Eleazar Ortiz v. WCAB (Raoul Rodriguez & Uninsured Employers Guaranty Fund); 446 C.D. 2012; filed 1/15/13; by Judge Leavitt

In a petition to suspend the benefits of an unauthorized worker, the employer must show that the claimant is unauthorized and that the claimant is no longer totally disabled.

The claimant suffered an injury while working for the employer and brought a claim against the Pennsylvania Uninsured Guaranty Fund (Guaranty Fund). The Workers' Compensation Judge granted the claim brought against the Guaranty Fund, awarding the claimant total disability benefits from the date of injury through November of 2007. By that time, the claimant was working on a part-time basis, and the judge awarded the claimant partial disability benefits. The claimant presented no evidence that he was authorized to work in the United States, and the employer did not appeal. Later, the employer filed a suspension petition, alleging the claimant was not authorized to work in the United States and that the claimant had returned to work.

The judge dismissed the employer's petition, concluding that the employer did not prove a change in the claimant's medical condition. But, at the judge level, there was evidence that the claimant had been working since November of 2007 at approximately 18 to 20 hours per week, with his doctor's permission. The Board reversed the judge's decision on appeal, concluding that the employer showed a change in the claimant's medical condition by virtue of the work the claimant was performing since November of 2007. The Board held that this established that the claimant was no longer totally disabled. The claimant appealed to the Commonwealth Court, arguing that benefits cannot be suspended solely on the basis that he is not authorized to work in the United States and that there must be proof of a change in condition.

The Commonwealth Court affirmed the Board's decision. In the court's view, the employer proved that the claimant's loss of earning power was caused by his immigration status once his medical condition improved enough to allow him to work part-time, which happened in November of 2007. The court concluded that in the case of an unauthorized worker, an employer need only demonstrate that a claimant's medical condition has improved enough to work at some job, even one with restrictions.

Case Law Alerts - 2nd Quarter 2013