Workers' Comp In-Cites
Welcome to the latest edition of Schaff & Young’s Workers’ Comp In-Cites. Designed to provide our clients with practical insight, Workers’ Comp In-Cites outlines recent developments in Pennsylvania workers’ compensation law and explains how those decisions impact our clients and their cases. Barbara Young, Michael Schaff and the other attorneys at Schaff & Young, P.C. are always available to discuss these cases – or any other questions or concerns you might have. Just give us a call at (215) 988-0090 or send an email to info@schaffyoung.com. We look forward to hearing from you.
New Evidence Required Before Termination & Modification Petitions
That is the ruling of the Pennsylvania Supreme Court in Lewis v. Workers’ Compensation Appeal Board (Giles & Ransome, Inc.), in which the Court held that in order to terminate benefits on the theory that a claimant’s disability has either ended or been reduced because of an improvement in physical ability, the petition must be based upon medical proof of a change in the claimant’s physical condition. Only then can a Workers’ Compensation Judge (WCJ) determine whether there is a change in a claimant’s disability status. When there have been prior petitions to modify or terminate, an employer must also demonstrate a change in physical condition since the last disability determination. Once an employer produces evidence of the requisite change in physical condition, it must still prove that all disability related to the injury has ceased or that the improvement in the employee’s physical condition has reduced his or her degree of disability.

May 2007 Edition
Volume 1
Number 5
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Do Not Request an IRE Before a Claimant Has Received 104 Weeks of Benefits
In Dowhower v. Workers’ Compensation Appeal Board (Capco Contractors), the Pennsylvania Supreme Court held that when an employer seeks to obtain an automatic reduction of a claimant’s benefits from total to partial, the employer’s insurer must request the employee’s attendance at an impairment rating examination (IRE) during the 60-day period subsequent to the expiration of the employee’s receipt of 104 weeks of total disability benefits.

Psychiatric Injuries & Abnormal Working Conditions – Still Very Hard to Prove
A prison nurse sought workers’ compensation benefits alleging that he suffered post-traumatic stress disorder as a result of numerous horrendous incidents involving inmates. Acknowledging the horrible conditions in which the claimant worked, the WCJ nonetheless denied the claim petition, finding that the claimant had not proven that (a) he was exposed to abnormal working conditions and (b) the events at work caused his injury. The Commonwealth Court agreed with the Workers’ Compensation Judge in Babich v. Workers’ Compensation Appeal Board (CPA Department of Corrections), concluding that the claimant had not established abnormal working conditions nor had he proven that the conditions he experienced caused his mental injury.

Dependency – It’s More Than Room and Board
Although a parent is not a per se partial dependent of a deceased child who contributes to the parent’s room and board, when the child pays for other expenses, including her mother’s car, her mother’s prescription medicines, and for certain entertainment that was ordinary to the parent’s lifestyle, the parent will be deemed a partial dependent entitled to workers’ compensation benefits. That is the ruling of the Commonwealth Court in Wyoming Valley Health Care Systems v. Workers’ Compensation Appeal Board (Kalwaytis).

Employer May Transfer its Liability & Subrogation Rights
An employer may transfer its liability and subrogation rights to a third party, according to the Commonwealth Court’s decision Risius v. Workers’ Compensation Appeal Board (Penn State University).

Utilization Reviewers Can Address Alternative Treatment Options
In Sweigart v. Workers’ Compensation Appeal Board (Burnham Corp.), the Commonwealth Court ruled that, although a utilization reviewer may not determine that treatment is unreasonable or unnecessary solely on the basis that the other courses of treatment exist, the doctor/reviewer is permitted to conclude that safer alternatives exist.