Aqua Pennsylvania, Inc. v. WCAB (McGonigle)

CourtCommonwealth Court of Pennsylvania
DecidedMay 14, 2020
Docket1202 C.D. 2019
StatusUnpublished

This text of Aqua Pennsylvania, Inc. v. WCAB (McGonigle) (Aqua Pennsylvania, Inc. v. WCAB (McGonigle)) is published on Counsel Stack Legal Research, covering Commonwealth Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Aqua Pennsylvania, Inc. v. WCAB (McGonigle), (Pa. Ct. App. 2020).

Opinion

IN THE COMMONWEALTH COURT OF PENNSYLVANIA

Aqua Pennsylvania, Inc., : Petitioner : : v. : No. 1202 C.D. 2019 : Submitted: December 20, 2019 Workers’ Compensation Appeal : Board (McGonigle), : Respondent :

BEFORE: HONORABLE RENÉE COHN JUBELIRER, Judge HONORABLE PATRICIA A. McCULLOUGH, Judge HONORABLE ELLEN CEISLER, Judge

OPINION NOT REPORTED

MEMORANDUM OPINION BY JUDGE COHN JUBELIRER FILED: May 14, 2020

Aqua Pennsylvania, Inc. (Employer) petitions for review of the Order of the Workers’ Compensation Appeal Board (Board) that affirmed the Decision of a Workers’ Compensation Judge (WCJ) denying Employer’s Petition to Terminate Benefits (Termination Petition) and granting Kevin McGonigle’s (Claimant) Petition to Reinstate Compensation Benefits (Reinstatement Petition) and Petition for Review of Utilization Review Determination (UR Petition). On appeal, Employer argues the Board erred in affirming because the evidence established that Claimant had fully recovered from his work-related injuries, had been released to his full-duty work, and the medical treatment at issue in the UR Petition was no longer reasonable and necessary as of March 6, 2017. Claimant responds Employer’s arguments are based on its misunderstanding of the nature of Claimant’s work injuries and are improper credibility challenges, making Employer’s appeal frivolous and, accordingly, attorneys’ fees should be imposed.

I. Background A. The Petitions Claimant worked for Employer on its maintenance crew, a heavy-duty position. On August 3, 2015, Claimant sustained work-related injuries, which were found in a 2016 WCJ decision (2016 WCJ Decision) to be “in the nature of a lumbar disc herniation at L5-S1 and an aggravation of degenerative disc and joint disease of the lumbar spine with overlying lumbar facet syndrome, lumbosacral strain and sprain as a result of cumulative trauma from the performance of his [work] duties.” (WCJ Decision, November 5, 2018 (2018 WCJ Decision), Finding of Fact (FOF) ¶ 2.) At the time of his injury, Claimant had an average weekly wage (AWW) of $1653.85. The 2016 WCJ Decision granted Claimant’s Claim Petition on December 9, 2016, but suspended Claimant’s benefits as of February 1, 2016, due to Claimant’s return to his position without loss of earnings. On February 8, 2017, Claimant filed the Reinstatement Petition, alleging he sustained a decrease in earning power due to the work-related injuries as of that date.1 Employer filed the Termination Petition on July 6, 2017, averring Claimant was fully recovered from the work-related injuries as of April 18, 2017. Finally, Claimant filed the UR Petition seeking review of a Utilization Review Determination (UR Determination) that had found the treatment provided by Robert Sing, D.O., not reasonable or necessary after March 6, 2017. Answers were filed by each party, denying the material allegations of the Petitions. The Petitions were

1 Claimant also filed a Penalty Petition, but later withdrew that petition.

2 consolidated and assigned to a WCJ, who held hearings2 at which the parties presented documentary and testimonial evidence.

B. Proceedings Before the WCJ Claimant testified as follows.3 He began working for Employer in 1999, left work due to work-related injuries on August 3, 2015, and returned to his full, heavy- duty work on February 1, 2016. (FOF ¶ 6.) Claimant again left work around August 5, 2016, because he was experiencing burning sensations in his back and throughout both of his legs. Claimant sought treatment from Dr. Sing for his ongoing complaints. Claimant received short-term disability benefits until February 2017, at which time he presented Employer with a doctor’s note releasing him to light-duty work. However, Employer sent Claimant a letter indicating that he could not return to work with restrictions and that no light-duty work would be offered. Claimant filed for unemployment compensation benefits, which he received. Claimant indicated he was not fully recovered but was ready to return to his full-duty job. On August 28, 2017, Dr. Sing released him to full-duty work, but Employer would not give Claimant his job back. Employer terminated Claimant on March 8, 2018. Claimant obtained new employment earning $17.80 per hour, which he worked for about five weeks before quitting due to his need to be home for his children and that position required him to work overnight. Claimant then started working as a bus driver for a local school district, earning $19.75 per hour for 25 to 35 hours a week.

2 The Petitions were initially assigned to one WCJ, who retired, at which point they were reassigned to the WCJ who issued the 2018 WCJ Decision. 3 Claimant testified at two hearings, and the transcript of his testimony can be found at pages 20a-34a and 57a-69a of the Reproduced Record. Claimant’s testimony is summarized in finding of fact 6.

3 Dr. Sing testified by deposition on Claimant’s behalf as follows.4 Dr. Sing, who is board certified in emergency, family, and sports medicine, first treated Claimant with physical therapy from November 2, 2015, through February 4, 2016, in addition to seeing Claimant monthly for prescription medication. At his regularly scheduled office visit on August 15, 2016, Claimant complained of severe pain in his back that radiated down both of Claimant’s legs. Claimant advised Dr. Sing that Claimant had stopped working on August 9, 2016. Following his examination of Claimant, Dr. Sing restarted Claimant on physical therapy. Dr. Sing opined that Claimant sustained a work-related aggravation of his degenerative lumbar spine and L5-S1 herniated disc, and was unable to return to his full-duty position with Employer. He did, however, release Claimant to work on February 6, 2017, with lifting restrictions so long as Claimant could change position as necessary. Dr. Sing increased the amount of lifting Claimant could perform on April 11, 2017, and May 11, 2017. Despite Claimant’s ongoing complaints of pain, Dr. Sing released Claimant, at Claimant’s “demand,” to his full-duty position contingent on Claimant stopping his narcotic pain medications, which Claimant did. (Reproduced Record (R.R) at 94a-95a.) Dr. Sing opined Claimant would always have pain and his ability to perform full-duty work depended on his ability to deal with the pain. Dr. Sing explained Claimant was not completely recovered from the work injuries set forth in the 2016 WCJ Decision and would not ever be completely recovered from those work injuries. (Id. at 95a.)

4 The transcript of Dr. Sing’s testimony can be found at pages 85a-103a of the Reproduced Record, and his testimony is summarized in finding of fact 7.

4 Employer presented the deposition testimony of Marc Manzione, M.D., a board-certified orthopedic surgeon, who testified as follows.5 Dr. Manzione examined Claimant in April 2017 and on October 19, 2017. Following his physical examination of Claimant and a review of Claimant’s medical records, including a November 21, 2017 Magnetic Resonance Image (MRI), Dr. Manzione opined that Claimant was fully recovered from his work-related injuries and capable of returning to work without restrictions that were related to those injuries. He noted the November 2017 MRI revealed no L5-S1 disc hernia or other traumatic pathology. Dr. Manzione did not return Claimant to his prior position because of Claimant’s longstanding, preexisting degenerative disc disease that would continue to be harmed if Claimant returned to his full-duty work, causing additional periods of disability. The Utilization Review Report (UR Report) of Sarah M. Reinhardt, D.O., was presented, which outlined the records she received and reviewed in analyzing Dr. Sing’s treatment.6 Dr. Reinhardt’s report found Dr.

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