Abington Memorial Hospital v. Workmen's Compensation Appeal Board

650 A.2d 407, 539 Pa. 34, 1994 Pa. LEXIS 625
CourtSupreme Court of Pennsylvania
DecidedNovember 15, 1994
StatusPublished
Cited by1 cases

This text of 650 A.2d 407 (Abington Memorial Hospital v. Workmen's Compensation Appeal Board) is published on Counsel Stack Legal Research, covering Supreme Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Abington Memorial Hospital v. Workmen's Compensation Appeal Board, 650 A.2d 407, 539 Pa. 34, 1994 Pa. LEXIS 625 (Pa. 1994).

Opinions

OPINION ANNOUNCING THE JUDGMENT OF THE COURT

PAPADAKOS, Justice.

On March 15, 1988, Louis Wyche, Appel-lee, was injured when he lifted a heavy trash can during the course of his duties as a sanitation worker at Abington Memorial Hospital, Appellant. Dr. Marc Kress, an employee of Appellant, diagnosed Appellee as having a ventral hernia. On the recommendation of his personal physician, Dr. Conrad King, Appellee consulted a surgeon, Dr. Nicholas Pedano, regarding surgical repairs of the hernia. Unfortunately, Appellee could not have the surgery performed since the hospital where Dr. Pedano had staff privileges would not accept Appellee’s health insurance. To further complicate matters, Appellant refused to authorize payment for Ap-pellee’s medical treatment.

On March 29, 1988, Appellee filed a claim petition seeking workmen’s compensation benefits. Appellant answered the claim by denying all material allegations. Additionally, Appellant alleged that Appellee was precluded from receiving benefits pursuant to the forfeiture provision of Section 306(f)(4) of the Pennsylvania Workmen’s Compensation Act (the Act) of June 2, 1915, P.L. 736, as amended, 77 P.S. § 531(4). The referee concluded that Appellee had met his burden of proving a compensable injury sustained in the course of his employment. Consequently, the referee granted the claim petition and ordered Appellant to pay Appellee temporary total disability benefits. Appellant appealed the referee’s decision to the Workmen’s Compensation Appeal Board (Board) which affirmed, finding that there was substantial competent evidence to support the referee’s findings of fact and conclusions of law.

On appeal, the Commonwealth Court, in affirming the decision of the Board, determined that Appellant cannot, on the one hand, deny liability for the injury (as it did), and on the other hand, invoke the forfeiture provision of Section 306(f)(4) of the Act, 77 P.S. § 531(4), to disqualify Appellee from receiving benefits. 151 Pa.Cmwlth. 258, 616 A.2d 767.

In addition, the Commonwealth Court noted that Appellant’s refusal to pay for the hernia operation precluded a forfeiture of benefits for Appellee’s alleged failure to submit to reasonable medical treatment. Also, the Commonwealth Court held that an employer is not relieved of its obligation to pay compensation benefits by an assertion that an injury is correctable by medical procedures and that the claimant has the means to obtain them without relying upon the employer.

In reaching its decision concerning forfeiture of benefits, the Commonwealth Court distinguished our holding in Joyce Western Corporation v. Workmen’s Compensation Appeal Board (Fichtorn), 518 Pa. 191, 542 A.2d 990 (1988), from the instant case because Joyce Western involved specific loss benefits and the present case involves a total disability.

We accepted further review to consider whether our decision in Joyce Western is applicable to situations as presented in this case and now affirm.

In essence, Appellant argues that Appellee is not entitled to disability benefits as he failed to avail himself of a reasonable corrective surgical procedure. Appellant reasons that under our ruling in Joyce Western, the forfeiture provision of Section 306(f)(4) of the [409]*409Act, 77 P.S. 531(4)1 may be applied to all workmen’s compensation cases at entitlement proceedings, not simply where claims for specific loss benefits are implicated, and, in this instance, would preclude the award of total disability benefits.

Appellee, however, maintains that Appellant cannot utilize the forfeiture provisions of Section 306(f)(4) of the Act, 77 P.S. § 531(4), at the entitlement level of this total disability case for two reasons. First, Appellee argues that Joyce Western applies only to specific loss cases where unique entitlement hearings are held. Secondly, Appellee asserts that he was willing to have medical procedures performed, but, he was prevented from having such reasonable medical treatment on account of Appellant’s conduct when it did not fulfill its statutory obligation to pay for the services, Section 306(f)(1) of the Act, 77 P.S. § 531(1).2

Our scope of review in workmen’s compensation matters is limited to determining whether there has been a constitutional violation, an error of law, or a violation of Appeal Board procedure, and whether necessary findings of fact are supported by substantial evidence. St. Joe Container Company v. Workmen’s Compensation Appeal Board (Staroschuck), 534 Pa. 347, 633 A.2d 128 (1993).

We begin our analysis by noting that Joyce Western clearly involved specific loss benefits. There, the claimant injured his eye in the course of his employment, was paid compensation benefits and subsequently returned to work without a loss of earnings. Claimant then filed a petition seeking compensation for the loss of use of his right eye. Claimant’s employer argued that the specific loss was caused by Claimant’s own refusal to undergo corrective surgery. We held that whether the Claimant sustained a qualifying specific loss of his eye necessarily included the issue of whether reasonable medical procedures will restore some portion of the loss of function, and therefore, Claimant’s refusal of reasonable medical services may be considered at the entitlement hearing.

On this basis alone, Joyce Western is clearly distinguishable from the instant matter because this is a disability claim. In affirming the Board, the Commonwealth Court noted that, concerning issues of injury corrects ability, there is a distinction between a disability case and a specific loss case. We agree.

Our courts have spoken to the three types of compensation provided for under the Act, 1.e., Total Disability, Section 306(a), 77 P.S. § 511; Partial Disability, Section 306(b), 77 P.S. § 512; and all disability resulting from permanent injuries (specific loss), Section 306(c), 77 P.S. § 513, and have noted that under Sections 306(a) and (b) of the Act, 77 P.S. §§ 511 and 512, the legislature has provided for compensation during the periods of disability following an injury. The schedule of payment is dependent upon the extent of the disability, i.e., total or partial, and reflects payments based on an incapacity to perform one’s duties and the loss of earning power resulting from that injury. Killian v. Heintz Div. Kelsey Hayes, 468 Pa. 200, 360 A.2d 620 (1976).

However, under Section 306(c) of the Act, 77 P.S. § 513, the legislature applies a different schedule of payment for compensation that stems from a permanent injury (specific loss). This amount is statutorily prescribed and is intended to include compensation for all disability emanating from or connected with the loss of a member or a permanent injury to that member. Moreover, a finding of a specific loss is not connected to a finding concerning a claimant’s [410]*410continuing ability to work.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Ricks v. Workers' Compensation Appeal Board (Parkway Corp.)
704 A.2d 716 (Commonwealth Court of Pennsylvania, 1997)

Cite This Page — Counsel Stack

Bluebook (online)
650 A.2d 407, 539 Pa. 34, 1994 Pa. LEXIS 625, Counsel Stack Legal Research, https://law.counselstack.com/opinion/abington-memorial-hospital-v-workmens-compensation-appeal-board-pa-1994.