Pennsylvania Workers’ Compensation Lawyer Blog

When a party files a document in the world of Pennsylvania workers’ compensation, it means something.  As with most areas of the law, parties are bound by what is filed.  So, a recent decision by the Commonwealth Court of Pennsylvania, addressing an attempt by a workers’ comp insurance carrier to withdraw a Notice of Compensation Payable, is significant.

In City of Philadelphia and PMA Management Corp. v. John Bell (Workers’ Compensation Appeal Board), the injured worker was a firefighter for the City of Philadelphia who was diagnosed with colon cancer.  Believing his cancer was caused by exposure to toxic fumes and compounds over his 17-year career, the injured worker reported this suspected work injury to his employer, as required under the law.

The City of Philadelphia investigated the allegation and then decided to deny the claim.  However, an inexperienced adjuster accidentally caused a Medical-Only Notice of Compensation Payable (MONCP) to be issued, which accepted a work-related injury in the nature of colon cancer.

As we have addressed in a previous blog post, discussing the case of City of Philadelphia v. Turner (Workers’ Compensation Appeal Board), a Workers’ Compensation Judge (WCJ) cannot allow the conditions considered by an Impairment Rating Evaluation (IRE) to be only those conditions formally accepted by the workers’ compensation insurance company.  Instead, the IRE physician must consider all conditions “due to” the work injury (in his or her medical opinion).

Just to refresh your recollection, an IRE is a tool available to PA workers’ compensation insurance carriers, which allows the status of workers’ comp benefits to be switched from “total” (for which there is no specific time limit) to “partial” (for which there is a maximum of 500 weeks available), if the “whole body impairment” (WBI) of the injured worker is found to be less than 35% (an extremely difficult standard to reach).  More detail on the IRE process can be found on our website here.

In a recent case, the Commonwealth Court of Pennsylvania faced this issue again, though in a slightly different context.  In the Turner case, the only medical evidence was the IRE physician, who was presented by the workers’ comp insurer.  Since that physician did not consider all conditions he believed to be “due to” the work injury, the Court was able to simply affirm the decision of the WCJ, and find that the insurer failed to meet its burden under the Pennsylvania Workers’ Compensation Act.

While we do not typically discuss “unreported” decisions of the Commonwealth Court of Pennsylvania (see this blog post on the difference between reported and unreported decisions), a recent such decision touches on an important topic – the concept of a voluntary withdrawal from the labor market, or, in normal language, retirement.

Once an injured worker proves an entitlement to PA workers’ compensation benefits, those benefits generally continue until something changes.  That change could be the injured worker returning back to work, or an intervening decision from a Workers’ Compensation Judge (WCJ) regarding the full recovery of the injured worker, or the availability of work within the restrictions of the injured worker (among other things that can impact the continued receipt of benefits).

One other concept which can impact the continued receipt of benefits is a “voluntary withdrawal from the labor market,” which was the subject of the unreported decision by the Commonwealth Court of PA in Ogden Corporation (Broadspire) v. Workers’ Compensation Appeal Board (Keene).  Essentially, if the workers’ compensation insurance carrier can establish that the injured worker has retired, then the injured worker may no longer be entitled to wage loss (what we call “indemnity” benefits – the right to medical benefits would not be disturbed).  The concept of “voluntary withdrawal from the labor market” is basically proving the injured worker “retired.”