Court Opinion

ID: 9946790
Source: CourtListenerOpinion
Date Created: 2024-03-01 15:21:44.263923+00
Date Added: 2024-06-11T14:23:43.397550
License: Public Domain

IN THE COMMONWEALTH COURT OF PENNSYLVANIA

William Dalzell,                    :
                   Petitioner       :
                                    :
                 v.                 :         No. 903 C.D. 2023
                                    :
Forest Hills Borough-Allegheny and  :         Submitted: February 6, 2024
Municipal Risk Management Workers’ :
Compensation Pooled Trust (Workers’ :
Compensation Appeal Board),         :
                   Respondents      :

BEFORE:      HONORABLE PATRICIA A. McCULLOUGH, Judge
             HONORABLE ELLEN CEISLER, Judge
             HONORABLE STACY WALLACE, Judge

OPINION NOT REPORTED

MEMORANDUM OPINION
BY JUDGE McCULLOUGH                                   FILED: March 1, 2024

             William Dalzell (Claimant) petitions for review of the Workers’
Compensation (WC) Appeal Board’s (Board) July 24, 2023 order affirming the
Workers’ Compensation Judge’s (WCJ) January 4, 2023 decision granting Forest Hills
Borough’s (Employer) Petition to Terminate Claimant’s WC benefits (2021
Termination Petition). On appeal, Claimant contends that the evidence was insufficient
to establish a change in his physical condition since the prior adjudication and that the
doctrine of res judicata precludes termination of his benefits. After review, we affirm.
                                 I. Background
             On April 10, 2019, Claimant sustained a lumbar strain while cleaning tree
branch debris during the course and scope of his employment as a maintenance worker
for Employer. Employer accepted the injury by a Notice of Temporary Compensation
Payable, which was later converted into a full Notice of Compensation Payable by
operation of law.
             On January 7, 2020, Employer filed a petition to terminate Claimant’s
WC benefits maintaining that Claimant had fully recovered from his injuries as of
November 11, 2019 (2020 Termination Petition). Hearings were held before WCJ
William Gallishen (WCJ Gallishen), at which Employer offered the July 7, 2020
deposition of James Cosgrove, M.D. (Dr. Cosgrove), who is board certified in physical
medicine and rehabilitation and examined Claimant on November 11, 2019. Claimant
testified and offered the deposition of orthopedic surgeon Robert Liss, M.D. (Dr. Liss).
By February 23, 2021 decision WCJ Gallishen denied the 2020 Termination Petition
based on his determination that Employer failed to demonstrate that Claimant had fully
recovered from his work injury. (Reproduced Record (R.R.) at 20a-21a.) WCJ
Gallishen found that Claimant’s ongoing back pain was a residual of his work injury
and that Claimant also sustained a T12 compression fracture as part of his injury, in
addition to the lumbar strain. (R.R. at 20a, 24a, 26a.)
             On August 24, 2021, Claimant underwent an independent medical
examination (IME) conducted by orthopedic surgeon Victor J. Thomas, M.D. (Dr.
Thomas), following which Dr. Thomas opined that Claimant had fully recovered from
his April 10, 2019 work accident and that he could return to his regular-duty job as a
maintenance worker for Employer. He further opined that, based on Claimant’s
unrelated diagnosis of osteoporosis, he should not perform any significant lifting.
(R.R. at 222a-23a.) On September 20, 2021, Employer filed the 2021 Termination
Petition based upon Dr. Thomas’s conclusion.
             Hearings were conducted before WCJ Gerald Yanity (WCJ Yanity) at
which Employer presented Dr. Thomas’ February 22, 2022 deposition wherein he

                                           2
testified that, as part of his examination of Claimant, he secured a history from
Claimant, reviewed his medical records including his magnetic resonance imaging
(MRI) history, obtained updated X-rays from his own office, and reviewed the
testimony from the initial round of litigation resulting in WCJ Gallishen’s decision.
Dr. Thomas indicated that, at the time of the IME, Claimant had not undergone any
active treatment for the past two years, although he had regular office visits with Dr.
Liss every six months. (R.R. at 68a-70a.) Claimant reported to Dr. Thomas that he
suffered from right-sided low back pain and that he had no left-side pain, numbness, or
tingling in his legs. Dr. Thomas relayed that Claimant had been diagnosed with
osteoporosis after the work injury and that he smoked cigarettes daily, which can delay
fracture healing and lead to lower back pain.
            As to Claimant’s initial diagnosis after the work injury, Dr. Thomas
understood that he sustained a lumbar strain and a T12 compression fracture, which he
agreed were the appropriate diagnoses. (R.R. at 81a.) Dr. Thomas opined that
Claimant had fully recovered from the lumbar strain because he had a normal range of
motion and there was no evidence of any muscular spasm. Dr. Thomas acknowledged
that WCJ Gallishen had noted in his decision that Claimant’s complaints of pain were
a result of his lumbar strain. However, Dr. Thomas explained that Claimant’s condition
had changed as of the IME, in that he observed no evidence of any ongoing lumbar
strain. He explained that the recovery time for the type of injury can last anywhere
from a couple of days to a few months. Dr. Thomas opined that Claimant’s complaint
of lower right back pain is not related to the lumbar strain or the T12 compression
fracture, which he described as mild and healed, and that it could be a result of the
degenerative changes in his back. (R.R. at 82a-86a.) Although Dr. Thomas agreed
that Claimant has a mild wedging deformity at the T12 level, he opined that it was not

                                          3
causing any functional deficit, as Claimant had made a full functional recovery from
the T12 compression fracture. (R.R. at 85a.) Dr. Thomas opined that Claimant does
not need any further treatment for the lumbar strain or compression fracture and that
he could return to work in his regular duty position without the need for restrictions
due to his work injury, although Claimant should be restricted from significant lifting
because of his osteoporosis, which in his view was inadequately treated. (R.R. at 86a-
88a.)
             On cross-examination, Dr Thomas agreed that it is not uncommon for
individuals who sustain a compression fracture to develop ongoing chronic back pain,
but he clarified that the percentage of patients who experience this is fairly low, about
ten percent. (R.R. at 101a-103a.) Insofar as WCJ Gallishen attributed Claimant’s
complaints of pain to the compression fracture, Dr. Thomas opined that while Claimant
did initially have pain as a result of the injury, that was no longer the case. (R.R. at
114a-15a.)
             Claimant testified that he remained under the care of Dr. Liss, who he saw
every six months, and that he was not undergoing any active treatment or taking
prescription medication for his condition, which he understood would not improve.
(R.R. at 200a.) Claimant attributed his lower right back pain to his work injury and
testified that he experiences pain on a daily basis when he sits or stands for too long,
or when he bends over to pick up materials. (R.R. at 201a-203a.)
             On cross-examination Claimant testified that he is sixty years old, that he
periodically takes Tylenol for pain and that he is not in physical therapy. Claimant
relayed that he has osteoporosis, that he is treating this condition with vitamins and that
he does not treat with a physician for this condition. Claimant relayed that he has

                                            4
smoked cigarettes for forty years and that he presently smokes about three quarters of
a pack per day. (R.R. at 215a.)
             Claimant also presented Dr. Liss’s April 8, 2002 deposition, wherein Dr.
Liss testified he began treating Claimant in May of 2019 and last saw him on April 5,
2020. Claimant continued to complain of pain in the right side of his lumbar spine that
is present when he stands for too long without changing position, and that the pain is
relieved when he sits or lies down. (R.R. at 160a-61a.) Dr. Liss reported that
Claimant’s symptoms are stable, that he is at maximum improvement and that he does
not anticipate changes in Claimant’s condition. Regarding the cause of Claimant’s
back pain, Dr. Liss opined that the T12 compression fracture subtly changed the
alignment of Claimant’s spine at the thoracolumbar junction and changed the
mechanics of his back at the level of the fracture, putting more stress on the lower back.
(R.R. at 163a-64a, 177a.) Dr. Liss agreed that Claimant’s compression fracture has
healed but explained that this assessment does not mean that Claimant’s back pain is
unrelated to the fracture, as it is common for patients with this type of injury to have
migration of pain to the lower back. With regard to work restrictions, Dr. Liss restricted
Claimant to light-duty work of lifting no more than twenty pounds and indicated that
this measure was necessary because of his work injury.
             On cross-examination Dr. Liss acknowledged that Claimant is a heavy
cigarette smoker and that there is an increased incidence of back pain in smokers. He
also acknowledged that osteoporosis can lead to back pain and that people with this
condition are more prone to fractures. (R.R. at 174a, 178a.)
             By January 4, 2023 decision, WCJ Yanity granted Employer’s 2021
Termination Petition and terminated Claimant’s WC benefits as of August 24, 2021.
In doing so, WCJ Yanity determined that the credible testimony of Dr. Thomas

                                            5
conclusively demonstrated that Claimant had made a full recovery from his work-
related injury as of the date of the IME. WCJ Yanity found that the evidence showed
“Claimant’s condition had changed since the previous litigation, insofar as Claimant’s
T12 compression fracture had healed, and there was no objective evidence of muscle
spasm which would suggest ongoing lumbar strain. Even Claimant’s own treating
physician, Dr. Liss, agreed that the T12 compression fracture had healed.” (R.R. at
224a.) WCJ Yanity rejected Dr. Liss’ testimony to the extent that it was contrary to
that of Dr. Thomas because there was no medical dispute that Claimant’s compression
fracture had healed and Dr. Liss offered no objective evidence that Claimant suffers
from an ongoing work injury. WCJ Yanity accepted as credible the “logical, thorough,
and well-reasoned opinions of Dr. Thomas, who convincingly explained that
Claimant’s current back problems are the result of osteoporosis and an underlying
degenerative condition.” (R.R. at 225a.)
              Claimant appealed to the Board, arguing that Dr. Thomas’s testimony
failed to show the required change of condition since the last disability adjudication
and that the WCJ’s finding of full recovery and termination of benefits is barred by the
doctrine of res judicata. On July 24, 2023, the Board affirmed WCJ Yanity’s decision.
(R.R. at 236a-37a.) This appeal followed.
                                         II. Analysis1
        Sufficiency of the Evidence to Support Termination of WC Benefits
              Claimant first argues the Board erred by affirming WCJ Yanity’s decision
granting Employer’s 2021 Termination Petition because Employer failed to establish

              1
                Our standard of review is limited to determining whether the findings of fact were
supported by substantial evidence, whether an error of law was committed, or whether constitutional
rights were violated. Phoenixville Hospital v. Workers’ Compensation Appeal Board (Shoap), 81
A.3d 830, 838 (Pa. 2013).

                                                6
that Claimant’s medical condition had changed since the 2020 Termination Petition
was denied.        (Claimant’s Br., at 18-30.)       Claimant contends that Dr. Thomas’s
testimony was insufficient as a matter of law to establish a change in his physical
condition and that, in contravention of controlling caselaw, Dr. Thomas failed to accept
the adjudicated diagnosis from the prior proceeding. Id. at 28-30. We disagree.
                Section 413(a) of the Workers’ Compensation Act (Act)2 authorizes
termination of benefits based on medical evidence demonstrating that a claimant’s
work-related injury has resolved. It provides in pertinent part:

                A workers’ compensation judge designated by the
                department may, at any time, . . . terminate a notice of
                compensation payable . . . upon petition filed by either party
                with the department, upon proof that the disability of an
                injured employe has increased, decreased, recurred, or has
                temporarily or finally ceased, or that the status of any
                dependent has changed.
77 P.S. § 772.3
                “To succeed in a termination petition, an employer bears the burden of
proving by substantial evidence that a claimant’s disability ceased, or any remaining
conditions are unrelated to the work injury.” Westmoreland County v. Workers’
Compensation Appeal Board (Fuller), 942 A.2d 213, 217 (Pa. Cmwlth. 2008). “An
employer may satisfy this burden by presenting unequivocal and competent medical
evidence of the claimant’s full recovery from [his] work-related injuries.” Id.

       2
           Act of June 2, 1915, P.L. 736, as amended, 77 P.S. §§ 1–1041.4; 2501–2710.

       3
        Under the Act, the term ‘disability’ is synonymous with loss of earning power. Donahay v.
Workers’ Compensation Appeal Board (Skills of Central PA, Inc.), 109 A.3d 787, 792 (Pa. Cmwlth.
2015).

                                                 7
              In Lewis v. Workers’ Compensation Appeal Board (Giles & Ransome,
Inc.), 919 A.2d 922 (Pa. 2007), our Supreme Court outlined the applicable standard as
follows:

              In order to terminate benefits on the theory that a claimant’s
              disability has reduced or ceased due to an improvement of
              physical ability, it is first necessary that the employer’s
              petition be based upon medical proof of a change in the
              claimant’s physical condition. Only then can the workers’
              compensation judge determine whether the change in
              physical condition has effectuated a change in the claimant’s
              disability, i.e., the loss of his earning power. Further, by
              natural extension it is necessary that, where there have been
              prior petitions to modify or terminate benefits, the employer
              must demonstrate a change in physical condition since the
              last disability determination.
Id. at 926.
              In a case where the claimant continues to experience pain, an employer’s
burden is met where its medical expert unequivocally opines within a reasonable
degree of medical certainty that the claimant is fully recovered, can return to work
without restrictions necessitated by the work injury and there are no objective medical
findings connecting the claimant’s substantiated complaints of pain to the work injury.
Baumann v. Workers’ Compensation Appeal Board (Kellogg Co.), 147 A.3d 1283,
1290 (Pa. Cmwlth. 2016). If the WCJ credits this testimony, the termination of benefits
is proper, as it is well settled that the WCJ is the ultimate factfinder with exclusive
province over questions of credibility and evidentiary weight and is therefore free to
accept or reject the testimony of any witness in whole or in part. Id.
               Here, Dr. Thomas unequivocally testified that Claimant’s work-related
injury, which he described as mild in nature, had fully healed since the prior
adjudication and that this injury was not the cause of Claimant’s continued complaints

                                            8
of low back pain. Dr. Thomas firmly attributed any ongoing pain to Claimant’s
separate condition of osteoporosis, which he opined had not been adequately treated,
and he also pointed to Claimant’s long-term heavy cigarette use as a potential
contributor to his pain. WCJ Yanity credited Dr. Thomas’s testimony which he found
logical and convincing over the testimony of Dr. Liss, which he found not credible to
the extent that it conflicted with Dr. Thomas’s testimony.
      Based upon its review of the record and mindful of WCJ Yanity’s role as
factfinder, the Board determined:

                     The WCJ found Dr. Thomas’ opinions credible,
             observing that Dr. Thomas conducted a thorough physical
             examination and his opinions were supported by the
             diagnostic studies. He further found Dr. Thomas credibly
             testified that Claimant’s condition had changed, insofar as
             the compression fracture had healed and there was no
             objective evidence of muscle spasm, and convincingly
             explained that Claimant’s then-current back problems were
             not related to the work injury. He rejected Dr. Liss’ opinion.
             ...
                     Upon review, we affirm. The employer must
             demonstrate a change in condition, and may not simply
             challenge the diagnosis as determined by a prior proceeding.
             Claimant argues that Dr. Thomas impermissibly challenged
             the causal connection between the compression fracture and
             Claimant’s low back pain. To the contrary, Dr. Thomas
             accepted the adjudicated diagnoses. He acknowledged
             Claimant could have had pain related to the fracture, but the
             pain of which Claimant complained at the time of his
             examination was not. The WCJ accepted Dr. Thomas’
             opinion and found that Claimant’s condition had changed. If
             the employer has accepted the adjudicated condition and
             proves recovery at a later date, the employer has shown a
             physical change of condition. We determine no error.
(R.R. at 235a-36a) (citations omitted).

                                           9
              Based on the foregoing, we conclude there was substantial evidence to
support WCJ Yanity’s conclusion that Employer proved there was a change in
Claimant’s physical condition since WCJ Gallishen’s prior decision such that the Lewis
standard was met. Accordingly, Claimant’s first issue lacks merit.
                     Applicability of the Doctrine of Res Judicata
             Claimant next contends that the doctrine of res judicata precludes a
termination of his WC benefits. Relying on this Court’s decision in Volkswagen of
America, Inc. v. Workers’ Compensation Appeal Board (Bennett), 858 A.2d 151 (Pa.
Cmwlth. 2004), Claimant maintains that because the issue of causation for his work-
related injury was previously adjudicated in the initial 2020 proceeding, Employer is
barred from re-litigating the issue. (Claimant’s Br., at 30-36.)
             The doctrine of res judicata encompasses the two related, yet distinct
principles of technical res judicata (claim preclusion) and collateral estoppel (issue
preclusion). Maranc v. Workers’ Compensation Appeal Board (Bienenfeld), 751 A.2d
1196, 1199 (Pa. Cmwlth. 2000). Claimant’s argument implicates collateral estoppel,
which bars re-litigation of an issue decided in a prior action. Boulin v. Brandywine
Senior Care, Inc. (Workers’ Compensation Appeal Board) __ A.3d__, (Pa. Cmwlth.,
No. 1273 C.D. 22, filed January 2, 2024), slip op. at 8, 2024 WL 15949, at *4.
“Collateral estoppel may be applied only if both cases involve the same issue, the prior
action was litigated to a final judgment on the merits, the party to be estopped was a
party or was in privity with a party to the prior action and had a full and fair opportunity
to litigate the issue in the prior action, and resolution of the issue in the prior proceeding
was essential to the judgment.” Id.
             In Volkswagen, the claimant was receiving benefits for an August 1988
back injury when his employer filed a termination petition in December of 1988

                                             10
alleging that he had fully recovered from the work-related injury. At the WCJ
proceedings, the claimant’s treating physician testified that the claimant continued to
have back problems, a left leg atrophy, and an absent Achilles reflex that were caused
by the work injury. The WCJ credited this testimony and denied the termination
petition.
             The employer then filed a second termination petition and offered the
testimony of a medical witness who testified that the claimant had fully recovered from
the back injury and that the left leg atrophy and absent Achilles reflex were caused by
non-work related factors. The WCJ accepted this testimony and granted the second
termination petition, but the Board reversed, holding that the findings in the second
termination proceeding conflicted with the findings in the initial termination
proceeding and therefore were precluded by the doctrine of res judicata. In affirming
the Board, we held that the cause of the claimant’s leg atrophy and absent Achilles
reflex had been judicially determined in the first termination proceeding and the
employer could not relitigate this issue where it “did not produce evidence that claimant
was fully recovered from the work-related injuries [and] failed to prove that there had
been some change in the disability or that it had ceased.” Volkswagen, 858 A.2d at
155.
            Here, in contrast to the circumstances of Volkswagen, Employer did
present evidence that Claimant was fully recovered from the April 2019 work-related
injury as of August 2021 through the testimony of Dr. Thomas, who accepted
Claimant’s initial diagnosis for his work injury of lumbar strain and T12 compression
fracture as appropriate. Dr. Thomas opined that Claimant’s work-related injury had
resolved during the time period that had passed between the first adjudication and the
Claimant’s 2021 IME. Dr. Thomas characterized Claimant’s compression fracture as

                                           11
mild and explained that the recovery time for lumbar strain can vary from weeks to a
few months. Based on his physical examination of Claimant and his review of
Claimant’s medical records, including MRI scans and updated X-rays, Dr. Thomas
opined that any low back pain Claimant presently experienced was attributable to his
osteoporosis and factors unrelated to his 2019 work injury.        Therefore, because
Employer’s 2021 Termination Petition did not relitigate the adjudication initially
reached in this matter but rather focused on the change in Claimant’s condition since
that decision, the doctrine of res judicata is not applicable and does not provide
Claimant with a basis for relief. See Boulin, slip op. at 11, 2024 WL 15949, at *4.
              Accordingly, we conclude that the Board properly affirmed WCJ
Yanity’s decision granting Employer’s 2021 Termination Petition. The Order of the
Board is affirmed.

                                          ________________________________
                                          PATRICIA A. McCULLOUGH, Judge

                                          12
            IN THE COMMONWEALTH COURT OF PENNSYLVANIA

William Dalzell,                    :
                   Petitioner       :
                                    :
                 v.                 :    No. 903 C.D. 2023
                                    :
Forest Hills Borough-Allegheny and  :
Municipal Risk Management Workers’ :
Compensation Pooled Trust (Workers’ :
Compensation Appeal Board),         :
                   Respondents      :

                                 ORDER

            AND NOW, this 1st day of March, 2024, the July 24, 2023 Opinion
and Order of the Workers’ Compensation Appeal Board is hereby AFFIRMED.

                                        ________________________________
                                        PATRICIA A. McCULLOUGH, Judge