Source: http://www.pawcj.com/2004/
Timestamp: 2018-06-22 01:47:57
Document Index: 679101402

Matched Legal Cases: ['§306', '§306', '§306', '§123', '§123', '§123', '§306', '§306', '§306', '§306', '§30']

Pennsylvania Workers' Compensation Journal: 2004
The Maximum Workers' Compensation Rate for 2005 is $716
Secretary of Labor and Industry Stephen Schmerin announced the 2005 maximum rates for workers' compensation and unemployment compensation in a press release today.
Posted by Robert Vonada at 5:54 PM 0 comments
New Life Tables Published
Life tables for the year 2002 were published recently and are available. United States Life Tables, 2002 .pdf The most updated life table yields the most advantageous Sciarotta calculation.
There is a link on the left side of the page to annual life table updates from the National Center on Health Statistics.
The suggested citation is: Arias E. United States life tables, 2002. National vital statistics reports; vol 53 no 6. Hyattsville, Maryland: National Center for Health Statistics. 2004.
Commonwealth Court Outlines Burden of Proof in §306(b)(1) Modification Based on Current Wages of Fellow Employee
In a very well organized opinion in Verizon Pennsylvania, Inc. v. WCAB (Baun), the Commonwealth Court provided guidance on the modification of benefits under §306(b)(1) which provides an employe shall not receive more in compensation and wages combined than the current wages of a fellow employe in employment similar to that in which the injured employe was engaged at the time of injury. Although the Court held the Employer did not meet its threshold burden to demonstrate what similarly situated employees were making at the time of injury, the Court went on to clarify its interpretation of the remainder of any §306(b)(1) analysis.
The Court held the threshold burden is to establish the wages at the time of injury of the class of similarly situated employees. The Court stated a WCJ may elect to evaluate the wages of each employee in the class or rely on an average or median, as the WCJ's discretion directs.
The court further stated Maier's Bakery v. Workers' Comp. Appeal Bd. (Sandt), 751 A.2d 1208 (Pa. Cmwlth. 2000) does not require that the Employer must show economic distress caused wages to be reduced. The Court explained there is no such requirement in the statute.
Finally, the Court stated the only comparison to be made by the WCJ is whether the Claimant is currently receiving more in wages and compensation combined than the class of similarly situated employees. The Claimant had returned to work at modified duty, and there would be a figure that represents the Claimant's wages and compensation combined. Even if, as here, some employees in the class were currently making more than the Claimant's Average Weekly Wage, this fact does not necessarily enter into the comparison to be made between what the Claimant receives and the representative current wages of the class that the WCJ determines.
Posted by Robert Vonada at 12:21 PM 0 comments
Commonwealth Court Holds Physical/Physical Injury Standard Can Still Apply to a Heart Attack Case
In J. Curren v. WCAB (City of Chester) the Commonwealth Court reversed an Order of the Workers' Compensation Appeal Board that held a mental stress causing physical injury standard of proof applies in a heart attack case. The Court accepted the Claimant's argument that compensation was awarded on a physical stress causing physical injury basis. The Court held the medical testimony credited by the Workers' Compensation Judge provided substantial evidence to support a physical stress causing physical injury standard of proof. Accordingly, the Claimant did not have to meet the heightened burden in a mental/physical case to show abnormal working conditions.
Posted by Robert Vonada at 12:45 PM 0 comments
AFL-CIO Press Release Notes Proposed Reduction in W.C. Rates
Pennsylvania AFL-CIO President William M. George issued a press release in response to news of a proposed rate decrease from the Pennsylvania Compensation Rating Bureau. The press release highlights positive trends in job safety.
Posted by Robert Vonada at 5:24 PM 0 comments
York Daily Record Series on Workers' Compensation
The York Daily Record is running a series on workers' compensation. Four articles have been printed to date. They are linked at the bottom of this article from today.
The articles begin with a discusssion of a specific case, then broaden into a discussion of Pennsylvania's statutory system and proposed changes of injured workers, their families, employers and insurers.
Posted by Robert Vonada at 5:14 PM 0 comments
WCRI to give Pennsylvania Briefing on January 19, 2005
The Workers' Compensation Research Institute will brief the newest results from the 5th Edition of the WCRI CompScope™ multistate benchmarks study, comparing workers' compensation system performance for Pennsylvania with 11 major states (California, Connecticut, Florida, Illinois, Indiana, Louisiana, Massachusetts, North Carolina, Tennessee, Texas and Wisconsin) in Harrisburg on January 19, 2005.
Posted by Robert Vonada at 8:44 PM 0 comments
Commonwealth Court Confirms Claimant Does Not Waive Timeliness Argument By Attending IRE
In Wellington Foods v. WCAB (Rice), the Claimant attended an IRE requested more than 60 days after payment of 104 weeks of total disability benefits. The Commonwealth Court rejected the Employer's argument the Claimant waived his objection to the timeliness of the IRE by attending the IRE.
Posted by Robert Vonada at 9:13 AM 0 comments
Claimants Can Get a Print Out of Unemployment Compensation Paid On-Line
Claimants who receive unemployment compensation benefits receive a PIN number that allows them to access all their benefit information on-line. A Claimant can get a print out of unemployment compensation paid to establish the unemployment compensation credit against workers' compensation benefits. The URL is: https://www.pauc.state.pa.us/welcomebenefit.asp
Posted by Robert Vonada at 10:29 PM 0 comments
Commonwealth Court Confirms 104 Weeks for IRE Runs From First Date of Payment
In S. Ramseur v. WCAB (Wachovia Corp.), the Commonwealth Court held that where the Claimant was entitled to benefits on March 3, 2000, but didn't receive the first payment until August 3, 2000 (presumably a payment including back benefits), the 104 weeks provided for in Section 306(a.2) of the Act expires on August 3, 2002. This made the August 27, 2002 IRE request timely.
Supreme Court Grants Allowance of Appeal in Heart Attack -- Abnormal Working Conditions Case
In Panyko v. WCAB (U.S. Airways), the Commonwealth Court reversed the grant of a heart attack claim based on Davis v. Workers' Compensation Appeal Board (Swarthmore Borough), 561 Pa. 462, 751 A.2d 168 (2000). The Commonwealth Court recognized the Claimant's argument that abnormal working conditions do not need to be shown in a heart attack case, but the Court noted the Supreme Court applied Davis to a heart attack case without further explanation in Erie Bolt Corporation v. Workers' Compensation Appeal Board (Elderkin), 777 A.2d 1169, 1998 Pa. Commw. LEXIS 1004 (Pa. Cmwlth., No. 1698 C.D. 1997, filed February 5, 1998), reversed, 562 Pa. 175, 753 A.2d 1289 (2000). The Supreme Court has now granted the Claimant's petition for appeal in the Panyko case.
Posted by Robert Vonada at 10:22 PM 0 comments
Supreme Court Discusses Substantial Evidence Standard of Proof
In Patric Gibson, c/o Kathy Gibson v. WCAB (Armco Stainless & Alloy Products), Appeal of: Armco Stainless & Alloy Products, the Supreme Court reversed the holding of the Commonwealth Court that a co-workers' observation of grey dusty material on the pipes leading from the boiler established the presence of asbestos. The Supreme Court articulated the substantial evidence standard of proof as follows:
"...information admitted into evidence must have sufficient indicia of reliability and be relevant to the matter under consideration. Accordingly, to test whether the evidence relied upon is substantial evidence in support of a finding, the reviewing court should ascertain whether the evidence admitted is competent, and if it is competent, whether it is sufficient to support the administrative finding. If the evidence is both competent and sufficient, then the finding is supported by substantial evidence." p. 7
In the case, the witness admitted he had no personal knowledge the material was asbestos. Although the Court would allow the witness to have obtained this knowledge by either formal education or practical experience, there was no evidence the witness possessed either.
The practical observation often made is that if one accepts medical evidence the Claimant has asbestosis, then work exposure is a likely cause. The Supreme Court made the following comment on the Claimant's medical evidence:
"...we are troubled by the absence of testimony from any of Decedent’s treating physicians, the want of a diagnosis of asbestos-related disease during his lifetime, and the lack of a post mortem examination that could have conclusively established asbestos-related disease among the actual contributory causes of death. Further, the existence of apparently inert opacities occurring on Decedent’s chest x-rays over a period of twelve years seriously undermines a finding of asbestos-related disease as a significant cause of death. While unnecessary for a determination in the instant matter, we would caution tribunals considering claims of this nature that the weight to be accorded to evidence of cause of death must reside primarily with the diagnosis of one or more treating physicians or significant findings upon post mortem. After-the-fact testimony by non-treating medical experts, who have had no contact with the decedent, and that is contrary to the diagnosis of a treating physician or the findings on post mortem, may be of limited value in establishing a cause of death." f.n. 5
Commonwealth Court Emphasizes Limited Basis of Appeal for Capricious Disregard of Competent Evidence
In E. Williams v. WCAB (USX Corp.-Fairless Works, et al.) the Claimant appealed the credibility findings of the WCJ. The Commonwealth Court made it clear that the Claimant could not cobble together bits and pieces of testimony to make an argument that the WCJ capriciously disregarded competent evidence. Rather, the WCJ's decision identified and explained the substantial, competent, and credible evidence on which the decision was based. The Court emphasized it will be a rare instance in which an appellate court would disturb an adjudication based upon the capricious disregard of material, competent evidence.
Pennsylvania Workers' Compensation Practice and Procedure Reference 29.217
Posted by Robert Vonada at 5:47 PM 0 comments
WTAE Pittsburgh's Site Offers Interesting Articles on New Developments in Treatment of Back Pain
WTAE's web site has information on Fish Oil used in place of NSAIDs for neck and low back pain. The research was done by Dr. Joseph Maroon. The links to the right under the heading "All About Back Pain" are interesting also.
Posted by Robert Vonada at 8:34 PM 0 comments
Pennsylvania Workers' Compensation Journal Will Return November 15, 2004
Pennsylvania Workers' Compensation Journal will return on a regular basis on November 15, 2004.
Penalty Granted On Prescriptions Unpaid When Insurer Cancels Prescription Card
In T. Brenner v. WCAB (Drexel Industries) the Commonwealth Court reversed the Board and affirmed the WCJ's holding that the Employer/Insurer violated the Act when it unilaterally ended a prescription card program. The Claimant was able to get medications through the prescription card program. When the card was cancelled without prior notice to the Claimant, she went without medications for a period of time, then submitted prescription expenses she was able to pay, only to have them sent to utilization review.
The Commonwealth Court held the WCJ was correct to apply McLaughlin v. Workers' Compensation Appeal Board (St. Francis Country House), 808 A.2d 285 (Pa. Cmwlth. 2002), appeal denied, 573 Pa. 717, 828 A.2d 351 (2003) which held the Employer cannot plead failure to present bills properly when it acts to prevent the treatment at issue. Where the Employer/Insurer gave no notice to the Claimant of the revocation of the prescription card, a penalty was appropriate under McLaughlin.
Pennsylvania Workers' Compensation Practice and Procedure Reference 13.37
Posted by Robert Vonada at 5:17 PM 0 comments
Posted by Robert Vonada at 6:02 PM 0 comments
Two More Cases Hold Date of Injury in Cumulative Trauma Case is Last Day of Work
In Leslie Fay Companies, et al. v. WCAB (Macaluso, et al.) the Commonwealth Court let stand a WCJ's decision finding the date of injury in a cumulative trauma case was the last day of work. The insurer appealed because the Claimant had a long history of symptoms and the last insurer only covered the Employer for two an a half months.
As stated recently by the Supreme Court in City of Philadelphia v. WCAB (Williams) the analysis of the appropriate date of injury in a cumulative trauma case looks only to whether credited medical evidence establishes each day of work causes an "aggravation" or new injury.
Pennsylvania Workers' Compensation Practice and Procedure Reference 3.104
Posted by Robert Vonada at 4:22 PM 0 comments
Commonwealth Court Affirms Dismissal of Petition To Set Aside Compromise and Release Agreement Alleging Lack of Mental Capacity
In M. Stiles v. WCAB (Dept. of Public Welfare) the Commonwealth Court affirmed a summary dismissal of a Petition to Set Aside a Compromise and Release Agreement. The Claimant alleged she was not mentally competent when the C&R was approved. The dismissal was summary because Claimant's Counsel moved for a continuance for medical testimony at the first hearing and deferred the Claimant's testimony. The Employer thereafter moved for dismissal on the basis of collateral estoppel, and the WCJ granted the motion.
The Court distinguished the case from North Penn Sanitation Inc. v. Workers' Compensation Appeal Board (Dillard), ___ A.2d ___, (Pa. Cmwlth. No. 2115 C.D. 2003, filed, May 10, 2004) on the basis that Dillard's blindness was unknown to the WCJ. The Court stated the Claimant's mental competency was an issue before the WCJ, who made a finding the Claimant understood the Agreement.
Pennsylvania Workers' Compensation Practice and Procedure Reference 26.3 et. seq.
Personal Injury Lawyers Look to Workers' Compensation as a Result of Tort Reform
An article from the Philadelphia Business Journal reports that as personal injury lawyers have fewer and less lucrative cases, they are appearing more often before WCJs. "With the various changes with the law, the personal injury attorneys are seeing their business hit," [George] Martin said. "They're less inclined to refer [workers' compensation cases] out when their business is down."
Posted by Robert Vonada at 7:01 AM 0 comments
Local SSA Interpretation Limits Fee Reduction to Lifetime Pro-Ration of Indemnity
When preparing Sciarotta Language for Compromise and Release Agreements, Counsel typically does not show the attorney's contingent fee coming out of the Medicare Set Aside Amount. This is Medicare's directed procedure, according to a May 7, 2004 All Regional Administrators memorandum. Thank You to Judge Torrey for the memo reference
Counsel instead applies the whole counsel fee to the net amount representing future indemnity. The fee then may exceed 20% of the indemnity amount, but the context clearly shows the fee has been reallocated in accordance with Medicare's directive.
The lifetime pro-ration calculation is performed on the net amount after Medicare set aside and attorney's fees. Recently, however, a counsel from the Pittsburgh area has been instructed by representatives of the Social Security Administration to allocate only a pro rata portion of the fee to the indemnity.
If SSA limits the fee reduction to 20% of the indemnity amount, the Claimant will have to be asked: "Do you understand a portion of the attorney's fee in this case amounting to (the attorney's fee on the Medicare set aside amount) will be included as your income from this settlement for the purpose of calculating your future entitlement to social security disability benefits?"
Pennsylvania Workers' Compensation Practice and Procedure Reference 26.24
Posted by Robert Vonada at 8:38 PM 0 comments
Commonwealth Court Defines Procedure for Proving Modification Based on Surveillance Evidence of Earning Power
J. Burrell v. WCAB (Philadelphia Gas Works, et al.) is a case that has application in many areas. In the final analysis the Commonwealth Court affirmed the Order of the WCJ and Board that imputed income of $9.93 per hour for eight hours per week based on evidence the Claimant was working at least that much as a shoe shiner in his mother's shop.
The first issue was whether modification can be granted without a Notice of Ability to Return to Work when surveillance found the Claimant working. The Commonwealth Court noted receipt of medical information documenting a change in condition triggers the Employer's obligation to send the Notice of Ability to Return to Work. The purpose of the statute is to place the Claimant on notice of the medical information. Where the Claimant deems himself able to work, such notice is not required.
The next issue was whether the Employer had to demonstrate it had no job available to the Claimant within his restrictions before an award of modification. The Court held where the Claimant deems himself able to work, this can only be an affirmative defense of the Claimant.
Another issue was whether the WCJ's holding that the Claimant's imputed hourly wage should be $9.93 was supported by substantial evidence. The Employer's Vocational Expert opined this is the average wage for a shoe shiner in Philadelphia. The Claimant basically argued he's not that good. The Court held the accuracy of the VE's opinion is beyond challenge when the WCJ gives full weight to the VE's testimony, and this determination is within the sole province of the factfinder.
Finally, the Employer requested a credit. The Court recognized "Unjust enrichment occurs when a person has and retains money or benefits, which in justice and equity belong to another." and a credit may be granted to prevent unjust enrichment. However, the Employer could not prove the Claimant received wages or gratuities.
Pennsylvania Workers' Compensation Practice and Procedure Reference 21.56; 21.38; 6.106
Posted by Robert Vonada at 9:36 PM 0 comments
Commonwealth Court Holds Claimant Did Not Meet His Burden to Reinstate After Retirement
A. Capasso v. WCAB (RACS Associates, Inc.) describes the Claimant's burden to overcome testimony that he retired. Once the Claimant testifies he retired, the presumption that his loss of earning power is through no fault of his own is abolished. The Claimant must show he is seeking to return to work or he was forced to retire because of his work injury.
The Commonwealth Court also held that where only the Claimant presented evidence, the WCJ was free to discredit it. The Court engaged in Daniels and Wintermeyer review of the WCJ's credibility finding that the Claimant's injury did not motivate him to retire, and the Court affirmed the finding.
Posted by Robert Vonada at 8:09 PM 0 comments
Penalties Are Awarded When Employer/Insurer Takes Unilateral Suspension Upon Accrual of Credit
In T. Palmer v. WCAB (City of Philadelphia) The Employer took a unilateral suspension because the Claimant became entitled to a pension that offset her workers' compensation benefits. Even though the Claimant was due no workers' compensation benefits after the offset was applied, the WCJ's award of a penalty on the amount of workers' compensation due before the offset was affirmed by the Commonwealth Court.
This could apply in the case of return to work unilateral suspensions as well. The Court stated the rule that no penalty can be awarded when no compensation is awarded does not apply when compensation is payable, but offset, because the purpose of the statutory provision is to penalize conduct of the Employer/Insurer that is unlawful, in this case the unilateral suspension.
Posted by Robert Vonada at 7:49 PM 0 comments
Bureau Statement of Policy Confirms Act 53 Qualifications of Vocational Experts are the Qualifications Set Forth at 34 Pa. Code §123.202
As noted in the recent Bureau of Workers' Compensation News and Notes, the Bureau issued a Statement of Policy providing the qualifications of vocational experts referred to in Act 53 of 2003 are as set forth in the "Qualifications (of vocational experts)" Regulation at 34 Pa. Code §123.202.
Later regulation is promised and may address the requirement that vocational experts comply with the code of professional ethics for rehabilitation counselors pertaining to the conduct of expert witnesses and other matters.
Pennsylvania Workers' Compensation Practice and Procedure Reference 21.51
Posted by Robert Vonada at 9:42 PM 0 comments
Requirement of "Furthering the Employer's Business or Affairs" When Work Injury Occurs Off the Premises
In an article in the Pennsylvania Bar Association Quarterly, James A. Tinnyo, Esquire analyzes Acme Markets, Inc. v. WCAB (Purcell) to hold that an employee must be engaged in the furtherance of business when he suffers an injury off the premises that arises out of employment.
In the case, the Claimant labored heavily for years for the employer, but when his lumbar disk herniated, he was at home. What distinguishes this case from others is that the WCJ credited Claimant's doctor who opined the substantial cause of the herniated disk was the years of employment, not getting up off the floor after assembling a file cabinet for personal use.
Perhaps in this pre Daniels, two months post Wintermeyer case the Commonwealth Court didn't feel it could review the credibility determination.
One has to ask what the Court would have done if the Claimant, due to his degenerative condition accumulated from years at work, simply couldn't get up in the morning due to pain. If the Court would still deny the Claimant because he was at home (which is contrary to the heart attack cases Mr. Tinnyo cites) then a new precedent has been created.
Posted by Robert Vonada at 9:22 PM 0 comments
No Proof of Change of Condition is Necessary for Second IRE in a Twelve Month Period
In S. Hilyer v. WCAB (Joseph T. Pastill, Jr. Logging), the Commonwealth Court endorsed the Bureau's Regulation at 34 Pa. Code §123.102(g) which provides an Employer can have an IME (Independent Medical Exam) that comments on the status of the Claimant's impairment under the AMA Guides within the twelve months following the IRE (Impairment Rating Evaluation) provided for in §306(a.2)(1) of the Act.
The Court danced around the fact the Act only allows an IME to be held after the Employer's one shot at an IRE which must be conducted within sixty (60) days after 104 weeks of temporary total disability is paid. §306(a.2)(6) The Court allowed to stand the obfuscation of the regulation that states an Employer can have two IRE's in a twelve month period, when the statute clearly says IMEs.
The bottom line, however, is the Court properly read §306(a.2) in pari materia to provide that in an IME that takes place after an IRE is properly conducted, the examiner can review the status of the Claimant's impairment under the AMA Guides. The Court further held no prefatory showing of a change in condition is required by §306(a.2)(6).
Pennsylvania Workers' Compensation Practice and Procedure reference: 17.31
Posted by Robert Vonada at 8:46 PM 0 comments
NCP, Including Description Of Injury, Can Be Reviewed Where Facts Were Available At Time NCP Was Issued
In Meenan Oil Co., L.P. v. WCAB (Pownall) the Commonwealth Court held that pursuant to Section 413(a) of the Act, a review petition can be filed "at any time" to correct material mistakes including the date of injury and the description of injury.
The key here is the facts that direct the relief requested existed at the time the NCP was issued. The WCJ considered these facts under a review petition. The WCJ's finding that the date of injury and the description of injury were incorrectly entered on the NCP was within the authority granted by Section 413(a).
Pennsylvania Workers' Compensation Practice and Procedure reference: 25.6
Posted by Robert Vonada at 7:45 PM
New NCP With Medical Only Check Box Published
The Notice of Compensation Payable (LIBC-495) to use for medical only cases is available at the Workers' Compensation Forms Matrix Site. This form replaces all prior versions of the NCP.
Pennsylvania Workers' Compensation Practice and Procedure reference: 9.6
Posted by Robert Vonada at 8:44 PM
Posted by Robert Vonada at 12:24 PM 0 comments
School District May Take a Pension Offset Only For What the School District Contributes
Pittsburgh Board of Education v. WCAB (Schulz) answered the question left unanswered in Pittsburgh Board of Education v. WCAB (Dancho). For the pension offset, a school district can offset only what it contributes, not the Commonwealth's contribution.
Posted by Robert Vonada at 12:05 PM 0 comments
Pennsylvania Costs Per Claim Rose, But Remain Lower Than Median of Other States
A press release regarding the latest WCRI Study states that while costs per claim in Pennsylvania rose 8.5 per cent per year on average from 1999 to 2002, costs per claim remained 15 per cent lower than the median of other states surveyed. Attorney involvement was not identified as a cost driver as it has been in the past. Cost drivers were identified as double-digit increases in medical costs per claim and benefit delivery expenses. Also, Pennsylvania public officials, insurers and employers were commended on compliance with the 21 day rule.
The WCRI site also touts a study that found workers in Pennsylvania and Massachusetts are more likely to have satisfactory recoveries and a timely return to work, although this is consistent with findings that workers in these states have better access to satisfactory medical care.
Posted by Robert Vonada at 6:14 PM 0 comments
Commonwealth Court Confirms Cafeteria Plan Funds Not Wages
In J. Weikel v. WCAB (PECO) The Employer provided "flex dollars" for benefits, and the Claimant could get them in cash if they were unused. The WCJ held amounts allocated by the Claimant to purchasing plan items are not includable in the average weekly wage. The Commonwealth Court affirmed, noting Section 309 excludes from the AWW calculation "employer payments for or contributions to a retirement, pension, health and welfare, life insurance, social security or any other plan for the benefit of the employe or his dependents."
Posted by Robert Vonada at 5:49 PM 0 comments
Commonwealth Court Affirms WCJ May Grant Motion To Dismiss on the Pleadings
In Karotka, et al. v. WCAB (Millcreek Community Hospital, et al.) the spouse of the Claimant who passed away from reasons unrelated to her work injury filed serial Penalty Petitions alleging vague misconduct by the Employer. The WCJ cut the Complainant off at the hearing and gave him an additional 30 days to state his case in writing. The WCJ then dismissed on the basis of res judicata.
The Commonwealth Court affirmed and further stated that nothing in Section 504 of the Administrative Agency Law requires an evidentiary hearing. Notice and the opportunity to be heard is satisfied if the WCJ reviews the pleadings and requests briefs. This can be on the WCJ's own motion, or on the motion of a party. The WCJ can dismiss a frivolous petition using this procedure.
Posted by Robert Vonada at 12:28 PM 0 comments
Commonwealth Court Further Defines Supersedeas Reimbursement After C&R
In Coyne Textile v. WCAB (Voorhis) the WCJ dismissed the Employer's Termination Petition after a C&R holding the C&R resolved all the issues in the case. The Employer wanted a decision on the Termination Petition to get supersedeas reimbursement.
The Commonwealth Court noted the following language in the C&R:
Upon approval of the Compromise and Release Agreement by [the WCJ], the [C]laimant will receive a total of $17,500 to fully and finally settle any entitlement for indemnity and medical benefits from August 16, 2000 into the future.
Specifically, the parties acknowledge that this Compromise and Release Agreement does not adjudicate the issues raised by [Claimant's Challenge Petition], filed in response to the [Suspension Petition] filed by the [E]mployer on June 23, 1999. Those issues will be decided by the [WCJ] based on the evidence of record already submitted by the parties.
(Emphasis in the decision of the Court)
With this language in the C&R Agreement, the Commonwealth Court held it was appropriate for a decision to be issued on the Employer's Petition for Termination. The Court remanded to the WCJ to render a decision.
When the WCJ receives the remand, the WCJ can either do a full opinion and order or follow the procedure set forth in Optimax, Inc. v, WCAB (Yacono). In Optimax, the parties entered into a stipulation that a Termination Petition should be granted. The WCJ entered a decision and order on the stipulation. The Employer proceeded to file a Petition for Supersedeas Reimbursement, and this petition was assigned to a WCJ. The WCJ who decided the Petition for Supersedeas Reimbursement dismissed the Petition because the termination was entered on a stipulation. The Commonwealth Court reversed and remanded to the WCJ that received assignment of the Petition for Supersedeas Reimbursement, with the direction that this WCJ review the record and determine whether the record supported the facts stipulated to, e.g. the facts supporting termination. The Court stated supersedeas reimbursement could be had if the record supported termination.
Therefore, the procedure according to these two cases is to provide in the C&R that the lump sum is in consideration of future benefits, and that the Employer's Petition will be decided on the record. There has to be a record, e.g. a supporting deposition or withdrawal of Claimant's objection to Employer's medical report under Section 422(c). To dispose of the Employer's Petition, the parties enter into a stipulation that the petition should be granted. The WCJ issues a decision on that stipulation. The Employer files a Petition For Supersedeas Reimbursement. The WCJ who receives assignment of the Petition For Supersedeas Reimbursement reviews the record and determines whether the record supports the stipulation. If so, supersedeas reimbursement may be granted.
Posted by Robert Vonada at 6:22 AM 0 comments
Supreme Court Denies Appeal on Some Cases of Interest, Consolidates Korach With Jeanes Hospital
The Supreme Court denied Allowance of Appeal in Sekulski v. WCAB (Indy Associates) (June 18, 2003 post) a course and scope of employment case commented on at Hershey.
The Supreme Court also denied Allowance of Appeal in Shire v. WCAB (General Motors) (July 8, 2003 post). The Shire holding including non-work related sickness and accident benefits in an AWW for a later injury may not be inconsistent with the way the Court is leaning in Colpetzer/Zerby (August 26, 2003 post), in which the issue is whether a Claimant's AWW from a prior work injury gets included in an AWW calculation for a later work injury.
The Supreme Court granted Allowance of Appeal in Westinghouse Electric, Pet v. WCAB(Korach) (July 1, 2003 post), consolidating it with Jeanes Hospital (September 23, 2003 post). In Korach, the statute of limitations with respect to the filing of a Claim Petition to add a psychiatric description of injury to the NCP was tolled by the payment of psychiatric bills by the Employer.
Supreme Court Holds WCJ May Determine Paternity, Limited To WC Claim
In Rossa v. WCAB (City of Philadelphia) the issue before the WCJ was the paternity of a child prosecuting a fatal claim petition. The Supreme Court held: "Given the familial relationships that the WCJ must often disentangle, determining the eligibility of a child is not an extraordinary task. It is a responsibility that the WCJ is well able to assume."
The Court further held the standard of proof is preponderance of the evidence.
Posted by Robert Vonada at 12:20 PM 0 comments
On December 23, Section 306(b) was amended to provide a vocational expert that meets qualifications established by the Department by regulation can conduct a vocational interview. On December 30, the Supreme Court in Caso v. WCAB (School District of Philadelphia) held that is what Section 306(b) meant all along. The Court held the Department's interpretation of the statute was entitled to great deference, and should not have been overturned unless such interpretation was clearly erroneous. Here, the interpretation that "approved" in Section 306(b) means "competent" was held by the Court to be reasonable.
The Court then reviewed the resulting application of the statute: an expert that meets the qualifications set forth in the regulations is deemed "approved" and the claimant may be compelled to attend a vocational examination with the expert. On a subsequent petition the WCJ determines competency of the vocational expert and may do so in light of the Bureau's (Department's) regulations. Finally, the Court noted defendant employers and insurers are subject to the imposition of penalties for bad faith selection of an unqualified interviewer.
Posted by Robert Vonada at 12:07 PM 0 comments
The Maximum Workers' Compensation Rate for 2005 is...
Commonwealth Court Outlines Burden of Proof in §30...
Commonwealth Court Holds Physical/Physical Injury ...
AFL-CIO Press Release Notes Proposed Reduction in ...
WCRI to give Pennsylvania Briefing on January 19, ...
Commonwealth Court Confirms Claimant Does Not Waiv...
Claimants Can Get a Print Out of Unemployment Comp...
Commonwealth Court Confirms 104 Weeks for IRE Runs...
Supreme Court Grants Allowance of Appeal in Heart ...
Supreme Court Discusses Substantial Evidence Stand...
Commonwealth Court Emphasizes Limited Basis of App...
WTAE Pittsburgh's Site Offers Interesting Articles...
Pennsylvania Workers' Compensation Journal Will Re...
Local SSA Interpretation Limits Fee Reduction to L...