Amazon wrongly denied comp claim for back surgery: Court
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A Delaware judge ruled Thursday that Amazon.com Inc. didn’t follow proper guidelines when it denied a claim filed by an injured employee.
Superior Court Judge Kathleen Miller, hearing an appeal by Amazon in a case by Hector Rook, said Amazon wrongly denied the workers comp claim based on the argument that Mr. Rook’s medical treatment fell outside of the health care practice guidelines of the state’s Division of Industrial Affairs.
Mr. Rook injured his back at work in May 2022, and he subsequently filed for comp benefits. He had surgery in September 2022, but Amazon argued that the surgery was not reasonable and necessary or related to the work incident.
The Industrial Accident Board in February 2023 said some treatment outside the guidelines can be found to be reasonable and necessary in some cases. The board determined benefits were warranted.
On appeal, Amazon argued that the board erred in ignoring the health care guidelines, but the Superior Court judge determined that the board acted properly, and Amazon was the one that erred.
“The Board did not commit an abuse of discretion because it was not required to construe the Guidelines as Amazon demands,” the ruling states.
The judge also dismissed Amazon’s argument that compensation for the surgery was not proper because Mr. Rook hadn’t exhausted “conservative treatment” before resorting to surgery, since Mr. Rook had previously tried physical therapy, chiropractic care and medication.
