Within the Scope?
You Forfeit
Give me the Moolah
It's All Medical
Potpourri
100

An employee is injured during his/her regular commute to and from work.

Not within C&S - Going & Coming Rule

100

T/F - Claimant is deported to his/her home country. Claimant's benefits are suspended/terminated under Sec. 2353

False. Del. Valley Field Servs. v. Ramirez, 105 A.3d 396 (2012), aff’d 61 A.3d 617.

100

Employer must establish this to earn a credit for a claimant's missed DME.

Bad faith – i.e., repeated failure to attend examinations

100

To establish causation of an injury, the claimant must show ___________  as set forth in Reese v. Home Budget Ctr., 619 A.2d 907 (Del. 1992)

The injury would not have occurred but for the accident - setting or trigger

100

T/F - Comp carrier can require the claimant to use the carrier's preferred provider. 

True. Boone v. Syab Services/Capitol Nursing, 72 A.3d 501 (Del. 2013) (TABLE)

200

Acts incident to employment, such as eating, drinking, smoking, restroom, etc. are protected under.....

Personal Comfort Doctrine

200

Claimant falls from scaffold. and breaks leg. Alcohol in his system. Employer must establish this to be successful on forfeiture defense. 

Proximate Cause

200

In a third-party tort claim, the WC carrier is responsible for its pro rata share including attorneys’ fee. This is known as...

Keeler Credit

200

Surgery which would have been required eventually is compensable if need is ____________ by work accident.

Accelerated 

200

T/F - Where a claimant is working two jobs, AWW is calculated using  wages from both jobs.

False. Peterman v. Caulk, 612 A.2d 159 (Del. 1992) (TABLE)

300

Employee arrives to work, slips on ice in employer's parking lot.

Within C&S - Premises Rule

300

Claimant refuses medical care.  Employer must establish this to succeed on forfeiture defense.

The refusal is unreasonable to that specific claimant - not just generally for anyone in claimant's position

300

When Employer is seeking a credit for overpayment of benefits, the Board will look to this.

Respective degree of fault of the parties.

300

To establish recurrence of total disability, claimant must show...

“Return” of an impairment; must be change in condition

300

When there's a Nally case, liability shifts to employer #_ if there’s a worsening of condition and unusual exertion.

Employer #2

400

HVAC cleaner finishes one job for employer, then proceeds to drive to the next job, picks up an iced coffee, and then, is injured in MVA.

Within C&S - Traveling Employee Exception


400

Claimant misses 3 DMEs.  Employer must establish this for Claimant's benefits to be suspended during period of non-cooperation.

No Good Cause for Claimant's failure to attend examinations

400

Carrier who is seeking reimbursement under Section 2363 has an ethical duty to __________ or otherwise not undermine, claimant’s 3rd party tort case.

Cooperate; Baio v Commercial Union Ins. Co., 410 A.2d 502 (Del. 1979)

400

T/F - Medical marijuana is not subject to the Fee Schedule and the carrier does not have to pay sticker price.

False. Giles & Ransome v. Kalix, 2018 WL 4922911 (Del. Super. Ct. Oct. 9, 2018)

400

This case set forth the proposition that “[a] displaced employee ... who does not know or have reason to know that [he] is a displaced employee cannot be expected to seek new employment.”

Hoey v. Chrysler Motors Corp., 655 A.2d 307 (Del. 1994

500

Manager's wife comes to office. Accuses claimant of having an affair with Manager husband. Then, proceeds to attack claimant and injures her.

Not within C&S. Rose v. Cadillac Fairview Shop. Ctr., 668 2d 782 (Del. 1995); Brogan v. Value City Furniture, 2002 WL 499721 (Del. Super. Ct. Mar. 27, 2002)

500

Claimant is trimming tree. Falls out of tree b/c harness was not tied off. Employer must show this to succeed on  forfeiture defenses

Deliberate or Reckless Indifference and/or intentional violation of safety rule

500

A Carrier's failure to pay benefits owing for workers’ compensation benefits may result in penalties under the wage payment and collections act. This seminal case is..

Huffman v. C.C. Oliphant & Sons, Inc., (Del. 1981)

500

“Objective Causal Nexus Test” is applied when a claimant asserts this injury/claim

Stress Claim. State v. Cephas, 637 A.2d 20 (Del. 1994)

500

This is known as the "Bathing Suit Test."

Visible, offensive and embarrassing when the body is normally clothed, to include bathing suit and recreational attire.

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