Payment of medical bills for treatment to body part not part of accepted work injury does not create implied agreement of compensability when evidence establishes that payments were made by mistake but not under a feeling of compulsion.

The applicable law, as set forth in Tenaglia-Evans v. St. Francis Hospital, 913A.2d 570 (Del. 2006), stands for the proposition that an implied agreement to pay compensation may be found where the employer has paid medical expenses or compensation out of a “feeling of compulsion.” The simple payment of expenses is not enough though. There must be a finding of “compulsion” on the part of the employer to pay those expenses. The Board applied this legal standard to this case and held that the medical payments made for the low back condition were done in error but not under a feeling of compulsion, and,f as such, they did not create an implied agreement or obligation under the Act. The Board accepted as credible the testimony of the claim adjuster presented by the employer on this issue. Claimant’s counsel had objected to some of that testimony on hearsay grounds, contending that this witness had not made all of the payments. However, the evidence did establish that the witness made several of the payments at issue and clearly had firsthand knowledge to provide the testimony that the Board accepted. Accordingly, the claimant’s petition seeking to establish the low back condition as compensable was dismissed.

Case Law Alerts, 4th Quarter, October 2014