Reinstatement of PA Workers’ Comp Benefits Proper With Change in Condition

Under PA workers’ comp, wage loss benefits are stopped (suspended) when an injured worker returns to work at no loss in wages (medical treatment continues, regardless of wage loss, however). What if the injured worker (“claimant”) voluntarily quits a job? Can he or she get reinstated to workers’ compensation benefits in PA? Well, it depends.

The Commonwealth Court of Pennsylvania faced this issue in Allen v. Workers’ Compensation Appeal Board (Delaware County SPCA, Inc.). Here, on August 24, 2007, the claimant injured his shoulder at work, but then subsequently returned to work, at his pre-injury job, at no loss in wages, causing the workers’ comp benefits to be suspended. The injured worker then voluntarily quit his job on January 3, 2008, because there was a “deterioration of the relationship” with the company, and he was having increased pain in his shoulder. On January 29, 2008, the injured worker saw a doctor who found that he was not physically capable of his pre-injury job as of that date.

A Workers’ Compensation Judge (WCJ) granted the Petition for Reinstatement, as of January 29, 2008, since the injured worker proved he had a change of condition as of that date. Upon appeal, the Workers’ Compensation Appeal Board (WCAB) reversed the WCJ, finding that claimant was not entitled to a reinstatement of his workers’ comp benefits, because he had voluntarily quit his job.

The Commonwealth Court of Pennsylvania reversed the WCAB, and reinstated the decision of the WCJ, saying that once claimant proved that his condition had changed, and that he was again disabled from his job, he was again entitled to PA workers’ compensation benefits. The fact the injured worker quit the job meant he was not entitled to benefits from January 8, 2008 to January 28, 2008 (since the reason he was not working in that time was not shown to be related to the work injury). Once the injured worker proved a change in his condition, the fact that he quit was no longer relevant.

One question, left unanswered by the Court, is what happens when the injured worker is again released to return to his pre-injury position? In a normal situation, the employer/workers’ comp insurance carrier must prove that a job is available to him before a suspension of benefits would be granted. Would the fact the claimant quit the job come back to haunt him then? I guess we will have to stay tuned.

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