Source: http://www.pawcj.com/2003/07/
Timestamp: 2019-04-24 18:33:49+00:00

Document:
Daniels v. WCAB (Tristate Transport) is the long awaited case from the Pennsylvania Supreme Court regarding the reasoned decision requirement of Section 422(a) of the Act. The result is: "... we hold that a decision is "reasoned" for purposes of Section 422(a) if it allows for adequate review by the WCAB without further elucidation and if it allows for adequate review by the appellate courts under applicable review standards. A reasoned decision is no more, and no less."
Cut back to Leon E. Wintermeyer, Inc. and American General Group v. WCAB (Marlowe). Wintermeyer held: "capricious disregard of material, competent evidence is an appropriate component of appellate consideration in every case in which such question is properly brought before the court." I posted on December 12, 2002: "Perhaps foreshadowing Daniels, the Supreme Court did note ... that Section 704 of the Administrative Agency Law will not be interpreted to make judicial review unavailable when substantial evidence supports an agency's factual findings, but it is clear beyond doubt that its conclusions are based on capricious disregard of other evidence..."
The Supreme Court remanded for only an explanation of the credibility determination favoring Dr. Williams over Dr. Fabian. The finding rejecting the Claimant's credibility without further explanation was accorded deference because the WCJ can make this finding solely on the demeanor of a witness who testifies live. Also, the relevance of the testimony was the Claimant's limitations based on his pain, something that another witness could not entirely rebut.
On remand, the Supreme Court will be looking for the WCJ to identify the factors the WCJ will have considered to make the ultimate credibility determination. The Supreme Court wants to know, as indicated in Wintermeyer, whether the WCJ's "conclusions are based on capricious disregard of other evidence." In the case where this is "clear beyond doubt," an appellate court may engage in judicial review.
In East v. WCAB (USX Corp.), Appeal of: USX, LLC the issue is whether a workers' compensation case is a "civil action" so that the minority tolling statute applies. The WCJ ruled that the stautue does not apply; the Commonwealth Court reversed based on the observation that if an action is not a criminal action, it is a civil action. The Supreme Court reviewed the Pennsylvania Constitution's provision for workers' compensation laws and noted the administrative action under these laws was created to replace a civil action. The Supreme Court also looked at several statutes that distinguish an administrative action from a civil action. The Supreme Court concluded the minority tolling statute's coverage of "civil actions" does not include workers' compensation matters.
In North Lebanon Township v. WCAB (Harbaugh) a volunteer fire policeman responded to a call in a neighboring municipality when the call came in to his friend, who worked as a volunteer for both municipalities' volunteer fire companies. The Claimant suffered a fatal heart attack in the line of duty. Based on the Mutual Aid Agreement that provides companies are to render aid when needed, the WCJ found the Claimant remained an employee of his home company and the home municipality was responsible for benefits. The Commonwealth Court affirmed.
Now that mine is up, I can note the Judgebooks containing local rules of practice and procedure before each Workers' Compensation Judge are available at the Bureau of Workers' Compensation's Quick Links site. All of the individual entries I have reviewed give clear and concise answers to twenty-four questions covering from the first hearing to the content of briefs.
The on-line format allows for easy reference, and hard copies can be printed from portable document format (.pdf). You could even download Adobe Reader for Palm OS and put Judgebooks on your Palm compatible device.
In Wheeling-Pittsburgh Steel Corp. v. WCAB (Sesco) the Employer explored several arguments regarding a hearing loss claim. The claim was awarded for the Claimant's whole 35.6% binaural hearing loss. The Employer argued the loss was diminished by I) the pre-employment audiogram in 1971; II) the hearing loss accumulated by the Claimant when he was working in Ohio and not subject to extraterritorial jurisdiction; III) the audiogram administered when the Claimant was transferred to a new facility in 1998; and IV) the Employer advanced a statute of limitations argument because the Claimant presently works half the time in the office and half the time in the plant.
With regard to the 1971 audiogram (which showed a 17.8% loss), the Commonwealth Court recognized OSHA regulations that the audiogram had to meet had not yet been published. The audiogram did not comply with later regulations because the Claimant testified he was exposed to occupational noise the day the test was administered. The Court held Section 306(c)(8)(iv) requires audiometric testing to conform to OSHA standards. In a footnote the Court mentioned the Employer's expert did not testify that the testing met OSHA standards at the time.
The Court dismissed the argument about the Ohio employment by noting the Claimant was employed in Pennsylvania on the date of injury as defined in Section 306(c)(8)(ix).
When the Claimant was transferred back from Ohio, he had a 1998 pre-employment audiogram. However, the Claimant testified he retained his seniority with the employer, therefore he was not a new employee and Section 306(c)(8)(vi) does not apply.
The Employer's statute of limitation defense failed because of the inclusion of the Ohio employment.
In a fifth section (designated IV by the Court) the Court found a reasonable contest on the 1971 audiogram issue and declined to award counsel fees.
Where are we now in the insurance cycle? see the report on "Workers' Compensation Insurance - Not Quite There Yet" from Business Wire or the complete report. It looks like a free? registration is required for the complete report.
In G. Zink v. WCAB (Graphic Packaging, Inc.) The Claimant had suffered injuries to his legs, right arm and back in the Vietnam War. He was further diagnosed in 1974 with anxiety neurosis, chronic with depressive features, related to his war experience. This condition rendered him unable to sleep during the night. Through the Vietnam Veterans' Readjustment Assistance Act of 1974 the Claimant got a job as a maintenance mechanic and until the May, 1995 Collective Bargaining Agreement, he was permitted to switch shifts with others so he always worked third shift. When the Claimant could no longer switch shifts, he developed shift work maladaptation syndrome (swms), which unfortunately was a subjective reaction to normal working conditions Metropolitan Edison Co. v. W.C.A.B. 553 Pa. 177, 718 A.2d 759 (1998).
While the claim was pending, the Employer ultimately exempted the Claimant's maintenance department from the shift requirement without objection from the union. By January 1997 the Claimant could return to work due to a stabilization of his condition.
The Commonwealth Court en banc held the case could be distinguished from Metropolitan Edison because the Claimant's pre-existing condition was known to the Employer, as the Claimant got the job under the Vietnam Veterans' Readjustment Assistance Act of 1974. Under these circumstances, abnormal working conditions existed in the opinion of the Court. Judge Leavitt dissented, declining to depart from the premise that "normal working conditions, such as requiring an employee to work an eight hour shift, do not constitute an injury under the Act." Metropolitan Edison 187, 718 A.2d at 764.
In The City of Nanticoke, et al. v. WCAB (Ziolkowski) a fireman requested Heart and Lung Act benefits for coronary artery disease via a grievance. The City did an internal review and granted the benefits, and terminated the Claimant's employment based on his total disability. The WCJ, the Board and the Commonwealth Court agreed that the Employer was estopped from denying the Claimant's workers' compensation claim even though an interim investigation by the Employer revealed there was no medical evidence supporting the award of Heart and Lung benefits.
The Employer's argument on appeal was that collateral estoppel did not apply because there was no "actual litigation". The Court said the City's internal review was litigation, and in any event the City had fifteen (15) months to investigate. The Court however found a reasonable contest on the issue of "whether or not Claimant's receipt of Heart and Lung Benefits alone with no formal award, would be enough to collaterally estop Employer from re-litigating the issue of causation."
There was no discussion of Gunter, the Supreme Court case that said even when the Employer grants benefits that are congruent, it still may contest liability under the provisions of Section 413 of the Act. In Gunter, as in this case, it was the Employer's argument that the initial award of benefits was erroneous.
T. Shire, Jr. v. WCAB (General Motors) is a case in which the Claimant received sickness and accident benefits for a non work-related condition in the year before the work injury. The WCJ excluded the S&A benefits from the Average Weekly Wage calculation and the Board affirmed, reasoning that S&A benefits are a fringe benefit like pension contributions or payment for life insurance. The Commonwealth Court reversed, and found the S&A benefits are includable in the AWW in the same manner as vacation pay or bonuses.
The Court then remanded for the WCJ to include "sickness and accident benefits for days missed from work" in the AWW calculation. The Court did not state the S&A amount should be included in the quarter in which it was paid, as opposed to the statutory treatment of vacation pay or bonuses, which is to divide the amount by 52 and add the result to the AWW calculated without the bonus amount. The Court did, however, cite Colpetzer for the premise that the intent of Section 309 of the Act is to establish an average weekly wage that reasonably reflects the reality of the Claimant's pre-injury earning experience as a predictor of future earning potential.
In Westinghouse Electric Corporation/CBS v. WCAB (Korach) the Employer continued to pay the Claimant's psychiatric expenses after commutation although the accepted injury was a back sprain. When the Employer stopped paying, the Claimant was out of the statute. The WCJ accepted the Claimant's evidence that the psychiatric condition arose out of the work injury, and found that the statute was tolled by the payment of medical. The Board affirmed. The Court also affirmed, although they did so by pulling out the Reinstatement of Contracts and finding it was the parties' intent in the commutation to continue to cover psychiatric expenses.
In the last two published cases, the Court has held the parties have a right to contract with respect to workers' compensation benefits. Parties should remember, however, that they cannot contract to reduce the Claimant's rights or to impose responsibilities on the Claimant that the Act does not authorize. see "Issues Arising Under Compromise and Release Practice" July PBA Workers' Compensation Section Newsletter, Page 10, by Judge David B. Torrey.

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