Delaware Industrial Accident Board Rejects Attempt to Expand Compensable Shoulder Claim

The Delaware Industrial Accident Board recently issued a defense decision in favor of C&S Wholesale Grocers, reinforcing an important limitation on compensability under Delaware workers’ compensation law. Acceptance of an initial injury does not require acceptance of every later condition involving the same body part.

The claimant sustained a compensable shoulder injury in 2022 and underwent shoulder surgery in September 2023 to repair a torn rotator cuff. During the surgery, the treating surgeon visually inspected the labrum and found it to be intact. Pre‑operative imaging similarly showed a rotator cuff tear but no labral pathology.

The claimant recovered well from surgery and completed post‑operative rehabilitation without complication. In August 2024, she was released to full duty with no work restrictions, and there was no indication at that time that further treatment would be required.

Several months later, however, the claimant reported a recurrence of shoulder symptoms. A January 2025 MRI arthrogram revealed a torn labrum, and her treating physician recommended additional surgery. C&S Wholesale Grocers denied authorization for the proposed procedure, contending that the labral tear was not causally related to the original work injury or the prior compensable surgery.

The claimant filed a petition seeking to have the labral surgery awarded.

The claimant argued, based on her surgeon’s opinion, that the labrum tear must have occurred in the initial injury but went undetected during the surgery and in pre-surgical imaging (which showed a torn rotator cuff, but no torn labrum). The claimant argued in the alternative that the tear may have been too small to see when the surgeon performed surgery in September 2023, but got much bigger because the rotator cuff surgery “changed how she used her shoulder,” causing her to damage the labrum by compensating.

C&S Wholesale Grocers disputed both theories. The defense argued that the most straightforward explanation was also the most credible: the labral tear occurred after the claimant had recovered from surgery and had been cleared to return  to full duty work. The employer’s medical expert testified that labral tears do not remain dormant for years only to appear for the first time long after surgery, particularly where the labrum was directly visualized during a prior procedure and found to be intact.

Regarding the claimant’s alternative argument that a small, hard-to-detect tear got worse as a result of “compensation,” the Board was particularly swayed by C&S Wholesale Grocers’ expert’s testimony that all post-surgical imaging showed that the rotator cuff tear healed completely and that the muscles in the shoulder were balanced—showing that the claimant continued to use her shoulder normally after the surgery and was not “compensating” at all.

The Board agreed with C&S and expressly adopted the opinion of the employer’s expert.

In its decision, the Board rejected the claimant’s attempt to retroactively link the labral tear to the original injury. The Board found no persuasive basis to conclude that a labral tear existed but somehow escaped detection through imaging, surgery, recovery, and a return to unrestricted work.

The Board was also unpersuaded by the claimant’s alternative compensation theory. Of particular significance was expert testimony establishing that post‑surgical imaging showed the rotator cuff repair had healed completely and that the shoulder musculature was balanced. Those objective findings demonstrated that the claimant was using her shoulder normally after surgery and was not compensating in a manner that would explain the development of a labral tear.

The petition was denied.

While the initial rotator cuff surgery was undisputedly compensable, the Board concluded that the evidence did not support expanding the claim to include a later-diagnosed labral tear. Decisions of this nature are relatively uncommon and underscore the Board’s willingness to draw principled limits on compensability where the medical evidence supports doing so. Decisions of this nature are relatively uncommon and underscore the Board’s willingness to draw principled limits on compensability where the medical evidence supports doing so.

C&S Wholesale Grocers was represented by Weber Gallagher Partner Brandon Herling before the Delaware Industrial Accident Board.

Practice Takeaway for Employers and Carriers

This decision highlights the importance of contemporaneous surgical findings, documented recovery, and well-supported expert testimony when a claimant seeks to expand an accepted claim to include later-arising conditions. Acceptance of an initial injury does not relieve a claimant of the burden to establish causation for subsequent treatment, particularly where objective evidence demonstrates full recovery and normal postsurgical function. Employers and carriers should carefully evaluate proposed treatment for newly diagnosed conditions, even when the same joint was previously treated on a compensable basis. Acceptance of an initial injury does not relieve a claimant of the burden to establish causation for subsequent treatment, particularly where objective evidence demonstrates full recovery and normal post‑surgical function.