Claim Petition in PA Workers’ Comp Denied, Despite Notice of Denial Acknowledging a Work Injury

As discussed in previous blog entries, Commonwealth Court of Pennsylvania has held that a Notice of Denial (NCD) can be used to properly “accept” a work-related injury. This continues to disappoint, and confuse, at least some of us who spend our careers protecting the rights of the injured worker. Logically, how can one use a Notice of DENIAL to accept an injury, and, if that is the proper method to do so, why did the PA Bureau of Workers’ Compensation go to the trouble of creating the Medical-Only Notice of Compensation Payable (NCP)?

Recently, this concept was confirmed by the Commonwealth Court of PA in Morrison v. Workers’ Compensation Appeal Board (Rothman Institute). Here, an NCD was issued over a year after the work injury (as noted in a previous blog entry, a PA workers’ comp insurance carrier has 21 days to issue documentation accepting or denying a claim). On the NCD, Box 4 was checked, acknowledging that an injury took place, but disputing that the injured worker was disabled as a result of the injury.

The Workers’ Compensation Judge (WCJ) rejected the testimony of Claimant, and the evidence from Claimant’s medical experts, and denied the Claim Petition. On appeal, the Workers’ Compensation Appeal Board (WCAB) affirmed. The Commonwealth Court of Pennsylvania also affirmed.

As we have discussed here previously, a WCJ makes the final determination as to the credibility of witnesses. Here, the WCJ found Claimant and Claimant’s medical evidence not credible. Therefore, I have no real issue with the Claimant not being successful in proving disability. However, this NCD, which the PA workers’ compensation insurance carrier issued, acknowledged that an injury took place. As such, I find it inconceivable that the Claim Petition could be denied entirely. That an injury took place in the scope and course of employment was admitted by a document the insurance carrier filed with the Pennsylvania Bureau of Workers’ Compensation. In my view, the Claim Petition should have been granted, but the request for disability should have been denied. A matter of semantics, perhaps, but what happens three years and a day after the injury? The Statute of Limitations expires at that point. What is the status of the work injury then? Can the injured worker get medical treatment then? All good, and unanswered, questions.

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