What’s Hot in Workers’ Comp – Special PA Alert
On May 29, 2024, in the matter of Erie Insurance Property & Casualty Company v. David Heater (Workers’ Compensation Appeal Board), No. 148 C.D. 2023, A. Judd Woytek and Audrey L. Copeland (both of King of Prussia, PA) successfully secured the following precedential decision from the Commonwealth Court of Pennsylvania.
The claimant was a sole proprietor who suffered an alleged work-related injury on September 28, 2015. The claimant failed to provide notice of his alleged injury to Erie Insurance until February 24, 2017. He filed a Claim Petition on September 6, 2018, just prior to the expiration of the statute of limitations.
The workers’ compensation judge issued a decision in July 2020 in which he found that the claim was barred by the notice provisions of the Act due to the claimant’s failure to report the injury to Erie Insurance within 120 days. The judge noted that, since the claimant was his own employer, it could be argued that notice was instantaneous (to himself). However, the judge found that the insurer was the party responsible for the payment of benefits and, therefore, notice had to be provided to the insurer within 120 days. Since the claimant failed to provide notice to Erie Insurance within 120 days of his injury, the judge denied the Claim Petition.
The claimant appealed, and the Workers’ Compensation Appeal Board reversed and remanded to the workers’ compensation judge, who then issued another decision in January 2022, awarding benefits. Judd appealed the judge’s second decision to the Appeal Board, which affirmed. Judd and Audrey then appealed to the Commonwealth Court.
In its May 29, 2024, decision, the Commonwealth Court agreed with our argument that the claimant needed to provide notice of his work-related injury to Erie Insurance within 120 days of the occurrence of the injury due to his combined status as both the claimant and the sole proprietor/owner/employer in this matter. The Commonwealth Court distinguished this case from prior cases where the employer was a small or closely held corporation. The court specifically noted that the claimant was a sole proprietor, owner and the only employee of his own business. The court agreed that allowing the claimant to pursue a claim by alleging that he provided notice to himself immediately when the accident occurred but did not bother to report the injury to Erie Insurance for over a year thereafter, would result in an absurdity and put Erie Insurance at a disadvantage in the investigation of the claim.
The court note that the definition of “employer” is different in Section 311 and Section 401 of the Act. Section 401 of the Act defines “employer” as including not only the actual employer, but also the employer’s “duly authorized agent, or his insurer, if such insurer has assumed the employer’s liability . . .” The court noted that, under those circumstances, the insurer is entitled to the same rights afforded to the employer, which includes prompt notice of the claim, so that an investigation can be conducted and that evidence does not become stale.
The court held, therefore, that since the claimant failed to report his alleged injury to Erie Insurance within 120 days, his claim was barred. The court reversed the Appeal Board and reinstated the judge’s original 2020 decision denying the Claim Petition.
Note that the holding in this decision is limited to situations where the claimant is both the injured employee and the sole proprietor/employer. In such a case, the claimant must provide notice of his/her injury to the insurance carrier within 120 days. In all other circumstances, the claimant must only provide notice to the employer within 120 days.
What’s Hot in Workers’ Comp – Special PA Alert – June 10, 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.