PENNSYLVANIA WORKERS’ COMPENSATION
CASE SUMMARIES
01/1/2025 – 1/31/2025
OCCUPATIONAL DISEASE
TIME LIMITATIONS AND FIREFIGHTER CANCER DIAGNOSES
West Conshohocken Borough v. David Markland (WCAB)
Commonwealth Court of Pennsylvania – Published Opinion
Decided: January 2, 2025
Issues:
Whether timely notice was provided; Whether the claim was barred by the three-year statute of repose; and whether Claimant was entitled to benefits under Section 108(r) of the Act?
Background:
Employer petitioned for review of the decision of the Workers’ Compensation Appeal Board, that affirmed the decision of the WCJ awarding benefits to claimant, a former firefighter, regarding colon cancer and cancer of the kidneys. Claimant filed a Claim Petition based upon an occupational disease. In the Answer, Employer asserted the statute of repose and statute of limitations and the notice provision of the Act, barred Claimant’s claim. The WCJ found Claimant was entitled to benefits under Section 301(c)(1) of the Act because he established his cancers were injuries. The WCJ granted Claimant’s Claim Petition. Employer appealed the Decision to the Board, and the Board affirmed.
Holdings:
The 21-day period to provide notice of injury began to run when claimant read the doctor’s report, not an earlier date on which claimant spoke with fellow firefighter about cancer presumption for firefighters. The three-year period to file a claim began to run, when claimant began dialysis, left work, and began receiving social security disability benefits. However, the Workers’ Compensation Act’s section defining the term “occupational disease” to include cancer suffered by a firefighter does not include precancerous or related conditions. The evidence in the record demonstrates Claimant was diagnosed with dysplasia. While, medically, Claimant’s dysplasia may be a precancerous condition or the last step in the progression toward cancer, when read as a whole, the testimony differentiates dysplasia from cancer. Therefore, even viewing the evidence in a light most favorable to Claimant and drawing all reasonable inferences therefrom, the WCJ’s finding of colon cancer is not supported by the record. The Court reversed the Board’s Order insofar as it affirmed the WCJ’s finding that Claimant sustained his burden of proving he had colon cancer but affirmed the Board in all other respects.
REVERSED in part and AFFIRMED in part.
CONCURRING/DISSENTING OPINION BY JUDGE COVEY
Judge Covey agreed with the Majority’s conclusions regarding Claimant’s timeliness and cancer diagnoses, that Claimant acted diligently, and that the WCJ made sufficient findings. However, she disagreed with the Majority’s affirmance of the Board’s conclusion that Claimant’s WC benefits were payable from July 2019.
TIME LIMITATIONS ON REVIEW AND REINSTATEMENT PETITIONS
Matthew Grow v. Peco Energy Company (WCAB)
Commonwealth Court of Pennsylvania – Published Opinion
Decided: January 8, 2025
Issue:
Whether the claimant’s reinstatement and review petitions were time-barred?
Background:
Claimant petitioned for review of the decision of the Workers’ Compensation Appeal Board’s order reversing the Workers’ Compensation Judge’s decision (WCJ), which granted claimant’s petitions to review and reinstate workers’ compensation benefits. In 2013, Claimant injured his neck in the course and scope of his employment with Employer. Claimant remained off work until January 10, 2014, when he returned to work with no loss of earnings. On January 13, 2014, Employer issued a Notice of Suspension stopping Claimant’s indemnity benefits. In 2015, Claimant began experiencing muscle stiffness and decreased mobility. In 2020, Claimant developed right shoulder issues for which he underwent surgery that resolved them. In 2021, Claimant started to experience left upper extremity symptoms. In 2022, Claimant filed a Reinstatement Petition alleging that he became disabled again when he underwent cervical disc replacement surgery at C6-C7 in 2021 related to his work injury. In a Review Petition, Claimant sought to amend his accepted work injury. The WCJ granted the Petitions, and the Board reversed the WCJ’s decision on the basis that the Petitions were time-barred by Section 413(a) of the Act.
Holding:
Claimant’s injury, though related to prior accepted work injury, was a distinct, consequential injury, and thus the three-year statute of limitations applied to claimant’s request to reinstate his workers’ compensation benefits. Where a review or modification petition seeks to add a new injury that resulted from the claimant’s accepted work-related injuries, the three-year limitation of Section 413(a) applies and bars the new claim if no petition was filed within three years after the date that the claimant last received compensation benefits. Also, a petition to correct an NCP or to add consequential injuries must be filed within three years of the date of the most recent payment of compensation. Based on the record evidence, Claimant was not here seeking reinstatement due to his accepted work injury – contusions and fractures at C3-C4 – but, rather, for C6-C7 disc replacement which, although related to the accepted work injury, was a distinct, consequential injury. Where Claimant was seeking to add a distinct, consequential injury to the NCP, and to reinstate his indemnity payments for disability related thereto, under Section 413(a) of the Act, he had to file the Petitions within three years of the date of the most recent compensation payment. Because Claimant filed the Petitions approximately eight years after his last WC payment, the Board properly determined that they were time-barred.
Affirmed.
REVIEW PETITION – TO RECIND THE NCP
INSURER RETROACTIVELY CANCELED THE EMPLOYER’S W.C. INSURANCE
American Builders Insurance Company v. James Scott et al. (WCAB)
Commonwealth Court of Pennsylvania – Unpublished Memorandum Opinion
Decided: January 3, 2025
Issue:
Whether the Insurer may rescind a Notice of Compensation Payable?
Background:
On September 8, 2015, Claimant sustained an injury while in the course of his employment with Employer. On September 15, 2015, Insurer issued a Notice of Temporary Compensation Payable (NTCP) and, thereafter, on October 8, 2015, issued a Notice of Compensation Payable (NCP). On September 2015, Insurer also filed a federal civil action against Employer seeking declaratory relief with respect to the WC insurance policy (Policy) underlying its liability for Claimant’s WC benefits, requesting recission of the Policy based on alleged material misrepresentations made in relation to the Policy, and asserting a separate claim of insurance fraud (Federal Action). The United States District granted Insurer’s request for partial summary judgment, rescinded the Policy, and declared that the Policy was void ab initio. As a result, on September 15, 2016, Insurer filed the instant Review and Termination Petitions alleging that, pursuant to the District Court’s order, the Policy under which Claimant’s injury was accepted was rescinded and rendered void ab initio, and Insurer had no obligation to any of Employer’s employees under the Policy, including Claimant. Insurer sought the revocation of all compensable obligations previously accepted as of the date of Claimant’s injury.
Holding:
The WCJ found credible and persuasive the evidence demonstrating that Insurer had issued the NTCP and NCP when it knew, or in the exercise of reasonable care, should have known, that the information supplied by Employer was inaccurate. Even if Insurer had proven a right to rescind the contract of insurance under the theory that the contract was void ab initio, recission would still not be an appropriate remedy due to the effect it would have on an innocent intended third-party beneficiary. The argument for considering the insurance policy void ab initio is further undermined by consideration of the fact that it would adversely affect the interest of an innocent intended third-party beneficiary of the insurance contract. It would be beyond harsh to preclude third parties who are innocent of trickery and injured through no fault of their own from receiving protection under the policy. Insurer next contends that the WCJ ignored substantial evidence establishing that the NCP issued here was materially incorrect. Where an employer promptly commences payment of compensation prior to commencement or completion of investigation into the cause of the injuries and later determines that the disability was never work-related, in the absence of evidence of repeated contests of the cause of the disability, the employer may be permitted to seek relief. This allows for the correction of material mistakes when an employer or insurer, in good faith, issues an NCP and upon completion of an investigation, learns that facts previously unknown indicate that the injury is not work-related or otherwise compensable. Here, Insurer was notified of the nature of Claimant’s accident the day after it occurred and within six days, called for an investigation because the accident involved roofing work. It then issued a NTCP that allowed it 90 days to complete an investigation but chose to issue an NCP before that time. While the court acknowledged Insurer’s assertion that it sought to do right by Claimant by accepting the injury, they did not agree that this meant that Insurer had not had sufficient opportunity to investigate the facts surrounding the claim to determine the compensability before filing the NCP, which acknowledged that Claimant had fallen through a roof. Critically, there was no contention that Claimant provided incorrect information that led to the issuance of the NCP.
Affirmed.
SUSPENSION FOR REFUSAL OF REASONABLE MEDICAL SERVICES
IGNORING THE DOCTOR’S ADVICE
Wegmans Food Markets, Inc. v. Bonnie Cole (WCAB)
Commonwealth Court of Pennsylvania – Unpublished Memorandum Decision
Decided: January 29, 2025
Issue:
Whether the Board erred in holding that the Employer met its burden of proof in a suspension petition for alleged refusal of reasonable medical services?
Background:
Claimant sustained a work-related injury, which Employer accepted via a Notice of Compensation Payable (NCP). The description was later amended to be a right open commuted ankle fracture slash dislocation involving the distal tibia as well as the proximal and distal fibular. In 2022, Claimant had to have her right leg below her knee amputated due to developing osteomyelitis, a bone infection. Employer subsequently filed the Petitions asserting that Claimant’s wage loss benefits should be suspended pursuant to Section 306(f.1)(8) because Claimant refused reasonable medical treatment and advice, which if it had been followed, would have reduced her disability and resulted in a reduction of medical treatment and lessened the chance that additional future treatment would be required. The reasonable recommended treatment refused was the advice of numerous physicians to stop smoking and drinking alcohol. The WCJ concluded that, based on this credible medical testimony, Employer met its burden of proving its entitlement to the forfeiture of benefits under Section 306(f.1)(8), due to Claimant’s refusal of reasonable medical treatment. Claimant appealed, and the Board reversed. Employer appealed.
Holding:
To establish reasonableness, the evidence submitted by the employer must show that the recommended [treatment] (1) involves minimal risk to the patient and (2) offers a high probability of success. The claimant’s reasons for refusing the treatment are irrelevant when the proposed treatment itself is not reasonable under the forfeiture provision. Section 306(f.1)(8) does not reference “medical advice,” instead referencing treatment, surgery, services, medicines, or supplies – the actual means of treating and improving an injury or condition. 77 P.S. § 531(8). Further, lifestyle advice, without offering a means to achieve the goal, is not treatment, and Employer’s contrary position is not supported by the text of Section 306(f.1)(8). The only evidence Employer presented was that it was reasonable to advise Claimant to stop smoking; however, there was no evidence that merely advising an individual like Claimant, who has smoked for over 40 years, to quit smoking, without providing any treatment, or a means of quitting, offers a “high probability of success” of such an individual actually being able to stop smoking. While Employer is correct that Section 306(f.1)(8) does not require a “cure” of the health problem at issue or a return to pre-injury position, it does require proof that the treatment improves the work-related injury or health problem and will increase the prospects of a return to some gainful employment. Because Employer presented no evidence on any of these points as to the Wellbutrin, and that Claimant refused such treatment, the Board did not err in finding that Employer had not met its initial burden of proof under Section 306(f.1)(8). Because Employer did not meet its initial burden of proof Claimant’s alleged refusal was not at issue and the WCJ should not have focused his analysis on Claimant’s actions. The Board did not err in concluding that Employer did not meet its burden of proof under Section 306(f.1)(8) to support the suspension of Claimant’s workers’ compensation benefits.
Affirmed.
JUDICIAL DISCRETION
Commonwealth of Pennsylvania, DOC v. Crystal Faison (WCAB)
Commonwealth Court of Pennsylvania – Unpublished Memorandum Opinion
Decided: January 9, 2025
Issues:
Whether the WCJ arbitrarily and capriciously disregarded competent evidence of record?
Background:
On May 20, 2018, Claimant sustained a work-related injury in the nature of post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) as a result of being raped while working for Employer. On March 29, 2022, Employer filed a termination petition alleging Claimant fully recovered from her work-related injuries. Claimant filed an answer denying all allegations and the matter was assigned to a WCJ. The WCJ issued a decision denying Employer’s termination petition.
Holding:
The medical professional had a complete grasp of the medical situation and/or the work incident. The Court rejected Employer’s assertion that claimant’s expert’s testimony was incompetent. This expert just had a different opinion as to whether Claimant was fully recovered from her work-related psychological injuries. It is well settled that a WCJ’s credibility determinations are entitled to substantial deference, and such determinations may only be overturned if they are arbitrary and capricious or so fundamentally dependent on a misapprehension of material facts, or so otherwise flawed, as to render them irrational. These credibility determinations were adequately explained and will not be disturbed by this Court on appeal.
Affirmed.
Black & Veatch Corporation v. Ashley Saranchak et al. (WCAB)
Commonwealth Court of Pennsylvania – Unpublished Memorandum Opinion
Decided: January 8, 2025
Issue:
Whether the Board capriciously disregarded competent evidence of record in concluding that Claimant sustained an ACL tear and complex regional pain syndrome as a result of an incident with One Employer, as opposed to the other?
Background:
At issue in this case are two work-related injuries suffered by Claimant. The first incident occurred in 2020, while Claimant was employed by Kalas. The second incident occurred in 2021, while Claimant was employed by Black & Veatch. Claimant filed a claim petition against Kalas alleging that she sustained an injury to her right knee, including but not limited to, tears of the anterior cruciate ligament (ACL) and medial collateral ligament (MCL) as a result of the Kalas Incident. On December 6, 2021, Claimant filed a second claim petition against Black & Veatch alleging that she sustained an aggravation of a prior knee injury now including, but not limited to, an ACL tear as a result of the Black & Veatch Incident. The WCJ concluded that Claimant sustained a right knee contusion as a result of the Kalas Incident, but that Claimant was fully recovered from that injury. The WCJ also granted Claimant’s claim petition filed against Black & Veatch. The WCJ concluded that Claimant sustained an ACL tear and developed chronic pain and complex regional pain syndrome as a result of the Black & Veatch Incident.
Holding:
Substantial evidence is such relevant evidence as a reasonable person might accept as adequate to support a conclusion. In performing a substantial evidence analysis, the court must view the evidence in a light most favorable to the party who prevailed before the factfinder. It does not matter that there is evidence in the record which supports a factual finding contrary to that made by the WCJ, rather, the pertinent inquiry is whether there is any evidence which supports the WCJ’s factual finding. Substantial evidence supported the WCJ’s conclusions that Claimant sustained a right knee ACL tear and developed chronic pain and complex regional pain syndrome due to the Black & Veatch Incident.
Affirmed.
Edwin Smith v. Giant Eagle, Inc. (WCAB)
Commonwealth Court of Pennsylvania – Unpublished Memorandum Opinion
Decided: January 10, 2025
Issue:
Whether the WCJ’s decision was unreasonable and violated the law of the case doctrine?
Background:
In early 2018, Claimant injured his lower back. Employer issued a medical-only notice of compensation payable for a lumbar strain. Because Claimant believed he was unable to work, he filed a claim petition. Employer requested a Termination. The WCJ granted Employer’s petition to terminate, and Claimant timely appealed. The Board affirmed.
Holding:
Claimant contends that Lewis barred recharacterizing Claimant’s work injury that was established in the initial claim petition proceeding. Lewis applies only when there is a prior termination petition and the instant petition was Employer’s first such petition. In any event, Employer complied with Lewis by challenging only whether Claimant had recovered from his lumbar strain. Employer did not “recharacterize” Claimant’s lumbar strain injury. Further, res judicata and the law of the case doctrines do not apply. The only issue before the WCJ in this termination proceeding was whether Claimant had fully recovered from his lumbar strain. There was no attempt to challenge a prior ruling. The decision was based upon substantial evidence and was not in error.
Affirmed.
EXTRATERRITORIAL JURISDICTION
Kenneth Grasso v. Siegel Distributing Company, Inc. (WCAB)
Commonwealth Court of Pennsylvania – Unpublished Memorandum Opinion
Decided: January 8, 2025
Issue:
Does Pennsylvania have jurisdiction over the claim?
Background:
Claimant filed a claim petition alleging that he sustained a cumulative injury to his low back during the course of his employment. Claimant’s duties included travel, and he averred that his injury was caused by prolonged driving over long distances in heavy traffic that resulted in total disability as of March 8, 2022. Employer contended that Pennsylvania lacked jurisdiction over the matter and that the case should properly be brought in New Jersey. The WCJ dismissed Claimant’s claim petition for lack of jurisdiction, finding that (1) Claimant resided in New Jersey; (2) the driving that allegedly caused his injury occurred largely, if not entirely, in New Jersey; and (3) although Employer has an office in Breinigsville, Pennsylvania, Claimant did not show that he regularly worked at or from that office. The WCJ noted that Claimant signed the “Agreement” in Pennsylvania and had tangential contacts with Pennsylvania over the years, but Claimant’s employment could not be said to be principally located in Pennsylvania. The Board, on appeal, also found that the “Agreement” was not an employment contract establishing jurisdiction in Pennsylvania for workers’ compensation purposes.
Holding:
Claimant challenged the dismissal of his claim petition for lack of jurisdiction where he was working pursuant to the Agreement, which required that, in any lawsuit, Pennsylvania jurisdiction must apply. Where a work injury occurs outside of Pennsylvania, as was the case here, the claimant bears the burden of proving that Pennsylvania has jurisdiction over his claim through the Act’s extraterritorial provisions. Pursuant to Section 305.2(d)(4), for claimant’s employment to be principally localized in Pennsylvania, he must show that pursuant to subsection (i), he regularly worked at or from the employer’s Pennsylvania office. The Agreement does not specify where Claimant’s employment was principally localized, nor does it state that workers’ compensation matters will be governed by Pennsylvania law. In fact, the Agreement does not mention workers’ compensation issues at all and is silent on this matter. Claimant’s injury occurred in New Jersey, not in Pennsylvania, a key distinction, and the Agreement did not include any provision specifically addressing workers’ compensation matters. Pennsylvania lacked jurisdiction over Claimant’s workers’ compensation matter and his claim petition was properly dismissed pursuant to the extraterritorial provisions of the Act.
Affirmed.
SPECIFIC LOSS BENEFITS
CALCULATING THE CORRECT WAGE AND RATE
Jennifer Jackiw v. Soft Pretzel Franchise (WCAB)
Supreme Court of Pennsylvania – Published Opinion
Decided: January 22, 2025
Issue:
What is the correct statutory formula for workers’ compensation benefits based on the loss of a body part?
Background:
While acting in the course and scope of her employment, Claimant sustained an injury necessitating the amputation of her right forearm. At the time of her injury, Claimant’s average weekly wage was $322.05. The parties agreed Claimant’s injury was a “specific loss” of a forearm which, under Section 306(c)(2) of the Act, entitled her to a healing period of up to 20 weeks followed by 370 weeks of compensation, for a total of up to 390 weeks of benefits. However, they differed on how to compute the weekly benefit amount for the 370 weeks. Employer asserted it should be calculated according to the formula for total disability in Section 306(a) of the Act, 77 P.S. § 511, while Claimant maintained that the formula for a specific loss under Section 306(c)(25) should apply. Under Section 306(a), the compensation amount is two thirds of the AWW, which is then capped at the maximum, and finally subjected to a remedial calculation for low-wage workers earning less than half of the SAWW. However, the formula for specific-loss benefits, contained in Section 306(c), is expressed differently. That provision provides different weekly compensation amounts and durations for different injuries. The formula given in 306(c) cross-references 306(a), with its statement that the benefit may not be less than one half of the maximum compensation payable per week for total disability as provided in subsection (a) of this section. This results in an entitlement to $540.50 per week in benefits, whereas her weekly wage during her active employment was lower than that, i.e., $322.05.
Holding:
The Supreme held that benefit cap under statute governing total-disability benefits is added into formula for specific-loss benefits so that half of that cap becomes floor in calculation of specific-loss benefits. The order of the Commonwealth Court was vacated and the matter was remanded for further proceedings consistent with this opinion.
Reversed and Remanded.
INTEREST CALCULATIONS – SUBROGATION
Flagship Niagara League v. Acadia Insurance Company et al (WCAB)
Commonwealth Court of Pennsylvania – Published Opinion
Decided: January 6, 2025
Issue:
Whether interest “due,” as that term is used in Section 406.1(a), is to be read to mean that interest did not become due until there was a legally enforceable judgment?
Background:
Employer petitioned for review from a decision and order of the Workers’ Compensation Appeal Board, reversing a decision and order of a WCJ. The WCJ ordered Employer to pay Acadia Insurance Company’s (Insurer) subrogation claim in the amount of $46,833.36, plus 10% simple interest per annum as specified in Section 319 of the Act from February 23, 2022 (the date of the Pennsylvania Supreme Court’s decision in Arlet). Claimant sustained injuries to his left arm and shoulder during the course and scope of his employment when he slipped on an icy sidewalk on Employer’s premises. Employer appealed to this Court, asserting that the Board erred in ruling that Insurer’s right to statutory interest began to accrue on April 8, 2013, rather than February 23, 2022.
Holding:
The Court found for the Insurer. Contrary to Employer’s arguments, neither the WC Act nor case law support its contention that, in this case, statutory interest should be awarded only as of the date of the Pennsylvania Supreme Court’s decision in Arlet II. Employer was asking the Court to diverge from its long-held precedent directing how statutory interest should be calculated. The term “due,” as that term is used in Section 406.1(a), is not to be read to mean that interest did not become due until there was a legally enforceable judgment. Statutory interest is not a penalty. It is not imposed because of any obdurate or bad faith behavior on the part of Employer; it is imposed to make Insurer whole for the benefits it paid to Claimant and for the time Insurer was unable to use those funds. Here, Insurer requested subrogation while pursuing a novel and ultimately successful legal argument. If the intent of Section 406.1(a) of the WC Act is to make a party whole, awarding Insurer statutory interest only as of February 23, 2022, would be illogical and inequitable.
Affirmed.
MITIGATION OF RIGHTS
Martha Garduno Mondragon v. Jo Jo Pizza (WCAB)
Commonwealth Court of Pennsylvania – Published Opinion
Decided: January 6, 2025
Issues:
Whether the Board erred in affirming the WCJ’s determination that “no circumstances exist” where an employer/insurer’s conduct can negatively impact its right to subrogation under Section 319 of the Act; and in affirming the WCJ’s determination that Employer’s refusal to compromise its subrogation lien did not constitute a bad faith waiver of its right to subrogation given Pennsylvania’s public policy encouraging settlements.
Background:
Claimant received workers’ compensation benefits and then entered into a compromise and release with employer. Claimant herein sought review of a WCJ decision granting employer’s review and modification petitions and directing payment of employer’s subrogation lien from worker’s recovery in third-party tort action. The WCJ rejected the Claimant’s argument that employer engaged in bad faith by refusing to compromise the amount of its subrogation lien during settlement negotiations in the third-party action. The Workers’ Compensation Appeals Board affirmed the WCJ.
Holdings:
The Employer’s rights to subrogation are immediate and absolute. The Commonwealth Court held that the WCJ did not erroneously conclude that there were no circumstances where an employer’s conduct could affect its subrogation rights and that the employer did not engage in bad faith when it exercised its right of subrogation against worker’s recovery in third-party tort action. The Court further held that, allowing employer to exercise its right of subrogation was not against public policy. An employer’s mere refusal to reduce or negotiate its subrogation lien, as Employer allegedly did here, does not constitute deliberate bad faith even if the entirety of the claimant’s third-party recovery, minus litigation costs, is needed to satisfy the lien. Concluding that an employer’s assertion of the full amount of its Section 319 subrogation lien does not constitute deliberate bad faith that would vitiate its right to subrogate against third-party recoveries actually encourages settlements in the workers’ compensation context.
Affirmed.
ESTOPPEL – PAYMENT IN LIEU OF WAGES
Andre Clarke v. City of Philadelphia (WCAB)
Commonwealth Court of Pennsylvania – Unpublished Memorandum Opinion
Decided: January 17, 2025
Issue:
Whether the E-time payments were made in lieu of compensation for his work-related COVID, and where an admission of liability, estopping Employer from denying liability under the Act?
Background:
Claimant petitioned for review of the Order of the Workers’ Compensation Appeal Board (Board) that affirmed a Workers’ Compensation Judge’s (WCJ) denial of the Reinstatement Petition and Penalty Petition. Through the Petitions, Claimant sought to establish that the City of Philadelphia had accepted his COVID-19 diagnosis, and subsequent “long-haul” symptoms, as work related through its payment of compensation in lieu of workers’ compensation and was estopped from denying the work relatedness of those conditions, and when it did so through the issuance of an untimely Notice of Compensation Denial (NCD), it violated the Workers’ Compensation Act. Crediting Employer’s witnesses that the payments made prior to the NCD were not intended to be made in lieu of WC and that Claimant did not otherwise meet his burden of proving an entitlement to WC benefits, the WCJ denied the Petitions. The Board affirmed.
Holding:
Claimant’s arguments are predicated on his contention that the E-time payments were being paid as wages in lieu of compensation and in recognition of a work-related injury. However, the WCJ found otherwise based on the credited testimony. When the credited, competent evidence and the reasonable inferences deducible therefrom are viewed in the light most favorable to Employer, that evidence supported the WCJ’s finding that Employer did not intend the E-time payments to be wages in lieu of compensation. Claimant did not meet his burden of proof on the Reinstatement Petition, and there was no legal error or abuse of discretion in denying that petition.
Affirmed.
Jaime Brown v. City of Philadelphia (WCAB)
Commonwealth Court of Pennsylvania – Published Opinion
Decided: January 17, 2025
Issue:
Whether the Claimant received wages in lieu of compensation from his employer?
Background:
This matter involved a reinstatement filed by Claimant, a police officer, alleging that Employer unilaterally terminated Claimant’s benefits in January of 2022 after accepting his claim related to Covid-19 by the payment of wages in lieu of benefits. Claimant did not file a claim petition seeking to establish a work-related exposure to Covid-19 and ongoing disability resulting from that exposure. While Claimant was absent from work, he received full pay without depleting his sick or vacation time and was informed that his time off was designated as “E-Time” (ET) or “excused time.” Claimant’s ET pay ended on March 5, 2022. From March 5, 2022, until April 1, 2022, Claimant was paid his normal salary through the use of his accrued vacation time. Employer issued a Notice of Workers’ Compensation Denial (NCD) denying liability for Claimant’s alleged November 4, 2020 injury due to possible exposure to Covid-19. The WCJ found that Employer’s use of its ET payroll designation in this case did not constitute the payment of wages in lieu of workers’ compensation benefits. Claimant appealed the denial to the Board.
Holding:
Whether payments constitute wages in lieu of compensation, the intent behind the making of the payments is the critical legal element, which must be determined by considering the evidence relevant to the issue. Based on the totality of substantial, competent evidence, the payments made through the E-time designation were not an acknowledgement that a police officer contracted Covid-19 at work. Further, Claimant had failed to prove that he provided notice to Employer that he had developed Covid-19 at work. Claimant did not present testimonial evidence from his supervisor, nor did he fill out the COPA II form required by his Employer indicating that he had suffered a work-related injury. Therefore, Claimant failed to present the necessary medical evidence to establish the causal relationship between his work activities and disability. Although the WCJ found Claimant’s testimony to be generally credible, the WCJ did not credit Claimant’s testimony indicating that his Covid-19 symptoms were due to work-related exposure to the virus.
Affirmed.
PENNSYLVANIA LEGISLATIVE REVIEW
As of January 2025, the Senate L&I Committee is still reviewing this House Bill and it has not sent it back to the Senate for review, alteration, or consideration.
Regular Session 2023-2024
House Bill 930
Short Title: An Act amending the act of June 2, 1915 (P.L.736, No.338), known as the Workers’ Compensation Act, in liability and compensation, further providing for schedule of compensation. Expanding Workers’ Compensation for Permanent Disfigurement
Subject: Expanding Workers’ Compensation for Permanent Disfigurement
This bill seeks to extend existing workers’ compensation eligibility for permanent disfigurement from 275 weeks to 400 weeks and clarify that Claimants are not precluded from collecting both total or partial disability benefits and disfigurement benefits simultaneously. It would also provide workers’ compensation coverage for disfigurement regardless of where it occurs on their body.
Last Action: Referred to LABOR AND INDUSTRY, May 9, 2023 [Senate]
NEW JERSEY LEGISLATIVE UPDATE
Assembly Bill 4750
Expands certain employer reporting requirements to include entities that employ or contract with individuals for financial compensation, including ridesharing and delivery technology platforms.
Last Action: January 14, 2025 – Received in the Senate, Referred to Senate Labor Committee
Assembly Bill 4371/S1943
Requires workers’ compensation, PIP, and health insurance coverage for the medical use of cannabis under certain circumstances.
Last Action: May 16, 2024 – Introduced, Referred to Assembly Financial Institutions and Insurance Committee
Assembly Bill 4283
Provides personal liability for owner, executive officer, or executive director of employer for failure to pay for workers’ compensation coverage.
Last Action: May 6, 2024 – Introduced, Referred to Assembly Labor Committee
Assembly Bill 4559
Concerns certain workers’ compensation supplemental benefits and funding method.
Last Action: June 13, 2024 – Introduced, Referred to Assembly Labor Committee
Assembly Bill 2100
Provides workers’ compensation benefits for certain public safety workers who developed illness or injury as result of responding to September 11, 2001 terrorist attacks.
Last Action: September 19, 2024 – Reported out of Asm. Comm. With Amendments, and referred to Assembly Public Safety and Preparedness Committee
Senate Bill 3772
Concerns valuation of board and lodging with respect to workers’ compensation.
Last Action: December 5, 2024 – Referred to Senate Budget and Appropriations Committee
Senate Bill 794
Concerns workers’ compensation insurance requirements for certain corporations and partnerships.
Last Action: December 5, 2024 – Reported from Senate Committee as a Substitute, 2nd Reading
