Christiana Care Health Services v. PalominoAnnotate this Case
Claimants Cecil Palomino, Salvador Avila-Hernandez and Julio Munoz were each injured in different work-related accidents. It was not disputed that their injuries were compensable under the Worker's Compensation Act and that payments of some worker's compensation have been made. After their doctors recommended certain treatments, their employers requested determinations of whether the treatment plans fell outside of the Health Care Practice ("HCAP") Guidelines through a utilization review ("UR"). The UR panel determined that portions of their treatments were not approved for coverage. Claimants petitioned the Industrial Accident Board for review of the UR determination after the 45 day time window prescribed by Department of Labor Regulation 5.5.1. The Board dismissed the petitions as untimely. Claimants appealed to the Superior Court, which determined that the 45 day limit of Regulation 5.5.1 was invalid because it conflicted with 19 Del. C. sec 2361. The employers appealed from the Superior Court's judgment. Finding no merit to the appeal, the Supreme Court affirmed.