Employer can pursue termination, suspension or modification of benefits as of a date prior to the issuance of a Notice of Compensation Payable.
The issue on appeal to the Commonwealth Court in this case was whether benefits can be terminated or suspended as of a date before a Notice of Compensation Payable is issued. The claimant was injured in a car accident on September 28, 1995, while working as a probation officer. He received treatment from a panel physician who determined that as of October 19, 1995, the claimant was fully recovered and capable of returning to his pre-injury job. However, because the claimant still complained of pain, the physician referred him for a second medical opinion. The second doctor agreed that the claimant was fully recovered. Thereafter, on November 7, 1995, the employer issued a Notice of Compensation Payable, noting the work injury and compensation rate, and stating that the claimant received salary in lieu of workers' compensation.
The employer then filed a petition asserting the claimant was fully recovered as of October 20, 1995, or alternatively, seeking suspension of benefits. The Workers' Compensation Judge granted the termination petition and dismissed the suspension petition as moot. After an appeal to the Appeal Board, a remand to the Workers' Compensation Judge and being affirmed by the Appeal Board, the Commonwealth Court first held that the employer was required to prove that the claimant's work-related disability had resolved sometime after the date the Notice of Compensation Payable was issued, based upon the decision in Beissel v. WCAB (John Wanamaker, Inc.), 465 A.2d 969 (Pa. 1983). The case was remanded to the Workers' Compensation Judge to rule on the suspension petition, but came back to the Commonwealth Court after the Judge suspended the claimant's benefits as of a date after the Notice of Compensation Payable. The court, on its second consideration of the issue, held that the employer's only burden in a termination petition is to prove that the claimant had fully recovered from the work injury described in the Notice of Compensation Payable, where the Notice did not state that the claimant remained disabled.
The claimant had argued that the statement from the decision in Beissel, that there must be a change in the claimant's condition "after the date of the … notice of compensation payable," precluded the termination of benefits on a date before the Notice of Compensation Payable. The court in City of Philadelphia found that this statement was taken out of context and that the principle in Beissel is only that an employer is bound by the contents of its own Notice of Compensation Payable and cannot seek to repudiate it after accepting liability. In this case, the employer did not seek to disavow the Notice; it sought to prove that the claimant had fully recovered from the injury on the Notice.
Case Law Alert - 1st Qtr 2012