Commonwealth Court holds that claimant who was sole proprietor is required to provide notice of work-related injury to workers’ compensation insurance carrier within 120 days of occurrence of the injury.

In this case, the claimant was the owner of the employer and the sole employee. He sustained work injuries on September 28, 2015, while coming off a ladder, when he tripped over a shovel, fell backwards and landed on his head. The claimant sustained serious injuries to his neck and underwent immediate surgery, including an extensive fusion from C2 to T1. A Claim Petition for benefits was then filed by the claimant.

The workers’ compensation judge denied the Claim Petition, finding that the claimant failed to provide timely notice of his work injury to the insurer—within 120 days of the injury’s occurrence as required by Section 311 of the Act. The claimant appealed, and the Appeal Board reversed the judge’s decision finding that the claimant was his own employee, notice of the work injury was instantaneous and Section 311 of the Act did not require notice to be given to an insurer. The Board remanded the case to the judge for a decision on the Claim Petition. Subsequently, the judge reversed himself and granted the Claim Petition. 

The workers’ compensation insurer then appealed to the Board, arguing that the claimant failed to timely notify them of the work injury, thus violating the insurer’s due process rights and preventing them from conducting a timely investigation into the claim. The Board affirmed the judge, and the insurer appealed to the Commonwealth Court.

A. Judd Woytek and Audrey Copeland of our King of Prussia office argued this case on behalf of the insurer before the Commonwealth Court, which granted their appeal, reversing the decisions of the judge and the Board. According to the court, the claimant, as sole proprietor, was required to provide notice of his work injury to the insurer within 120 days based on his combined status as both the claimant and sole proprietor/owner/employer. The court pointed out that the claimant was the only employee of his own business and that his failure to report the injury to the insurance carrier for over a year after the incident would result in an absurdity and put the insurer at a disadvantage in investigating the claim. The court additionally noted that the definition of employer in Section 401 of the Act includes a “duly authorized agent, or his insurer, if such insurer has assumed the employer’s liability…” 

_{What’s Hot in Workers’ Comp, Vol. 28, No. 7, July 2024, is prepared by Marshall Dennehey to provide information on recent legal 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. We would be pleased to provide such legal assistance as you require on these and other subjects when called upon. ATTORNEY ADVERTISING pursuant to New York RPC 7.1 Copyright © 2024 Marshall Dennehey, all rights reserved. No part of this publication may be reprinted without the express written permission of our firm. For reprints or inquiries, or if you wish to be removed from this mailing list, contact tamontemuro@mdwcg.com.}