Saturday, January 12, 2008

Largest Workers’ Compensation Rate Reduction in a Decade

The Pennsylvania Compensation Rating Bureau (PCRB) has proposed a 10.22 percent average reduction in workers’ compensation policy rates for 2008, according to a Pittsburgh Business Times Article. The recommendation will go to the Pennsylvania Insurance Department for approval.

On January 19, 2007 the PCRB recommended a 2.95 percent average increase.

In 2006, the PCRB recommended an average 8.5 percent reduction, which was reported to be the biggest decrease sought since 1997.

In 2005, the PCRB recommended a 2.89 percent average reduction, which was predicted to save employers $32.5 million.

Labor Market Survey May Be Done In Area Of Claimant's Residence Even If Out Of State

In H. Riddle v. WCAB (Allegheny City Electric, Inc.), the Claimant was injured in Pittsburgh, but had a residence in Wheeling, West Virginia and lived with his father at a nearby address in Ohio, where the Claimant held a driver’s license.

The Claimant’s benefits were modified based on a labor market survey focusing on Wheeling. The Claimant argued since he resides out of state, the labor market survey must be done in the usual employment area where the injury occurred, i.e. Pittsburgh, according to 306(b)(2) of the Act.

The Commonwealth Court applied the rule of statutory construction that the legislature could not have intended an absurd result. Where the Employer accommodates the Claimant in conducting the labor market survey, the results are valid.

Friday, November 30, 2007

SWMS Associated With Cancer

The International Agency for Research on Cancer, the cancer arm of the World Health Organization, will designate overnight shift work as a probable carcinogen according to a Pittsburgh Post-Gazette article. Judge David Torrey identifies the 1998 case of Met. Ed. v WCAB, 718 A2d 759 (Pa. 1998) as the Supreme Court case which previously held shift work maladaptation syndrome is not a compensible injury.

Friday, November 09, 2007

Report From National Workers’ Compensation and Disability Conference and Expo

Human Resource Executive Online summarizes a discussion from the National Workers’ Compensation and Disability Conference and Expo about outcome based workers’ compensation management. The panelists are all names Pennsylvania workers’ compensation practitioners will recognize.

Monday, November 05, 2007

Furlough Benefits Are Not Severance Benefits

In G. Kelly v. WCAB (US Airways Group, Inc.) the Commonwealth Court reversed the opinion of the Board and WCJ that furlough benefits are severance benefits for which the Employer is entitled to a credit under Section 204(a) of the Act. The Court applied a plain language analysis.

Thursday, October 25, 2007

L&I Offers Policy Search Via Internet

Information on workers compensation coverage for Pennsylvania employers is available at PA Employer WC Insurance Info on L&I's web site. The search will show the current insurance carrier and the coverage history.

Wednesday, October 10, 2007

Commonwealth Court Holds Expense Reimbursement Should Be Included in AWW

In T. Lennon, Dec', et al. v. WCAB (Epps Aviation, Inc.), the Claimant, an airplane pilot, received expense reimbursement for board and lodging from his employer. Claimant’s Counsel argued these amounts should be included in the average weekly wage calculation under Section 309(e) of the Act on the basis that they represent payments for board and lodging.

The WCJ denied the request to include reimbursed board and lodging expenses. The rule prior to this case was that board and lodging expenses are included in the average weekly wage only when a daily or weekly advance is paid to the claimant. These are reimbursements made under a nonaccountable plan and are therefore wages subject to withholding and employment taxes. Expense reimbursements paid to an employee under an accountable plan are exempt from withholding and employment taxes, and under the prior rule these were not included in the AWW.

The Board affirmed the WCJ’s decision, but the Commonwealth Court reversed. The Court stated according to the plain language of the statute, these amounts are includable in the average weekly wage. If there are policy considerations underlying the prior rule, the statute should except board and lodging reimbursement.

Tuesday, October 09, 2007

Commonwealth Court Reinforces Principle That Average Weekly Wage Calculations Should Be Made According To The Act’s Provisions.

In Lahr Mechanical, et al. v. WCAB (Floyd) the WCJ accepted the Claimant’s testimony about his expected wages and hours to make a Section 309(d.2) average weekly wage calculation. The Claimant testified he expected the prevailing rate. The Claimant was actually paid at three different rates: local, prevailing and overtime.

On appeal by the Employer, the Board averaged the Claimant’s rates. This resulted in a slightly lower AWW than the one found by the WCJ.

The Court reinstated the findings of the WCJ. Recent cases have allowed average weekly wage calculations outside the framework of the Act’s provisions, but the preferred disposition is to make findings of fact that allow a calculation within the framework of Section 309, as the WCJ did in this case.

Article Reporting Medicare Delays in New Jersey Workers’ Compensation Settlements

This Star-Ledger article reports on the history and development of CMS reviews of workers’ compensation settlements and the delays in processing these reviews. It is a very complete overview of the issue.
Thanks to WCJ David Torrey

Elizabeth Crum Elected President of IAIABC

Liz Crum, Deputy Secretary of Compensation and Insurance, was elected President of the International Association of Industrial Accident Boards and Commissions. The IAIABC’s mission is to advance the administration of workers’ compensation systems throughout the world through education, research, and information sharing.

Thursday, September 13, 2007

Commonwealth Court Allows WCJ to Review Description of Injury Without Review Petition

In Cinram Mfg., Inc. & PMA Group v. WCAB (Hill), the Claimant had a herniated lumbar disc as early as 2000. When the Claimant had a work injury in March of 2004, the Employer described the injury as a lumbar strain. The Employer later filed a Termination Petition, alleging the lumbar strain had resolved.

The WCJ accepted the testimony of the Claimant’s expert that the March 2004 injury resulted in a significant change in the Claimant’s imaging study and symptoms. The WCJ concluded the Claimant’s herniated lumbar disc was either caused or materially aggravated by the March 2004 work injury, and denied the Termination Petition.

The Claimant did not file a review petition to expand the description of injury. The Employer argued on appeal that the Claimant’s expert’s opinion was incompetent. The Board and the Court rejected this argument.

The Claimant’s failure to file a review petition is harmless error so long as the WCJ places the burden on the Claimant to prove the nature of the injury beyond the insurer’s description. According to the WCJ’s credibility findings in this case, the record established the Claimant met his burden.

It is better practice, however, to file appropriate review petitions. These memorialize diagnoses for the medical experts to comment on, ensuring due process. The filing of a review petition also guides the WCJ to properly analyze the description of injury.