PA Workers’ Comp Check is Only A “Conditional Payment,” So A “Stop Payment” Means Workers’ Compensation Was Not “Paid.”

Under Section 406.1 of the Pennsylvania Workers’ Compensation Act, an employer/insurance carrier has 21 days to investigate a workers’ compensation claim and issue appropriate documentation, either accepting (by Notice of Compensation Payable (NCP) or Agreement for Compensation) or denying (Notice of Denial (NCD)) the claim. If the employer/insurance carrier is unsure whether the claim is compensable, a Notice of Temporary Compensation Payable (TNCP) can be issued. This document can then be revoked, within 90 days, if the employer/insurance carrier wishes to deny the claim.

If an employer/insurance carrier wishes to revoke a TNCP, and deny liability, there are certain procedures which must be followed. If the procedures are not followed exactly, the TNCP can simply convert to an NCP (which cannot be revoked). One of the requirements is that a TNCP can only be revoked if the revocation is made within five days of the last workers’ compensation check.

Using magic powers which would be the envy of Merlin, the Commonwealth Court of Pennsylvania recently made this “requirement” disappear, allowing a TNCP to be revoked despite a clear violation of this provision. In Barrett v. Workers’ Compensation Appeal Board (Vision Quest National), the injured worker suffered a fractured ankle while doing her job. The workers’ comp insurance carrier issued a TNCP, along with the first check for workers’ compensation benefits.

Unbeknownst to the injured worker, the workers’ comp insurance carrier stopped payment on the check (the injured worker only learned of this when the bank notified her of the shortage in her account). Then, over a month after the TNCP was issued, and the check was sent, the TNCP was revoked and an NCD was issued.

The injured worker filed a Petition for Penalties, alleging that the workers’ comp insurance carrier violated the Pennsylvania Workers’ Compensation Act by stopping her payments. Since the TNCP was not revoked within five days of the check, the TNCP had converted into an NCP.

After litigating the matter, the Workers’ Compensation Judge (WCJ) denied the Petition for Penalties. This was affirmed by the Workers’ Compensation Appeal Board (WCAB), and then the Commonwealth Court of Pennsylvania. The Court found that a check for workers’ compensation benefits in PA is only a “conditional payment.” The payment is not truly accomplished, said the Court, until “payment of the monetary funds is actually received.” So, since the stop-payment was issued, and the check was never actually cashed, no payment to the injured worker was ever made. As such, the TNCP was revoked properly.

Aside from my obvious displeasure, that being that a workers’ compensation check now is just a fancy “IOU,” my bigger gripe is what was not addressed. The TNCP was in force for over a month before being revoked. The workers’ comp insurance carrier openly admitted that no payments were made in that time. How can there be no violation of the Act if payments were not made under an existing TNCP? At the worst, even accepting the Court’s reasoning, the Penalty should have been granted for the period during which the TNCP was in force.

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