Court Opinion

ID: 9411986
Source: CourtListenerOpinion
Date Created: 2023-07-28 18:07:50.475301+00
Date Added: 2024-06-11T16:41:22.511641
License: Public Domain

IN THE SUPERIOR COURT OF THE STATE OF DELAWARE

STATE OF DELAWARE                        )
                                         )
           Employer-Appellant,           )
                                         )
     v.                                  )     C.A. No. N22A-06-003 CEB
                                         )
SHARON WILLIAMS                          )
                                         )
           Employee-Appellee.            )

                          Submitted: April 21, 2023
                           Decided: July 26, 2023

                       MEMORANDUM OPINION

               Upon Appeal from the Industrial Accident Board,
                               AFFIRMED.

John J. Klusman, Esquire, TYBOUT, REDFEARN & PELL, Wilmington,
Delaware. Attorney for Employer-Appellant State of Delaware.

Michael G. Owens, Esquire, and Justin K. Weeks, Esquire, MORRIS JAMES LLP,
Wilmington, Delaware. Attorneys for Employee-Appellee.

BUTLER, R.J.
                               INTRODUCTION

      Appellant-Employer State of Delaware (“Employer”) seeks review of a

decision of the Industrial Accident Board (“Board”) that awarded permanency

benefits to Appellee-Employee Sharon Williams (“Claimant”) for a head injury

sustained during a work-related motor vehicle accident.

      The Court finds the Board’s award of permanency benefits is supported by

substantial evidence. Therefore, the decision of the Board must be AFFIRMED.

                               BACKGROUND1

A. The Accident

      In 2016, Claimant began experiencing migraine headaches and was

subsequently diagnosed with “headaches with migraine features, and occipital

neuralgia and she was averaging three headache days a month. . . .”2 Claimant was

on a preventative regimen consisting of 30mg a day of Cymbalta, ibuprofen, and

Reglan.3   Then, in December 2018, while working within her duties for the

Employer, Claimant suffered a head injury in a motor vehicle accident.4 That same

1
  The Court assumes the parties’ familiarity with the facts contained in the Record
and only recounts the background relevant to affirming the Board’s Determination.
2
  See Williams v. State, No. 1482282 at 6, 18. (Del. IAB May 31, 2022) (Decision
on Petition to Determine Additional Compensation Due) [hereinafter “IAB
Decision”].
3
  Id. at 2.
4
  Id.
                                        1
day, her symptoms as a result of the accident included nausea, head pressure, blurred

vision, and she was dazed and confused.5

      After visiting an urgent care center and her primary care physician, Claimant

was referred to a neurologist at Jefferson Health, where she had been previously

treated for migraines.6    Her new symptoms were distinguishable from prior

migraines as being “on the top of her head,” rather than occipital.7         So, the

neurologist increased her Cymbalta dose to 90mg a day, but Claimant soon began

experiencing negative side effects.8 Accordingly, the dose was reduced, but her head

injury symptoms worsened.9       Claimant also received Botox treatments which

reduced her headaches to “one to two days per month.”10

B. Claimant’s Petition for Additional Compensation

      Claimant received “medical expenses and multiple periods of total disability,”

but her condition continued to deteriorate.11 So, in October 2021, Claimant filed a

Petition to Determine Additional Compensation Due with the Industrial Accident

5
  Id. at 3; Hr’g Tr. at 14:17–21, 57:22–58:13.
6
  IAB Decision at 3.
7
  Id. at 3; Hr’g Tr. 24:6–24.
8
  IAB Decision at 3, 18; Hr’g Tr. at 22:5–11.
9
  IAB Decision at 3, 18; Hr’g Tr. at 22:12–14
10
   IAB Decision at 18; Hr’g Tr. at 107:7–17.
11
   IAB Decision at 2.
                                         2
Board, seeking permanent impairment benefits related to her headaches, vestibular

dysfunction, convergence insufficiency, and cognitive dysfunction.12

      During the hearing, Claimant explained that she suffers from continuous

vertigo and tends to lose her balance, has blurred and double vision, has numbness

in her hands, and experiences nine severe migraines each day for 30 minutes at a

time.13 She relies on her mother’s assistance for activities of daily living.14

      Claimant was examined by both Dr. John Townsend (for the Claimant) 15 and

Dr. William Sommers (for the Employer),16 who testified via deposition. While both

experts agree that Claimant had “a chronic aggravation of her preexisting migraine

headaches” they diverged on other issues.17 Where Dr. Townsend awarded 15%

permanency for headaches,18 Dr. Sommers awarded 10% permanency.19                 For

12
   Id.
13
   Hr’g Tr. at 25:14–24.
14
   Id. at 27:4–15.
15
   Dr. Townsend is a board-certified neurologist and testified via deposition on
behalf of Claimant. See Deposition of John B. Townsend, M.D., Apr. 14, 2022
[hereinafter “Townsend Dep.”].
16
   Dr. Sommers is a board-certified neurologist and testified via deposition on
behalf of the State. See Deposition of William Sommers, D.O., Mar. 9, 2022
[hereinafter “Sommers Dep.”].
17
   IAB Decision at 25.
18
   Townsend Dep. at 30:17–20. Dr. Townsend relies on Claimant’s extensive
medical history, increased severity of headaches post-accident, and her increased
treatment and lack of responsiveness thereto. Id.
19
   Sommers Dep. 22:3–23:8. Dr. Sommers relies on the severity and frequency of
Claimant’s headaches. Id.
                                           3
convergence insufficiency, Dr. Townsend awarded 14% permanency,20 while Dr.

Sommers declined to assign a rating.21 For vestibular dysfunction, Dr. Townsend

gave a 16% permanency rating,22 while Dr. Sommers declined to assign a rating.23

For cognitive dysfunction, Dr. Townsend awarded a 10% permanency, 24 while Dr.

Sommers declined to assign a rating.25

      Finally, Dr. Townsend testified that Claimant’s condition was causally related

to the employment-related injury. Dr. Sommers believed that Claimant suffered from

some psychiatric or other issues and her condition was not causally related to the

auto accident.

C. The Board’s Determination

      In May 2022, the Board issued its determination. It concluded that Claimant

met her burden of proof, showing she sustained permanent injuries as a result of the

20
   Townsend Dep. 35:8–36:18. Dr. Townsend relies on his own observations of
Claimant and those of other doctors, including the optometrist who identified the
condition. Id.
21
   Sommers Dep. at 25:7–26:9. Dr. Sommers believes Claimant’s complaints of
double and blurry vision are implausible. Id.
22
   Townsend Dep. at 34:5–35:3. Dr. Townsend relies on Claimant’s consistent
complaints of vertigo, rapid uncontrollable eye movement accompanied by nausea,
and American Medical Association guidelines. Id.
23
   Sommers Dep. at 24:7–25:3. Dr. Sommers does not think Claimant’s symptoms
had been validated because she was not subjected to any “objective vestibular
testing,” and he believed there was “no organic basis to support her symptoms.” Id.
24
   Townsend Dep. at 37:12–38:18. Dr. Townsend relies on Claimant’s “persistent
complaint[s]” and his own observations. Id.
25
   Sommers Dep. at 26:10–27:11. Dr. Sommers does not believe there is “any
objective evidence of any memory or cognitive impairment.” Id.
                                         4
2018 motor vehicle accident and awarded Claimant 15% permanent impairment for

the headaches, 14% for convergence insufficiency, and 16% for vestibular

dysfunction.26 It did not grant an award for cognitive impairment, finding the matter

premature.27 But it noted specifically that it “accepts Dr. Townsend’s opinion as

more reliable Dr. Sommer’s opinion in this case.”28

                            STANDARD OF REVIEW

      Review of a Board 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.”29 Substantial evidence is “such

relevant evidence as a reasonable mind might accept as adequate to support a

conclusion.”30   Substantial evidence is “more than a scintilla, but less than a

preponderance of the evidence.”31 The Board’s finding of substantial evidence “is a

low standard to affirm and a high standard to overturn.”32 “Weighing the evidence,

determining the credibility of witnesses, and resolving any conflicts in the testimony

26
   IAB Decision at 27.
27
   Id.
28
   Id. at 25.
29
   Sheppard v. Allen Family Foods, 279 A.3d 816, 826 (Del. 2022) (internal
citations omitted).
30
   Powell v. O TAC, Inc., 223 A.3d 864, 870 (Del. 2019) (internal quotation marks
and citations omitted).
31
   Id.
32
   Hanson v. Del. State Pub. Integrity Comm’n, 2012 WL 3860732, at *7. (Del.
Super. Aug. 30, 2012).
                                          5
are functions reserved exclusively to the Board.”33        “Only when there is no

satisfactory proof to support a factual finding of the Board may the Superior

Court . . . overturn that finding.”34

                                        ANALYSIS

      The Employer argues that the Board’s determination should be reversed

because: (1) it failed to articulate and apply a proper causation standard to determine

whether Claimant’s symptoms were causally related to the work accident; and (2)

its decision that Claimant’s condition was consistent with her prior condition was

not supported by substantial evidence.

A. The Board sufficiently articulated that its permanent impairment findings
   were causally related to the work accident.

      Under 19 Del. C. § 2345, the Board “shall hear and determine the matter in

accordance with the facts and the law and state its conclusions of fact and ruling of

law.”35 The Employer argues that the Board did not clearly articulate or apply the

appropriate legal standard for permanent impairment as required by 19 Del. C. §

2345.36 This Court has held that, although the reasoning of the Board must be clear,

      [W]here the testimony has been explained as part of the preface to the
      findings of fact and law and where the Board’s decision contains the

33
   Noel-Liszkiewicz v. La-Z Boy, 68 A.3d 188, 191 (Del. 2013).
34
   Id.
35
   19 Del. C. § 2345.
36
   Appellant’s Opening Br. at 16–17.
                                           6
      appropriate details which led to its reasoning, this Court will not reverse
      simply because the Board did not repeat those facts in its ‘Findings.’37

So, it is enough that the Board’s decision contains the appropriate details that led to

its reasoning.38 The Court is capable of inferring from the Board’s conclusions what

the underlying findings must have been.39 And remand of a permanency issue will

not be ordered if it will merely produce “a more technically precise opinion” rather

than bring about a different result.40

      Here, taken together, the “Permanent Impairment” and “Summary of the

Evidence” sections of the Board’s decision make it clear that the Board evaluated

Dr. Townsend’s and Dr. Sommers’ testimony, personally observed Claimant, and

concluded that Dr. Townsend’s testimony was more credible.41 A remand of the

permanency issue would do nothing more than force the Board to produce a more

technically precise opinion. Accordingly, the Court finds the Board has provided

sufficient explanation for its findings to meet the requirements of 19 Del. C. § 2345.

37
   Justison v. Home Health Corp., 1999 WL 463702, at *4 (Del. Super. May 19,
1999).
38
   Washington v. Del. Transit Corp., 226 A.3d 202, 211 (Del. 2020) (internal
citations omitted).
39
   Johnson v. E.I. Dupont de Nemours & Co., 2000 WL 33115805, at *4 (Del.
Super. Oct. 4, 2000), aff’d 768 A.2d 469 (Del. 2001).
40
   Id.
41
   The Board is free to choose between conflicting medical opinions. See
DiSabatino Brothers, Inc. v. Wortman, 453 A.2d 102, 106 (Del. 1982).
                                          7
B. The Board’s finding of permanent impairment is supported by substantial
   evidence.

     Weighing the evidence and determining questions of credibility are functions

reserved exclusively for the Board.42 “When, as here, there is contradictory expert

testimony supported by substantial evidence, it is within the Board’s discretion to

accept the testimony of one physician over another.”43 The State argues that the

Board failed to articulate its rationale for accepting Dr. Townsend’s testimony over

Dr. Sommers’ testimony.44 The Board, however, does so quite clearly. Regarding

headaches:

       [T]he evidence points to a more serious chronic headache condition
       then Dr. Sommers allowed and therefore Dr. Townsend’s rating reflects
       this condition more accurately.45

Regarding convergence insufficiency:

       Dr. Sommers did not provide a rating. The Board finds that this is not
       helpful, particularly when one of the reasons for this opinion could have
       been resolved with a complete review of the medical records. . . . Dr.
       Sommers does provide an opinion that some of Claimant’s symptoms
       are not causally related to the accident because they arose several years
       after the accident. However the evidence suggests symptoms related to
       these two impairments did arise early on or at least during 2019. . . .
       Dr. Sommers was not aware of the treatment Claimant had for vision
       related complaints.46

42
   Noel-Liszkiewicz, 68 A.3d at 191.
43
   Cottman v. Burris Fence Constr., 2006 WL 3742580, at *3 (Del. Dec. 19, 2006)
(TABLE) (internal quotation marks and citations omitted).
44
   Appellant’s Opening Br. at 20–28.
45
   IAB Decision at 25.
46
   Id. at 25–26.
                                          8
Regarding vestibular dysfunction:

      Dr. Townsend found objective signs of vertigo on
      examination . . . some of these findings showed up on early
      examinations, which confirms they were present early on as opposed to
      what Dr. Sommers stated.47

The Court will defer to the Board’s reasoning.

      The Employer further contends that Claimant’s increase in symptoms

following the accident is inconsistent with expert testimony.48 Specifically, the

Employer argues Ms. Williams’ symptoms should not have increased over time. But

Dr. Townsend’s testimony, on which the Board relied, explains that a patient may

get better with therapy, but then decline after that therapy stops—which is the case

here.49 Further Claimant’s symptoms and diagnoses from multiple physicians have

been consistent.50

      The Employer also argues that the Board failed to address Claimant’s pre-

existing condition and psychiatric issues.51 But the Board “is not obligated to issue

decisions that scrutinize every shred of evidence on every issue presented to the

Board.”52 The Record shows that both experts addressed Claimant’s pre-existing

47
   Id. at 26.
48
   Appellant’s Opening Br. at 20–26.
49
   IAB Decision at 14; Townsend Dep. at 60:19–61:8.
50
   IAB Decision at 9–10; Townsend Dep. at 27:12–28:10.
51
   Appellant’s Opening Br. at 26–28.
52
   Lee v. UE&C Catalytic, Inc., 1999 WL 459257, at *4 (Del. Super. Mar. 31,
1999).
                                         9
migraines in their impairment rationales, and Dr. Townsend addressed Claimant’s

possible obsessive-compulsive disorder in his deposition testimony.53       That is

sufficient.   Accordingly, the Court finds the Board decision is supported by

substantial evidence and free from legal error.

                                  CONCLUSION

       For the foregoing reasons, the decision of the Industrial Accident Board is

AFFIRMED.

       IT IS SO ORDERED.

                                              /s/ Charles E. Butler
                                              Charles E. Butler, Resident Judge

53
  IAB Decision at 25 (“Both experts agree that Claimant has an impairment due to
her chronic headaches, or at a minimum a chronic aggravation of her preexisting
migraine headaches. The difference is the amount of rating.”); Townsend Dep. at
82:20–84:13.
                                         10