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.
EMT Workers Entitled to Receive Wage Loss Benefits Regardless of Actual Earnings
In, Borough of Heidelberg v. Workers’ Compensation Appeal Board (Selva), the Pennsylvania Supreme Court has ruled that there is an irrrebuttable presumption that the wages of a member of a volunteer ambulance corps – injured while actively engaged as an EMT – are at least equal to the statewide average weekly wage, pursuant to Section 601 of the Workers’ Compensation Act, 77 P.S. § 1031, regardless of their time of injury earnings status.

September 2007 Edition
Volume 1
Number 9
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No Supersedeas Fund Reimbursement if C&R Granted Before Termination Petition
Timing is everything. If you intend to seek reimbursement from the Supersedeas Fund, then do not enter into and have a C&R approved before a Workers’ Compensation Judge rules on a termination petition. That is how the Commonwealth Court ruled in Commonwealth, Dept. of Labor & Industry v. Workers’ Compensation Appeal Board (US Food Service). In this case, the Court held that an employer is not entitled to reimbursement from the Supersedeas Fund when it enters into a Compromise & Release Agreement fully resolving all aspects of the claim prior to the granting of the Termination Petition.

Timing of Medical Bill Submissions
When an insurer makes payment of a medical bill under the Workers’ Compensation Act, and only the amount to be paid is in dispute, the medical provider is required to file the petition for fee review within the time limits specified in Section 306(f.1)(5) of the Act, 77 P.S. § 531(5). So ruled the Commonwealth Court in Hospital of the University of Pennsylvania v. Workers’ Compensation Appeal Board (Tyson Shared Services, Inc.).

Only Licensed Medical Providers are Entitled to Payment for Services Rendered
In Boleratz v. Workers’ Compensation Appeal Board (Airgas, Inc.), the Commonwealth Court held that an employer is not responsible for paying bills for prescribed medical treatment rendered by an individual who is not a licensed health care provider. In this, the provider was a massage therapist.

Recoupment of Overpayment Available Only In Limited Circumstances
According to the Commonwealth Court in Dollar Tree Stores, Inc. v. Workers’ Compensation Appeal Board (Reichert), an employer may not recoup an overpayment of workers’ compensation benefits from an employer solely based on the doctrine of unjust enrichment. Rather, an employer is entitled to a recoupment under Section 413(a) of the Act only to correct errors in existing agreements.

No Offsets Unless an Employer Affirmatively Notifies a Claimant of the Obligation
Under Section 204 of the Act and 34 Pa. Code § 123.501, an employer must notify an injured worker of the obligation to notify the employer of the receipt of old age Social Security benefits. Only after an employer provides the required notice is an employer entitled to an offset to the claimant’s workers’ compensation benefits. When an employer fails to exercise due diligence in seeking the offset, and there is prejudice to the claimant, the doctrine of laches precludes the employer from recouping the offsetable benefits, according to the Commonwealth Court in Maxim Crane Works v. Workers’ Compensation Appeal Board (Solano).

No Pension Offsets When Employer Provides Incorrect Information
In Gadonas v. Workers’ Compensation Appeal Board (Boeing Defense & Space Group), the Commonwealth Court held that, pursuant to 34 Pa. Code § 123, “Pension benefits which are rolled over into an IRA or other similarly restricted account may not offset workers’ compensation benefits, so long as the employe does not withdraw or otherwise utilize the pension benefits from the restricted account while simultaneously receiving workers’ compensation benefits from the liable employer.” Further, an Employer is estopped from disputing that pension payments received should be treated as a rollover when the evidence establishes that Claimant relied on a benefits administrator’s assurance that the disability pension would not affect the workers’ compensation benefits.

No Limits On When An Employer May Seek A Vocational Review
An Employer may require a Claimant to submit to a vocational interview without the need for and before filing a petition to modify benefits, according to the Commonwealth Court in Vaneman v. Workers’ Compensation Appeal Board (Apollo Moving). Rather, a request for a vocational interview may occur even if the claimant has returned to work at a modified wage and concurrently receives partial disability benefits.