PENNSYLVANIA WORKERS’ COMPENSATION
CASE SUMMARIES
02/1/2025 – 2/28/2025
CLAIMS ESTOPPEL – PAYMENT IN LIEU OF COMPENSATION
COVID EMERGENCY PAYMENTS
William Bolds v. City of Philadelphia (WCAB)
Commonwealth Court of Pennsylvania – Published Opinion
Decided: February 25, 2025
Issue:
Whether the payments to Claimant by the Employer were made in lieu of workers’ compensation and, thus, could be discontinued without implicating the Workers’ Compensation Act?
Background:
On April 13, 2022, Claimant filed reinstatement and penalty petitions. Each petition alleged that Employer unilaterally terminated benefits in January 2022 after accepting the claim for COVID-19 with the payment of wages in lieu of benefits as a matter of law. Employer designated Claimant’s time off work, beginning as “E-Time,” or “excused time,” and paid him full salary without depleting his sick or vacation time. Employer issued a notice of workers’ compensation denial. The WCJ found that Employer’s payments made to an employee under the E-Time designation did not constitute an acknowledgement the employee had contracted COVID-19 at work. Accordingly, the WCJ rejected Claimant’s assertion that he gave timely notice to Employer of his alleged work injury. The Board affirmed the WCJ.
Holding:
Any payment made under an established plan or policy of insurance for the payment of benefits on account of non-occupational illness or injury and which payment is identified as not being workmen’s compensation shall not be considered to be payment in lieu of workmen’s compensation, and such payment shall not toll the running of the Statute of Limitations. However, the Employer does have an obligation to render prompt payments under the Act, if warranted. An Employer may not profit by its delinquency in failing to carry out the mandates of the Act and is estopped to disavow acceptance of liability and be held bound by agreement to pay compensation with the same legal effect as would apply if it had formally complied with the Act. Here, an important distinction was that the Employer disputed that it ever made payments in lieu of compensation or accepted liability for Claimant’s alleged work injury. Employer’s objective was to pay all employees out of work due to COVID-19, regardless of cause, in order to protect other employees and citizens from exposure. While Claimant maintains that he notified Employer that his COVID-19 was work related, nothing in the record corroborated this assertion. The fact that Employer did not invoke Act 17 until 2022 does not support the inference that Employer’s E-Time payments were made in lieu of compensation. E-Time was not intended for work injuries but was undertaken pursuant to an emergency plan for non-occupational injury or illness categorized as non-workers’ compensation benefits. Payments on account of non-occupational illness shall not be considered payment in lieu of compensation.
Affirmed.
COMPROMISE AND RELEASES AGREEMENTS – PRECLUSIVE EFFECT
Darren Borrelli v. Interstate Gas Supply (WCAB)
Commonwealth Court of Pennsylvania – Unpublished Memorandum Opinion
Decided: February 24, 2025
Issue:
Whether the C&R Agreement should preclude expanding the description of the injuries and defeat a Termination?
Background:
Petitioner suffered work-related injuries when he slipped and fell on ice while working for Employer as a door-to-door salesman. Petitioner returned to work the following day. He received indemnity and medical benefits for his injuries. In 2021, Employer filed a termination petition, asserting that Petitioner had fully recovered from his head injury. Claimant also filed claim and review petitions, seeking clarification of the injuries. Claimant later amended these petitions to request approval of a C&R agreement with Employer, which resolved all issues related to the nature of his injuries and any further non-medical benefits. The termination was subsequently granted.
Holding:
Petitioner challenges the preclusive effect of the C&R Agreement. Clamiant initially filed claim and review petitions asserting injuries to his left knee but later amended them into a single petition seeking C&R agreement approval without reserving the right to litigate the left knee issues. This left only the termination petition, where the sole issue was whether Petitioner had recovered from the accepted soft tissue head injury, which the Claimant did not dispute. Because the C&R Agreement limits the scope of compensable injuries to the soft tissue head injury, and Petitioner does not contest his recovery from that injury, the termination petition was properly granted.
Affirmed.
SUSPENSION – VOLUNTARY REMOVAL FROM THE WORK FORCE
Ogden Corporation (Broadspire) v. WCAB (Keene)
Commonwealth Court of Pennsylvania – Unpublished Memorandum Opinion
Decided: February 27, 2025
Issues:
Whether the WCJ erred by denying the “voluntary removal” Suspension Petition?
Background:
In October 1989, Claimant sustained a work-related injury to her right knee. Employer issued a notice of compensation payable accepting the injury, described as a right knee sprain, as compensable. Claimant returned to work for Employer in a part-time, light-duty position until 2000, when Employer eliminated the position. Claimant had not returned to work and continued to receive total indemnity benefits at the rate of $161.03 per week. In 2007, Employer filed a prior petition to suspend benefits alleging that Claimant had voluntarily removed herself from the workforce. The court, at that time, found that the Employer did not meet its burden of proving that Claimant removed herself from the workforce. In 2015, Employer filed the current Suspension Petition again alleging that Claimant has voluntarily withdrawn from the workforce. The WCJ found that Claimant continued to have right knee pain and restrictions related to the work injury and that Claimant’s work-related injury continued to restrict her to modified work. The WCJ further found that Claimant did not consider herself retired, did not receive any retirement benefits, and continued to look for work within her restrictions. The WCJ concluded that Claimant had not voluntarily withdrawn from the workforce.
Holding:
There is no presumption of retirement arising from the fact that a claimant seeks or accepts a pension, much less a disability pension; rather, the worker’s acceptance of a pension entitles the employer only to a permissive inference that the claimant has retired. Such an inference, if drawn, is not on its own sufficient evidence to establish that the worker has retired—the inference must be considered in the context of the totality of the circumstances. The factfinder must also evaluate all the other relevant and credible evidence before concluding that the employer has carried its burden of proof. There was no dispute that Claimant was capable of performing modified-duty work, or that Claimant only applied for two positions. However, the WCJ’s findings are based on Claimant’s testimony, which the WCJ credited finding it both forthcoming and believable. An employer cannot rely solely on a claimant’s failure to seek work to prove voluntary retirement from the workforce, as an employer has a duty to make job referrals until a claimant voluntarily retires. Based on the totality of the circumstances, Employer did not meet its burden of proving that Claimant has retired or otherwise removed herself from the workforce. Affirmed.
PENNSYLVANIA LEGISLATIVE REVIEW
House Bill 183
Last week, the Commonwealth of Pennsylvania House Labor and Industry Committee passed what is now designated as HB 183. This Bill expands access to workers compensation disfigurement benefits by increasing the duration of eligibility from up to 275 weeks to a new level of up to 400 weeks, extending the benefit to the entire body, and not just to the head, face and neck, and allowing these benefits to be paid simultaneously with indemnity benefits. It is worthy of note that this bill was amended, just prior to passage in the Committee, to apply to injuries for which “permanent disfigurement was reached” after the effective date of the provision, whereas it was previously intended to only apply to injuries sustained on or after the effective date. The bill goes on to the House vote, and then moves on to Senate
NEW JERSEY LEGISLATIVE UPDATE
Assembly Bill 4750
Expands certain employer reporting requirements to include entities that employ or contract with individuals for financial compensation, including ridesharing and delivery technology platforms.
Last Action: January 14, 2025 – Received in the Senate, Referred to Senate Labor Committee
Assembly Bill 4371/S1943
Requires workers’ compensation, PIP, and health insurance coverage for the medical use of cannabis under certain circumstances.
Last Action: May 16, 2024 – Introduced, Referred to Assembly Financial Institutions and Insurance Committee
Assembly Bill 4283
Provides personal liability for owner, executive officer, or executive director of employer for failure to pay for workers’ compensation coverage.
Last Action: May 6, 2024 – Introduced, Referred to Assembly Labor Committee
Assembly Bill 4559
Concerns certain workers’ compensation supplemental benefits and funding method.
Last Action: June 13, 2024 – Introduced, Referred to Assembly Labor Committee
Assembly Bill 2100
Provides workers’ compensation benefits for certain public safety workers who developed illness or injury as result of responding to September 11, 2001 terrorist attacks.
Last Action: September 19, 2024 – Reported out of Asm. Comm. With Amendments, and referred to Assembly Public Safety and Preparedness Committee
Senate Bill 3772
Concerns valuation of board and lodging with respect to workers’ compensation.
Last Action: December 5, 2024 – Referred to Senate Budget and Appropriations Committee
Senate Bill 794
Concerns workers’ compensation insurance requirements for certain corporations and partnerships.
Last Action: December 5, 2024 – Reported from Senate Committee as a Substitute, 2nd Reading
