We had heard on the grapevine that The Honorable Joseph Hagan, the current Judge Manager for the Southeastern District for the Pennsylvania Bureau of Workers’ Compensation, would be stepping down in the near future.  We have now heard confirmation of this change from the Bureau.  We are pleased to relate that Judge Hagan will, indeed, be retiring in the middle of April.  While we will miss practicing before Judge Hagan, we wish him health and happiness in his retirement.

Meanwhile, since the cases keep coming, no matter who leaves, the Judge Manager position must be filled.  We are also pleased to let everyone know that the new Judge Manager for the Southeastern District will be The Honorable Holly San Angelo.  From practicing in front of Judge San Angelo for several years, we are sure that she will do a terrific job in this role.  This will be effective as of March 16, 2018.  For reference, the Southeastern District includes the workers’ compensation hearing offices in Philadelphia and Upper Darby.

Whether an employee hurt during the commute to work is covered by the Pennsylvania Workers’ Compensation Act (Act) is always a difficult analysis, and one we often encounter here.  Each case depends on the specific facts involved. While most employees (those who are “stationary” employees) are not covered for the commute to work, one reaches a point in the commute when the employee is no longer still commuting, but has, for the purposes of the law, arrived at work.  “Parking lot” cases are frequently an aspect of this situation.

Recently, the Commonwealth Court of Pennsylvania made a decision in the matter of  US Airways, Inc. v. Workers’ Compensation Appeal Board (Bockelman).  This was one of those “parking lot” cases.  Here, the employee (Claimant) labored for US Airways as a Philadelphia-based flight attendant.  Employees were not required to drive to work, but, if they did so, there were two designated employee parking lots.  These lots were owned, operated, and maintained by the City of Philadelphia/Division of Aviation (DOA), for the use of all airport employees, not just those of US Airways.  An employee identification badge was required to park in these lots.  A shuttle bus, operated by DOA (and not US Airways) then took the employee from the lots to the airport terminal.  Claimant hurt her left foot when she slipped while riding this shuttle bus after parking her car.

As could be expected, the Employer denied that Claimant was entitled to workers’ compensation benefits, since her injury was sustained while on the commute to work.   A Claim Petition was filed.  After considering the evidence, the Workers’ Compensation Judge (WCJ) found that Claimant was within the scope and course of her employment at the time of the injury, and granted the Claim Petition.  This was affirmed by the Workers’ Compensation Appeal Board (WCAB).

We have often discussed the importance of winning a case before the Workers’ Compensation Judge (WCJ).  This is because the WCJ is the “ultimate finder of fact.”  Determinations of credibility made by a WCJ cannot be challenged on appeal.  Indeed, appellate courts can only change the decision of a WCJ if there has been an “error of law.”  Given this great power held by the WCJ, it is critical that an injured worker’s case be litigated as well as possible before the WCJ.

We say this to point out that it really does matter what PA workers’ comp attorney an injured worker selects.  Certainly, one can simply search on the internet and find many attorneys from which to choose.  But, therein lies the difficulty – how should an injured worker in Pennsylvania choose his or her workers’ compensation attorney?

To try to bring some common sense to this situation, we have added a page to our website, intended to help an injured worker make this important selection.  Obviously, we would like an injured worker to call us, but whether you do or not, these are some things an injured worker can consider when making this important decision.

We have lamented the severe and draconian limits on the ability to challenge Utilization Reviews (URs) on this blog before.  We have seen a case where a healthcare provider sent a treatment summary and talked with the reviewer, and a case where records were actually submitted by the provider, but then returned by the reviewer due to a missing verification, both of which were deemed unreachable by appeal (finding that the Workers Compensation Judge (WCJ) lacked jurisdiction due to the failure to supply records).

Considering that UR is the process to limit medical treatment to an injured worker, and that the Supreme Court of Pennsylvania just told us, in Parker v. Workers’ Compensation Appeal Board (County of Allegheny), “we observe that the Workers’ Compensation Act is to be liberally construed in favor of workers in order to effectuate its remedial purpose,” these cases are hard to rationalize.  And, with this latest contribution from the Commonwealth Court of Pennsylvania, even more disappointing.

As noted above, the case law, and regulations, have told us that when a healthcare provider fails to provide records, no report is to be prepared by the Utilization Reviewer, and no challenge can be made from the Utilization Review to a Workers’ Compensation Judge (WCJ).  In fact, the Utilization Review Determination Face Sheet has a specific box to be checked for when no Determination can be issued due to the failure to supply records.

Pennsylvania’s legislators try their best to represent their constituents; I believe this is true the vast majority of times.  But, there are certainly times when the results of their actions are very difficult to reconcile with the best interests of those they have sworn to protect.

Currently pending in the PA legislature is House Bill 18/Senate Bill 936.  If passed, this legislation would completely change how an injured worker in Pennsylvania can receive medications.  A “drug formulary” would be set up.  This means that no longer would a patient be treated based on the individual needs of the patient, and the individual judgement of his or her doctor.  Nope.  Instead, decisions would be based on “evidence-based medicine.”  That means that what medications would generally be prescribed for a given condition, for the period generally prescribed, would be all that an injured worker in PA could receive.

Therefore, the individual judgment of the doctor is totally irrelevant.  The needs of the patient?  Not a factor.  This is an absurd system, since medicine is not an exact science.  Indeed, any physician will openly admit that not every patient will react to every condition in the same way.  Some heal faster than others.  Not every patient has exactly the same symptoms or limitations, even from the same condition.

Several years ago, we were excited to tell everyone about the Supreme Court of Pennsylvania decision in Phoenixville Hospital v. Workers’ Compensation Appeal Board (Shoap).  It was this case that made clear workers’ compensation insurance carriers in PA could not simply use a classified “help wanted” ad to reduce every injured worker’s benefits.

If a workers’ compensation insurance carrier in Pennsylvania wants to reduce the benefits of an injured worker, said the Court, the jobs shown must not only be open at the time they are found, the potential jobs in a Labor Market Survey (LMS) or Earning Power Assessment (EPA) should “remain open until such time as the claimant is afforded a reasonable opportunity to apply for them.”  The reasoning behind this, of course, is that an LMS/EPA is not just a tool to cut the benefits of injured workers; it should be a device to assist an injured worker back to gainful employment.

The Commonwealth Court of Pennsylvania recently had to address exactly what a workers’ compensation insurance carrier needs to prove in this regard.  In Smith v. Workers’ Compensation Appeal Board (Supervalu Holdings PA, LLC), the injured worker (Claimant) hurt his neck and back.  At the time he was injured, he was earning an “Average Weekly Wage” (AWW; the calculation we do under the PA Workers’ Compensation Act to see the amount of benefits due to the injured worker) of $992.50.  The injury was accepted by the insurance carrier as a cervical strain and sprain (making eventual fusion surgery required due to the work injury a curious fit to that modest diagnosis).

Among the benefits available under the Pennsylvania Workers’ Compensation Act (Act), are “fatal claim” benefits.  Since these are only relevant for work accidents which involve the death of a worker, these are not things we like to often see.  Unfortunately, sometimes these things do happen, and they are cases which need attention.

In addition to modest “burial expenses,” fatal claim benefits also include benefits for any surviving minor children, and, potentially, a spouse (among other categories of possible recipients beyond this topic).  We say “potentially” since benefits to a spouse are not automatic.

Recently, the Commonwealth Court of Pennsylvania dealt with this issue in Grimm v. Workers’ Compensation Appeal Board (Federal Express Corporation).  Here, the worker who died (Decedent) was employed by Federal Express.  She suffered a fatal heart attack while delivering packages in her normal course of work.

As we have previously mentioned, the Pennsylvania Bureau of Workers’ Compensation rarely provides official or formal notice regarding the addition or subtraction of Workers’ Compensation Judges (WCJs) in the Commonwealth.  As usual, it is up to us to point out these changes, from our contact with other attorneys, and from our appearances in the many workers’ compensation hearing offices across PA.

Along these lines, we announce, with mixed feelings, the retirement of The Honorable Paul Baker.  Over his illustrious career, Judge Baker has presided over cases in Philadelphia, Pottsville and Harrisburg (at least these are the courts where we have appeared before him over the years).  Judge Baker was always known for his thoughtful and thorough handling of his cases, and we will miss his intelligence and compassion from the bench.  On the other hand, we are thrilled for him personally, in that he can step away from the bench, and enjoy his retirement.

Please join us in congratulating Judge Baker on a wonderful career as a jurist, and wishing him well in his retirement!

Sometimes odd facts in a Pennsylvania workers’ compensation case make for an odd decision.  Yet, even then, we can often find something of use in that decision.  Seeing how appellate courts approach different situations helps us understand how that may translate to other fact patterns and enable us to better represent injured workers in PA.

Recently, the Commonwealth Court of Pennsylvania issued a decision in Dorvilus v. Workers’ Compensation Appeal Board (Cardone Industries).  Here, the injured worker hurt his low back in 2009.  A Claim Petition was filed, and a Workers’ Compensation Judge (WCJ) granted the Petition, awarding both disability and medical benefits.

On appeal, the Workers’ Compensation Appeal Board (WCAB) reversed the decision of the WCJ as to the award of disability benefits (though the injured worker received disability payments until this reversal in 2013).  Though the injured worker did prove that a work injury took place, said the WCAB, he failed to prove that he was “disabled” as a result of that injury.  This was affirmed by the Commonwealth Court of Pennsylvania (not the decision we are discussing here).  Though requested, an appeal to the Supreme Court of Pennsylvania was not accepted (unlike the WCAB and Commonwealth Court of PA, the Supreme Court of PA has the discretion to accept or decline an appeal).

What is “medical treatment”?  Though most folks know that medical treatment for a work injury is covered under the Pennsylvania Workers’ Compensation Act (Act), even the courts seem confused as to what constitutes “medical treatment.”  In some ways, this issue was recently clarified by the Commonwealth Court of Pennsylvania.

In Schriver v. Workers’ Compensation Appeal Board (Commonwealth of Pennsylvania, Department of Transportation), the injured worker suffered an injury to his low back.  For relief, the injured worker began treating with a chiropractor.  The chiropractor, in turn, referred the injured worker to a massage therapist in his office.  When presented with bills for the massage therapy, the workers’ compensation insurance carrier refused payment, denying that “massage therapy” falls under the category of “medical treatment.”

The injured worker filed a Petition for Review of Medical Treatment/Billing, and a Petition for Penalties.  After hearing the evidence, the Workers’ Compensation Judge (WCJ) granted both Petitions and ordered payment of the massage therapy bills, in addition to penalties.

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