Court rejects worker's request for physician-dispensed pain medication
Boone v. Syab Services, No. 525, 2012 (Del. 07/16/13).
Ruling: The Delaware Supreme Court held that an employer was permitted to require a worker to obtain her prescriptions from its preferred pharmacy provider rather than from her physician.
What it means: In Delaware, an employer can require a worker to obtain prescriptions from its preferred pharmacy provider rather than prescriptions dispensed from her physician's office.
Summary: A worker suffered a work-related lower back injury. Her employer sought to require her to have her pain medication prescription filled by its "preferred provider" benefit program. The program saved the employer money at no additional cost to its workers. Under the program, the worker could go to any covered pharmacy or have her medication mailed to her home. The worker objected to the employer's request as she had been getting her prescriptions filled at her treating physician's office, which she said was more convenient. Although the employer's program was less expensive, her physician charged the amount set forth in the fee schedule. The Delaware Supreme Court held that the employer was permitted to require the worker to obtain her prescriptions from its preferred pharmacy provider instead of her physician.
The court found that state laws did not provide an "absolute right" for a worker to choose her own pharmacy. Workers have an absolute right to choose certain physicians, but the law did not include pharmacist or pharmacy.
The worker also argued that it was reasonable for her to receive her prescriptions from her physician since the physician's charges were within the fee schedule. As reasonable as the physician's charges may be, the court said it did not diminish the reasonableness of the employer's less costly alternative.
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September 30, 2013
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