Pennsylvania Workers' Compensation Lawyer Blog

When an injured worker in PA wants to settle his or her Pennsylvania workers’ compensation claim in exchange for a lump sum of money, the process generally used is the “Compromise & Release Agreement.” This type of workers’ comp settlement is voluntary between the parties. A Compromise & Release can only take place when agreed to by both the injured worker and the PA workers’ comp insurance carrier.

As we have noted in a previous blog entry, a Compromise & Release Agreement is not final until it is actually approved by a Workers’ Compensation Judge (WCJ). The law requires that a WCJ determine whether the injured worker understands and accepts the terms and conditions of the Compromise & Release Agreement. Until the approval of the WCJ is obtained, either party may back out of the Agreement.

The limits of this theory were recently tested before the Commonwealth Court of Pennsylvania in the case of McKenna v. Workers' Compensation Appeal Board (SSM Industries, Inc. and Liberty Mutual Insurance Co.). In this case, the parties agreed to settlement terms at a mediation (a settlement conference with a WCJ, usually not the WCJ hearing the case). A Compromise & Release Agreement was signed by both parties.

At the hearing before the WCJ to approve the Compromise & Release Agreement, however, the employer demanded that the injured worker agree never to seek re-employment with employer. The injured worker refused to agree to this new term, and the Compromise & Release Agreement was not approved (since it was no longer agreed to by the parties).

The injured worker then filed a Petition for Penalties, alleging the employer violated the Pennsylvania Workers’ Compensation Act by failing to proceed with a Compromise & Release Agreement once the Agreement was signed and completed. The WCJ granted the Petition for Penalties, but the Workers’ Compensation Appeal Board (WCAB) reversed.

On appeal, Commonwealth Court of PA agreed with the WCAB that the WCJ erred by granting the Petition for Penalties. The Court found that employer did not violate the Pennsylvania Workers’ Compensation Act, since a Compromise & Release Agreement is not final until it is approved by a WCJ, a step missing from the facts in this case. The Court confirmed that until a WCJ approves a Compromise & Release Agreement, either party may withdraw from the agreement without penalty.

As Pennsylvania Workers’ Compensation attorneys, we see a wide variety of conditions faced by injured workers, from broken arms and legs to Complex Regional Pain Syndrome and Brachial Plexopathy, and everything in between. While the conditions plaguing these injured workers vary widely, there is one constant we see in case after case – chronic pain.

All too often, we see an injured worker become addicted to prescription pain medication. Nobody wants to live in pain, and often the first thing doctors try to relieve symptoms is a pill of one type or another. Many times, as the injured worker recovers from the work injury, and the pain relents, the need for the pain medication disappears. Unfortunately, when the work injury does not get better, and the pain becomes chronic, prescription pain medication may no longer be a viable alternative.

According to a recent article on Medical News Today, there are options aside from pain medication to relieve symptoms. Advances are being made in “neurostimulators,” small devices which are implanted to help block pain impulses from reaching the brain. There is hope that these, and other advances, may lessen the need for giving medications to injured workers in chronic pain.

Under the Pennsylvania Workers’ Compensation Act, as that set of laws has been interpreted by Courts in Pennsylvania, there has been some confusion regarding when an injured worker can be reinstated to total disability workers’ compensation benefits. For example, an injured worker who returns to light duty work with the pre-injury employer, and is later laid off from the light duty job, is entitled to a reinstatement to total workers’ comp benefits. However, the question remained whether the same injured worker would lose this ability to obtain reinstatement if he or she leaves the pre-injury employer (like for a better or higher paying job).

This situation was faced squarely in Bufford v. Workers’ Compensation Appeal Board (North American Telecom), decided by the Supreme Court of Pennsylvania on August 17, 2010. In this case, the injured worker returned to light duty work with the pre-injury employer. He then left the pre-injury employer for a higher paying, less physical, job with another employer. A few years later, Mr. Bufford was laid off from the new employer.

The Workers’ Compensation Judge (WCJ) denied the Petition to Reinstate Benefits, finding that Mr. Bufford failed to prove there was a change (a worsening) in his condition, and his loss in earnings stemmed solely from economic reasons (rather than related to his disability). The WCJ even recognized the case would be different if the injured worker had remained at work with the pre-injury employer. On appeal, both the Workers’ Compensation Appeal Board (WCAB) and the Commonwealth Court of Pennsylvania affirmed the decision.

In a refreshing opinion, the Supreme Court of Pennsylvania lent some sanity, logic and compassion to the equation. In reversing the Commonwealth Court of Pennsylvania, the Supreme Court found it absurd that the injured worker should be punished simply for seeking better employment. The Court clarified the injured worker’s burden of proof in a Petition to Reinstate is simply to prove that his earning power is again affected by his work injury, and that his work-related disability continues. The burden then shifts to the workers’ compensation insurance carrier to prove that the loss in earnings is not caused by the work injury. There was no requirement that the injured worker prove a change, or worsening, in his condition.

The Supreme Court of Pennsylvania found that the injured worker here met his burden. The workers’ compensation insurance carrier then failed to carry its burden opposing reinstatement. Specifically, the defendant failed to prove the claimant showed “bad faith” by rejecting available work. As such, the Court found the reinstatement must be granted.

A work injury is covered by the Pennsylvania Workers’ Compensation Act when the injury takes place in PA. However, even when a work injury occurs outside Pennsylvania, there are times PA has “jurisdiction” to hear the case.

One of those situations when PA workers’ comp laws can apply to a work injury taking place in another State is when the injured worker’s employment is “principally localized” in PA. Recently, the Commonwealth Court of Pennsylvania addressed what “principally localized” means in John D. Williams v. Workers’ Compensation Appeal Board (POHL Transportation).

In this case, Mr. Williams, who lives in PA, was hired by a trucking company in Ohio. The trucking company had no offices or facilities in Pennsylvania. Mr. Williams’ mileage log showed that 38% of his mileage was within Pennsylvania, 32% was in Ohio and the remaining 30% was spread over 19 different States. The injury took place in Vermont.

The Workers’ Compensation Judge (WCJ) found that PA had jurisdiction and granted the Claim Petition. The Workers’ Compensation Appeal Board (WCAB) reversed, finding that Mr. Williams did not primarily work in PA, because the employer was located in Ohio, Mr. Williams was hired in Ohio and all assignments came from Ohio.

On appeal, the Commonwealth Court of PA reversed the WCAB and reinstated the granting of the Claim Petition as found by the WCJ. The Court found that the burden faced by Mr. Williams in this situation was to show that he was domiciled in PA and that “a substantial part” of his working time for employer was within PA. He did not have to show the work was “primarily” in PA.

Defendant argued that 38% (the time Mr. Williams worked in PA) could not be considered “a substantial part” of the working time, as 62% of the work was in a different State. The Court explained that the burden is not to show the work was primarily, or even mostly, in PA, but just to show it was “substantial.” Here, more than a third of the work was in PA, and more work was within PA than any other State. There was no argument that Mr. Williams lived in Pennsylvania. As such, the burden was met for jurisdiction to be in PA.