PENNSYLVANIA WORKERS’ COMPENSATION
CASE SUMMARIES
06/1/2025 – 06/30/2025
BAD FAITH REFUAL OF EMPLOYMENT
COMPIANCE WITH EMPLOYER’S COVID POLICY
Kathleen A. Fee v. Prospect Medical Holdings (WCAB)
Commonwealth Court of Pennsylvania – Published Opinion
Decided: June 30, 2025
Issue:
Whether the Board’s conclusion that Claimant’s decision to decline the COVID-19 vaccination constituted bad faith was in error?
Background:
Claimant petitioned for review of the order of the Board, reversing the WCJ’s decision granting her claim petition seeking ongoing total disability benefits under the Pennsylvania Workers’ Compensation as a result of an injury she sustained while working for Employer. Employer terminated Claimant’s employment after she had transferred to light-duty work for her refusal to comply with its COVID-19 vaccination policy, despite her requests for religious and medical exemptions. Employer argued that Claimant’s termination for cause should act as a bar to an award of WC benefits. Although Claimant had requested religious and medical exceptions from the vaccination requirement on two separate occasions and submitted supporting documentation, Employer denied her requests. The WCJ found Claimant to have been terminated while under work restrictions, and the burden was upon the Employer to demonstrate Claimant’s failure to obtain a COVID-19 vaccination amounted to “lack of good faith” which would negate her entitlement to benefits. The WCJ found Employer failed to do this. Employer appealed to the Board, which reversed the WCJ’s decision.
Holding:
Employer argued that Claimant’s own testimony establishes that her loss of earnings is not due to her work injury but is instead a result of her voluntary decision not to comply with its mandatory vaccine policy, which she was aware of before she was injured. Employer argued that Claimant’s requests for religious and medical exemptions were denied because they were deficient, as she offered only a vague argument that there was not enough information available at the time about the COVID- 19 vaccine in order to take it. The Court concluded that the Board wholly ignored the evidence of record showing that Claimant acted in good faith in pursuing religious and medical exemptions to Employer’s vaccination policy, which did not include any reasonable accommodations such as weekly testing for the virus and/or wearing a mask, and that her non-compliance with the policy did not amount to bad faith.
Reversed.
TIMELINESS OF CLAIM
FIREFIGHT CANCER CLAIM
James Gilbert v. South Whitehall Township (WCAB)
Commonwealth Court of Pennsylvania – Published Opinion
Decided: June 12, 2025
Issue:
Whether the Board and the WCJ erred because Section 301(f) provides that firefighter cancer claims may be made within 600 weeks after the last date of employment and that provision supersedes Section 315’s shorter limitations period?
Background:
Claimant petitioned for review of the Order of the Board upholding a WCJ’s dismissal of a Claim Petition as untimely because the Petition was not filed within the three-year period required by Section 315 of the Workers’ Compensation Act (Act). Claimant joined Woodlawn Volunteer Fire Department as a fire police volunteer around 2006, a position that does not involve active firefighting duties but does require presence at active fires. Prior to joining Woodlawn, Claimant volunteered as a firefighter for Tri-Clover Volunteer Fire Company (Tri-Clover) beginning in 1992 or 1993. On or about February 8, 2018, Claimant was diagnosed with prostate cancer, for which he received medical treatment and suffered a wage loss from March 5, 2018 to April 15, 2018. Claimant filed the Petition on January 23, 2023, asserting that his prostate cancer was compensable. After hearing the evidence, the WCJ concluded there was no tolling of Section 315’s requirements and, having not been filed within three years of either February 8, 2018 (date of diagnosis) or March 5, 2018 (date of disability), the Petition was untimely. Claimant appealed to the Board, and the Board affirmed.
Holding:
The Court held that the 600-week period in Section 301(f) has not supplanted the 300-week limitations period set forth in Section 315. Accordingly, the Court concluded that the Board properly affirmed the dismissal of the Petition as untimely. There is no dispute the Petition was filed more than three years after Claimant was diagnosed with and disabled by prostate cancer, which occurred in, respectively, February 2018 and March 2018. It is also undisputed that Claimant advised Employer of his cancer diagnosis in February 2018. Thus, on its face, the Petition would appear to be untimely, and Claimant had to establish that there is a reason to toll the running of the three-year period under Section 315. However, Claimant maintains that the Section 315 limitations period did not begin to run until he received confirmation from a physician presenting this as a per se rule. However, the Court noted that such a per se rule was being “illogical” and inconsistent with Section 311, which, like Section 315, contains a “reasonable diligence” requirement. Had the General Assembly intended to require a physician’s confirmation to serve as the start of the notice period, it could have included straightforward language in the Act to the effect. Nothing in Section 315 ties the commencement of the three-year period, or tolling of that period, to a claimant’s knowledge that a claim would be “viable.” Because Claimant did not establish that the Petition was filed within the period required by Section 315, the Board did not err in affirming the dismissal of the Petition as untimely.
Affirmed.
PENALY AWARDS
ABUSE OF DISCRETION AND TECHNICAL VIOLATIONS
MM Metals v. Lewis Warner (WCAB)
Commonwealth Court of Pennsylvania – Unpublished Memorandum Opinion
Decided: June 4, 2025
Issues:
(1) Whether the WCJ erred in admitting the operative report, which violates the Walker Rule, such that there is not substantial evidence to support a finding that the surgery Claimant underwent is related to the work injury; and (2) Whether the 20% penalty was grossly disproportionate to any purported violation?
Background:
Claimant filed a Claim Petition asserting that, while working for Employer he fell, resulting in a left shoulder strain/sprain. Claimant averred he notified his supervisor on the same day. Claimant alleged that he was temporarily totally disabled. Claimant filed the Penalty Petition contending Employer violated the Workers’ Compensation Act by not filing a Notice of Compensation Denial within 21 days. The WCJ found that Claimant provided sufficient notice of the work injury to Employer, including on the date of the injury. The WCJ concluded that Claimant suffered from left shoulder pain secondary to rotator cuff tears as a direct result of the work incident. The WCJ further found that the surgery on Claimant’s left shoulder was causally related to that work injury. Finally, the WCJ found that Employer violated the Act by not timely accepting or denying the claim but filing the NCD two months after notice of the work injury and imposed a 20% penalty on the wage loss benefits and interest up to the date of the WCJ’s decision. Thus, the WCJ granted the Claim Petition in part and granted the Penalty Petition. Employer appealed to the Board. The Board affirmed the WCJ’s decision.
Holding:
In workers’ compensation cases, hearsay medical reports do not constitute substantial evidence and cannot support an independent finding of a WCJ. The WCJ improperly admitted an operative report over Employer’s objection, it cannot form the basis of the WCJ’s finding that the surgery was related to the work injury. All other testimony that the surgery was causally connected to the work injury was equivocal. As such, the record does not contain competent, substantial evidence to support the finding that Claimant’s surgery was related to the work injury, and that determination was reversed. The finding of disability is supported by substantial evidence. No discernable prejudice to the claimant resulted from the employer’s delay in untimely filing the NCD, which was, at worst, a technical violation of the Act. The 20% award of a penalty on all indemnity benefits, plus interest, through the circulation of the WCJ’s Decision nearly two years after the Claim Petition was filed is manifestly unreasonable given the technical nature of the violation, and with no apparent prejudice to Claimant. It was an abuse of discretion. The WCJ erred by admitting hearsay evidence, over Employer’s objection, which formed the basis for the WCJ’s finding that Claimant’s surgery was work related. Accordingly, the Court reversed the Board’s Order to the extent it affirmed that portion of the WCJ’s Decision. The Court vacated the Board’s Order, which affirmed the WCJ’s grant of the Penalty Petition, and remanded the matter for consideration of a new penalty amount. However, the findings of the work injury and entitlement to benefits as of December 21, 2021 are supported by substantial evidence of record. Therefore, the Board’s Order was affirmed in those regards.
Affirmed, Reversed, Remanded, and Vacated.
JUDICIAL DISCRETION
WITNESS CREDIBILITY
Joan Cassidy v. Presbyterian Medical Center (WCAB)
Commonwealth Court of Pennsylvania – Unpublished Memorandum Opinion
Decided: June 2, 2025
Issues:
Whether the WCJ and Board should not have credited Employer’s expert’s testimony of full recovery?
Background:
Claimant was in a parked car hit by another car and sustained work-related strain/contusion injuries to the right neck, shoulder, thigh, and knee. Claimant filed a claim petition asserting that as a result of the incident, she sustained multiple injuries, including a traumatic brain injury, and seeking ongoing disability. The WCJ credited Claimant as to her injury but not as to its duration; she credited employer’s medical expert over claimant’s as to the duration of Claimant’s injury and concluded that Claimant was fully recovered as of the date of the IME. The Board affirmed.
Holding:
In the claim petition context, it is the claimant’s burden to prove the extent and duration of his or her disability. If the WCJ concludes that the evidence supports a finding of disability only for a closed period, the WCJ is free to make such a finding. The employer need not formally file a petition to terminate the claimant’s benefits if the evidence shows that the claimant is fully recovered from the work injury and any remaining disability is no longer the result of the work injury. The record supports the WCJ’s credibility determination regarding Claimant’s testimony. The WCJ has exclusive province over questions of credibility and evidentiary weight and is free to accept or reject the testimony of any witness, including a medical witness, in whole or in part. The record supports the WCJ’s credibility determinations regarding the medical evidence. Qualifications and greater or lesser interaction with the patient are among the generally accepted reasons that a WCJ may credit or reject a medical expert’s testimony. As for a treating doctor, the WCJ was not bound by that status alone to credit one doctor over another. Further, the WCJ also did not err in fully crediting employer’s expert’s testimony that Claimant was physically fully recovered as of the IME. Finally, although surveillance evidence alone is not sufficient to satisfy a party’s burden, it may be used to impeach credibility and to establish facts in a case. The WCJ was within her province to conclude that video evidence impeached Claimant’s testimony and contributed to a factual determination that Claimant was no longer disabled. There was no error in that evaluation and conclusion. The WCJ’s determination that Claimant sustained a disabling work-related head injury, and that she recovered from that injury, is supported by substantial record evidence. Claimant did not meet her burden to refute the WCJ’s conclusions, which the Board affirmed.
Affirmed.
REINSTATEMENT PETITION
Sean Schmied v. City of Philadelphia (WCAB)
Commonwealth Court of Pennsylvania – Unpublished Memorandum Opinion
Decided: June 25, 2025
Issues:
(1) Whether the WCJ erred by denying the Reinstatement Petition; (2) Whether the Board erred by denying the Penalty Petition.
Background:
The City of Philadelphia (Employer) employed Claimant as a police officer. Employer designated Claimant’s time off as E-Time or excused time, and Claimant received full pay without depleting his sick or vacation time. On January 5, 2022, Employer notified Claimant that he would receive 60 days (from the date of the notice) of additional full salary pursuant to the COVID-19 Enforcement Officer Disability Benefits Act and, thereafter, he would have to use sick and vacation time if he remained out of work. On January 14, 2022, Employer issued a Notice of Compensation Denial (NCD) denying liability for Claimant’s alleged injury to his lungs due to exposure to COVID-19. Claimant returned to full-duty work without restrictions on March 8, 2022. Claimant filed Reinstatement and Penalty Petitions alleging therein that Employer violated the Act by unilaterally stopping WC benefits pursuant to the January 14, 2022 notice, after accepting a WC claim for COVID-19 by paying wages in lieu of compensation.
Holding:
Employer disputed that it ever made payments in lieu of compensation or accepted liability for Claimant’s alleged work injury. The WCJ found that E-Time was intended to respond to the emerging Pandemic in 2020 without regard to whether the disability was work- related. That testimony established that Employer’s objective was to pay all employees out of work due to COVID-19, regardless of cause, in order to protect other employees and citizens from exposure. As for the Penalty, there is simply nothing in the Act or case law that would permit a WCJ to award a penalty while simultaneously refusing to award benefits.
Affirmed.
JUDICIAL DISCRETION
CONTROL OF THE DOCKET
Niheem Lewis v. Clemens Family Corp. (WCAB)
Commonwealth Court of Pennsylvania – Unpublished Memorandum Opinion
Decided: June 4, 2025
Issue:
Whether the WCJ erred by excluding Claimant’s expert medical report, and closing the record?
Background:
Claimant filed a claim petition. Over the next two years, the WCJ scheduled evidentiary hearings numerous times. Although the WCJ repeatedly extended Claimant’s deadline to provide evidence in support of his claim, Claimant failed to present any evidence until he submitted his deposition testimony. At that time, Claimant also informed the WCJ that he was limiting his claim to less than 52 weeks and would, therefore, proceed with medical reports. However, despite further extensions and a final evidentiary deadline, Claimant did not file a timely expert medical report and the record was closed. The WCJ specifically found Claimant’s testimony not credible and concluded that Claimant had failed to establish a compensable, work-related injury. Accordingly, the WCJ denied and dismissed the claim petition. The Board affirmed.
Holding:
In a claim petition, the claimant bears the burden of establishing all elements necessary for relief. This includes proof that the claimant sustained a work-related injury and, absent an obvious causal connection between the injury and the alleged work-related cause, unequivocal medical evidence establishing the connection. Further, in guiding litigants through the prosecution and defense of a claim, the WCJ has discretion to control her docket by ordering parties to comply with litigation in a timely manner. If the parties do not comply, the WCJ may close the record and preclude the submission of evidence, provided she first warns the parties that the record will close. There is no abuse of discretion when a party has had ample opportunity to present evidence yet fails to do so before the record is closed. Here the WCJ conducted nine hearings in this matter. Thus, Claimant was given ample opportunity to present evidence in support of his claim. Claimant repeatedly failed to present any evidence. The WCJ warned Claimant on multiple occasions that she could not keep the record open indefinitely and would close the record with or without his evidence. Accordingly, it was within the WCJ’s discretion to preclude Claimant’s untimely expert report. Further, an expert medical report was necessary to prove causation. Absent competent medical evidence, Claimant failed to prove his claim.
Affirmed.
JUDICIAL DISCRETION
SUFFICIENCY OF EVIDENCE
Mirsa Salguero v. Chos Ez Brunc, et al (WCAB)
Commonwealth Court of Pennsylvania – Unreported Memorandum Opinion
Decided: June 13, 2025
Issue:
Whether the WCJ erred in holding that the Claimant met her burden in a claim petition, through the testimony of the Employer’s expert?
Background:
In the claim petition, Claimant averred that she sustained a work injury on February 4, 2020, while lifting and carrying restaurant supplies. She described the injury as including but not limited to a lumbar injury with radiating lower extremity pain. In the first claim petition against UEGF, Claimant made identical averments. Following Claimant’s failure to timely prosecute the first UEGF claim petition, the WCJ permitted Claimant to withdraw it without prejudice. Claimant filed a second UEGF claim petition. The WCJ concluded that Claimant sustained a work injury in the form of a lumbar strain on February 4, 2020, and that she was temporarily totally disabled as a result of that injury. The WCJ denied the second claim petition against UEGF, because it was filed more than 180 days after the March 2020 notice of claim. Claimant, Employer, and UEGF all appealed to the Board. The Board reversed the WCJ’s decision granting the claim petition against Employer and affirmed the WCJ’s decision in all other respects. Claimant’s petition for review followed.
Holding:
The Court would not usurp the WCJ’s credibility determinations and reweigh the evidence. Once the WCJ decided to accept Employer’s expert testimony as more credible and convincing than that of Claimant, then all that remained was the expert’s opinion as to whether Claimant sustained a work-related injury and to what extent any injury continued. The WCJ’s reliance on the opinion of an employer’s expert in ruling for a claimant is infrequent but not unprecedented. However, here there was no obvious causal connection between the alleged injury and a work-related cause, unequivocal medical testimony was necessary to establish that connection. Said expert’s testimony was equivocal even as to the issue of whether Claimant sustained a work injury. Accordingly, Claimant did not meet her burden to prove the elements necessary to prevail on her claim petition against Employer. Further, Claimant withdrew the first claim petition against UEGF. Consequently, regardless of why she did so, the filing date of the first claim petition is no longer relevant. Hence, the second claim petition against UEGF was untimely.
Affirmed.
TERMINATION PETITION
BURDEN OF PROOF
Rodney Cortez v. James Floor Covering (WCAB)
Commonwealth Court of Pennsylvania – Unreported Memorandum Opinion
Decided: June 12, 2025
Issue:
Whether the Employer met its burden on the termination petition to show full recovery?
Background:
Employer filed a medical-only NCP which stated that Claimant suffered burns to his left palm and second, third, and fourth fingers after an electrical cord caught fire. Claimant filed a Claim Petition alleging a disabling, left hand injury. The Employer filed a termination petition. The WCJ granted the Claim Petition in part, finding that Claimant sustained a burn injury to the left hand and palm. However, the WCJ also granted Employer’s Termination Petition on the ground that Claimant was fully recovered as of the IME. Claimant appealed to the Board, which affirmed.
Holding:
In a workers’ compensation proceeding, the WCJ is the ultimate factfinder and is the sole authority for determining the weight and credibility of evidence. Claimant maintains Employer failed to prove full recovery from all the injuries. The medical-only NCP described an injury to Claimant’s second, third, and fourth fingers, which and Employer’s expert only opined recovery of a burn to the left palm. Based upon a review of all the evidence of record considered in its entirety, the WCJ found a recovery from all these conditions, as supported by the credible evidence of record. This is consistent with employer’s expert’s credited testimony that Claimant sustained only a mild burn injury to his left palm.
Affirmed.
PENNSYLVANIA LEGISLATIVE REVIEW
House Bill 183
A few months ago, the Commonwealth of Pennsylvania, House L&I Committee, voted on what is now designated as HB 183. This Bill expands access to workers compensation disfigurement benefits by increasing the duration of eligibility from up to 275 weeks to a new level of up to 400 weeks, extending the benefit to the entire body, and not just to the head, face and neck, and allowing these benefits to be paid simultaneously with indemnity benefits. The bill was passed by the House on April 7, 2025, and has now been referred to the Senate Labor & Industry Committee. It remains with this committee. It is worthy of note that this bill was amended, just prior to passage, to apply to injuries for which “permanent disfigurement was reached” after the effective date of the provision, whereas it was previously intended to only apply to injuries sustained on or after the effective date. As of today, there has been no new action.
NEW JERSEY WORKERS’ COMPENSATION
CASE SUMMARIES
6/1/2025 – 6/30/2025
IMMUNITY UNDER THE ACT
Estate of Alexander v. Northeast Sweepers
Superior Court of New Jersey, Appellate Division – Unpublished Opinion
A-1486-23; 2025 WL 1711136
Decided: 6/19/2025
Background:
Petitioner, Mike Alexander, passed away as a result of an incident when he was struck by a sweeper truck while working in an active construction zone on the New Jersey Turnpike. The New Jersey Turnpike Authority (NJT Authority) hired Crisdel as one of the contractors as part of a project to resurface portions of the Turnpike. Alexander worked for Crisdel. Alexander and his estate received workers’ compensation benefits as a result of the accident. Alexander’s estate filed complaints, including one alleging that Crisdel engaged in conduct constituting intentional wrongs which resulted in Alexander’s death. Crisdel asserted that the claims were barred by the Workers’ Compensation Act (the Act). Crisdel moved for summary judgment. The trial court granted summary judgment in favor of Crisdel finding that Plaintiffs did not present evidence that would allow a reasonable fact finder to find that Crisdel committed an intentional wrong within the meaning of the Act. They further stated that the accident that caused the death was in the nature of the type of accidents that occur in construction areas. Plaintiffs appealed the order granting summary judgment.
Holding:
The Act is the exclusive remedy for employees injured under the Act, except when the injuries are caused by intentional wrongs. To prove an intentional wrong under the Act, the “plaintiff must show: ‘(1) the employer must know that his actions are substantially certain to result in injury or death to the employee, and (2) the resulting injury and the circumstances of its infliction on the worker must be (a) more than a fact of life of industrial employment and (b) plainly beyond anything the Legislature intended the [WC Act] to immunize.’” The court found that in this case, there was no evidence presented that shows an intentional wrong. Evidence was presented of lights on vehicles, including lights which shined behind the sweeper vehicle as it backed up. The lack of light towers does not show an intentional wrong. Further, the milling machines and sweepers have backup alarms. The noise in the work area that could have drowned out the sound of the alarms is not an intentional wrong. Overall, the facts of the case do not establish that the employer’s conduct amounted to an intentional wrong under the Act and the court did not err in granting summary judgment.
Affirmed.
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 4559
Concerns certain workers’ compensation supplemental benefits and funding method. Last Action: June 13, 2024 – Introduced, Referred to Assembly Labor Committee
Assembly Bill 2100/S1470
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
Assembly Bill 5198/S3772
Concerns valuation of board and lodging with respect to workers’ compensation.
Last Action: January 23, 2025 – Reported and Referred to Assembly 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
Assembly Bill 5792/ S4590
Provides for workers’ compensation coverage of certain counseling services for first responders and provides that certain mental health related communications are confidential.
Last Action: June 26, 2025 – Reported from Senate Committee with Amendments, 2nd Reading
