Delaware court denies subsequent surgery over ‘chain of causation’

A Delaware court ruled Monday that the “chain of causation” of a 2004 work injury was broken when an injured Pep Boys manager underwent an unapproved sixth back surgery and that a state board was correct in denying a seventh surgery to rectify the complications caused by the previous procedure.

Calling Robert Jackson “an entirely sympathetic litigant” who injured his lower back at work and continues to suffer pain, the Delaware Superior Court ruled in Robert Jackson v. Pep Boys that evidence supports the Delaware Industrial Accident Board’s assessment that a sixth surgery to install hardware in his lower back — which did not provide any relief and called for a seventh to remove the hardware — was not compensable.

The board, in 2020, called the sixth surgery, a spinal fusion, “not reasonable and necessary.” Thus, surgery to provide pain relief by removing the hardware that was put in place is not compensable, either, the court said in the latest ruling.

“The Board credited the testimony of (a physician) regarding his inability to determine a causal connection between the proposed surgery and the 2004 work injury,” and that such “findings rest on substantial evidence,” the court ruling says.