Court Opinion

ID: 9928303
Source: CourtListenerOpinion
Date Created: 2024-01-31 15:10:31.253492+00
Date Added: 2024-06-11T09:52:34.752160
License: Public Domain

IN THE COMMONWEALTH COURT OF PENNSYLVANIA

Augustine Sesay,                        :
                   Petitioner           :
                                        :   No. 551 C.D. 2022
            v.                          :
                                        :   Submitted: February 10, 2023
Southeastern Pennsylvania               :
Transportation Authority (Workers’      :
Compensation Appeal Board),             :
                  Respondent            :

BEFORE:     HONORABLE PATRICIA A. McCULLOUGH, Judge
            HONORABLE ANNE E. COVEY, Judge
            HONORABLE STACY WALLACE, Judge

OPINION NOT REPORTED

MEMORANDUM OPINION
BY JUDGE McCULLOUGH                                FILED: January 31, 2024

            In this workers’ compensation appeal, Petitioner Augustine Sesay
(Claimant or Sesay) petitions for review, pro se, of the April 21, 2022 order of the
Workers’ Compensation Appeal Board (Board), which affirmed the August 27, 2021
order of Workers’ Compensation Judge Denise Krauss (WCJ). The WCJ (1) granted,
in part, and denied, in part, Claimant’s Petition to Review Compensation Benefits
(Review Petition); (2) granted the Petition to Suspend Compensation Benefits
(Suspension Petition) filed by Respondent Southeastern Pennsylvania Transportation
Authority (Employer or SEPTA); and (3) denied Employer’s Petition to Terminate
Compensation Benefits (Termination Petition). In his Petition for Review (PFR) and
brief, Claimant argues that (1) his counsel “suppressed” evidence of Claimant’s Post-
Traumatic Stress Disorder (PTSD) and failed to seek amendment of the description of
Claimant’s injury to include PTSD; and, relatedly, (2) the WCJ erred in finding that
Claimant could return to work in his pre-injury position with Employer. After careful
review, we affirm.
                   I.    FACTS AND PROCEDURAL HISTORY
              The Board summarized many of the pertinent facts underlying this appeal
as follows:
              Claimant sustained a work injury to his eye during the course
              and scope of his employment with [Employer] on May 18,
              2018. On June 5, 2018, [Employer] issued a Notice of
              Temporary Compensation Payable (NTCP), agreeing to pay
              medical and indemnity benefits for an injury described as a
              laceration of Claimant’s eye/face. The NTCP converted to a
              Notice of Compensation Payable (NCP) by operation of law.
              On November 5, 2019, [Employer] filed [the Suspension
              Petition], requesting [that] the WCJ suspend Claimant’s
              benefits based on a specific job offer made by [Employer].
              On November 15, 2019, Claimant filed [the Review
              Petition], averring an incorrect NCP work-injury description.
              Claimant specifically sought to amend the NCP injury
              description to include “[t]raumatic [h]yphema, [v]itreous
              [d]egeneration, [m]acular [e]dema and loss of sight of the
              right eye.”
              On December 10, 2019, [Employer] filed [the Termination
              Petition], alleging that Claimant had fully recovered from his
              work injuries as of October 3, 2019.

(Board Opinion (Op.), Certified Record (C.R.) Document (Doc.) 19, at 1-2.) The
Suspension, Review, and Termination Petitions were consolidated for a hearing before
the WCJ on February 5, 2021. At the hearing, Claimant testified on his own behalf
and submitted, in addition to several medical exhibits, a transcript of his deposition
taken February 28, 2020. Employer presented the deposition testimony of Dr. Kenneth
S. Schindler, who conducted an independent medical examination of Claimant on
October 3, 2019.

                                            2
            During the hearing before the WCJ, a question arose regarding whether
Claimant sought to add PTSD to the description of his injury. The following exchange
occurred among Claimant, Claimant’s counsel (Attorney Magaldi), Employer’s
counsel (Attorney Wagner), and the WCJ:
            [WCJ]: Just for my edification[,] there’s a Review Petition[;]
            what is the basis of that?
            Attorney Magaldi: The basis is we want to expand the
            diagnosis of the eye injury which I believe [Employer’s
            Counsel] agreed to.
            [WCJ]: Okay. So, we’re not going to discuss the PTSD in
            the decision then if it hasn’t been alleged.
            [Claimant]: I did talk to my lawyer.
            [WCJ]: I’m talking to Mr. Magaldi.
            [Claimant]: I’m sorry.
            [WCJ]: Okay.
            Attorney Magaldi: Correct, Judge.
            ....
            Attorney Wagner: Sir, did your PTSD prevent you from
            looking for any work[?] Is that correct?
            [Claimant]: The PTSD does not prevent me, no, from
            looking for work, but if I’m going—the lady told me
            exactly—the psychiatrist told me exactly that I need to find
            a job within an area.
            ....
(Notes of Testimony (N.T.), February 5, 2021, at 33-34; C.R. Doc. 22.)
            By [ ] Decision and Order circulated on August 27, 2021, the
            WCJ granted in part and denied in part Claimant’s Review
            Petition, granted [Employer’s] Suspension Petition, and
            denied [Employer’s] Termination Petition. The WCJ found
            that Claimant’s work injury description should be expanded
            to include traumatic hyphema and macular edema, as
            stipulated by the parties. The WCJ determined that Claimant

                                          3
             failed to establish that he sustained vitreous degeneration
             and/or specific loss of use of the right eye as a result of the
             work incident. The WCJ concluded that Claimant was
             physically able to perform the pre-injury position offered by
             [Employer] as of November 3, 2019. The WCJ further
             determined that [Employer] failed to establish that Claimant
             fully recovered from his work injuries.

(Board Op. at 2.) In particular, the WCJ credited Claimant’s testimony regarding how
he sustained the injury to his eye and his ongoing subjective symptoms of eye pain and
related difficulties. (WCJ Findings of Fact (FOF) 11(a).) The WCJ discredited
Claimant’s testimony that he was unable to return to work in his pre-injury capacity
and that he had lost all vision in his injured eye because the WCJ found that Claimant’s
testimony was credibly rebutted by Employer’s medical witness, Dr. Schindler. Id.
             The WCJ found Dr. Schindler’s testimony to be credible to the extent that
he testified that Claimant suffered a traumatic hyphema and macular edema but
nevertheless could return to his pre-injury position with Employer. (FOF 11(b).) The
WCJ further found Dr. Schindler’s testimony that Claimant was fully recovered from
his injury to be not credible, chiefly because Dr. Schindler’s opinions in this regard
contradicted (1) Claimant’s subjective, ongoing complaints of eye pain, blurriness, and
vision loss in his injured eye; (2) the medical records from Claimant’s treating
physicians; and (3) the report of Claimant’s independent medical examiner, Dr.
Edward A. Deglin. Id. The WCJ accordingly concluded that, although Claimant
suffered traumatic hyphemia and macular edema, he did not “suffer a specific loss of
use of the right eye for all practical intents and purposes,” “was physically capable of
performing the offered pre-injury job position at his regular rate of pay as of November
3, 2019,” and “was not fully recovered from the injuries related to the May 18, 2018
work incident . . . .” (FOF 11(c)-(g).)

                                           4
               Claimant appealed to the Board, arguing that he is not fully recovered
from his injury and is not able to perform all of the duties of his pre-injury position.
(C.R. Doc. 13.) Notably, Claimant did not challenge before the Board any of the
WCJ’s evidentiary findings and did not argue that his counsel suppressed evidence or
was otherwise negligent or ineffective in not seeking to add PTSD to the description
of Claimant’s injury. Id. Employer also appealed to the Board, arguing that the WCJ
erred in denying the Termination Petition based on the finding that Claimant was not
fully recovered from his injury, which finding Employer alleged was not supported by
substantial evidence. (C.R. Doc. 15.)
               The Board affirmed, concluding first that the WCJ did not err or abuse her
discretion in denying Employer’s Termination Petition based on a finding that
Employer had not established that Claimant was fully recovered from his work injury.
Id. at 11. The Board also concluded that Claimant did not establish that his counsel’s
conduct in declining to present any medical evidence of Claimant’s PTSD to the WCJ
warranted a remand for rehearing. Id. at 13-14.
               Claimant now appeals to this Court pro se.
                                II.     ISSUES PRESENTED1
               From what we can glean from Claimant’s PFR and brief, he raises two
issues in this appeal: (1) whether the Board erred in affirming the WCJ’s finding that
Claimant is capable of returning to his pre-injury position with Employer; and (2)
whether Claimant was denied due process because of his counsel’s “suppression” of

       1
          Our standard of review of a Board order limits us to determining whether the necessary
findings of fact are supported by substantial evidence, whether an error of law or a violation of Board
procedure has occurred, or whether constitutional rights were violated. Republic Steel Corp. v.
Workmen’s Comp. Appeal Board (Petrisek), 640 A.2d 1266, 1268 (Pa. 1994). “Substantial evidence”
is “such relevant evidence that a reasonable mind might accept as adequate to support a conclusion.”
Valley View Civic Association v. Zoning Board of Adjustment, 462 A.2d 637, 640 (Pa. 1983) (citations
omitted).

                                                  5
evidence that would have established that Claimant suffers from PTSD, which
condition precludes his return to his pre-injury position.2 For the sake of logical
consistency, we address the issues in reverse order.
                                     III.    DISCUSSION3
                                            A.      PTSD
               Regarding      Claimant’s         contention   that    his   counsel     wrongfully
“suppressed” evidence of PTSD, we address Employer’s last argument first because it
is dispositive. Employer argues that Claimant has waived the issues he raises on appeal
because his appeal form filed with the Board is defective. We agree, in part.
               Section 111.11(a) of Chapter 111 of the Special Rules of Administrative
Practice and Procedure before the Board establishes the form and content requirements
for appeals from a WCJ decision. 34 Pa. Code § 111.11(a). Section 111.11(a)(2)
requires that an appeal contain “[a] statement of the particular grounds upon which the
appeal is based, including reference to the specific findings of fact which are challenged
and the errors of the law which are alleged.” Id. It further provides that “[g]eneral
allegations which do not specifically bring to the attention of the Board the issues
decided are insufficient.” Id. Failure to adequately raise issues in the Board’s appeal

       2
         Claimant at times argues that he is not “fully recovered” from his work injury. The WCJ
found that Claimant was not fully recovered and, accordingly, denied Employer’s Termination
Petition. The Board affirmed, and Employer has not petitioned for review in this Court. Thus,
whether Claimant is fully recovered is not before us. Rather, the pertinent question is whether
Claimant presently is capable of returning to his pre-injury position with Employer, notwithstanding
his ongoing symptoms.

       3
         Claimant attaches to his PFR and brief several documents that appear nowhere in the certified
record and that post-date the hearing before the WCJ. In rejecting Claimant’s previous noncompliant
brief, we directed him to refrain from attaching documents that were not made part of the record
before the WCJ. See Order, 10/4/2022; see also Pennsylvania Rule of Appellate Procedure 1951;
B.K. v. Department of Public Welfare, 36 A.3d 649 (Pa. Cmwlth. 2012). He once again has done so,
and we once again reject their consideration in this appeal.

                                                   6
form can result in waiver. Jonathan Sheppard Stables v. Workers’ Compensation
Appeal Board (Wyatt), 739 A.2d 1084, 1089 (Pa. Cmwlth. 1999).
             In Claimant’s appeal to the Board, he generally argued that he could not
return to work because of ongoing symptoms in his injured eye and certain mental
conditions, including PTSD. (C.R. Doc. 13.)       He nowhere challenged any specific
findings of fact, conclusions of law, or rulings of the WCJ and, most importantly, does
not anywhere lodge a challenge to his counsel’s conduct during the hearing before the
WCJ. We also cannot find in the certified record any indication that he otherwise
adequately raised this issue before the Board. “The law is well settled that issues not
raised before the Board are waived and cannot be raised for the first time before this
Court.”    Myers v. Workers’ Compensation Appeal Board (Family Heritage
Restaurant), 728 A.2d 1021, 1023 (Pa. Cmwlth. 1999). Further, while the Board chose
to review the question of whether Claimant’s counsel erred in failing to present
evidence of Claimant’s PTSD, see Board Op. at 13-14, that does not change the fact
that Claimant failed to comply with the requirements set forth in 34 Pa. Code §
111.11(a)(2). Thus, and notwithstanding the Board’s analysis, we conclude that this
issue is waived.
             Moreover, even if this issue properly was before us, it would be without
merit. The Board concluded:
             Unfortunately, the issues that Claimant appeals are of a
             private attorney-client nature and are not matters within [the]
             Board’s scope to resolve. Moreover, the stipulations made
             by Claimant’s counsel are binding on Claimant in his
             litigation of the case. Additionally, while . . . the Board may
             remand a matter for the presentation of additional evidence
             where the circumstances suggest that the actions of the
             claimant’s attorney in failing to submit certain named
             evidence could lead to manifest injustice to the claimant, the
             Board is not obligated to order a rehearing every time a

                                           7
              losing party can point to some evidence which his attorney
              did not introduce. [Martell v. Workers’ Compensation
              Appeal Board (Doyle Equipment), 707 A.2d 242 (Pa.
              Cmwlth. 1998); Bickel v. [Workmen’s Compensation Appeal
              Board] (Williamsport Sanitary Authority), 538 A.2d 661 (Pa.
              Cmwlth. 1988).] Where counsel has medical evidence . . .
              during the WCJ proceedings, and the reasons for not
              presenting it “are as readily explained as strategic decisions
              as negligence,” there is no basis for a rehearing or remand.
              [Martell]. Since Claimant’s counsel did submit medical
              records on Claimant’s behalf [into] the record, Claimant’s
              counsel presumably had the opportunity to present the extent
              of the medical evidence . . . available[,] and in fact did so.
              Thus, if Claimant’s arguments on appeal can be construed as
              Claimant alleging that his counsel failed to present necessary
              evidence during the litigation, it appears that this was just as
              likely a strategic legal decision made by counsel, in which
              we may not interfere.

(Board Op. at 14-15.) We would agree with the Board’s assessment. Where a claimant
argues that his or her counsel incompetently failed to take a certain legal course of
action before a WCJ, we have analyzed the argument as one requesting rehearing
pursuant to Section 426 of the Workers’ Compensation Act, 77 P.S. § 871.4 As we
very recently summarized in Finck v. Union County Commissioners (Workers’
Compensation Appeal Board) (Pa. Cmwlth., No. 1029 C.D. 2022, filed December 18,
2023):
              In summary, [Johnson v. Workers’ Compensation Appeal
              Board, 321 A.2d 728 (Pa. Cmwlth. 1974)], Bickel, and
              Martell teach, first, that allegations of attorney incompetence
              are a rehearing issue under Section 426 of the Act, which
              requires “cause shown.” 77 P.S. § 871. Our cases further
              reveal that for attorney incompetence to amount to “cause
              shown” in this context, the claimant must satisfy two

       4
        Act of June 2, 1915, P.L. 736, as amended, 77 P.S. §§ 1-1041.4, 2501-2710. Section 426
was added by Section 6 of the Act of June 26, 1919, P.L. 642.

                                              8
             elements: (i) objective incompetence on the part of counsel,
             Johnson, and (ii) manifest injustice to the claimant flowing
             from that objective incompetence, Bickel, Martell.
Id., slip op. at 13-14. Absent this exacting standard, “piecemeal hearings prompted by
the wisdom of hindsight would become the rule rather than the exception.” Martell,
707 A.2d at 244.
             Here, there is no evidence in the record that would establish either
objective incompetence or manifest injustice. First, the record is clear that Claimant’s
counsel presented a substantial amount of competent medical evidence before the WCJ
and, in fact, succeeded in both amending the description of Claimant’s injury and
defeating Employer’s Termination Petition.        The record reveals that Claimant’s
counsel was active and engaged in the proceedings before the WCJ and manifested no
objective signs of incompetence or indolence. Merely because counsel, with full
knowledge of Claimant’s alleged PTSD and the medical records and testimony from
Claimant’s physicians, elected not to seek to add PTSD to the description of Claimant’s
compensable injury is insufficient in itself to establish that counsel’s decision was born
of incompetence and not reasonable legal strategy.
             Second, Claimant did not suffer manifest injustice from Counsel’s
decision, chiefly because the admission of such evidence would not necessarily have
changed the WCJ’s decision. The WCJ found that Claimant had not fully recovered
from his work injury but, nevertheless, could return to his pre-injury position. (FOF
11(f), (g).) Although the WCJ did not consider any medical evidence of PTSD, she
nevertheless received and acknowledged Claimant’s testimony regarding the reasons
that he could not return to his pre-injury position, which included his belief that he
suffered from PTSD.       (FOF 3(i).)    The WCJ further acknowledged Claimant’s
testimony that, when he attempted to return to his pre-injury job, he could only work

                                            9
for approximately one hour and had to leave because of traumatic flashbacks and a
panic attack. (FOF 3(j).) Thus, the WCJ heard and considered Claimant’s testimony
and nevertheless concluded that he could return to his pre-injury position with
Employer.    Counsel’s decision to not introduce additional evidence, medical or
otherwise, of Claimant’s alleged PTSD thus resulted in no manifest injustice,
particularly given Claimant’s own testimony that his alleged PTSD does not prevent
him from seeking work.
             In sum, although this issue is waived, we nevertheless would affirm the
Board if it properly was before us.
                               B.     Suspension Petition
             Section 413(a) of the WC Act authorizes a WCJ to modify a claimant's
WC benefits if the employer proves that “the disability of an injured employe has
increased, decreased, recurred, or has temporarily or finally ceased . . ..” 77 P.S. § 772.
Pursuant to Section 413(a), “when an employer seeks to modify a claimant's benefits
by a reduction, suspension, or termination of such benefits, the employer must first
come forward with medical evidence of a change in the claimant’s physical condition
that correspondingly establishes a change in the claimant’s ‘disability[,]’” which means
the loss of earning power. Phoenixville Hospital v. Workers’ Compensation Appeal
Board (Shoap), 81 A.3d 830, 841 (Pa. 2013). An employer seeking to suspend an
employee’s workers’ compensation benefits based on the employee’s ability to return
to work must establish with medical evidence that the employee is capable of returning
to work and that the employer has presented a job offer within the employee’s
capabilities. Dixon v. Workers’ Compensation Appeal Board (Medrad, Inc.), 134 A.3d
518, 521-22 (Pa. Cmwlth. 2016) (citations and quotations omitted). Once the employer
has carried its burden, the burden of proof shifts to the claimant to demonstrate that he

                                            10
or she responded to the offer in good faith; if good faith is not exercised, benefits may
be modified. Id. at 522.
               Here, there is no dispute that Employer offered Claimant his pre-injury
position. The only remaining disputed question is whether the position was within
Claimant’s medical capabilities. Claimant argues that the WCJ erred in finding that
Claimant could return to his pre-injury job with Employer because his mental
conditions, chiefly his PTSD, are preventing him from returning to work. Claimant
reiterates that he tried to return to work in 2019, but had to leave because he had a panic
attack caused by flashbacks of his prior work incident and fear that his other eye could
be injured. (Claimant’s Br. at 2.) Although Claimant at times notes that he has ongoing
pain and partial blindness in his injured eye, he does not argue in this Court that those
ongoing symptoms prevent him from returning to work. Thus, because PTSD was not
added to Claimant’s injury description, it cannot serve as a valid ground to challenge
the WCJ’s finding that Claimant can return to work. We accordingly find this issue to
be without merit.5

       5
          To the extent that Claimant does or could argue that the ongoing physical limitations in his
injured eye preclude him from returning to work, the WCJ made extensive findings regarding the
credibility of both Claimant’s and Employer’s medical experts. Based on those findings, the WCJ
concluded that the medical evidence indicates that Claimant’s ongoing physical limitations do not
preclude him from returning to his pre-injury position. (FOF 11(a), (b), (f).) The WCJ’s findings are
based on substantial evidence, namely, Dr. Schindler’s testimony, which the WCJ found to be
credible. “[T]he WCJ is the ultimate finder of fact and the exclusive arbiter of credibility and
evidentiary weight,” Thompson v. Workers’ Compensation Appeal Board (USF&G Co.), 781 A.2d
1146, 1150 (Pa. 2001), and “[t]he WCJ, therefore, is free to accept or reject, in whole or in part, the
testimony of any witness, including medical witnesses.” Griffiths v. Workers’ Compensation Appeal
Board (Red Lobster), 760 A.2d 72, 76 (Pa. Cmwlth. 2000). Here, because the WCJ’s findings
regarding Dr. Schindler’s testimony are supported by substantial evidence, they will not be disturbed
on appeal.

                                                 11
                              IV.   CONCLUSION
            Having concluded that Claimant’s issues on appeal are either waived or
without merit and that the WCJ did not err or abuse her discretion in issuing her
Decision and Order, we affirm the Board.

                                           ________________________________
                                           PATRICIA A. McCULLOUGH, Judge

                                           12
            IN THE COMMONWEALTH COURT OF PENNSYLVANIA

Augustine Sesay,                       :
                   Petitioner          :
                                       :    No. 551 C.D. 2022
            v.                         :
                                       :
Southeastern Pennsylvania              :
Transportation Authority (Workers’     :
Compensation Appeal Board)             :
                  Respondent           :

                                     ORDER

            AND NOW, this 31st day of January, 2024, the April 21, 2022 order of
the Workers’ Compensation Appeal Board hereby is AFFIRMED.

                                           ________________________________
                                           PATRICIA A. McCULLOUGH, Judge