Workers’ Compensation Judge in PA Must Issue “Reasoned Decision”

As we have discussed in the past, Workers’ Compensation Judges (WCJs) in PA have the ultimate say on which witnesses are credible and which are not. Upon appeal, these determinations cannot be challenged. Instead, appellate courts in Pennsylvania can only review whether there has been an error of law, or whether the WCJ made a “reasoned decision.”

What constitutes a “reasoned decision” is difficult to put into an exact definition (I am reminded of the old definition of pornography as stated by Supreme Court Justice, Potter Stewart, “I know it when I see it”). Generally, it appears a “reasoned decision” is one which provides enough information for an appellate review. While most arguments challenging whether a WCJ’s decision is a “reasoned” one fail, some do succeed.

Recently, the Commonwealth Court of Pennsylvania issued a decision in one of these cases, Cucchi v. Workers’ Compensation Appeal Board (Robert Cucchi Painting, Inc.). Here, the injured worker suffered severe trauma, including lumbar, thoracic, and rib fractures, lung pneumothorax, and liver lacerations. After some period of time, the injured worker settled the wage loss (called the “indemnity”) aspect of the case, but left the case open for medical treatment. As so often happens, the workers’ comp insurance carrier then challenged future treatment by filing for Utilization Review.

After litigating the Petition for Review of Utilization Review Determination before the WCJ, a decision was rendered finding the treatment not reasonable and necessary. In concluding this, the WCJ found the expert witness offered by the workers’ comp insurance carrier more credible than the treating healthcare professional. Specifically, the testimony of the treating physician was stated by the WCJ to be “not convincing.” No further detail for this conclusion was provided by the WCJ. The Workers’ Compensation Appeal Board (WCAB) affirmed this decision on appeal.

The Commonwealth Court of Pennsylvania, however, reversed. The Court concluded that the WCJ “failed to adequately explain the reasons for his credibility determinations.” Though the WCJ is the ultimate determiner of credibility, there must be sufficient basis for a finding of credibility. Simply stating that an opinion was “not convincing” did not provide the Court enough information to determine whether there was a sufficient basis for this finding.

While we applaud this decision by the Court, and like to know why a WCJ did or did not find a witness credible, in this situation, the injured worker may have won the battle but may yet lose the war. The Court remanded back to the WCJ to explain the reasons for the determinations of credibility. The WCJ may very well provide sufficient explanation such that the injured worker will still lose the Petition for Review of Utilization Review Determination. But, at least the injured worker here can continue his fight.