Title: Boone v. Syab Services/Capitol Nursing

State: delaware

Issuer: Delaware Supreme Court

Document:

IN THE SUPREME COURT OF THE STATE OF DELAWARE 
 
PATRICIA BOONE,  
§ 
 
 
 
§ 
No. 525, 2012  
 
 
Claimant Below- 
§ 
 
Appellant 
§ 
Court Below:  Superior Court  
 
  
§ 
of the State of Delaware in and  
v.  
§ 
for Kent County  
 
 
§  
 
SYAB SERVICES/CAPITOL  
§  
C.A. No. K11A-10-003 
 
NURSING, 
§ 
 
 
 
§ 
 
 
Employer Below- 
§ 
 
 
Appellee 
§ 
 
Submitted:  May 8, 2013 
Decided:  July 16, 2013 
 
 
Before STEELE, Chief Justice, JACOBS and RIDGELY, Justices.  
 
O R D E R 
 
On this 16th day of July, 2013, it appears to the Court that:  
(1)  Claimant-below/Appellant Patricia Boone appeals from a Superior Court 
order affirming a decision of the Industrial Accident Board (the “Board”) permitting 
Employer-below/Appellee Syab Services/Capitol Nursing (“Syab”) to require Boone 
to use Syab’s contracted prescription service to obtain pain medication.  Boone raises 
one claim on appeal.  Boone claims that the Board erred as a matter of law in ruling 
that Boone must obtain her prescriptions from Syab’s preferred pharmacy provider 
instead of her own doctor.  We find no merit to Boone’s appeal and affirm.  
(2)  In 2001, Boone suffered a work-related lower back injury while employed 
2 
 
by Syab.  Syab petitioned the Board to require Boone to have the prescription filled 
by Syab’s “preferred provider” benefit program known as Express Scripts.  Using this 
program would save Syab money at no additional cost to Boone.  With Express 
Scripts, Boone would be able to go to any covered pharmacy or have her medication 
mailed to her home.  Boone objected to Syab’s request as she had been getting her 
prescriptions filled at the office of her treating physician, Dr. Genesh Balu, a more 
convenient option for her.  Though Express Scripts is less expensive, Dr. Balu 
charges the amount set forth in the Delaware Fee Schedule.1 
(3)  The Board found that Syab’s request was reasonable and permissible under 
the Workers’ Compensation statute.2  The Superior Court affirmed the Board’s order.3  
This appeal followed.   
(4)  We review a decision of the Board for errors of law and determine whether 
substantial evidence exists to support the Board’s findings of fact and conclusions of 
law.4  “Substantial evidence equates to ‘such relevant evidence as a reasonable mind 
might accept as adequate to support a conclusion.’”5  We will not weigh the evidence, 
                                          
 
1 See 19 Del. Admin. C. § 1341-4.13.1  (“Reimbursement for pharmacy services, prescription drugs, 
and other pharmaceuticals is 100% of the Average Wholesale Price (AWP) as of the date of service, 
or the actual charge, whichever is less”).  
2 Boone v. SYAB Services, Hearing No. 1198151 (I.A.B., Oct. 5, 2011). 
3 Boone v. SYAB Services, C.A. No. K11A-10-003 (Del. Super., Aug. 23, 2012) 
4 Person-Gaines v. Pepco Holdings, Inc., 981 A.2d 1159, 1161 (Del. 2009) (citing Stanley v. Kraft 
Foods, Inc., 2008 WL 2410212, at *2 (Del. Super. Mar. 24, 2008)). 
5 Id. (quoting Olney v. Cooch, 425 A.2d 610, 614 (Del. 1981)). 
3 
 
determine questions of credibility, or make our own factual findings.6  Errors of law 
are reviewed de novo.7  Absent an error of law, the standard of review for a Board’s 
decision is abuse of discretion.8  “The Board has abused its discretion only when its 
decision has ‘exceeded the bounds of reason in view of the circumstances.’”9   
(5)  Boone argues that the Board erred in requiring her to obtain her 
prescriptions from Syab’s preferred pharmacy provider.  The claim centers on 
Section 2322(a) of the Workers Compensation statute, which states: 
During the period of disability the employer shall furnish 
reasonable surgical, medical, dental, optometric, chiropractic and 
hospital services, medicine and supplies, including repairing 
damage to or replacing false dentures, false eyes or eye glasses 
and providing hearing aids, as and when needed, unless the 
employee refuses to allow them to be furnished by the employer.10 
(6)  A plain reading of Section 2322(a) shows that it does not provide an 
absolute right for an employee to choose his or her own pharmacy.  Rather, it only 
requires the employer to furnish “medicine and supplies . . . as and when needed” and 
then gives the employee the right to refuse what is supplied.  Section 2323 of the 
Workers Compensation statute provides employees with the absolute right to choose 
certain other physicians: 
                                          
 
6 Id. (citing Johnson v. Chrysler Corp., 213 A.2d 64, 66-67 (Del. 1965)). 
7 Id. 
8 Person-Gaines, 981 A.2d at 1161 (citing Stanley, 2008 WL 2410212, at *2). 
9 Id. (quoting Stanley, 2008 WL 2410212, at *2). 
10 19 Del. C. § 2322(a) (emphasis added).  
4 
 
Any employee who alleges an industrial injury shall have the right 
to employ a physician, surgeon, dentist, optometrist or 
chiropractor of the employee's own choosing.11     
Significantly, Section 2323 does not include “pharmacist” or “pharmacy.”  Absent 
case law to the contrary,12 the Board’s interpretation of the law was without error.   
(7)  After determining the statute did not provide Boone with an absolute right 
to choose her own pharmacy, the Board made a factual determination that Syab’s 
request was reasonable.  Boone argues it is also reasonable for her to receive her 
prescriptions from Dr. Balu, as Dr. Balu’s charges are within the fee schedule.  But, 
as reasonable as Dr. Balu’s charges may be, it does not diminish the reasonableness 
of Syab’s less costly alternative.  It was within the Board’s discretion to determine 
that Boone must obtain her prescriptions from Syab’s preferred pharmacy provider 
instead of her own doctor.  
NOW, THEREFORE, IT IS ORDERED that the judgment of the Superior 
Court is AFFIRMED. 
 
BY THE COURT: 
 
 
 
 
 
 
 
/s/ Henry duPont Ridgely 
 
 
 
 
 
 
Justice 
 
                                          
 
11 19 Del. C. § 2323.  
12 Boone cites to Davis Plumbing Co. v. Burns, 967 So.2d 94 (Ala. Civ. App. 2007) to support her 
argument.  In Davis, the Court of Civil Appeals of Alabama considered facts very similar to this 
case and found a right to choose a pharmacist.  Alabama has a markedly different Workers 
Compensation law, which requires the employer to “pay an amount not to exceed the prevailing rate 
or maximum schedule of fees as established herein of reasonably necessary ... medicine ... as may 
be obtained by the injured employee....”  Ala. Code § 25-5-77 (1975).  This Alabama statute more 
clearly gives the employee power to obtain the medication independently.