Last week, we were fortunate enough to be in attendance as the Bucks County Bar Association presented a seminar addressing the three separate branches of government, as a celebration of Law Day.  Listening to presentations from each of the branches provided fascinating insight to see how government works, from the eyes of those who were there.  Sometimes, since we are litigation attorneys focused so deeply on each case, we lose sight of the bigger picture.

From the Judicial Branch, we heard from The Honorable Robert O. Baldi, with the Bucks County Court of Common Pleas in Doylestown.  Former Governor of Pennsylvania Mark Schweiker told us about his perspective from the Executive Branch.  Finally, Michael G. Fitzpatrick Esq. relayed his experiences in the Legislative Branch during his eight years with the U.S. House of Representatives before he retired.

While the Pennsylvania workers’ compensation system has its own Workers’ Compensation Judges, and holds hearings (depending on the county) in locations other than a county courthouse, the system still is a product of the three branches of government.  When the PA Workers’ Compensation Act was initially enacted in 1915, and in every addition, revision or amendment since, the three branches of government were involved.  Indeed, just recently, the Executive Branch kept the Legislative Branch from harming injured workers across the entire State of Pennsylvania (When Gov. Wolf vetoed the incredibly flawed SB 936).

Recently, we discussed the status of Senate Bill 936, which was passed by the House.  We are pleased to relate that Governor Thomas Wolf has vetoed this legislation, recognizing that it was a thinly disguised attack on injured workers and not a solution to any problem.

As discussed in the Morning Call, Gov. Wolf said:

Make no mistake, Senate Bill 936 is not a bill designed to fight the opioid crisis. Senate Bill 936 threatens health care for millions of workers who could be injured on the job, including police, corrections officers, and firefighters, who put their lives on the line every day, and whose injuries can be unique, debilitating and severe. It is wrong to sacrifice health care for our first responders to protect the bottom-line for insurance companies and corporations.”

A critical stage of a workers’ compensation case in PA can happen if the injured worker is offered a job by his or her employer.  This may be the regular job, with or without modifications, or a different job entirely.  This is when an injured worker really needs to get representation by an attorney Certified as a Specialist in Workers’ Compensation Law (if he or she has not already done so – many injured workers do not realize that being represented by an attorney DOES NOT COST A DIME unless and until the case goes to court, or the case settles).

Whether (and how) to respond to the employer, and whether to go back and try the job, will always depend on the circumstances in each case.  Keep in mind that case law is not friendly to the injured workers in many areas of workers’ compensation law in PA, including this one.  For example, the modifications an employer would be willing to make to a job may not need to be stated in the job offer.

This time in a workers’ comp case is a critical one.  If the injured worker makes a rash decision, without the benefit of advice from an attorney Certified as a Specialist in Workers’ Compensation Law, the case may be irreparably damaged.  Since obtaining the services of an attorney will not cost anything, is there really a reason to handle these things without counsel?

Previously, we have warned of the pending legislation that will restrict the access of injured workers across the State of Pennsylvania to get medications they need.  Now, thanks to the House passing Senate Bill 936, the legislation heads to the Governor.  It is not bad enough that innocent people suffered injuries at work, now they have to deal with the reality that they will be treated different than patients who are not in the Pennsylvania workers’ compensation system.

As noted in an article on Pennlive.com, this legislation “was drawn up in response to reports in the Philadelphia Inquirer and Daily News about doctors and law firms specializing in worker’s compensation that were operating their own pharmacies.”  Perhaps someone would be kind enough to explain why the legislation did not simply prohibit the ownership of pharmacies by these groups?  Instead, this legislation does not even deal with this issue.  At all.  Rather, the legislation makes medications (all medications, not just the opioids that caused all of the supposed angst) more difficult for an injured worker in PA to obtain.

And, again we ask, is this fair?  Is this how our elected representatives protect us?  By making sure that we have difficulty getting medications if we are unlucky enough to be injured at work?  We urge all injured workers, those who care about injured workers and those who care about fairness and justice, to reach out to their legislators, and reach out to the Governor’s office, and let everyone know this will not be done without a fight!

On our blog, as you probably noticed, we like to share court opinions which are of interest to the injured worker in PA.  Typically, of course, these opinions deal with interpretations of the Pennsylvania Workers’ Compensation Act (Act).  Also, typically, these are opinions rendered by the Commonwealth Court of Pennsylvania.  Why that court?  And are all decisions of Commonwealth Court the same?  Glad you asked!

Once a Workers’ Compensation Judge (WCJ) renders a decision, the next level of appellate review is the Workers’ Compensation Appeal Board (WCAB).  This is a process we have discussed on this blog in the past.  Decisions rendered by the WCAB can be cited to WCJs, by attorneys, in future cases, but the WCAB opinions are only “persuasive” not “binding.”  This means that a WCJ need not follow a decision of the WCAB.  For this reason, we rarely devote a blog posting to a WCAB decision.

After the WCAB issues a decision, an appeal can be taken to the Commonwealth Court of Pennsylvania.  Like with the WCAB, an appeal to Commonwealth Court is a right, so the Commonwealth Court cannot decline an appeal.  The Commonwealth Court will then make a decision.  This is either “reported” or “unreported.”  These terms have their usual meaning – a “reported” decision is published in a law reporter; an “unpublished” one may not.  More importantly, as a practical matter, a “reported” decision can be cited in future cases (and is binding on both the WCJ and the WCAB).  While an “unreported” case can be cited in future cases, like a WCAB opinion, it is not binding on a WCJ (only persuasive).  Though they are far more plentiful, “unpublished” decisions are not typically made blog posts by us.  They simply are not as significant, since they need not be followed.  Note that an “unpublished” on “unreported” decision, upon motion of a party, could be changed to “published” or “reported.”

Previously on this blog, we have discussed the rights held by injured workers in Pennsylvania to choose their own medical providers.  This is only one area of confusion in the wacky world of medical benefits under the Pennsylvania Workers’ Compensation Act (Act).

A common complaint we get from an injured worker is that, “They are denying my medical treatment.”  In this situation, “they” is almost always the workers’ compensation insurance carrier.  And the word “denying” may or may not be accurate.

Under the Act, the workers’ comp insurance carrier has 30 days to either pay a medical bill or institute Utilization Review (the tool used to challenge whether medical treatment is reasonable or necessary), provided the bill is properly submitted by the medical provider (including supporting documentation).  As you can see, this means the workers’ compensation insurance company need not give an opinion on how they view treatment until it is actually performed.

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.