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 We look forward to hearing from you.

Simultaneous Calculation of Pension Offset is Permissible

An employer may calculate a workers' compensation pension offset against benefits that are simultaneously received by an employee under Section 204 of the Workers' Compensation Act, 77 P.S. § 71, according to the Commonwealth Court in Horner v. Workers' Compensation Appeal Board (Liquor Control Board).

July 2011 Edition
Volume V
Number 7

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Notice of Available Work May Come From the Employer

In an Opinion that seems obvious, the Commonwealth Court in Vaughn v. Workers' Compensation Appeal Board (Carrara Steel Erectors) ruled that an employer's letter to a claimant contains sufficient notice of an available job within the claimant's capabilities when known restrictions are attached to the letter, the employer assures the claimant that the restrictions will be accommodated, and the claimant's past experience in the job acquaints him or her with its suitability.

Carrier May Change Provider’s Billing Codes

In Jaeger v. Bureau of Workers' Compensation Fee Review Hearing Office (American Casualty of Reading c/o CNA), the Commonwealth Court affirmed that an insurer may properly change billing codes to calculate a doctor's fee reimbursement for workers' compensation treatment if the insurer follows proper down-coding procedures. Proper procedures include (1) notifying the provider in writing with an explanation of the review and allowing ten days to respond, (2) giving the provider an opportunity to discuss and oppose the proposed changes, (3) having sufficient information to make the changes, and (4) maintaining consistency with Medicare guidelines. Copies of the dated ten-day written notice sent to the doctor and explanations of review combined with evidence demonstrating that the insurer's decision was based on sufficient information is enough to satisfy the insurer's burden for showing that it followed proper procedures.

No Reinstatement of Benefits Unless There is a Change in Condition

When a claimant settles all issues by stipulation in prior litigation, the claimant is bound by the agreement unless he or she can prove entitlement to a reinstatement of total disability benefits by showing "that something changed in his condition or circumstances" after the stipulation was adopted. That’s the ruling of the Commonwealth Court in Upper Darby Township v. Workers' Compensation Appeal Board (Nicastro).