NWCDN Members regularly post articles and summary judgements in workers’ compensations law in your state.
Select a state from the dropdown menu below to scroll through the state specific archives for updates and opinions on various workers’ compensation laws in your state.
Contact information for NWCDN members is also located on the state specific links in the event you have additional questions or your company is seeking a workers’ compensation lawyer in your state.
BEING SPECIFIC ABOUT SPECIFIC LOSSES
By Jeffrey D. Snyder, Esquire
In Jacqueline Fields v. WCAB (City of Philadelphia), decided by the Pennsylvania Commonwealth Court on November 14, 2014, the Court addressed the issue of whether benefits payable for an injured employee sustaining multiple specific losses, arising from the same injury, should be paid consecutively, as opposed to being paid concurrently under the Pennsylvania Workers’ Compensation Act.
In Fields, the Pennsylvania Commonwealth Court ruled that the benefits should be paid consecutively, regardless of whether that meant that the benefits due and owing might not be completely paid within the injured employee’s life expectancy.
This case arose as a result of the injured employee sustaining injuries to her left shoulder, arm, wrist, and hand, while restraining an inmate, in the course of working as a prison guard for the City of Philadelphia in January of 2013.
In December of 2013, she was awarded workers’ compensation benefits, in the form of temporary total disability benefits, by the Workers’ Compensation Judge.
Three years later, a different Workers’ Compensation Judge granted the injured employee’s Review Petition, adding additional descriptions of injury to the injury nexus for the injured employee’s 2003 injury, including adding a partial tear of the left rotator cuff, a left brachial plexus traction injury, and reflex sympathetic dystrophy of the injured employee’s left upper extremity.
Yet another Workers’ Compensation Judge then granted the injured employee’s Claim Petition in 2008, awarding the injured employee 410 weeks of specific loss benefits for the specific loss of her left arm, finding that the specific loss benefits were payable as of the injured employee’s injury becoming a complete loss of use for all practical intents and purposes in August of 2006.
In addition, a 20 week healing period was also awarded to the injured employee.
The Workers’ Compensation Judge also ordered that the injured employee’s temporary total disability benefits would continue, as the injured employee was totally disabled, and the specific loss benefits would then be payable after total disability benefits concluded.
The injured employee then filed a second Claim Petition, alleging a specific loss of her right lower extremity and right foot, later amending the petition to include a specific loss of her left leg.
In 2009, yet another Workers’ Compensation Judge found that the injured employee’s work injuries had resolved into specific losses of her left arm, and both legs. Doing so, the Workers’ Compensation Judge granted the Review Petition, awarding 410 weeks of specific loss benefits to the right leg, 410 weeks of specific loss benefits for the left leg, and a 25 week healing period.
The 2009 Decision also resulted in the employer, the City of Philadelphia, being entitled to a credit for weekly temporary total disability benefits that had been paid through the date of the Judge’s 2009 Decision.
An Amended Decision was then issued by the Workers’ Compensation Judge, changing the dates relevant for the interest that would be payable on the various awards of specific loss benefits.
The 2009 Decision was appealed, with the Appeal Board determining that the 2009 Decision incorrectly awarded interest to commence on different dates for each specific loss, with the Appeal Board modifying the Judge’s Decision, to reflect an accrual date, for interest purposes, for all three awards.
The Appeal Board held that the date of accrual for interest was when the evidence proved that the injured employee’s disability injuries had resolved into specific losses, with specific loss benefits then being payable, as temporary total disability benefits ended.
The Appeal Board’s Decision was then affirmed by the Commonwealth Court in the firstFields Decision, issued in 2012.
In 2010, the injured employee filed a Petition to Review Medical Treatment, alleging that she required a personal care attendant, as well as modifications to her home and vehicle, also filing a Penalty Petition, alleging that the employer had violated the Act, by unilaterally reducing her compensation benefits.
In 2011, the Workers’ Compensation Judge concluded that the injured employee had met her burden of proof in support of her Review Medical Petition, without entering a specific award for the costs of the vehicle modifications, and home care services sought, since the injured employee did not present evidence of any modification estimates or service invoices.
The Penalty Petition was denied, on grounds that the Workers’ Compensation Judge found that the employer did not violate the Act.
The Workers’ Compensation Judge also concluded that, based upon the injured employee having multiple specific losses arising from the same injury, that the injured employee could elect to be paid specific loss benefits, rather than indemnity or temporary total disability benefits, but that the injured employee could not receive concurrent multiple awards of specific loss benefits.
This Decision was then appealed by both parties, with the Board disagreeing with the Judge’s determination as to how benefit payments should be made to the injured employee under the Act. The Board also determined that the injured employee’s specific loss benefits should be paid consecutively, as opposed to concurrently.
Holding that the plain language of Section 306(c)(21) of the Pennsylvania Workers’ Compensation Act dictated that the employer should pay the injured employee specific loss benefits consecutively, the Commonwealth Court concluded, as the employer suggested, that the injured employee was attempting to back-door her specific loss benefits as though the same were being commuted, effectively accelerating the payment of benefits, although there was not a commutation petition before the Court.
Consequently, the Commonwealth Court determined, that an injured employee claiming bilateral specific losses, who chooses to receive the specific loss benefits rather than total disability benefits, mandates that the specific loss benefits should then be paid “in the same manner as the legislature intended other multiple specific losses, … which is consecutively”.
Holding that the injured employee’s disabilities resulted from a single occurrence, the Commonwealth Court ordered that the injured employee’s multiple specific losses should be aggregated pursuant to Section 306(c) of the Act, requiring that the benefits be paid consecutively, and not concurrently.
What is the take away from this specific loss Decision?
Simply put, it is that the Commonwealth Court has now made a bright line line ruling on an issue that rarely arises, being that an employer’s obligation to pay specific loss benefits, for multiple specific losses arising out of the same injury, requires consecutive and not concurrent payments, with an injured employee not being permitted to attempt to accelerate payments, in the absence of the benefits being commuted.
Trust us, we just get it! It is trust well spent!
We defend Employers, Self-Insureds, Insurance Carriers, and Third Party Administrators in Workers’ Compensation matters throughout Pennsylvania. We have over 100 years of cumulative experience defending our clients against compensation-related liabilities, with no attorney in our firm having less than ten (10) years of specialized experience, empowering our Workers’ Compensation practice group attorneys to be more than mere claim denials, enabling us to create the factual and legal leverage to expeditiously resolve claims, in the course of limiting/reducing/extinguishing our clients’ liabilities under the Pennsylvania Workers’ Compensation Act.
Every member of our Workers’ Compensation practice group is AV rated. Our partnership with the NWCDN magnifies the lens for which our professional expertise imperiously demands that we always be dynamic and exacting advocates for our clients, navigating the frustrating and form-intensive minefield pervasive throughout Pennsylvania Workers’ Compensation practice and procedure.