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An employer is not entitled to Supersedeas Fund reimbursement of unilaterally withheld medical benefits that are retroactively paid pursuant to a judge’s order.

July 1, 2019
Erie Insurance Company and Powell Mechanical, Inc. v. WCAB (Commonwealth of Pennsylvania, Department of Labor and Industry, Bureau of Workers’ Compensation); 20 C.D. 2018; filed Feb. 21, 2019; by Judge Robson

The employer accepted liability for work injuries the claimant suffered in a vehicular accident but later learned he was intoxicated and had been charged with driving under the influence. The employer unilaterally stopped paying the claimant’s medical expenses and filed termination and review petitions and also requested Supersedeas.

The employer’s request for supersedeas was granted by a workers’ compensation judge, who later granted the employer’s petitions and set aside the Notice of Compensation Payable (NCP). The judge also granted a penalty petition filed by the claimant, finding that the employer violated the Act for unilaterally stopping payment of medical benefits, and ordered the employer to pay medical bills from the date the NCP was issued through the date of decision. The claimant and the employer appealed to the Workers’ Compensation Appeal Board, which affirmed. After the claimant’s appeal to the Commonwealth Court was dismissed, the employer filed an application for Supersedeas Fund reimbursement, which was granted by the workers’ compensation judge.

The Bureau of Workers’ Compensation appealed the judge’s decision with respect to reimbursement of medical expenses, and the Board reversed. The Board concluded the judge did not have the authority to grant supersedeas for medical expenses under the Act; therefore, his supersedeas order effectively denied supersedeas with respect to payment of medical bills. The Board also reasoned the employer’s payment of medical bills following the judge’s decision was only because they were ordered to do so by the judge.

In its appeal to the Commonwealth Court, the employer argued they were entitled to reimbursement for payment of medical expenses because the judge’s order granting supersedeas as to wage loss benefits impliedly denied the supersedeas request for payment of medical expenses. The Bureau countered by arguing the employer’s payment of medical expenses was prompted by the judge’s order granting the penalty petition, not by the prior denial of supersedeas. The Commonwealth Court dismissed the employer’s appeal and affirmed the Board. They concluded the employer unilaterally withheld payment of medical expenses in violation of the Act and were not entitled to reimbursement for those payments. According to the court, it was irrelevant that the employer subsequently prevailed on the termination petition because earlier violations of the Act may not be excused.

 

Case Law Alerts, 3rd Quarter, July 2019

Case Law Alerts is prepared by Marshall Dennehey Warner Coleman & Goggin to provide information on recent developments of interest to our readers. This publication is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. Copyright © 2019 Marshall Dennehey Warner Coleman & Goggin, all rights reserved. This article may not be reprinted without the express written permission of our firm.

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