Pennsylvania Workers’ Compensation Lawyer Blog

Sometimes the dispute in the litigation of a Claim Petition in Pennsylvania is a medical one – whether the injury was caused by the work duties (often seen in a repetitive trauma case, like carpal tunnel syndrome, in a heart attack case, or when degenerative changes are aggravated by work). Other times, though the dispute is whether the injury took place within the “scope and course” of employment. Interestingly, though this is occasionally a threshold issue in a workers’ comp case in PA, the words “scope and course” do not even appear in the Pennsylvania Workers’ Compensation Act – the entire concept of “scope and course” is derived from decisions by the appellate courts in PA.

We have seen cases on this topic when an employee takes a “break” from his or her actual job duties. Another time the concept of scope and course becomes important is when the employee is injury in the employer’s parking lot, before or after his or her shift. Such a case was recently decided by the Commonwealth Court of Pennsylvania in Ace Wire Spring and Form Company v. Workers’ Compensation Appeal Board

(Walshesky).

Whether one was actually in the scope and course of his or her job at the time of a work injury is not an uncommon reason for litigation. This is an issue we have addressed on our blog in the past.

Recently, the Commonwealth Court of Pennsylvania tackled this issue in Wetzel v. Workers’ Compensation Appeal Board (Parkway Service Station). Here, the worker was a manager at a gas station. He had arrived early for his shift to go over a problem with the cash register. Once that issue was completed, the worker was stocking some shelves until his shift was actually started. During this time, a thief came in and attempted to grab money from the register. The worker chased the thief outside. When the thief got in his car, the worker drew a gun and ordered the thief to stop. Unfortunately, the thief elected to instead run over the worker with his car. The worker suffered very serious injuries, which led to his death several months later.

A Claim Petition was filed on behalf of the worker (not a Fatal Claim Petition, because the worker had no wife, children or eligible dependents). The workers’ comp insurance carrier defended the Claim Petition by alleging that carrying a gun was a violation of a positive work order, and also that the worker was no longer in the scope and course of his employment at the time he was injured. The Claim Petition was granted by the Workers’ Compensation Judge (WCJ), but this decision was reversed by the Workers’ Compensation Appeal Board (WCAB), which concluded that attempting to apprehend the thief was outside the scope and course of the job.

We have previously discussed Impairment Rating Evaluations (IREs) in our blog. An IRE is a tool the PA workers’ comp insurance carrier can use to start the clock ticking on the maximum 500 weeks of partial disability available to an injured worker. While an IRE can change the status of an injured worker, from total to partial disability, the amount of the compensation benefits is not changed. A threshold issue in an IRE is whether the injured worker has reached Maximum Medical Improvement (MMI); until this finding is made, an impairment rating cannot be determined.

Since whether the injured worker has reached MMI is a threshold issue for a workers’ comp insurance carrier litigating an IRE in PA, one would think there cannot be a successful IRE without such a finding. One might be wrong.

In Arvilla Oilfield Services, Inc. v. Workers’ Compensation Appeal Board (Carlson), the injured worker suffered a labral tear in his right hip, and also hurt his low back and right shoulder in the accident at work. There was surgery on the hip, followed by a total hip replacement. In addition to other litigation, the workers’ compensation insurance carrier filed a Petition for Modification to change the disability status of the injured worker, based on an IRE.

We previously discussed the decision in Keene v. Workers’ Compensation Appeal Board (Ogden Corp.). Here, the Commonwealth Court of Pennsylvania reversed the Workers’ Compensation Appeal Board (WCAB), which had reversed the Workers’ Compensation Judge (WCJ). Essentially, the Court had found that the workers’ comp insurance carrier had failed to prove the injured worker had “voluntarily removed herself from the labor market.”

Subsequently, after the Supreme Court of Pennsylvania decided the City of Pittsburgh v. Workers’ Compensation Appeal Board (Robinson) case in 2013, the Supreme Court vacated the decision of the Commonwealth Court in Keene, and remanded back to the Commonwealth Court to reconsider the decision in light of the Robinson case.

Upon remand, in a recent decision, the Commonwealth Court of Pennsylvania again reversed the WCAB, and again found the workers’ comp insurance carrier had failed to prove the injured worker had “voluntarily removed herself from the labor market.” This result is not surprising when one considers that the decision in Robinson also found that the injured worker had not “retired.” Indeed, it seems a bit odd that the Supreme Court even vacated the decision in Keene to begin with – the previous decision seemed perfectly consistent with Robinson anyway. Regardless, the result is again comforting to injured workers, as it is more difficult for a workers’ comp insurance carrier to stop benefits merely by alleging that an injured worker retired or voluntarily left the labor market.

You probably knew that almost any injury at work which takes place in PA can lead to benefits under the Pennsylvania Workers’ Compensation Act (other than those employees who work for the Federal Government, U.S. Military, or in the maritime or railroad industries). But, did you know that, under certain circumstances, one can receive PA workers’ comp benefits for an injury which takes place in a State other than Pennsylvania?

This is called “extraterritorial jurisdiction,” and can happen when one of three situations apply. Either the injured worker’s employment is “principally localized” in Pennsylvania, the injured worker is working under a contract of hire made in PA in

employment not principally localized in any state, or the injured worker is working under a contract of hire made PA in employment principally localized in another state whose

A frequent topic of blog entries here is the Uninsured Employers Guaranty Fund (UEGF), which steps in for an employer who (in direct violation of Pennsylvania law) fails to carry PA workers’ compensation insurance. There are many hoops through which an injured worker must jump successfully to obtain benefits from the UEGF.

The PA Workers’ Compensation Act was amended in 2007 to create the UEGF. Under this scheme, when an injured worker knows his or her employer does not have Pennsylvania workers’ comp insurance, he or she must first file a Notice of Claim against the UEGF, then file a Claim Petition against the UEGF. There are time limitations within this process which can derail an otherwise compensable claim, making this area very dangerous for the injured worker who does not have an attorney.

For example, under the Act, an injured worker has 45 days from when he or she “knows” that his or her employer failed to carry workers’ comp insurance. This time limit can be devastating to a case, as was the situation in Pennsylvania Uninsured Employers Guaranty Fund v. Workers’ Compensation Appeal Board (Lyle and Walt & Al’s Auto & Towing Service). Here, the injured worker, a mechanic, suffered a compression fracture of his thoracic spine while doing his job on July 14, 2008. The injured worker filed the Notice of Claim against the UEGF on October 7, 2008, a few days after receiving a letter from the PA Bureau of Workers’ Compensation, suggesting his employer may have not had insurance coverage.

In 1996, major changes were made to the Pennsylvania Workers’ Compensation Act. One of them was providing a credit to the workers’ compensation insurance carrier for unemployment compensation benefits, “old age” (their words, not ours!) Social Security benefits, and pension and severance benefits (to the extent funded by the employer directly responsible for the payment of the workers’ compensation benefits). We occasionally see litigation on when an offset can be taken, and in what amount.

A previous decision by the Commonwealth Court of Pennsylvania in 2007, called Maxim Crane Works v. Workers’ Compensation Appeal Board (Solano), denied a workers’ compensation insurance carrier a retroactive credit for Social Security retirement benefits. This was because the insurance carrier failed to send a form to the injured worker called “Employee’s Report of Benefits for Offsets.” By not sending this form to the injured worker every six months, the Court reasoned, the delay in knowing of the existence of the Social Security retirement benefits was the fault of the insurance carrier. An ongoing credit was permitted, but retroactive was not.

Recently, there was another issue with the application of a retroactive credit, this time regarding a pension plan. In City of Pittsburgh v. Workers’ Compensation Appeal Board (Wright), the injured worker was a firefighter who hurt his right knee fighting a blaze. When the knee did not heal, the injured worker filed for a disability pension from his employer, the City of Pittsburgh. Oddly, because the injured worker first received “Heart and Lung benefits” (a program for police, fire and related professions), the Notice of Compensation Payable was issued about two weeks AFTER the disability pension was requested.