Michael is an experienced workers' compensation attorney who focuses his practice on defending employers and insurance carriers in matters related to workers' compensation. He counsels clients on all aspects of workers' compensation claims management to help minimize their exposure. He has successfully defended employers in many industries, including trucking, construction, landscaping, manufacturing, hospitality and assisted living facilities.
Michael earned his Bachelor of Arts in Political Science from The Pennsylvania State University and his juris doctor from Widener University Delaware Law School. He is admitted to practice in Pennsylvania and New Jersey.
An active member of the legal community, Michael is a member of the Pennsylvania Workers' Compensation Coalition, Brehon Law Society, Philadelphia Bar Association and Judge Alexander F. Barbieri Workers’ Compensation Inn of Court.
Results
Favorable Decision Secured in Multi-Million Dollar Workers’ Compensation Matter
We received a favorable decision that saved our client millions of dollars. The claimant filed a claim petition alleging he sustained a left shoulder dislocation, stroke, traumatic brain injury, gait dysfunction, central pain syndrome and post-traumatic seizures as a result of a fall at work. After the claimant fell at work and sustained a left shoulder dislocation, he went to the hospital for the dislocation, was treated and discharged. Four days later he sustained a stroke at home. He had multiple surgeries and was hospitalized for four months. He is severely disabled as a result of the stroke and requires full-time care. The claimant initially alleged he sustained a head injury from the fall at work which caused the stroke. He claimed he was bleeding from his nose and mouth and had a laceration to his forehead. We were able to show that did not occur by presenting fact witnesses who established the claimant fell off one step, never hit his head, was not bleeding from his head or face, only dislocated his shoulder, and was discharged home without issue. Claimant’s counsel then alleged the claimant’s stroke was related to a spike in his high blood pressure that placed him in a hypertensive crisis resulting in the stroke. We showed that the claimant had unregulated high blood pressure before the work injury and that he was released from the hospital with high blood pressure, but not enough to be in hypertensive crisis. The judge agreed with our arguments, finding that the claimant only sustained the agreed-upon shoulder dislocation. Therefore, the claimant was awarded one day of wage loss benefits for the shoulder dislocation. The stroke, traumatic brain injury, gait dysfunction, central pain syndrome, and post traumatic seizures were denied and dismissed. As the claimant is only 48 years old and his compensation rate resulted in $30,000 a year wage loss benefit, wage loss for the rest of his life would likely have been around $1 million. The claimant’s medical costs were going to be much higher as he requires round-the-clock care, which over his lifetime would have cost millions. His hospital bills alone were over $1 million, and claimant’s counsel would have argued for home modifications and vehicle modifications. Instead, the claimant will receive a one-day payment of about $88.
Termination Petition Affirmed before the Workers’ Compensation Appeal Board
We received an opinion from the Workers’ Compensation Appeal Board affirming the decision granting our termination petition. The employer had accepted an “upper back area” injury through a Notice of Compensation Payable. Prior to issuing the NCP, the employer secured an IME, where the doctor ultimately opined that the claimant was fully recovered from a lumbar sprain. The workers’ compensation judge found that the claimant was fully recovered from the work injury based upon the credible opinions of the employer’s medical expert. The claimant appealed, arguing the termination was improper as the IME occurred before the NCP was issued; therefore, the change in condition needed to occur after the NCP. Additionally, the claimant argued the termination was improper as the IME doctor found a different injury than the injury noted on the NCP. The Appeal Board opined that the employer sustained its burden of proof as its expert’s testimony constituted substantial evidence, sufficient in nature to meet its burden of proof. The Appeal Board further found that since the employer was not disputing an injury occurred, it was not attempting to re-litigate whether the claimant sustained a work injury. Rather, it was disputing whether the claimant was still disabled. The Appeal Board further opined that the claimant’s expert evaluated the whole back and that the credible evidence revealed the claimant was fully recovered.
Thought Leadership
Defense Digest
A Costly Mistake
June 1, 2025
Key Points: A workers’ compensation judge is not required to correct a mistakenly-issued Notice of Compensation Payable, but they may correct a mistakenly-issued Notice of Compensation Payable. The court would not overturn a workers’ compensation judge’s refusal to correct a mistakenly-issued Notice of Compensation Payable. The decision to correct a mistakenly-issued Bureau document is in the workers’ compensation judge’s discretion. The Commonwealth Court of Pennsylvania recently issued an opinion finding that, although a workers’ compensation judge may correct a mistakenly-issued Notice of Compensation Payable, it is within the judge’s discretion and is not required. In City of Philadelphia and PMA Management Corp. v. John Bell (WCAB), 2025 WL 980776 (Pa. Cmwlth. April 2, 2025), the claims handler incorrectly issued a “partial denial,” or a Medical-Only Notice of Compensation Payable (Medical-Only NCP), after the determination was made to issue a denial. After working 17 years as a firefighter for the City, the claimant was diagnosed with colon cancer. He requested that the City recognize his cancer as job-related and pay workers’ compensation benefits. After issuing the Medical-Only NCP, the employer filed a review petition, alleging it mistakenly issued the Medical-Only NCP when it intended to issue a Notice of Compensation Denial. The employer/carrier presented an affidavit from the City’s Risk Management and Employee Disability Manager in which she noted that, after an investigation, it was recommended that PMA deny the claimant’s claim. The employer/carrier also presented an affidavit from the claims handler which noted that she had begun working for PMA on June 6, 2022, and processing workers’ compensation claims on June 27, 2022. She received the claimant’s claim on September 12, 2022. She contacted the aforementioned risk manager and was advised to issue a denial because there was no evidence of a causal relationship between the claimant’s condition and his employment as a firefighter. She understood the Claims Center’s software allowed her compensability choices of: fully accept, temporarily accept, undetermined, partially deny, and fully deny. The claims handler did not understand the Electronic Data Interchange (EDI) system’s process or the automatic generation of compensability-establishing documents through these choices. She chose to “partially deny” the claim because she believed she was agreeing to pay for only the medical appointments to any posted panel physician. She did not understand that the form generated would accept liability on the claim. She did not intend to issue a Medical-Only NCP, although that is what clicking “partially deny” generated. Emails exchanged between the claims handler and the risk manager established the intent to deny the claim. The workers’ compensation judge found both the adjuster and the claims handler credible and accepted that the adjuster made a mistake and did not intend to generate a Medical-Only NCP. However, the judge was not willing to set aside the Medical-Only NCP. The judge noted that EDI has been around for approximately 10 years, the adjuster should have received better training, and she should have sought advice before taking the action. The judge stated that allowing Bureau documents to be set aside when mistakes are made is not a precedent she was going to set. The judge also found this was distinguishable from cases where information has been made available prior to the completion of an investigation where the claim has already been accepted. The Workers’ Compensation Appeal Board affirmed. On appeal, the Commonwealth Court noted that the judge and the Board incorrectly relied on Beissel and Barna, which addressed changing a Bureau document after information was gained prior to the completion of an investigation. The court noted that this case was distinguishable because it was the insurer’s intention at the onset to deny the claim after it conducted its investigation. The issuance of the Medical-Only NCP was a mistake. The court looked at whether Section 413(a) of the Act requires a judge to set aside a mistakenly issued NCP. The court looked at the language in Section 413(a), which it determined was unambiguous and permissive in nature. Section 413(a) states: “a workers’ compensation judge may, at any time, review and modify or set aside a notice of compensation payable…if it be proved that such notice of compensation payable…was in any material respect incorrect.” The court analyzed whether “may” could mean “shall” in some circumstances and determined that because “may” and “shall” are both used throughout the Act, and are not used interchangeably, “may” is permissive rather than mandatory. Thus, the judge had the discretion to decide whether to set aside the mistakenly issued Medical-Only NCP, which the judge elected not to do, even after she had found it was incorrectly issued. The court would not overturn that decision. This decision reinforces the possibility of reversing an incorrectly and mistakenly-issued Bureau document by way of a review petition. However, the decision also reinforces the judge’s discretion to make that correction. As the judge noted in this case, most judges are hesitant to change a Medical-Only NCP or an NCP to a denial even if the mistake was clearly established. Therefore, the claims handler or whomever issues the EDI transaction should take the proper precautions and exercise due diligence before issuing any Bureau document. More often than not, the judge will not correct a Bureau form. Proper training and safeguards should be exercised prior to issuing a Bureau document to avoid these issues. *Michael is a member of our Workers’ Compensation Department and works in our King of Prussia, PA office. Defense Digest, Vol. 31, No. 2, June 2025, 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. ATTORNEY ADVERTISING pursuant to New York RPC 7.1. © 2025 Marshall Dennehey. All Rights Reserved. This article may not be reprinted without the express written permission of our firm. For reprints, contact tamontemuro@mdwcg.com.
Bullying in the Workplace
December 14, 2021
Bullying has become a point of focus for parents and school administrators due to its documented harmful effects on adolescents. Unfortunately, bullying does not end with childhood. The Workplace Bullying Institute (WBI) defines bullying as “repeated, health-harming mistreatment of others in the workplace via one or more forms of verbal abuse, threats, humiliation, intimidation, work interference, or sabotage/exploitation of psychological or physical vulnerability.” Though this is a helpful definition, it leaves open for interpretation whether covert or subversive acts are, in fact, workplace bullying.
