In a claim petition where there is both a documented work injury—either by adjudication or acceptance—and that injury gives rise to disability, the proper burden of proof is that of a reinstatement petition.
The claimant sustained a work-related injury to his right knee. Thereafter, the employer issued a medical only Notice of Compensation Payable (NCP). The employer also agreed to continue paying the claimant's salary. The claimant returned to work on modified duty, and the employer continued paying full salary. The claimant then resigned, at which time the employer stopped paying his salary. The claimant filed a reinstatement petition, alleging his injury had worsened and that his earning power was affected.
The Workers’ Comepnsation Judge denied the reinstatement petition on the basis that the employer's issuance of the medical only NCP and its payment of the claimant's salary was a de facto NCP and that the claimant failed to meet his burden of proving his condition had worsened such that he could not perform a modified-duty job. The Appeal Board affirmed the Judge's decision on appeal. However, the Board disagreed with the finding that the medical only NCP was a de facto NCP. The claimant appealed to the Commonwealth Court.
The claimant first argued that the Judge improperly used the burden of proof for a claim petition rather than a reinstatement petition (in the underlying case, the claimant amended his reinstatement petition to a claim petition). The court held that the Judge did use the burden of proof for a reinstatement petition. According to the court, the employer's issuance of a medical only NCP, along with salary continuation to the claimant and evidence from the employer that the claimant was a valued employee whom they intended to transition back to work, established a de facto NCP. Therefore, the court concluded that the Judge properly found that the claimant failed to meet his burden of proof on a reinstatement petition. The court also rejected the claimant's argument that the de facto NCP obligated the employer to pay him workers' compensation benefits since the employer did not file a suspension petition after the claimant resigned from the employer. The court found that the Judge properly suspended the claimant's benefits without a formal petition since strictness of pleadings is not required in workers' compensation cases and because the Judge is empowered to take appropriate action based on the evidence presented.
Case Law Alerts, 3rd Quarter, July 2014