What's Hot in Workers' Comp - News and Results*
NEWS
Angela DeMary (Mount Laurel, NJ) was a featured speaker in the Camden County Bar Association CLE program, “Practicing Workers’ Compensation Law Remotely and COVID-19 Type Cases.” The webinar was held on January 27 and focused on the process of managing a workers’ compensation claim; what is an essential worker and who is considered a first responder; and recent legal and legislative updates based on the Governor’s Orders. The usage of DocuSign and remote forms as well as Zoom settlements and trials were also discussed.
RESULTS*
Judd Woytek (Allentown, PA) was successful in receiving a decision denying a penalty petition. The claim had settled by Compromise & Release. The claimant had undergone three surgeries to her wrist while litigating her review petition to expand the accepted injury. As part of the C&R, the claimant agreed that the carrier would not be responsible for any medical bills related to her second and third wrist surgeries. The carrier agreed to pay her $5,000 to cover her out-of-pocket expenses related to those surgeries. Her private health insurance carrier later retracted payments it had made for her follow-up care and physical therapy post-surgery. The claimant then filed a penalty petition against the workers’ compensation carrier when it refused to pay the bills on which the private insurance carrier had retracted payment. The judge denied and dismissed the penalty petition, finding that the claimant had negotiated away her right to seek payment from the workers’ compensation carrier with regard to any bills related to the subsequent wrist surgeries as she had accepted $5,000 in exchange and was bound by the C&R. The workers’ compensation carrier had no obligation to pay the bills.
Judd also received a decision denying a reinstatement petition in a claim where the claimant, who was working under restrictions, sought reinstatement of temporary total disability for a closed period of time when he was laid off due to Governor Wolf’s Order issued in March 2020 directing that all non-life-sustaining businesses close. The judge agreed with our position that the claimant’s loss in earnings was unrelated to the work injury and was due solely to the Governor’s Order. The reinstatement petition was denied and dismissed.
Judd was again successful in receiving a decision denying a widow’s claim for Federal Black Lung benefits. The deceased miner worked in underground coal mining for 11 years. His lifetime claim for benefits was denied after numerous claim filings and appeals. The widow then sought survivor’s benefits based upon the opinion of her medical expert, who opined that the miner’s death was hastened by coal workers’ pneumoconiosis. The judge rejected the widow’s expert in favor of our expert, who testified that the miner’s death was not caused or hastened by pneumoconiosis. The widow requested reconsideration and attempted to submit additional evidence (an additional medical report and 12 medical journal articles) that she had not submitted during the litigation of the widow’s claim. The judge again rejected the claim on reconsideration and found that, even if the employer’s medical expert testimony were rejected, the testimony of the widow’s medical expert was insufficient to sustain her burden of proving by a preponderance of the evidence that the miner’s death was caused by or hastened by pneumoconiosis. The judge also agreed with our argument that the additional evidence submitted in conjunction with the request for reconsideration was impermissible and should be stricken from the record.
Tony Natale (Philadelphia, PA) was successful in dismissing the employer and insurer from a fatal claim as a result of COVID-19 infection. The claimant-widower filed the claim on behalf of his deceased wife, alleging she contracted COVID-19 while working in the capacity of a caretaker for a sick client. Tony argued that the correct employer for workers’ compensation purposes was the claimant’s client, not the named employer. The Workers’ Compensation Judge agreed and dismissed the named employer and insurer as party defendants.
Tony also successfully defended a Philadelphia-based university in litigation surrounding both a claim and reinstatement petitions. The claimant sustained a non-disabling injury in the form of right thumb CMC joint arthritis from her repetitive job duties. After several years of employment, she alleged that her work injury forced her out of the labor market, and she requested disability benefits. The Workers’ Compensation Judge accepted as credible, by preponderance of the medical evidence, that the claimant did not suffer a work-related disability of any kind. A big part of the rationale for this determination was Tony’s cross examination of the claimant’s medical expert, which exposed that the claimant’s disability may have been due to a variety of non-work-related conditions to the left hand and upper extremity.
Tony also successfully defended a Delaware County machine shop before the Workers’ Compensation Appeal Board with reference to the claimant’s appeal from a Workers’ Compensation Judge’s decision denying work-related disability arising from an alleged head injury and a full recovery conclusion of law. Tony was able to have the appeal quashed based on its untimely filing. The Board also adjudged the appeal on the merits (which is unusual) and further found that the appeal lacked merit on all grounds.
Ashley Eldridge (Philadelphia, PA) was successful in defending a claim petition for an alleged spine injury on behalf of a construction company. The claimant was employed as a construction worker for the employer, and a week after being hired, he was allegedly injured while using a jackhammer. He filed a claim petition for multilevel disc injuries in the lumbar spine. Ashley presented the medical testimony of an orthopedic expert who explained how the injury was soft tissue in nature and had resolved as of an independent medical examination. While there was significant, multilevel disc bulges and herniations, which the opposing expert attempted to ascribe as work-related, the judge agreed these findings to be degenerative rather than acute. This conclusion was further supported by an ongoing factual investigation, which uncovered 17 prior low back injuries, the majority of which were denied by the claimant. Ultimately, the judge accepted the defense’s evidence over that of the claimant and granted the full relief requested by the employer.
Michele Punturi (Philadelphia) successfully prosecuted a termination petition and defended the claimant’s petition to review to expand the nature of the accepted injury on behalf of a well-known hospital. The injury was accepted as a right distal bicep strain, which included a partial tear resulting in surgery. The claimant asserted the injury should be expanded to also include right carpal tunnel, right elbow sprain and trigger fingers. A detailed cross-examination of the claimant established the complaints referable to right carpal and trigger fingers began six months after the injury, which was corroborated by the claimant’s treating physician’s records. The IME expert, a board-certified orthopedic surgeon with specialized training in hand surgery, had the opportunity to perform a comprehensive physical examination and review the diagnostic studies, post- and pre-injury medical records and the claimant’s family physician’s records. These records revealed non-work-related carpal tunnel risk factor conditions, including obesity, post-menopausal, non-insulin dependent diabetes and testing for hypothyroidism. It was further argued that the claimant’s medical expert did not have expertise in the surgery involved in the case and failed to review the claimant’s testimony and diagnostic films. Ultimately, the judge found the defense medical expert to be competent, credible and persuasive. This case highlights the importance of a defense expert having the opportunity to review all medical records, diagnostic films, claimant’s testimony and claimant’s expert’s testimony to develop a timeline for claimant’s complaints consistent with the medical evidence.
*Prior Results Do Not Guarantee A Similar Outcome
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