A Workers’ Compensation Judge’s decision that found surgery unrelated to the work injury and said no further treatment was necessary for the injury did not bar a subsequent penalty petition for non-payment of medical expenses related to the injury.

The claimant sustained a work injury in 1988, which the employer acknowledged via a Notice of Compensation Payable (NCP). The NCP described the injury as a “leg/back” injury. The claimant’s benefits were suspended in 1995. In 2015, the claim was settled by a Compromise and Release (C&R) Agreement, which said the employer would remain responsible for certain medical bills regarding the work injury. In addition, the agreement left open a petition for penalties over the issue of whether fusion surgery performed on the claimant was causally related to the March 1988 work injury.

The Workers’ Compensation Judge denied the penalty petition, finding that the claimant achieved maximum medical improvement by May of 2009, that no surgery was recommended or needed, and that the surgery was unrelated to the work injury. The judge also said, “There is no further treatment that is necessary or that can be expected in the future relative to the low back condition as a result of the March 21, 1988, work event.”

In 2018, the claimant filed another penalty petition, alleging the employer violated the Act by not paying for medical expenses for treatment received since the surgery, consisting of pain management care. The employer took the position that they were not responsible for payment of medical bills, based on the statement, “[n]o further treatment is necessary,” made by the judge in the decision on the prior penalty petition.

The judge granted this penalty petition, finding the treatment was related to the claimant’s work injury. The judge found that the statement made by the prior judge in the other penalty petition had no binding effect and believed the only issue in the prior petition was whether the low back surgery was related to the work injury. The employer appealed to the Workers’ Compensation Appeal Board, and the Board affirmed.

The Commonwealth Court affirmed the Board’s decision. They concluded that the decision issued in the first penalty petition, involving the low back surgery, did not preclude the judge’s subsequent decision granting a penalty petition. According to the court, the finding made by the judge in the prior penalty petition, that the claimant did not need further medical treatment for her 1988 work injury, was not essential to the judge’s judgement that the employer was not liable for the 2014 back surgery. Therefore, the prior decision did not collaterally estop the judge from considering whether the claimant’s work injury continued to require palliative treatment.

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