAC”) utilization review determinations; 
e.  
Agreement to bill only for services and items performed or 
provided, and medically necessary, cost-effective and related 
to the claim or allowed condition; 
f.  
Agreement to inform an employee of that employee’s liability 
for payment of noncovered services prior to delivery; 
g.  
Acceptance of reimbursement and not unbundled charges into 
separate procedure codes when a single procedure code is more 
appropriate; and 
h.  
Agreement not to balance bill any employee or employer.  
Employees shall not be required to contribute a copayment or 
meet any deductibles.42 
 
Employer asserts that the first sentence of Section 2322D(a)(1) creates a 
requirement that the Delaware Certification be current.  Specifically, Employer points to 
the terms “shall” and “be.”  Employer argues that the term “shall” is mandatory and that 
the term “be” is present tense, thereby necessitating a current certification.   
Section 2322D(a)(1) outlines the minimum requirements necessary to obtain a 
Delaware Certification, ranging from having a current license to practice to providing proof 
 
42 19 Del. C. § 2322D(a). 
 
 
 
 
 
 
 
17 
 
of adequate, liability insurance.43  Specifically, the last sentence of Section 2322D(a)(1) 
states that “[a] health-care provider shall be certified only upon meeting the following 
minimum certification requirements.”44    But Dr. Bose’s Delaware Certification did not 
lapse due to his failure to meet one of the six minimum requirements.  There is no question 
that at the time of Wilson’s Second Cervical Surgery, Dr. Bose met the minimum 
requirements necessary to obtain a Delaware Certification.   
Instead, this case focuses on the second portion of Section 2322D(a), which sets 
forth the terms and conditions a healthcare provider must agree to in order to be certified.  
Section 2322D(a)(2) provides that “[t]he certification rules shall require that any healthcare 
provider to be certified agree to the following terms and conditions” which includes 
completion of State-approved education courses every two years.45  The terms “shall” and 
“be” suggest that these are requirements that a healthcare provider must agree to in order 
to be certified.  Yet the statute is silent as to the consequences of failing to adhere to the 
terms and conditions listed in Section 2322D(a)(2).     
Employer argues that the requirements are of an ongoing nature, and therefore, the 
provider must fulfill these ongoing requirements in order to keep her certification active.  
This interpretation is consistent with the statute’s plain language.  Although the statute’s 
language weighs most heavily in the analysis, three factors weigh in Wilson’s favor, 
 
43 See 19 Del. C. § 2322D(a)(1)(a)-(f). 
44 19 Del. C. § 2322D(a)(1) (emphasis added).  
45 19 Del. C. § 2322D(a)(2) (emphasis added). 
 
 
 
 
 
 
 
18 
 
namely:  (1) the Act’s remedial purpose; (2) the fact that Wyatt and VanVliet are 
distinguishable; and (3) the prior two IAB decisions.  We discuss each in turn.   
1. The Remedial Purpose of the Act  
 
Weighing against this plain language argument is the remedial purpose of the Act, 
which might suggest that a temporary lapse should not result in a lack of coverage.   “In 
general, the construction given to a statute by the state agency charged with the statute’s 
enforcement is accorded great judicial deference, so long as the construction is reasonable 
and does not contradict the plain language of the statute.”46  This Court has “observed that 
the Act is a remedial statute with a benevolent purpose.”47   This Court has also observed 
that the Act is to be interpreted “liberally so as to effectuate its remedial purpose.”48  Thus, 
we are obliged to interpret the Act in a manner that fulfills the legislative intent but avoids 
an “unreasonable result.”49  
 
“Delaware’s first Workers’ Compensation Statute was enacted in 1917.”50  One 
purpose behind the statute was “‘to provide more direct and economical compensation for 
injured employees and create a pool of employers that would bear the burden of 
 
46 3C Shambie Singer, Sutherland Statutes and Statutory Construction § 75:3 (8th ed. 2021). 
47 State v. Cephas, 637 A.2d 20, 25 (Del. 1994). 
48 Konstantopoulos v. Westvaco Corp., 690 A.2d 936, 939 (Del. 1996) (citing Cephas, 637 A.2d 
at 25 (“It is the settled law of this State that the Act should be liberally construed to effectuate its 
purpose.” (citing Del. Tire Ctr. v. Fox, 411 A.2d 606, 607 (Del. 1980)))). 
49 2A Sutherland Statutes & Statutory Construction, § 45:12 (7th ed. 2008) (“It is important that a 
statute not be read in an atmosphere of sterility, but in the context of what actually happens when 
human beings go about the fulfillment of its purposes.”). 
50 Nat’l Union Fire Ins. Co. of Pittsburgh v. McDougall ex rel McDougall, 877 A.2d 969, 972 
(Del. 2005).  See also Rafferty v. Hartman Walsh Painting Co., 760 A.2d 157, 159 (Del. 2000); 29 
Del. Laws ch. 233 (1917).  
 
 
 
 
 
 
 
19 
 
ameliorating the losses resulting from industrial accidents.’”51  Another was “to provide 
prompt financial and medical assistance to injured employees and their families because 
the lengthy and protracted nature of tort litigation arising out of injuries to an employee 
often delayed such assistance for an extended period of time.”52  In most states, including 
Delaware, worker’s compensation statutes “were adopted . . . in response to the failure of 
the common law to provide a quick, practical, cost effective remedy for on the job injuries 
suffered by workers.”53  It has become “the exclusive remedy for injured workers.”54  Given 
the purpose for the workers’ compensation system, there is at least a colorable argument 
that an inadvertent lapse in certification due to an administrative error would not render 
otherwise reasonable and necessary treatment noncompensable.  
2. Both Wyatt and VanVliet are Distinguishable 
The Board, as well as the Superior Court, relied on this Court’s precedent in Wyatt.55  
But Wyatt is distinguishable in certain respects.  In Wyatt, this Court considered whether 
an uncertified doctor’s surgery performed without preauthorization was compensable.  The 
doctor in Wyatt had never obtained a Delaware Certification.  Further, the doctor’s office 
made it known to the claimant that he did not handle workers’ compensation cases.  In 
order to receive treatment and fearful that she would be unable to find immediate treatment 
 
51 Nat’l Union Fire Ins. Co. of Pittsburgh, 877 A.2d at 972 (quoting Rafferty, 760 A.2d at 159). 
52 Id. (quoting Rafferty, 760 A.2d at 159). 
53 Id. at 973 (quoting Rafferty, 760 A.2d at 159). 
54 Del. Valley Field Servs. v. Ramirez, 105 A.3d 396, 403 (Del. Super. 2012), aff’d sub nom. Del. 
Valley Field Servs. v. Melgar-Ramirez, 61 A.3d 617 (Del. 2013) (TABLE). 
55 B-40-41 (IAB Decision at 3-4); Wilson, 2022 WL 701632, at *6-7. 
 
 
 
 
 
 
 
20 
 
elsewhere, the claimant told the doctor that her injury occurred when she woke up rather 
than when she was at work.   
This Court engaged in a detailed statutory analysis as to why a doctor must either 
have a Delaware Certification, seek preauthorization, or fall into the narrow exception 
under the Act in order to have his or her treatment deemed compensable.  This Court held 
that because the doctor was not certified (and had never been certified), the treatment was 
noncompensable.56 
In this case, the Superior Court also relied on this Court’s precedent in VanVliet v. 
D&B Transportation.57  VanVliet is distinguishable for the same reason.  In VanVliet, the 
employee was involved in a work-related injury.  The injury necessitated surgery.  The 
employee’s surgery was performed by a Maryland surgeon.  The Maryland surgeon was 
uncertified under the Act at the time she performed the surgery, even though either most 
or all of the other members of her medical practice firm were Delaware certified.  The 
Maryland surgeon also did not seek preauthorization for the surgery. 
The employee sought reimbursement under the Act from his employer for the 
surgery performed by the Maryland surgeon.  The Superior Court initially found that a lack 
of Delaware Certification did not act as a total bar on an employee’s ability to receive 
reimbursement from his employer for the cost of treatment.  The court remanded the matter 
to the IAB. 
 
56 See Wyatt, 81 A.3d at 1263. 
57 Wilson, 2022 WL 701632, at *7 n.64; see also VanVliet v. D&B Transp., 105 A.3d 390 (Del. 
2014). 
 
 
 
 
 
 
 
21 
 
In the interim, this Court decided Wyatt, which held that a claimant could not obtain 
reimbursement for care provided by a physician who was not Delaware certified unless the 
physician obtained preauthorization.  When the employer appealed the Board’s award of 
reimbursement for surgery costs in the VanVliet matter, the Superior Court applied Wyatt 
and reversed the Board’s decision.  The employee then appealed to this Court.    
The employee argued that Wyatt was wrongly decided because there was no way to 
compel non-Delaware physicians to become Delaware certified.  But we disagreed.  This 
Court found that VanVliet could not be distinguished from Wyatt, and, therefore, the 
employee in VanVliet was not entitled to reimbursement because it was undisputed that the 
surgery was performed by a non-certified Maryland surgeon, and none of the limited 
statutory exceptions to the Delaware Certification requirement applied.  Again, the key 
distinction is that in VanVliet, the surgeon was never certified under the Act.58   
3. The Board’s Precedent (Williams and Zayes) Also Supports Wilson  
  
Wilson asserts that the Board’s decision was arbitrary and capricious because it 
deviated from its own precedent without explanation.  He argues that on two occasions, 
under circumstances indistinguishable from those here, the Board found that a lapse in 
 
58 We note that in footnote 5 of VanVliet, Chief Justice Strine stated: 
One of us believes it is a close question whether Wyatt was correctly decided or 
whether the Superior Court’s different earlier interpretation in this matter is correct, 
in view of the complexity of the statutory provisions cand the liberal construction 
that is generally given to the Act.  But none of us believe[s] that we should deviate 
from the principle of stare decisis given the General Assembly’s ability to amend 
the Act if it disagrees with our interpretation in Wyatt.   
105 A.3d at 391 n.5.   
 
 
 
 
 
 
 
22 
 
Delaware Certification due to an administrative error did not disqualify a provider’s bills 
from payment.  Therefore, Wilson contends that the Board abused its discretion when it 
failed to explain its departure from these precedents.   
Williams, decided in 2012, appears to be the first time the Board addressed a “lapse” 
in a provider’s Delaware Certification.  In Williams, the State filed a motion to dismiss a 
claimant’s petition on the basis that the medical treatment was not performed by a certified 
healthcare provider under the Act.  The claimant sought treatment from Dr. Mann, who 
was previously certified under the Act.  Unbeknownst to the claimant, Dr. Mann’s 
certification had “lapsed on the dates of two of the three prescription medication refills, 
which represent the relief sought in the [claimant’s] petition.”59  The Board denied the 
State’s motion to dismiss.   
In making this determination, the Board reviewed the certification records provided 
by the Health Care Payment System.  From those records, the Board learned that Dr. Mann 
was previously certified from May 13, 2008 through May 13, 2010.  Claimant sought 
prescription refills on June 21, 2011, and August 17, 2011.  At the time of the prescription 
refills, Dr. Mann’s certification had “lapsed” due to Dr. Mann’s “fail[ure] to complete a 
continuing education filing to re-certify his status as a workers’ compensation healthcare 
provider.”60   
The Board characterized this “lapse” as a “simple administrative error on [Dr. 
 
59 Williams, No. 1282260, at 2. 
60 Id. at 2. 
 
 
 
 
 
 
 
23 
 
Mann’s] part, given his former and current compliance.”61  The Board stated that “[g]iven 
the relative newness of the regulations, which became effective in May 2008, and for which 
continuing education requirements would not have been necessary for Dr. Mann until at 
least 2010, the Board fail[ed] to find significant grounds to dismiss [claimant’s] pending 
petition.”62  Thus, the Board concluded that “[u]nder these unique circumstances, Dr. 
Mann’s de minimus [sic] omission in completing the continuing education filing in 2010 
fail[ed] to constitute a willful disregard for the Health Care Payment System regulations 
and or/its purposes,” and therefore “[c]laimant’s pending petition should not be dismissed 
based on merely a procedural technicality.”63 
This case is similar to Williams.  In his deposition, when asked why his name had 
been crossed off the workers’ compensation website, Dr. Bose stated that “[w]ell, it was -
- we have taken care of the paperwork.  It was like the CME was not filed so we sent them 
the paperwork last week so they were going to take it off.  We noticed that.”64   
In 2015, the Board in Zayes was again faced with determining whether a lapse in 
Delaware Certification disqualified a provider’s bills from payment.  During closing 
arguments before the Board, the employer’s counsel raised the issue of whether claimant’s 
doctor, Dr. Damon Carey, was a certified provider at the time of treatment.  The Board 
found that, on initial questioning, Dr. Carey thought that he was certified.  However, it was 
 
61 Id. 
62 Id. 
63 Id. 
64 B-28 (Dr. Bose Dep. at 28:6-11) (emphasis added). 
 
 
 
 
 
 
 
24 
 
brought to Dr. Carey’s attention that his name appeared to be stricken from the list of 
current certified providers on the DOL website.65  Dr. Carey testified that “he did not get 
the reminder e-mail to re-new his certification and he recently went online to take the 
required test.”66  The Board found that “in the context of this case Dr. Carey’s error was de 
minimus [sic],” but that “at some point a continuing failure to adhere to the process may 
well bring different results.”67 
Although these cases bear close resemblance to the facts at issue here, we are not 
persuaded that we should judicially craft a de minimis exception to Section 2322D’s 
requirements.  In addition to our view that crafting such an exception lies within the 
General Assembly’s province, various facts cut against creating a de minimis exception.  
Dr. Bose still had the right to practice medicine and to treat workers’ compensation 
patients.  He simply needed to get pre-authorization while de-certified.  Further, we are 
hesitant to craft such an exception on this extremely limited record where the circumstances 
surrounding the lapse are largely unexplained.68     
Moreover, distinguishing between the minimum requirements in Section 2322 
D(a)(1) and the additional terms and conditions in Section 2322D(a)(2) could deemphasize 
the importance of staying compliant with the additional terms and conditions set out in 
 
65 Zayes, No. 1365817, at 15.  Even though Zayes was decided after Wyatt, the Board found a de 
minimis exception anyway.  
66 Id. 
67 Id. 
68 For example, we do not know why Dr. Bose’s Delaware Certification lapsed in 2019.  We do 
not know whether he ever received notification that his continuing education requirement was not 
fulfilled.  Nor do we know who was at fault for the administrative error. 
 
 
 
 
 
 
 
25 
 
Section 2322D(a)(2).  These are policy determinations better left to the General 
Assembly.69    
B. The Balance Billing Issue is Not Ripe 
Wilson contends that if his Second Cervical Surgery is found noncompensable, he 
will be liable to Dr. Bose for his medical bills associated with this procedure.70  Employer 
responds that such a result would be inconsistent with the Act’s remedial purpose and 
possibly Section 2322F(l)(1)’s language.  Although this issue was briefed fully here, and 
it was briefed before the Superior Court, the Superior Court did not address the issue.  Nor 
will we because no such claim has been asserted.  Any opinion by this Court would be 
purely advisory.71  Thus, the issue is not ripe.  Delaware courts will decline to exercise 
jurisdiction over a case unless the underlying controversy has “matured to a point where 
 
69 See Cordero v. Gulfstream Dev. Corp., 56 A.3d 1030, 1037 (Del. 2012) (explaining that an 
“unfortunate result can only be corrected by the General Assembly, because courts lack the 
constitutional power to rewrite the statute”). 
70 Wilson points to Section 2322(F)(l)(2) & (3) and argues that he would be responsible if this 
Court affirms Superior Court’s decision.  Wilson contends that Section 2322F applies to medical 
expenses incurred in connection with a work injury irrespective of a healthcare provider’s 
certification status, and that Section 2322F(l)(2)(a) expressly permits a healthcare provider to 
commence collection efforts against a claimant (an employee) once the issue of compensability is 
ultimately decided.  19 Del. C. § 2322F(l)(2)(a).  Accordingly, he argues that Section 2322F would 
render him liable for the medical bills associated with his Second Cervical Surgery if his second 
surgery is not compensable.  The Employer counters that, “[f]undamentally, the healthcare 
payment system provided under Chapter 19 does not permit a healthcare provider, as defined by 
19 Del. C. § 2301(13), who is not certified as required by 19 Del. C. § 2322D to collect charges 
for those services.”  Ans. Br. at 17.  Employer states that since Dr. Bose was not certified at the 
time he performed the surgery, his charges were not “authorized by this chapter” or the “healthcare 
payment system” under 19 Del. C. § 2322D.  Id.  Thus, Employer contends that Dr. Bose cannot 
recover these charges. 
71 Heathergreen Commons Condominium Ass’n v. Paul, 503 A.2d 636, 639 (Del. Ch. 1985) 
(“Controversies that are hypothetical and would result in only an advisory opinion are not 
justiciable.”).   
 
 
 
 
 
 
 
26 
 
judicial action is appropriate.”72  For these reasons, and given the undeveloped record on 
this issue, we decline to address it.73 
VI. 
CONCLUSION 
For the reasons set forth above, the Court AFFIRMS the Superior Court’s decision.   
 
72 Stroud v. Milliken Enters., Inc., 552 A.2d 476, 480 (Del. 1989) (citing Schick Inc. v. 
Amalgamated Clothing & Textile Workers Union, 533 A.2d 1235, 1239 (Del. Ch. 1987)).   
73 “To address a matter before the facts surrounding the dispute are fully developed necessarily not 
only increases the risk of an incorrect judgment in the particular case, but risks, as well, an 
inappropriate or unnecessary step in the incremental law building process itself.”  Schick, 533 A.2d 
at 1239 (citing Wright, Miller & Cooper, Federal Practice and Procedure § 3532 (1984)).