Significant Pennsylvania Case Summaries
CLAIMANT DENIED BENEFITS FOR AN AGGRAVATION
OF A WORK-RELATED INJURY WHERE CLAIMANT FAILED TO PROVE
SHE PROVIDED TIMELY NOTICE OF THE AGGRAVATION TO HER EMPLOYER
In Matthews v. W.C.A.B. (Elwyn Institute), No. 1413 C.D. 2008 (Pa. Cmwlth. March 12, 2009), the claimant filed a claim petition alleging she sustained a work-related injury to her left knee on 1/16/2003 when she was kicked by a resident of the residential facility where she worked. Claimant had outpatient surgery on her left knee in April 2003 and on September 9, 2003 she was involved in an automobile accident while on her way to physical therapy for her knee. Claimant suffered a strain to her left knee, an injury to her back and a pulmonary embolus as result of the automobile accident. The WCJ granted the claim petition for a closed period and determined that the September 2003 automobile accident was not related to the work injury. Both parties appealed. The WCAB vacated, in part, the Decision of the WCJ and stated that if claimant’s automobile accident occurred while she was en route to treatment for the work injury, injuries she sustained in the accident would be compensable so long as she met the necessary burdens. The matter was remanded to the WCJ and no new evidence was admitted. The WCJ concluded on remand that the work injury should be expanded to include the re-injury to the left knee, back injury and the pulmonary embolus, all sustained during the automobile accident. He found claimant totally disabled and awarded ongoing total disability payments. This matter was appealed up to the Commonwealth Court by the employer.
An aggravation of a pre-existing condition is deemed a new injury for the purposes of the Act. Therefore, the claimant has the burden of proving each and every element to support an award of compensation. Notice is one of the essential elements that the claimant must prove. If notice of the work injury is not given to the employer within 120 days of its occurrence, the claim for compensation must be denied. The Commonwealth Court held that in this case the claimant was required to present evidence that she notified the employer of her automobile accident within 120 days of the accident. This notice must include that the claimant was injured “in the course of his employment on or about a specified time, at or near a place specified“ and this information must be communicated “to the employer, or any agent of the employer regularly employed at the place of employment of the injured employee.” Section 313 of the Act. Since the claimant did not provide 120 day notice to the employer that she suffered a work injury on September 9, 2003 during her automobile accident, the Commonwealth Court denied her benefits for the injuries suffered in that accident.
Any questions regarding this case can be directed to Carrie E. Smyth at (717) 441-7068 or csmyth@tthlaw.com.
COMMONWEALTH COURT DENIES CLAIMANT BENEFITS WHERE THE WAGE LOSS IS A RESULT OF PRE-INJURY MISCONDUCT (DISCOVERED POST-INJURY)
AND NOT THE WORK INJURY
In Reyes v. W.C.A.B. (AMTEC), No. 643 C.D. 2008 (Pa. Cmwlth. March 16, 2009), the claimant was involved in a work related motor vehicle accident. The employer disputed the extent of disability and claimant’s assertion that his loss of earning power was caused by the accident. In support of its defense, the employer presented the testimony of S. Ross Noble, M.D. who had performed an IME. Dr. Noble opined that claimant may have sustained a soft tissue injury at the time of the accident but he was fully recovered at the time of the IME. Also, Dr. Noble opined the claimant was never fully disabled from his work injury and could have been working at all points in time. The employer also presented testimony from the claimant’s supervisor who testified that he discovered claimant had submitted false paperwork claiming he performed cable disconnects on the day before the accident that he had in fact, not performed. This infraction required that claimant be terminated. The supervisor only learned of the false billing on April 29, 2006, three days after the work injury and that was the date claimant was terminated. The employer testified that but for the claimant’s misconduct, the company would have accommodated any limitations claimant had as a result of the work injury.
Claimant appealed the Decisions of the WCJ and the WCAB who affirmed the trial judge’s decision to deny indemnity benefits. The Commonwealth Court also affirmed and denied claimant disability benefits because it was determined that the claimant’s disability/wage loss related to his termination for cause and not the work injury. In addition, claimant was denied litigation costs because he failed to prevail on the issues in controversy. The Court agreed with the WCJ’s rationale and held that the employer was not required to show job availability where the claimant was terminated for pre-injury conduct that was discovered post-injury. The Court found that although the misconduct occurred before the work injury, the employer learned of the misconduct three days after the work injury and therefore, the employer only needed to show that it would have attempted to accommodate any work restrictions imposed as a result of the work injury. There was no requirement to show job availability. The Court also determined that the claimant did not prevail on the contested issued in the case (nature of injury and extent of disability) and therefore, he was not entitled to his litigation costs.
Any questions regarding this case can be directed to Carrie E. Smyth at (717) 441-7068 or csmyth@tthlaw.com.