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Rescare Home Care v. Wyatt

Superior Court of Delaware

March 6, 2013

Rescare Home Care
Amanda Wyatt

Date Submitted: December 17, 2012


Dear Counsel:

This is my decision on the cross-appeals filed by Amanda Wyatt and Rescare Home Care in this workers' compensation case. Wyatt was employed as a certified nursing assistant with Rescare. Wyatt's job was to care for a five-year-old boy, Isaac. Isaac, who weighed approximately 50 pounds, was completely dependant on Wyatt for his care. She would care for him at his home and school. In caring for Isaac, Wyatt often had to lift him from his wheelchair to the floor or to another chair and back. On December 15, 2010, Wyatt was lifting Isaac from his wheelchair to his lunch chair when she lost feeling in her left leg. Wyatt described the feeling as "everything was numb." Four days later, Wyatt had surgery to correct a herniated disc in her back. Wyatt filed a Petition to Determine Compensation Due with the Industrial Accident Board on June 10, 2011. The main issue before the Board was whether Wyatt suffered a compensable work-related accident in the course and scope of her employment with Rescare.

The Board held a hearing on January 18, 2012. Six people testified at the hearing. Wyatt, LeAnne Waltz, Mary Leight and Dr. Balapur Venkataramana testified in favor of Wyatt. Dr. Kevin Hanley and Betty Alfree testified in favor of Rescare. Wyatt testified about the nature of her job, and how she injured her back and the medical treatment she sought for it. Leanna Waltz is Wyatt's mother. She testified about her daughter's complaints of back pain. Mary Leight is a physical therapy assistant at Isaac's school. She testified about seeing Wyatt limping on December 15, 2010. Betty Alfree is a manager for Rescare. She testified about Wyatt's complaints of back pain after December 15, 2010. Dr. Balapur Venkataramana is a board certified neurosurgeon. He testified about the surgical procedure he performed on Wyatt. He also testified that the nature of her work caused her back problem. Dr. Kevin Hadley is a board certified orthopedic surgeon. He examined Wyatt for Rescare. He testified that her back problem was not caused by her work. The Board issued its decision on February 3, 2012. The Board found in favor of Wyatt and awarded her total disability benefits from December 15, 2010 though February 1, 2011 at a rate of $364.33 per week, an award of attorney's fees of $8, 000.00, reimbursement of medical witness fees, and the payment of her medical bills. On February 15, 2012, Rescare filed a Motion for Reargument. The Board issued its decision on Rescare's Motion for Reargument on May 30, 2012. In that decision the Board found that Rescare was not obligated to pay for Dr. Venkataramana's medical bills, other than the initial consultation, because he is an in-state physician who is not certified and did not obtain preauthorization for Wyatt's treatment. The Board did find Wyatt's other medical bills to be compensable. On June 19, 2012, Rescare filed an appeal of the Board's finding on causation. On June 27, 2012, Wyatt filed a cross-appeal on the Board's finding on Dr. Venkataramana's bills.


Wyatt's job was to provide individualized care to a five-year-old boy named Isaac. Isaac weighed approximately 50 pounds. Isaac was completely dependant on Wyatt for his care. Among other things, Wyatt would feed, bathe, transfer, and walk him. Wyatt would also have to frequently lift Isaac from his wheelchair to the floor or to another chair by herself. A normal work day for Wyatt involved meeting Isaac at school, caring for him throughout the school day, and making sure he got back on the bus to go home at the end of the day. Two or three evenings a week, Wyatt would go over to Isaac's house to help care for him.

On the morning of October 21, 2010, prior to going into work, Wyatt experienced back pain while bending over to pick something up off of the floor. Wyatt attempted to get through the workday, but was unable to do so due to the pain in her back. Wyatt went to the emergency room for treatment. She was prescribed pain medication and told she had a lumbar back strain. Wyatt took three days off from work to recover.

On Friday, December 10, 2010, Wyatt experienced back soreness while at Isaac's school. Wyatt believed her back was sore from working. She did not seek medical treatment for her back. Wyatt instead used the weekend to rest her back. She also took Monday, December 13th off to give her back another day to heal. On the evening of Tuesday, December 14th, Wyatt went over to Isaac's house to help his mom with his care.

On Wednesday, December 15, 2010, Wyatt was taking care of Isaac at school. As she was lifting Isaac from his wheelchair to his lunch chair, Wyatt felt all of the pain in her back disappear and everything go numb. The numbness went into Wyatt's legs and caused her to walk with a limp because she was forced to drag her left foot due to a lack of feeling in it. She also had an urgency to urinate. Over the course of the evening Wyatt's symptoms worsened.

Wyatt went to see Dr. Venkataramana on December 17, 2010. While in the waiting room, Wyatt and her mother were discussing her injury. The receptionist overheard the discussion and asked Wyatt if her injury was a workers' compensation case. Dr. Venkataramana does not handle workers' compensation cases. Wyatt told the receptionist that it was not a workers' compensation case because she feared she would not be able to see the doctor if she admitted she was hurt at work. Wyatt told Dr. Venkataramana about her October 21st and December 10th back incidents. Still scared that Dr. Venkataramana would not treat her if she told him the truth about the cause of her injury, Wyatt told Dr. Venkataramana that she woke up the morning of December 15th with numbness. She did not tell him that the numbness started after she lifted Isaac from his wheelchair to his lunch chair. Dr. Venkataramana sent Wyatt for x-rays, an MRI, and bloodwork. The MRI showed a large disc herniation at L5/S1 lateralized to the left, significant spinal stenosis at L4/5, and early degeneration of L5/S1.

Wyatt met Dr. Venkataramana to go over the results of her tests on December 18, 2010. He informed her that she needed surgery on an urgent basis, and scheduled the surgery for the following day. Dr. Venkataramana performed spinal surgery on Wyatt on December 19, 2010. In addition to decompressing the spinal canal, he performed a discectomy, laminectomy, and fusion. Wyatt continued to treat with Dr. Venkataramana after the surgery. It was after surgery that Wyatt disclosed the true nature of her injury to Dr. Venkataramana.

Dr. Venkataramana's Testimony

Dr. Venkataramana is a board certified neurosurgeon. He first examined Wyatt on December 17, 2010. Dr. Venkataramana testified that Wyatt reported to him with numbness in both buttocks, the back of both thighs, and on the left side the numbness was all along the left leg to the heel and toes. Wyatt also informed him about her incontinence issues since the injury. Dr. Venkataramana testified that he was aware Wyatt had been working as a caregiver to a dependant child. Dr. Venkataramana reviewed Wyatt's medical files. Dr. Venkataramana testified, after reviewing the results of the x-rays and MRI, that he believed Wyatt needed surgery on an urgent basis. He reasoned that it was necessary to relieve the compression on the nerves before any permanent damage occurred. Dr. Venkataramana concluded that the type of work that Wyatt did caused the herniated disc which resulted in the need for surgery. Dr. Venkataramana acknowledged that Wyatt presented to Dr. ...

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