Court Opinion

ID: 9556501
Source: CourtListenerOpinion
Date Created: 2023-08-17 15:08:23.180703+00
Date Added: 2024-06-11T17:21:39.035057
License: Public Domain

IN THE COMMONWEALTH COURT OF PENNSYLVANIA

Barbara Tiano,                                 :
                              Petitioner       :
                                               :
               v.                              :    No. 438 C.D. 2022
                                               :    Submitted: April 6, 2023
City of Philadelphia and                       :
PMA Management Corp.                           :
(Workers’ Compensation                         :
Appeal Board),                                 :
                              Respondents      :

BEFORE:        HONORABLE RENÉE COHN JUBELIRER, President Judge
               HONORABLE CHRISTINE FIZZANO CANNON, Judge
               HONORABLE LORI A. DUMAS, Judge

OPINION NOT REPORTED

MEMORANDUM OPINION
BY JUDGE DUMAS                                                    FILED: August 17, 2023

               Barbara Tiano (Claimant) has petitioned this Court to review the
adjudication of the Workers’ Compensation Appeal Board (Board), which reversed
in part the decision of the Workers’ Compensation Judge (WCJ) and remanded for
appropriate subrogation calculations in favor of the City of Philadelphia and PMA
Management Corp. (collectively, Employer). On appeal, Claimant argues that
Employer is not entitled to recover, by subrogation against her award from a third-
party tortfeasor, benefits paid pursuant to what is commonly known as the Heart and
Lung Act (HLA).1 Based on well-established precedent, we affirm.

      1
          Act of June 28, 1935, P.L. 477, as amended, 53 P.S. §§ 637-38.
                                     I. BACKGROUND2
               Claimant was employed as a police officer by Employer. On October
20, 2016, Claimant sustained a work-related injury after falling into a utility hole.
Employer accepted responsibility for Claimant’s injury by a Notice of Compensation
Payable under the Workers’ Compensation Act (the WC Act).3 In lieu of WC
benefits, Employer paid HLA benefits to Claimant.
               In August 2019, Claimant was awarded $450,000 from a settlement
against PECO Energy Co., the third-party tortfeasor responsible for her injury.4
Claimant has recovered $50,000 of the settlement. After dispersing attorney’s fees
and additional costs, a total of $264,385.31 remains in escrow pending resolution of
the HLA lien.
               In April 2020, Employer filed review and modification petitions
seeking subrogation against Claimant’s third-party recovery.5 Employer asserted a
lien of $325,074.63, comprised of $13,782.26 in medical payments, $319,206.63 in
wage loss benefits, and $5,868.00 in indemnity payments.
               On May 29, 2020, while Employer’s petitions were pending before the
WCJ, the parties reached an agreement to cease HLA benefits because Claimant had

       2
          Unless stated otherwise, we adopt the factual background for this case from the WCJ’s
decision, which is supported by substantial evidence of record. See WCJ Dec., 6/9/21.
        3
          Act of June 2, 1915, P.L. 736, as amended, 77 P.S. §§ 1–1041.4, 2501–2710.
        4
          See Settlement Agreement. Claimant describes the circumstances leading to her injury:
“while investigating a vehicle collision, [] she stepped into a hole left by a utility company [PECO
Energy Co.] which had previously relocated the utility hole.” Claimant’s Br. at 5.
        5
          Because this appeal only concerns the underlying issues involved in Employer’s review
and modification petitions, a complete dispensation of the procedural history, including other
petitions filed throughout the course of these proceedings, is unnecessary.

                                                 2
achieved maximum medical improvement.                     Additionally, Employer presented
evidence that Claimant’s HLA benefits had changed to WC benefits.6
               On June 9, 2021, the WCJ denied Employer’s petitions in part and
limited its subrogation right to benefits paid after the parties’ settlement. The WCJ
determined that prior to the parties’ agreement, Claimant was only paid HLA
benefits. The WCJ concluded that once the HLA benefits stopped pursuant to the
parties’ agreement, Claimant then began receiving WC benefits. Accordingly, the
WCJ found that Employer could begin subrogating paid WC benefits as of the May
29, 2020 agreement. Employer appealed.
               The Board affirmed in part, reversed the WCJ on the subrogation issue,
and remanded for calculations. Bd. Op., 4/18/22, at 13. Citing established precedent
from this Court,7 the Board concluded that because the third-party settlement arose
from a non-motor vehicle related cause of action, Employer has a subrogation right

       6
           Although both the WCJ and the Board cite “May 24, 2020,” as the date that Employer
presented evidence of an alleged change in benefits, we cannot find additional support for this date
in the record. See WCJ Dec., 6/9/21, Findings of Fact (F.F.) at 16; Bd. Op., 4/18/22, at 8. This
appears to be a typographical error, as the parties agreed to cease HLA benefits on May 29, 2020,
which seems to be the only evidentiary support in the record of an alleged change in benefits. See
Agreement Order, 5/29/20.
         7
           The Board relied on Alpini v. Workers’ Compensation Appeal Board (Tinicum Township)
(Pa. Cmwlth., No. 92 C.D. 2020, filed July 19, 2021) (Alpini I), rev’d, Alpini v. Workers’
Compensation Appeal Board (Tinicum Township), 294 A.3d 307 (Pa. 2023) (Alpini II). During
the pendency of this appeal, after the Board issued its decision and Claimant filed a review petition
before this Court, our Supreme Court issued a reversal of Alpini I. Nevertheless, because Alpini I
and II involve an underlying injury caused by a motor vehicle, neither matter governs the matter
sub judice. See Reynolds v. Zoning Hearing Bd. of Abington Twp., 578 A.2d 629, 630 n.1 (Pa.
Cmwlth. 1990) (we may affirm a lower ruling under a different rationale where our basis to affirm
is clear from the record).

                                                 3
to paid HLA benefits from the date of the work injury, October 20, 2016. Id. at 9-
12. Claimant timely petitions this Court for review.8
                                           II. ISSUES
               Claimant argues that Employer, a self-insured government entity, has
no subrogation right to paid HLA benefits against her third-party recovery,
regardless of whether the underlying injury was caused by a motor vehicle.
Claimant’s Br. at 20; see generally id. at 14-21. Alternatively, Claimant asserts that
even if this Court were to find that Employer is entitled to subrogation, it is
nevertheless barred from exercising this right under Section 23 of Act 449 due to
Claimant’s status as a government employee. Id. at 21-25.
                                     III. DISCUSSION10
                                        A. Jurisdiction
                As a preliminary matter, Employer seeks dismissal of Claimant’s
review petition on the grounds that it is an interlocutory appeal that predated the
WCJ’s remand decision. Emp.’s Br. at 13-14. An appeal of a remand order is
permissible where execution of the adjudication on remand does not require exercise
of administrative discretion.         See Pa. R.A.P. 311(f)(1).           Generally, a remand

       8
           On August 1, 2022, during the pendency of Claimant’s appeal to this Court, the WCJ
issued a remand decision. The WCJ found that Employer’s payments to Claimant from the injury
date to present were WC benefits, thereby entitling Employer to a subrogation lien of $264,385.31
(Claimant’s remaining settlement). WCJ Remand Dec., 8/1/22, at 6. Because the WCJ lacked the
authority to issue a decision after Claimant filed a review petition before this Court, this remand
decision is a nullity. See Pa.R.A.P. 1701(a).
        9
          Act of July 2, 1993, P.L. 190, No. 44 § 25(b) (“Act 44”). Section 23 of Act 44 is available
in the historical and statutory notes of Section 305 of the WC Act. See 77 P.S. § 501; Stermel v.
Workers’ Comp. Appeal Bd. (City of Phila.), 103 A.3d 876, 886 (Pa. Cmwlth. 2014).
        10
           Our scope of review is limited to determining whether constitutional rights were violated,
whether the adjudication is in accordance with the law, or whether necessary findings of fact are
supported by substantial evidence. Cmwlth. v. Workers’ Comp. Appeal Bd. (Piree), 182 A.3d 1082,
1086 n.8 (Pa. Cmwlth. 2018).

                                                 4
instruction for an “appropriate award” that involves the computation of benefits is
an appealable order which does not require exercise of discretion. SKF USA, Inc. v.
Workers’ Comp. Appeal Bd. (Smalls), 728 A.2d 385, 387 (Pa. Cmwlth. 1999); City
of Phila. v. Workers’ Comp. Appeal Bd. (Doherty), 716 A.2d 704, 704 n.1 (Pa.
Cmwlth. 1998) (declining to quash the employer’s appeal as interlocutory based on
a ministerial remand instruction to calculate average weekly wages). But see Jones
v. Workers’ Comp. Appeal Bd. (Steris Corp.), 874 A.2d 717, 721-22 (Pa. Cmwlth.
2005) (holding that the calculation of litigation costs required the WCJ’s discretion
because “[f]or litigation costs to be reasonable, the WCJ must ascertain the extent to
which they relate to the ‘matter at issue’ on which the [c]laimant prevailed”). Here,
the Board remanded to the WCJ for calculations consistent with its determination
that Employer’s subrogation right to paid benefits began from the date of injury. Bd.
Dec., 4/18/22, at 13. Accordingly, use of further discretion was not required. See
Smalls, 728 A.2d at 387.      Thus, we decline to dismiss Claimant’s appeal as
interlocutory and proceed to the merits of this case. See Pa. R.A.P. 311(f)(1).
                               B. Subrogation Right
             We begin by discussing the interplay of the two statutes at issue: the
WC Act and the HLA, which each compensate employees following work-related
injuries but operate under distinct statutory frameworks. City of Phila. v. Workers’
Comp. Appeal Bd. (Ford-Tilghman), 996 A.2d 569, 573 (Pa. Cmwlth. 2010). The
WC Act serves as “accident insurance,” by paying 66⅔% of a totally disabled
employee’s pre-injury wages in exchange for her consent to relinquish all other
actions against her employer. Soppick v. Borough of West Conshohocken, 6 A.3d
22, 26 (Pa. Cmwlth. 2010). The WC Act is remedial in nature and liberally construed
in favor of the injured employee to achieve its humanitarian objectives. Id. By

                                          5
contrast, the HLA is more narrowly applied and only accessible to important public
safety personnel, like police officers and firefighters. Id.; see also City of Erie v.
Workers’ Comp. Appeal Bd. (Annunziata), 838 A.2d 598, 602-603 (Pa. 2003). Yet,
to attract qualified persons to public safety professions, the HLA provides more
generous benefits than the WC Act by paying injured employees their full salaries
during recovery. Soppick, 6 A.3d at 26.
               Here, the parties’ competing views may be summarized as follows:
Claimant argues that Employer cannot recover HLA benefits from a third-party
settlement regardless of the cause of the underlying injury, see Claimant’s Br. at 20;
whereas Employer maintains that it is only barred from subrogating paid HLA
benefits where the underlying action involves a motor vehicle, which is not
implicated here. See Emp.’s Br. at 19.
               This Court has expressly resolved this issue.                  While there is no
functional equivalent to Section 319 of the WC Act, which affords employers a
subrogation right to paid WC benefits, 77 P.S. §671,11 Pennsylvania common law
has recognized an employer’s right to subrogation of paid HLA benefits against a
third-party tortfeasor.12 City of Phila. v. Zampogna, 177 A.3d 1027, 1030 (Pa.
Cmwlth. 2017). See also Stermel, 103 A.3d at 878; Fulmer v. Pa. State Police, 647

       11
           See Section 319 of the WC Act, 77 P.S. § 671 (“the employer shall be subrogated to the
right of the employe . . . against such third party to the extent of the compensation payable . . . by
the employer”).
        12
           Although “not directly implicated by this case, … normally in subrogation, the right of
action lies in the injured employee, and the action for subrogation against the third-party tortfeasor
is brought in the employee’s name.” Frazier v. Workers’ Comp. Appeal Bd. (Bayada Nurses, Inc.),
52 A.3d 241, 248 n.10 (Pa. 2012). In the subrogation context, reimbursement “is an independent
cause of action available to an employer[] and brought against solely the injured employee after
he receives an award or settlement from the third-party tortfeasor.” Id. We use “subrogation” in
this opinion for simplification of analysis, where the majority of cited cases use the same
terminology. However, as in Frazier, “this case only concerns reimbursement.” Id.

                                                  6
A.2d 616, 619 (Pa. Cmwlth. 1994); Cmwlth. v. Workers’ Comp. Appeal Bd. (Piree),
182 A.3d 1082, 1087 (Pa. Cmwlth. 2018); Kenney v. Workers’ Comp. Appeal Bd.
(Lower Pottsgrove Twp. & Del. Valley Workers’ Comp. Tr), 213 A.3d 1055, 1060
(Pa. Cmwlth. 2019). The public policy support for subrogation is three-fold, it
allows for prevention of: (1) a claimant’s double-recovery, (2) an employer from
making payments based on a third-party’s negligence, and (3) a third-party escape
of liability for its negligence. Id. Our Supreme Court has long recognized that
“[t]here can be no question of the right of the [employer] to recover by way of
subrogation from the third[-]party tortfeasor all the salary, medical and hospital
expenses paid to or for [the claimant].” Topelski v. Universal S. Side Autos, Inc.,
180 A.2d 414, 420 (Pa. 1962) (emphasis added).13
               Thus, in Pennsylvania, the general rule is that an employer has a
subrogation right regardless of the underlying benefit available to a claimant. Id. at
421 (observing that the doctrine of subrogation is designed to place the burden of
debt on the responsible party and is rooted in considerations of equity, good
conscience, and the promotion of justice). Stated otherwise, irrespective of whether
the claimant is the recipient of WC or HLA benefits, an employer is entitled to
recoup benefit payments from any third-party recovery that the injured employee
has secured. Stermel, 103 A.3d at 878.
               There are recognized exceptions to this rule. For example, there is a
critical distinction between the WC Act and the HLA in the subrogation context
where the underlying injury is caused by the “use or maintenance” of a motor
vehicle, invoking the Motor Vehicle Financial Responsibility Law. See 75 Pa. C.S.

       13
          In fact, our Supreme Court previously recognized Pennsylvania as the only jurisdiction
to allow subrogation under equitable principles in the absence of a controlling statute. Topelski,
180 A.2d at 420 n.3.

                                                7
§§ 1701-1799. In such matters, an employer paying HLA benefits has no right to
subrogation of a claimant’s third-party recovery. Pa. State Police v. Workers’ Comp.
Appeal Bd. (Bushta),184 A.3d 958, 962 (Pa. 2018). Although frequently involved
in subrogation cases before this Court, the motor vehicle exception is not implicated
here, and therefore, irrelevant to the present case.14
               Accordingly, the general rule is applicable. As such, Employer is
entitled to recover paid HLA benefits from Claimant’s third-party recovery. See
Zampogna; Stermel; Topelski.
               Despite the clear legal support for Employer’s subrogation right,
Claimant argues that Employer asserts an unauthorized subrogation right by
manipulating its self-insured status to reclassify its payments of HLA benefits as
WC benefits. Claimant’s Br. at 17-18. We disagree. It is true that a self-insured
employer paying HLA benefits does not also tender payment of WC benefits.15
Annunziata, 838 A.2d at 605 n.7. Additionally, there appears to be some evidence
of record of Employer’s attempt to recharacterize its payment of HLA benefits as

       14
           Claimant maintains that Employer has no right to subrogate paid HLA benefits “in any
case, motor vehicle or otherwise.” Claimant’s Br. at 12 (emphasis in original). To advance this
argument, she relies on Stermel, the “broader” holding of Annunziata and Oliver v. City of
Pittsburgh, 11 A.3d 960, 966 (Pa. 2011) (Oliver II). Claimant’s Br. at 20. However, Stermel,
Bushta, and Oliver II, all involved underlying injuries caused by motor vehicle accidents, and
although Annunziata did not involve a motor vehicle, it did not concern a subrogation issue either.
Accordingly, Claimant’s cited precedent does not support a subrogation bar in the present matter.
        15
           An employer is responsible to pay WC benefits to an injured employee receiving HLA
benefits. Annunziata, 838 A.2d at 605. To prevent double recovery, a claimant must return any
WC benefits to her employer that she receives during payment of HLA benefits. Id.; Section 1 of
the HLA, 53 P.S. § 637. However, self-insured employers paying HLA benefits are absolved from
also paying WC benefits. Annunziata, 838 A.2d at 605 n.7. Instead, to “avoid th[e] absurdity” in
such situations of paying a claimant WC benefits, only for the claimant to remit them back to the
employer, a self-insured employer may issue an NCP and refuse to pay WC benefits. Id.

                                                8
WC benefits.16 See WCJ Dec., 6/9/21, Findings of Fact (F.F.) at 16. However, this
distinction is only critical to matters involving the Motor Vehicle Financial
Responsibility Law, which precludes an employer’s subrogation of paid HLA
benefits. Stermel, 103 A.3d at 885 n.15. Outside of claims involving motor vehicle
incidents, this Court recognizes an employer’s subrogation right against third-party
recovery for payments of either benefit. Id. at 878. Because Employer retains a
subrogation right under both Acts in non-motor vehicle cases, the categorization is
a distinction without difference in the present matter. Therefore, although Employer
tendered payments to Claimant in the form of HLA benefits, it holds a subrogation
right regardless of how benefits are classified because this underlying injury did not
involve a motor vehicle. See Stermel; Zampogna.
               In further effort to distinguish HLA and WC benefits to prevent
Employer’s subrogation, Claimant contends that the Legislature intended to treat
HLA benefits differently, and to hold otherwise would have a chilling effect on
employing first responders. Claimant’s Br. at 20-21. We reject this assertion.
Claimant’s argument fails to consider that the Legislature already affords
preferential treatment to public safety personnel by paying their full salaries through
the HLA, as opposed to 66⅔% of weekly wages under the WC Act. Compare
Section 1 of the HLA, 53 P.S. § 637, with Section 306(a) of the WC Act, 77 P.S. §
511(1). Moreover, subrogation represents other important public policy interests.
See Stermel, 103 A.3d at 878. Therefore, we reject Claimant’s arguments and
conclude that because this case does not arise out of the “use or maintenance” of a

       16
          In subrogation cases, this Court has rejected an employer’s attempts to characterize part
of a claimant’s receipt of her full salary of HLA benefits as WC benefits. See Piree, 182 A.3d at
1090.

                                                9
motor vehicle, Employer is entitled to a subrogation right of paid benefits against
Claimant’s third-party recovery. See Stermel; Zampogna.
                                   C. Immunity Claim
              Alternatively, Claimant maintains that if a subrogation right does exist,
Section 23 of Act 44 bars Employer’s recovery based on her government employee
status. Claimant’s Br. at 21-25. This argument lacks legal support.
              Section 23 of Act 44 codifies a sovereign immunity doctrine, which
protects government officials and employees acting within the scope of their duties
from subrogation claims against a claimant’s tort recovery in workers’ compensation
matters.17 See 77 P.S. § 501 (historical and statutory notes).
              However, Section 23 of Act 44 does not protect Claimant’s government
employee status as the injured party. It protects government tortfeasors, not injured
government parties, and does not preclude an employer’s subrogation right against
its own employee’s third-party recovery. See Oliver v. City of Pittsburgh, 977 A.2d
1232, 1242 (Pa. Cmwlth. 2009) (Oliver I), rev’d on other grounds, 11 A.3d 960 (Pa.
2011) (Oliver II). See also Stermel, 103 A.3d at 886 n.16 (resolved matter without
reaching immunity issue but acknowledged that the claimant’s government
employee status was irrelevant because he was the injured party, not the tortfeasor).
Further, it does not bar Employer’s subrogation right to recoup benefits paid to
Claimant from settlement proceeds received by Claimant from a private, third-party

       17
         Section 23 of Act 44 provides:
               The Commonwealth, its political subdivisions, their officials and
               employees acting within the scope of their duties shall enjoy and
               benefit from sovereign and official immunity from claims of
               subrogation or reimbursement from a claimant’s tort recovery with
               respect to workers’ compensation benefits.
See 77 P.S. § 501 (historical and statutory notes).

                                             10
tortfeasor. See Frazier v. Workers’ Comp. Appeal Bd. (Bayada Nurses, Inc), 52
A.3d 241, 247 (Pa. 2012) (recognizing that Section 23 bars subrogating against a
third-party recovery where the third party is a government entity). Here, PECO
Energy Co. is a private, non-government entity. Thus, Section 23 of Act 44 is
inapplicable.
                              IV. CONCLUSION
            Our precedent clearly supports Employer’s subrogation right to recoup
paid HLA benefits from third-party settlement proceeds. See Stermel; Zampogna.
Further, Claimant is not immune from Employer’s right of subrogation. See Stermel;
Frazier. Accordingly, for the foregoing reasons, we affirm.

                                            LORI A. DUMAS, Judge

                                       11
         IN THE COMMONWEALTH COURT OF PENNSYLVANIA

Barbara Tiano,                            :
                           Petitioner     :
                                          :
            v.                            :   No. 438 C.D. 2022
                                          :
City of Philadelphia and                  :
PMA Management Corp.                      :
(Workers’ Compensation                    :
Appeal Board),                            :
                           Respondents    :

                                        ORDER
            AND NOW, this 17th day of August, 2023, the order of the Workers’
Compensation Appeal Board, entered April 18, 2022, is AFFIRMED.

                                 LORI A. DUMAS, Judge