When a party files a document in the world of Pennsylvania workers’ compensation, it means something. As with most areas of the law, parties are bound by what is filed. So, a recent decision by the Commonwealth Court of Pennsylvania, addressing an attempt by a workers’ comp insurance carrier to withdraw a Notice of Compensation Payable, is significant.
In City of Philadelphia and PMA Management Corp. v. John Bell (Workers’ Compensation Appeal Board), the injured worker was a firefighter for the City of Philadelphia who was diagnosed with colon cancer. Believing his cancer was caused by exposure to toxic fumes and compounds over his 17-year career, the injured worker reported this suspected work injury to his employer, as required under the law.
The City of Philadelphia investigated the allegation and then decided to deny the claim. However, an inexperienced adjuster accidentally caused a Medical-Only Notice of Compensation Payable (MONCP) to be issued, which accepted a work-related injury in the nature of colon cancer.
When the mistake was discovered by the City of Philadelphia, they filed a Review Petition, seeking to have the MONCP set aside. After litigating the matter before a Workers’ Compensation Judge (WCJ), the Review Petition was denied. The WCJ found that the issuance of the MONCP came about 90 days after the “work injury” was reported. Though the WCJ agreed that the City of Philadelphia intended to deny the claim, and only accepted in error, the WCJ was not willing to set aside the MONCP. According to the WCJ, the investigation of the claim was complete and the document was issued. Regardless of whether it was done by mistake, this is not something that can simply be undone.
On appeal, the Workers’ Compensation Appeal Board (WCAB) affirmed the decision of the WCJ. Since the injured worker did not provide any incorrect information (impacting the decision to accept or deny), and no new information was discovered during the investigation which would alter a decision whether to accept a claim, there was no proper basis for relief. Essentially, the mere fact the adjuster was inadequately trained is not sufficient to lead to such dramatic relief.
The Commonwealth Court of Pennsylvania then affirmed the decision as well. Distinguished were cases where an initial acceptance of a claim were then followed by the receipt of information indicating the claim was not actually compensable. That is not the case here. In this case, the investigation was complete and there was no subsequent information received.
Under the Pennsylvania Workers’ Compensation Act, explained the Court, a WCJ has the discretion such that he or she “may” set aside an incorrect MONCP. This WCJ elected not do so, based on the facts of the case. The Court determined that this basis was perfectly acceptable, and the decision of the WCJ must be affirmed.