Medical Evidence Doesn't Show Need to Zero Out Worker's Morphine

28 Mar, 2023 Frank Ferreri


Dover, DE ( -- While no one would dispute that having an injured worker reach the point where she no longer needed to use morphine would be a positive outcome, just because it's a good goal, doesn't mean it's medically or legally necessary.

Such was on display in Cantoni v. Delaware Park Racetrack & Slots, No. N22A-06-002 (Del. Super. Ct. 03/16/23), where the court explained that expert witness testimony from a doctor established that it wasn't quite time for the court to decide that the worker was ready to be morphine-free. 

A worker for a racetrack experienced a compensable injury when she slipped and fell while working. She experienced injuries to her head, neck, and back. The track’s carrier accepted the injury. The worker underwent surgery and received disability benefits without interruption for 18 years. 

The track, disputing the worker’s need for continued medical treatment, filed a petition to terminate benefits with the Delaware Industrial Affairs Board. The board found that the worker’s injection and ablation treatments were no longer compensable. However, the board stopped short of halting her treatment altogether. 

Instead, the board ordered the track to continue compensating the worker for her morphine medication, albeit at a lesser amount; it directed the worker to reduce her morphine intake from 300 milligram equivalents to 90 milligram equivalents over 10 months.  

The track ordered a medical examination, which revealed that the worker was still taking the 300-milligram amount. As a result, the track filed a renewed petition to terminate benefits to compel the worker’s compliance with the narcotic weaning process. The track also offered to voluntarily pay for morphine up to the level of 90 milligram equivalents per day. Eventually, the worker went down to 75 milligrams per day, but the track sought further reductions. 

In the end, the board ordered the worker to wean down to zero morphine within six months. The worker appealed. 

As elsewhere, in Delaware, workers’ compensation law requires an employer to pay for reasonable and necessary medical services, medicine, and supplies causally connected with the injury. 

In this case, the court held that the board’s decision against the worker had to be reversed based on the expert witness testimony of a doctor. 

The doctor, who was the sole provider of medical testimony at the hearing, testified that: 

  • The worker complied with the treatment plan previously ordered. 
  • It would be reasonable for the worker to continue taking 75 milligrams if weaning beyond that dosage increased her discomfort. 
  • Further weaning the worker off narcotics would be appropriate only if her treating physician deemed it so. 

“The board, obviously, is not [the worker’s] treating physician,” the court wrote. “Thus, the order requiring [the worker] to entirely wean off narcotics within six months is not only unsupported by substantial evidence; it is not supported by any evidence at all.” 

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    About The Author

    • Frank Ferreri

      Frank Ferreri, M.A., J.D. covers workers' compensation legal issues. He has published books, articles, and other material on multiple areas of employment, insurance, and disability law. Frank received his master's degree from the University of South Florida and juris doctor from the University of Florida Levin College of Law.

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