Delaware Code Title 19 Sec. 2322 – Medical and other services, and supplies as furnished by employer
(a) During the period of disability the employer shall furnish reasonable surgical, medical, dental, optometric, chiropractic and hospital services, medicine and supplies, including repairing damage to or replacing false dentures, false eyes or eye glasses and providing hearing aids, as and when needed, unless the employee refuses to allow them to be furnished by the employer.
Terms Used In Delaware Code Title 19 Sec. 2322
- Board: means the Industrial Accident Board. See Delaware Code Title 19 Sec. 2301
- Employee: means every person in service of any corporation (private, public, municipal or quasi-public), association, firm or person, excepting those employees excluded by this subchapter, under any contract of hire, express or implied, oral or written, or performing services for a valuable consideration, excluding spouse and minor children of a farm employer unless the spouse or minor child is a bona fide employee of a farm employer and is named in an endorsement to the farm employer's contract of insurance, and excluding any person whose employment is casual and not in the regular course of the trade, business, profession or occupation of his or her employer, and not including persons to whom articles or materials are furnished or repaired, or adopted for sale in the worker's own home, or on the premises not under the control or management of the employer. See Delaware Code Title 19 Sec. 2301
- Employer: includes all those who employ others unless they are excluded from the application of this chapter by any provision of this subchapter, and if the employer is insured, the term shall include the insurer as far as practicable; employer shall also include the governing body for which employable relief recipients are assigned work under §§ 901-905 of Title 31. See Delaware Code Title 19 Sec. 2301
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Insurance carrier: means any insurance corporation, mutual association or company or interinsurance exchange which insures employers against liability under this chapter or against liability at common law for accidental injuries to employees. See Delaware Code Title 19 Sec. 2301
- Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
- Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
- State: means the State of Delaware; and when applied to different parts of the United States, it includes the District of Columbia and the several territories and possessions of the United States. See Delaware Code Title 1 Sec. 302
- Statute of limitations: A law that sets the time within which parties must take action to enforce their rights.
(b) If the employer, upon application made to the employer, refuses to furnish the services, medicines and supplies mentioned in subsection (a) of this section, the employee may procure the same and shall receive from the employer the reasonable cost thereof within the above limitations.
(c) Upon application made to the Board by the injured employee or someone in the injured employee’s behalf, the Board may, at its discretion, require the employer to furnish additional services, medicines and supplies of the kind mentioned in subsection (a) of this section, as and when needed, for such further period as it shall deem right and proper. The charges for such additional services, medicines and supplies shall not exceed the rates regularly charged to other individuals for like services and supplies, provided, however, that the Board shall at all times have jurisdiction to determine and shall determine the character of services and supplies to be furnished.
(d) An employee, at any time after a claim for compensation is made, shall have the right, upon application to the employee’s employer, to inspect, copy and reproduce any medical records pertaining to said employee in the possession of the employee’s employer or the employee’s insurance carrier. Medical records, as used in this subsection, shall include physician’s reports, hospital reports, diagnostic reports, treatment reports, X-rays and X-ray reports.
(e) The fees of medical witnesses testifying at hearings before the Industrial Accident Board in behalf of an injured employee shall be taxed as a cost to the employer or the employer’s insurance carrier in the event the injured employee receives an award.
(f) Every insurance carrier or self-insurer shall be required to replace or renew a defective or worn out prosthesis for the life of the injured person without such replacement or renewal constituting a new claim period.
(g) An employee shall be entitled to mileage reimbursement in an amount equal to the State specified mileage allowance rate in effect at the time of travel, for travel to obtain:
(1) Reasonable surgical, medical, dental, optometric, chiropractic and hospital services; and
(2) Medicine and supplies, including repairing and replacing damaged dentures, false eyes or eyeglasses, and providing hearing aids and prosthetic devices.
(h) An employer or insurance carrier may pay any health care invoice or indemnity benefit without prejudice to the employer’s or insurance carrier’s right to contest the compensability of the underlying claim or the appropriateness of future payments of health care or indemnity benefits. In order for any provision or payment of health care services to constitute a payment without prejudice, the employer or insurance carrier shall provide to the health care provider and the employee a clear and concise explanation of the payment, including the specific expenses that are being paid, the date on which such charges are paid, and the following statement, which shall be conspicuously displayed on the explanation in at least 14-point type:
This claim is IN DISPUTE and payment is being made without prejudice to the Employer‘s right to dispute the compensability of the workers’ compensation claim generally or the Employer’s obligation to pay this bill in particular.
(1) Partial payment of the uncontested portion of a partially contested health care invoice shall be considered a payment without prejudice to the right to contest the unpaid portion of a health care invoice, provided the above notice requirements are met.
(2) No payment without prejudice made under a reservation of rights pursuant to this subsection shall be subject to return, recapture or offset, absent a showing that the claim for payment was fraudulent.
(3) No payment without prejudice that complies with the above is admissible as evidence to establish that the claim is compensable.
(4) No payment without prejudice that complies with the above shall extend the statute of limitations unless the claim is otherwise determined by agreement or the Board to be compensable.
(i) Availability of vocational rehabilitation services.
(1) Statement of intent. — The General Assembly realizes that despite the best efforts of all concerned, some injured workers may not be able to return to their pre-injury employment and may benefit from vocational rehabilitation.
(2) To the extent assistance may be required in this regard, resources are available to employees including, but not limited to, from the following organizations:
a. Delaware Division of Vocational Rehabilitation;
b. First State Project with Industry; and
c. One Stop Centers.
(3) Nothing in this section is intended to change the existing rights and responsibilities of injured employees or employers regarding vocational rehabilitation services.
Code 1915, § ?3193h; 29 Del. Laws, c. 233; 30 Del. Laws, c. 203, § ?2; 32 Del. Laws, c. 186, § ?1; 37 Del. Laws, c. 239, § ?1; Code 1935, § ?6078; 43 Del. Laws, c. 269, § ?6; 46 Del. Laws, c. 27; 48 Del. Laws, c. 229; 19 Del. C. 1953, § ?2322; 50 Del. Laws, c. 267, § ?1; 50 Del. Laws, c. 339, § ?5; 53 Del. Laws, c. 126; 61 Del. Laws, c. 505, § ?1; 65 Del. Laws, c. 469, § ?1; 70 Del. Laws, c. 172, § ?4; 70 Del. Laws, c. 186, § ?1; 72 Del. Laws, c. 85, § ?1; 76 Del. Laws, c. 1, § ?9;