**Update – On April 4, 2011, The Supreme Court of Pennsylvania accepted appeal in the Robinson case. Therefore, what we have written here about the status of the law in Pennsylvania may change. Stay tuned for more details!**

In this blog, we have addressed the consequences of “retirement,” as it affects PA workers’ compensation cases, on several occasions. As far as we could tell, taking a pension from an employer led to a finding that an injured worker had “retired,” triggering the draconian consequences of placing the Pennsylvania workers’ comp benefits in jeopardy. Specifically, we addressed the Hensal case, which seemed to suggest the act of simply taking a pension created a presumption that an injured worker had “retired,” or, in PA workers’ comp language, had voluntarily withdrawn from the labor market.

Recently, however, The Commonwealth Court of Pennsylvania issued a decision in City of Pittsburgh v. Workers’ Compensation Appeal Board (Robinson). While this decision may have made a complicated issue even more convoluted, it also sprinkled in a desperately needed dose of reality and compassion for the injured worker. In essence, this decision guided us on how to determine when an injured worker is “retired.”

When an injured worker in PA wants to settle his or her Pennsylvania workers’ compensation claim in exchange for a lump sum of money, the process generally used is the “Compromise & Release Agreement.” This type of workers’ comp settlement is voluntary between the parties. A Compromise & Release can only take place when agreed to by both the injured worker and the PA workers’ comp insurance carrier.

As we have noted in a previous blog entry, a Compromise & Release Agreement is not final until it is actually approved by a Workers’ Compensation Judge (WCJ). The law requires that a WCJ determine whether the injured worker understands and accepts the terms and conditions of the Compromise & Release Agreement. Until the approval of the WCJ is obtained, either party may back out of the Agreement.

The limits of this theory were recently tested before the Commonwealth Court of Pennsylvania in the case of McKenna v. Workers’ Compensation Appeal Board (SSM Industries, Inc. and Liberty Mutual Insurance Co.). In this case, the parties agreed to settlement terms at a mediation (a settlement conference with a WCJ, usually not the WCJ hearing the case). A Compromise & Release Agreement was signed by both parties.

As Pennsylvania Workers’ Compensation attorneys, we see a wide variety of conditions faced by injured workers, from broken arms and legs to Complex Regional Pain Syndrome and Brachial Plexopathy, and everything in between. While the conditions plaguing these injured workers vary widely, there is one constant we see in case after case – chronic pain.

All too often, we see an injured worker become addicted to prescription pain medication. Nobody wants to live in pain, and often the first thing doctors try to relieve symptoms is a pill of one type or another. Many times, as the injured worker recovers from the work injury, and the pain relents, the need for the pain medication disappears. Unfortunately, when the work injury does not get better, and the pain becomes chronic, prescription pain medication may no longer be a viable alternative.

According to a recent article on Medical News Today, there are options aside from pain medication to relieve symptoms. Advances are being made in “neurostimulators,” small devices which are implanted to help block pain impulses from reaching the brain. There is hope that these, and other advances, may lessen the need for giving medications to injured workers in chronic pain.

Under the Pennsylvania Workers’ Compensation Act, as that set of laws has been interpreted by Courts in Pennsylvania, there has been some confusion regarding when an injured worker can be reinstated to total disability workers’ compensation benefits. For example, an injured worker who returns to light duty work with the pre-injury employer, and is later laid off from the light duty job, is entitled to a reinstatement to total workers’ comp benefits. However, the question remained whether the same injured worker would lose this ability to obtain reinstatement if he or she leaves the pre-injury employer (like for a better or higher paying job).

This situation was faced squarely in Bufford v. Workers’ Compensation Appeal Board (North American Telecom), decided by the Supreme Court of Pennsylvania on August 17, 2010. In this case, the injured worker returned to light duty work with the pre-injury employer. He then left the pre-injury employer for a higher paying, less physical, job with another employer. A few years later, Mr. Bufford was laid off from the new employer.

The Workers’ Compensation Judge (WCJ) denied the Petition to Reinstate Benefits, finding that Mr. Bufford failed to prove there was a change (a worsening) in his condition, and his loss in earnings stemmed solely from economic reasons (rather than related to his disability). The WCJ even recognized the case would be different if the injured worker had remained at work with the pre-injury employer. On appeal, both the Workers’ Compensation Appeal Board (WCAB) and the Commonwealth Court of Pennsylvania affirmed the decision.

A work injury is covered by the Pennsylvania Workers’ Compensation Act when the injury takes place in PA. However, even when a work injury occurs outside Pennsylvania, there are times PA has “jurisdiction” to hear the case.

One of those situations when PA workers’ comp laws can apply to a work injury taking place in another State is when the injured worker’s employment is “principally localized” in PA. Recently, the Commonwealth Court of Pennsylvania addressed what “principally localized” means in John D. Williams v. Workers’ Compensation Appeal Board (POHL Transportation).

In this case, Mr. Williams, who lives in PA, was hired by a trucking company in Ohio. The trucking company had no offices or facilities in Pennsylvania. Mr. Williams’ mileage log showed that 38% of his mileage was within Pennsylvania, 32% was in Ohio and the remaining 30% was spread over 19 different States. The injury took place in Vermont.

Before Labor Market Surveys (LMS)/Earning Power Assessments (EPA), workers’ comp insurance carriers in PA used to actually have to prove a specific job was available to an injured worker in order to modify or suspend workers’ compensation benefits. This changed in the 1996 amendments to the Pennsylvania Workers’ Compensation Act, but any injured worker who was hurt before the amendments took place continues to fall under the “Old Act.”

In those cases, and even in LMS/EPA cases these days, the litigation starts with an Independent Medical Examination (IME), better, and more accurately, known as a “Defense Medical Examination.” Once some doctor releases the injured worker to some kind of work, the workers’ comp insurance carrier can start the vocational process (whether that be LMS/EPA, or the “Old Act” job referrals). But, when is a medical release too old, or stale, to be used?

In Verizon Pennsylvania, Inc. v. Workers’ Compensation Appeal Board (Guyders), the Commonwealth Court of Pennsylvania addressed this issue. This was an “Old Act” case, so the injured worker was sent on 73 job referrals (yes, you read that right, 73 – apparently, the workers’ comp insurance company does not know the meaning of the word “overkill.”)

A recent study published in the New England Journal of Medicine, reported by the Associated Press, found that amateur athletes (and by extension, victims of work injuries in PA), who have torn the anterior cruciate ligament (ACL) in their knee, actually do better by trying to rehab the knee before trying the surgical route.

According to the article, less than half of those in the study needed the ACL surgically repaired within two years. It appears the rehabilitation, alone, was enough in those cases.

“It seems that if you start out with rehabilitation only … you have a good chance of ending up with an equally good outcome as if you had early ACL surgery,” said Richard Frobell, of Lund University Hospital in Sweden, an author of the work.

In an earlier blog entry, we discussed the 2009 decision by the Supreme Court of Pennsylvania in Cinram Manufacturing v. Workers’ Compensation Appeal Board (Hill). This case discussed the procedure for amending a Notice of Compensation Payable (NCP).

The Court, in Cinram, decided that a “corrective amendment” (a condition which was present at the time of the injury and was erroneously left off the NCP) was to be treated differently than a “subsequently-arising” or “consequential” condition (a diagnosis not present at the time of the injury, but rather developed after the date of the injury). In the former, a Workers’ Compensation Judge (WCJ) can amend the NCP at any time any type of Petition is being litigated. On the other hand, in the latter, the injured worker must actually file a Petition to Review to achieve an amendment to the NCP.

An issue left open in Cinram was the appropriate “statute of limitations” in either of these situations. This issue has now been addressed, by the Commonwealth Court of Pennsylvania, in Fitzgibbons v. Workers’ Compensation Appeal Board (City of Philadelphia). In this decision, the Court found there to be no difference between the two situations for statute of limitations purposes.

Some time ago, we made a brief deviation from our normal course of not blogging about own active cases, to discuss a liquor store clerk who was robbed at gunpoint. The PA Liquor Control Board (LCB) denied the claim, stating that being robbed at gunpoint was not an “abnormal working condition” for a PA LCB clerk (remember that the next time you think of stepping into a State Store in Pennsylvania – armed robbery is simply accepted as a normal course of a day by management). We filed a Claim Petition on the clerk’s behalf and litigated the case.

We are pleased to report that the Workers’ Compensation Judge (WCJ) did not buy Defendant’s argument, and did not believe that society has degraded far enough such that a clerk can expect armed robbery on his or her normal day at work. In granting our Claim Petition, the WCJ rejected the Defendant’s attempt to expand the Commonwealth Court of Pennsylvania’s disastrous decision in of McLaurin v. Workers’ Compensation Appeal Board (SEPTA), wherein the Court, in its infinite wisdom, found that a SEPTA driver’s normal workday includes being assaulted by a gun-wielding teen (sending the message, as we understand it, that anyone foolish enough to step on a SEPTA vehicle can expect to face such consequences).

Undaunted, however, the PA LCB has filed an appeal with the Pennsylvania Workers’ Compensation Appeal Board (WCAB). It appears the PA LCB’s argument is that the WCJ was incorrect and Pennsylvania liquor stores are just as deadly as SEPTA vehicles (how very proud they must feel while making these arguments). We find it amazing, not to mention disheartening, that our own governmental agencies would be stooping to such disgraceful antics to deny a case. Rather than address what they clearly view as a “normal working condition,” perhaps by improving security methods, the PA LCB instead is trying to use its stubborn ignorance and incompetence as a basis to deny an injury to one of its own employees. How can one put any word other than “disgraceful” on that?

We are pleased to present a guest blog post from http://www.metropolitanmds.com regarding the use of acupuncture. We thought this may be of benefit to injured workers, who may be interested in exploring alternative areas for pain relief:

Acupuncture is one of the oldest forms of health care and treatments on the planet, but it still serves its purposes even today. Now, while inserting dozens of needles into your body doesn’t seem like the most fun way to treat ailments, acupuncture is a tried and true therapeutic practice that has helped people deal with pain for centuries.

By inserting needles into various pressure points around the body, physical pain and stress can be relieved and even treated using acupuncture. For most, it’s funny to think that sticking needles into the pain areas and pressure points of the body would be the answer, but when it comes to people who suffer from fibromyalgia and chronic fatigue syndrome, it might just be that.

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