Pennsylvania Workers' Compensation Lawyer Blog

According to the American Academy of Orthopedic Surgeons, recent advances in hip replacements have made the procedure easier, and made the results last longer. All of the news is not good, however, as these advances may come with potential consequences.

Metal-on-metal hip replacements can dramatically improve a patient's quality of life, and return an injured worker to gainful employment. Unfortunately, the metal-on-metal hip replacements can also lead to cobalt toxicity. Patients getting metal-on-metal hip replacements may require some monitoring, or testing, after the procedure, to make sure cobalt levels are not unusually elevated.

The type of hip replacement performed, and, of course, whether a patient should even get a hip replacement at all, are discussions we encourage our clients to have with their orthopedic surgeons.

**Update - This opinion was vacated (withdrawn) by the Commonwealth Court of Pennsylvania on February 24, 2011. The en banc (all of the Judges) Court will review the case and issue a new decision**

Under the Pennsylvania Workers’ Compensation Act, an employer or, more likely, workers’ compensation insurance carrier, has 21 days to accept or deny a workers’ comp claim in PA. An acceptance can be accomplished by issuing a Notice of Compensation Payable (NCP), Notice of Temporary Compensation Payable (TNCP) or an Agreement for Compensation. A rejection of a claim requires that a Notice of Denial (NCD) be filed (there are, of course, nuances and exceptions, but this is generally the case).

The Supreme Court of Pennsylvania held back in 1983 (Beissel v. Workers’ Compensation Appeal Board (John Wanamaker, Inc.)) that, to obtain a termination of workers’ comp benefits, the workers’ compensation insurance carrier must prove there was a change of condition after the NCP was issued. But, what if an injured worker recovers before an NCP can be issued?

This very issue was faced by the Commonwealth Court of PA in City of Philadelphia v. Workers’ Compensation Appeal Board (Butler). Here, the claimant was involved in a motor vehicle accident while doing her job. A doctor pronounced her fully recovered from her work injury on October 19, 1995. A job offer was made shortly thereafter. On November 7, 1995, the City of Philadelphia issued an NCP, accepting the claim.

Subsequently, the City of Philadelphia filed a Petition for Suspension and Termination, as of October 19, 1995. The Workers’ Compensation Judge (WCJ) found the doctor offered by the City of Philadelphia credible, and granted the Petition for Termination. On appeal, the Workers’ Compensation Appeal Board (WCAB) affirmed.

The Commonwealth Court of PA, however, reversed, holding that, under Beissel, the Termination Petition could not be granted, because there was no change in condition shown after the date of the NCP. The Court remanded (sent back to the WCJ) for a decision on the Suspension Petition.

After the WCJ granted the Suspension Petition on the remand, and it was affirmed by the WCAB, the Court again considered the issue, this time regarding the Suspension Petition. This time, the Court found that the date an NCP is issued does not bar a Suspension or Termination as of any certain date. Instead, the key is whether the Suspension or Termination seeks to dispute some aspect of the NCP. Since the Suspension here did not dispute any aspect of the NCP, the WCJ properly granted the Suspension.

As attorneys who represent injured workers in PA, we have trouble reconciling the two decisions by the Commonwealth Court in this matter. While the Court did not vacate its initial decision, the reasoning of the second decision completely undermines the basis of the first. It remains unclear why the Suspension in Butler would be granted, but the Termination would not. As we say so frequently, we, as attorneys, ask for nothing more than consistency and reliability in our judiciary. Cases like this make trying cases, and advising our clients, especially difficult.

Under the Pennsylvania Workers’ Compensation Act, to be eligible for PA workers’ comp benefits, the disabled person must be an “employee.” Often, this is obvious and not even in question. There are times, however, when a case turns on whether, in fact, the injured person was truly an “employee.” We most often see this situation when the issue is whether the injured worker was an “employee” or an “independent contractor.”

The analysis, to determine whether someone was an “employee” or an “independent contractor,” depends on the facts in each case. It frequently becomes a very complicated issue, requiring multiple depositions and extensive litigation.

At least some of this situation will be easier to determine, now that the Pennsylvania Legislature passed Act 72 of 2010, on October 13, 2010 (This is listed as House Bill 400). The law will take effect 2/11/11. While this law applies only to the construction industry, we expect that to be read broadly, to include roofing, plumbing and other related areas.

Under Act 72, an injured worker (in the construction industry) will be considered an “independent contractor” only if all of the following conditions are met:

(1) the individual has a written contract to perform such services;
(2) the individual is free from control or direction over performance of
such services both under the contract of service and in fact; and
(3) as to such services, the individual is customarily engaged in an independently established trade, occupation, profession or business.

This law should significantly limit an employer’s ability to try and escape liability under the PA Workers’ Compensation Act, and make it easier for injured workers in the construction industry to get the workers’ comp benefits they need.

In PA workers’ comp, when an injured worker returns to employment, there is a change in the workers’ compensation benefits he or she receives. If the injured worker is again earning the wages he or she earned before the work injury, then workers’ comp benefits are stopped completely (“suspended”). If the injured worker is earning less than before the injury, as a result of the injury, then workers’ comp benefits may only be “modified” to a lower rate.

Often the key to whether modified workers’ compensation benefits continue, in the case of an ongoing loss in wages, is whether the ongoing loss in wages is actually a result of the injury.

Recently, the Commonwealth Court of Pennsylvania addressed this issue in Trevdan Building Supply v. Workers’ Compensation Appeal Board (Pope). In this case, the employee ruptured his biceps tendon while unloading building material. Eventually, the injured worker was released to resume his regular duty employment, without any specific restriction, though his doctor noted that he may require some assistance with heavy lifting (which was also the case, on occasion, prior to the injury).

The injured worker went back to his regular duty position, and regular wages. The workers’ comp benefits were then suspended. Due to the economic downturn, the employer stopped offering overtime to the employees. As a result, the injured worker’s wages became lower than his “Average Weekly Wage” under the workers’ compensation case (which had included the previous overtime).

Since he was now losing wages, the injured worker filed a Petition for Reinstatement. The Workers’ Compensation Judge (WCJ) denied ongoing workers’ comp partial disability benefits, since the loss in wages resulted from a general economic situation, rather than the work injury.

The Workers’ Compensation Appeal Board (WCAB) reversed the WCJ, but upon further appeal, the Commonwealth Court of PA reversed the WCAB and reinstated the decision of the WCJ. The Court agreed with the WCJ that the ongoing loss in wages was not shown to be as a result of the work injury. The Court did observe that the situation may be different if the injured worker did not return to his pre-injury position, without restriction.