Source: http://www.pawcj.com/2003/06/
Timestamp: 2019-04-20 00:56:26+00:00

Document:
G. Varkey v. WCAB (Cardone Industries & Fireman Fund)is a case rather limited to its facts, but the Commonwealth Court did reverse the Board and find a penalty and attorney's fees were due on late payment under a stipulation, even though the WCJ had not issued his decision approving the stipulation when the late payment was made.
Business wire reports Atlantic Mutual Insurance Company's Standard and Poor's rating dropped to BBB from BBB+. If the Company is not able to reduce its reliance on financial reinsurance, the ratings could be lowered further, according to the article.
It was reported in the Johnstown Tribune-Democrat that Rockwood Casualty Insurance Co. has filed Petitions for Modification or Suspension of the Quecreek Miners workers' compensation benefits based on the $150,000.00 each received from The Walt Disney Co. for movie and book rights.
The Workers' Compensation Research Institute released its CompScope™ Benchmarks: Multistate Comparisons, 1994-2000 comparing 12 states' workers' compensation programs, including Pennsylvania's. The only information contained in the abstract is that benefit delivery expenses remain at a double digit level (between 12 and 15 per cent) and continue to increase at a double-digit rate. An Insurance Journal Article reports Illinois apparently performed worst in the survey.
In a Hazleton Times-Leader article Luzerne County's "close-out program' is reviewed. The County has earmarked 4.9 million of bond money to settle cases. The County is using a consultant, Case-Con Capital, Inc., Michael Judge. The article discusses Mr. Judge's fees and results.
City of Philadelphia v. WCAB (Rilling) is a case involving the Section 301(e) presumption that a firefighter's lung disease resulted from his employment. The WCJ didn't apply the presumption in the first instance, and the Employer won. After the Board remanded for application of the presumption, a different WCJ awarded the claim. The Commonwealth Court stated it was appropriate for the WCJ on remand to arrive at the WCJ's own credibility determinations, especially since they are so closely tied to applying the proper standard of proof.
In A. Cryder v. WCAB (National City) the Claimant was discharged for failing to meet production goals. The Commonwealth Court reversed the WCJ and the Board and held the Claimant was entitled to reinstatement. The Court stated that because the reason for the Claimant's termination could in no way be characterized as bad faith on her part in carrying out her duties, her earning power was not adversely affected through any fault of hers, so the Claimant met her burden under Pieper.
In cases of chronic low back pain with disc degeneration, a Norwegian study compared disability outcomes with cognitive therapy and fusion surgery. "Those who received cognitive therapy attended a lecture that taught patients that ordinary activity would not damage their discs, and that they could bend their backs (the Indahl talk). The main aim of the talk is to help patients avoid the fear of harming themselves through activity, to teach them not to be over-cautious and to correct negative feelings that would have psychological impact on their condition. Their instruction was completed by teaching them three daily exercise routines." As compared to the group that had fusion surgery: "No differences were seen in pain, use of analgesics, emotional distress or life satisfaction, and an equal number of patients returned to work from both groups."
PennLive.com carried an article that Virginia regulators ordered insurance company Reciprocal of America to Liquidate.
Judd Shoval, president of Guard Insurance Co., in Wilkes-Barre, a company that writes workers compensation policies in 20 states, said he was highly interested in the governor's responses to questions about workers compensation.
Shoval said the governor informed the business leaders he believes there needs to be some changes to the workers compensation system and that he plans to tackle these issues after the end of the current legislative session.
"His presentation was superb," Shoval said of Rendell. "His heart is in it. His delivery was excellent."
While Shoval believes the workers compensation system does not need a major overhaul, he agreed some areas within the system need improvement, such as the resolution of disputes and claims in a more rapid manner.
In Wheeling Pittsburgh Steel Corp. v. WCAB (Bruce) the Employer's expert, Dr. Chen, posited that the predominant portion of sensorineural hearing loss occurs during the first ten (10) to fifteen (15) years of noise exposure, and the Claimant had an interim audiogram with a 5.63% binaural hearing loss. Dr. Chen testified as the Claimant then aged, he acquired age-related hearing loss that brought him up to 14.325%. Dr. Chen cited a treatise supporting his analysis. However, the WCJ credited Dr. Bell, who related all 14.325% to cumulative occupational noise exposure.
The Board affirmed, and the Employer argued before the Court that the Board erred in applying Mozena in this situation because Dr. Chen did not use a table to deduct age-related hearing loss. The Court rejected this argument, holding "A WCJ may dismiss an entire school of science if he determines it lacks credibility." The Court did not award counsel fees for a frivolous appeal however, finding it was reasonable for the Employer to seek this clarification of Mozena.
Village Auto Body v. WCAB (Eggert) is a fatal claim. The Commonwealth Court reluctantly found that medical expenses for counseling of Claimant and her children who witnessed the decedent's death are not compensable. The Court found the term "compensation" in Section 307 is free from ambiguity, and it contemplates only wage benefits.
Claimant Not In The Course and Scope of Employment While Merely "On Call"
In D. Sekulski v. WCAB (Indy Associates) the Claimant was a maintenance man for apartments. He carried a beeper and was to remain within 15 minutes away in case he needed to respond. While on his way home from a bowling alley, the Claimant was assaulted. The WCJ, Board and Commonwealth Court found him out of the course and scope of employment. The Court distinguished precedents that awarded benefits when the Claimant was on a lunch break, on a special mission for employer or on travelling employee status. The Court concluded that without more, the claimant who is simply "on call" is not furthering the employer's affairs.
Many practitioners have reviewed the April 4, 2003 Order of the Board in Struble v. Rocky Mountain Garage which affirmed the WCJ's grant of a petition to compel a vocational evaluation where the vocational expert had the Department's approval letter. In that Order the Board basically said it would not look behind the Department's post-Caso procedure. The Claimant appealed the Board's Order.
In Gunter v. WCAB (City of Philadelphia) the Claimant police officer was assaulted while off-duty in her driveway. The WCJ found her to be out of the course and scope of her employment. In the beginning, she was erroneously awarded Injured on Duty (IOD) benefits. The WCJ, Board and Commonwealth Court held these are different benefits with a different standard, therefore the City was not estopped from contesting the claim.
The Supreme Court affirmed on different grounds. The Court found the standards for IOD benefits and WC benefits are congruent. However, after an excellent analysis of when an Employer may contest liability in a Review Petition under section 413 of the Act, the Court held this was such a situation because the award of IOD benefits was erroneous.
Newcomer Products, et al. v. WCAB (Irvin) is a hearing loss case where the Claimant established a prima facie case, and the Employer put on a substantial defense with medical, industrial hygiene and supervisor testimony. The WCJ rejected the Employer's witnesses as not credible, and explained his reasons for doing so. The Employer's argument on appeal was that the WCJ capriciously disregarded competent evidence.
The Commonwealth Court went so far as to state it might not have agreed with the WCJ's reasoning, but held that the WCJ's reasoning is outside the Court's scope of review. Accordingly, the Court went on to hold that the Employer was only seeking review of the WCJ's credibility determinations, found the appeal was frivolous under Pa. R.A.P. 2744, and awarded attorney's fees of four hours at $150.00 per hour.
To the extent there was still confusion whether volunteer firefighters and emergency medical personnel get the maximum comp rate or two-thirds of the maximum comp rate, the Commonwealth Court has put the issue to rest. In V. Fearon v. WCAB (Borough of Ashland) the Court rejected the Claimant's assertion that the statewide average weekly wage defined in Section 601(b) of the Act is actually the maximum comp rate times 1.5. The Court held that what the Department of Labor and Industry publishes as the statewide average weekly wage under Sections 105.1 and 105.2 of the Act is the Section 601(b) presumed wage for firefighters and emergency medical personnel, and the presumed compensation rate is 2/3 of this wage.
The Safety Next site news has articles regarding Hearing Conservation, Respiratory Protection and Stress in Workers with Advanced Degrees.
In Harris v. Board of Education of Howard County the Maryland Court of Appeals stated that a requirement an accident arise from "unusual activity" is not supported in the Maryland Act, and is a minority view in the nation. Accordingly, the Court overruled the line of cases that injected the "unusual activity" requirement. An article in the Washington Post comments on the magnitude of this change.
In Gingerich v. WCAB (US Filter) a continuing 20% attorney's fee was awarded on the grant of a fatal claim. When the Widow entered into a compromise and release waiving future benefits in consideration of wavier of the subrogation lien, The WCJ approved the Agreement and terminated the attorney fee and the Board affirmed. The Commonwealth Court held that even though the Claimant exercised her Section 449(a) right to compromise any and all liability under the Act, she did not have the right to extinguish the 20% counsel fee.
The result in this case might be explained by the answer to the question: "If the Attorney's fee is owed, who pays?" The Claimant is contractually bound to pay the fee. However, in the Compromise and Release Agreement in this case the Defendant agreed that it would pay the fee if it was found that the fee is owed.
In M. Capper v. WCAB (ABF Freight Systems, Inc.) the Claimant pressed the issues of reasonable contest where: 1) The Claimant returned to work full time, full duties, but with a wage loss due to lack of overtime (Employer sought suspension); and 2) the Employer initially contested thirty to forty mile trip expenses to obtain medical treatment in eastern Pennsylvania. The Commonwealth Court held there was a reasonable contest on both issues. Importantly, the Court cited the Supreme Court's decision in Harle and stated the Claimant may not be entitled to a partial if overtime was no longer available for economic reasons.
The Employer in Bureau of Workers' Compensation v. WCAB (Exel Logistics) sought supersedeas reimbursement when a supersedeas was denied, and the WCJ later granted suspension for refusal of reasonable medical treatment. The Commonwealth Court analyzed Section 443, and concluded supersedeas reimbursement is for change of status under Section 413 cases, and there is no such remedy in a section 306(f.1)(8) case.
The dissent suggested a common sense approach would not distinguish a Section 306(f.1)(8) forfeiture from a suspension that can be sought under Section 413. After all, the Court stated in Stuart Painting v. W.C.A.B. (Asvestas) 611 A.2d 787 (Pa. Commw. 1992) that the relief under Section 306(f.1)(8) is a suspension rather than a forfeiture.
Dept. of Corrections v. WCAB (Clark) is a case in which the collective bargaining agreement required the Claimant to pay back WC benefits when he had used sick time. The case was settled with a Compromise and Release providing that the Claimant would collect about $2,000.00. When the personnel office recovered the amount from the Claimant's pay, the WCJ rather perfunctorily directed payment of the C&R amount with no credit pursuant to the CBA. The WCJ also granted the Claimant's request for 50% penalties and attorney's fees for unreasonable contest. The Compromise and Release Agreement did not reflect that the Claimant was required to reimburse the Employer, and apparently it did not come up at the hearing. The Board and the Court affirmed.
In R. Jackson v. WCAB (Boeing) the treating chiropractor's care was found not reasonable and necessary. The Court held: 1) the WCJ did not shift the burden of proof to the Claimant when the WCJ noted the treating chiropractor failed to respond to the reviewer's points; 2) the fact that the treating chiropractor offered treatment to alleviate pain did not overcome the WCJ's finding that the reviewer was more credible; and 3) even though the UR was requested late, e.g. more than thirty days after the billing was submitted, the request for prospective review was timely.
A study of oucomes of prompt administration of plain x-ray vs. MRI determined that people who had the MRI did not necessarily have better outcomes of treatment. There was a correlation between the MRI and surgery, and the study suggested the MRI pathology may not have correlated with the patient's symptoms, yet surgery was still performed on the MRI findings.

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