Section 305.2(c.1) Does Not Require Claimant to Prove Non-Entitlement to Benefits Before Record Closes and Imposes No Timeline for Submission

The claimant filed a Claim Petition, alleging he suffered a spine and hand fracture on March 30, 2022, after falling from a roof while working as a laborer for Joe Miller Construction Company. Joe Miller denied it was the claimant’s employer. The claimant then filed a Claim Petition for benefits from the Uninsured Employer’s Guaranty Fund, which then joined Life Time Home Improvement Contractors LLC as an additional defendant and the claimant’s statutory employer. 

The workers’ compensation judge granted the Claim Petition, finding that the claimant sustained a work injury as a roofer for Life Time. The judge specifically found that Joe Miller was not the claimant’s employer. Instead, the judge found that Life Time employed the claimant and Joe Miller subcontracted Life Time to do shingle work on the date of injury. The judge also determined Life Time was domiciled in New Jersey and did not have workers’ compensation insurance in Pennsylvania. Thus, the judge dismissed the Claim Petition filed against Joe Miller, granted the petition filed against the Fund and granted the Fund’s joinder petition against Life Time. The judge found Life Time was responsible for payment of benefits and that the Fund was secondarily liable. However, the judge noted that the Fund was not responsible for payment until the claimant showed he was not receiving or entitled to benefits in the state of New Jersey, consistent with Section 305.2(c.1) of the Act. The Fund appealed to the Appeal Board, which affirmed.

On appeal to the Commonwealth Court, the Fund argued that the judge and Appeal Board erred in finding it secondarily liable for payment of compensation where the claimant failed to satisfy the requirements of Section 305.2(c.1) of the Act. According to the Fund, the claimant’s non-entitlement to New Jersey workers’ compensation benefits should have been known by the claimant before the record closed, not after the judge’s decision. 

However, the Commonwealth Court rejected the Fund’s argument and dismissed their appeal. According to the court, Section 305.2(c.1) of the Act does not mandate submission of evidence establishing a claimant was not entitled to benefits in New Jersey while a claim is pending before the judge. Instead, the statute provides that “[No] compensation shall be payable from the Fund until Claimant submits evidence demonstrating that Claimant is not entitled to workers’ compensation benefits from another State.” According to the court, Section 305.2(c.1) of the Act conditions the Fund’s payment of compensation on a claimant’s submission of evidence and makes no reference of a required timeline for the submission of such evidence. 

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