Daniels v. Workers' Compensation Appeal Board

828 A.2d 1043, 574 Pa. 61, 2003 Pa. LEXIS 1271
CourtSupreme Court of Pennsylvania
DecidedJuly 22, 2003
Docket51 EAP 2000
StatusPublished
Cited by326 cases

This text of 828 A.2d 1043 (Daniels v. Workers' 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
Daniels v. Workers' Compensation Appeal Board, 828 A.2d 1043, 574 Pa. 61, 2003 Pa. LEXIS 1271 (Pa. 2003).

Opinions

OPINION OF THE COURT

JUSTICE CASTILLE.

This Court granted allowance of appeal to determine whether the Workers’ Compensation Judge (“WCJ”) in this case failed to adequately explain on the record why she rejected claimant/appellant’s conflicting medical evidence pursuant to Section 422(a) of the Workers’ Compensation Act (“the Act”). See 77 P.S. § 834 (effective August 23, 1996). For the following reasons, we vacate and remand to the WCJ for proceedings consistent with this opinion.

On December 13, 1990 appellant was involved in a motor vehicle accident while in the course and scope of his employment with his employer, Tristate Transport. He filed a claim petition for workers’ compensation benefits alleging injury to his lumbosacral spine and continuing lower back pain with [64]*64radiation into his lower extremities. On August 10, 1991 the WCJ found that appellant had sustained a work-related injury and awarded benefits at the rate of $200 per week as of December 14, 1990. On January 9, 1992 Employer filed a termination petition, alleging that as of November 7, 1991 appellant’s disability had ceased and he was able to return to work without restrictions. On February 19, 1992 appellant filed an answer denying Employer’s allegations and claiming that he remained temporarily totally disabled.

The medical expert evidence concerning the status of appellant’s work injury was disputed. Employer submitted the deposition testimony of John T. Williams, M.D., a board-certified orthopedic surgeon, who had examined appellant on November 7, 1991. Dr. Williams opined that appellant had sustained an acute lumbosacral strain and sprain that had since resolved and, thus, appellant was able to return to work without restrictions. In reaching his diagnosis, Dr. Williams did not review the x-rays, CAT scan, and nerve conduction tests which had been previously performed on appellant sometime between mid-December 1990 and November 7, 1991.

Appellant rebutted this evidence by submitting the deposition testimony of Dr. Steven Fabian, M.D., a family physician and appellant’s treating physician, who first examined appellant on the date of his work injury. During this examination, Dr. Fabian determined that appellant suffered from spasms in the paraspinal muscles of the cervical and lumbar regions, and that appellant had a 45% limitation of motion in his cervical spine and a 50% limitation of flexion, extension, and rotation in the lumbar region of his back. After nine months of physical therapy, Dr. Fabian found that appellant had hit a plateau of a 20-25% limitation of motion. Dr. Fabian had last examined appellant on October 16, 1992, at which time appellant complained of pain in his lumbar spine and legs. Based upon that examination Dr. Fabian opined that appellant’s limitation of cervical flexion, extension, and rotation had improved substantially, ie., it was now at 15%. Dr. Fabian also opined that appellant suffered from post-traumatic cervical and lumbar sprain with a protruding disc at L-4-5 level. Dr. Fabian [65]*65reviewed the CAT scan, which revealed a mildly concentrically protruding disc at level L-4-5 and a normal EMG. Dr. Fabian opined that appellant could not return to his duties as an ambulance driver with Employer, or to any other employment at that time, as he still experienced pain which was exacerbated by physical activity. Dr. Fabian also noted that appellant had limited mobility in his back which precluded him from doing any active physical work, sitting for periods of more than fifteen to twenty minutes, or walking more than short distances.

Appellant testified before the WCJ on December 10, 1992 and claimed that his lower back and legs had continued to bother him since the work injury. Appellant stated that he still could not stand or sit for more than one hour; he experienced pain in his lower back when he walked; and he could lift only twenty pounds. Due to his continued pain and limited mobility, appellant testified, he did not think he could return to work with Employer in his pre-injury capacity as an ambulance driver, a job which required him to lift patients and equip ambulances with items such as oxygen tanks weighing up to one hundred pounds. Appellant further testified that he was receiving physical therapy three times a week, that he sees Dr. Fabian once a week, and that he takes Tylenol with codeine for pain.

The WCJ filed her decision on March 14, 1997, finding in favor of Employer and ordering the termination of appellant’s benefits as of November 7, 1991.1 After summarizing the testimony of Dr. Williams, Dr. Fabian, and appellant, the WCJ made the following, determinative findings:

16. Based upon a review of the evidentiary record as a whole, this Judge finds the testimony of the Claimant is not credible or persuasive.
17. Based upon a review of the evidentiary record as a whole, this Judge finds the opinions of Dr. Williams to be more credible and persuasive than the opinions of Dr. [66]*66Fabian. Accordingly, the opinions of Dr. Fabian are rejected wherever inconsistent with the opinions of Dr. Williams. 18. This Judge finds Claimant was fully recovered from his December 13, 1990 work injury as of November 7, 1991.

WCJ’s Decision at 4.

Appellant appealed to the Workers’ Compensation Appeal Board (“WCAB”), which affirmed the WCJ’s termination decision. Upon further appeal, the Commonwealth Court, sitting en banc, affirmed by a 5-2 vote. Daniels v. Workers’ Compensation Appeal Bd. (Tristate Transport), 753 A.2d 293 (Pa.Cmwlth.2000). On the salient question presented here— 1. e., the contours of the “reasoned decision” requirement set forth in Section 422(a) of the Act in a case where the WCJ is presented with conflicting evidence — the majority opinion by Judge Kelley noted that questions of credibility and weight of the evidence fall within the exclusive province of the WCJ as fact-finder. Id. at 303. The majority then found that the WCAB had “properly determined that the WCJ provided an adequate explanation for her determination by outlining all of the evidence considered, stating the credible evidence on which she relied, and setting forth the reasons for the ultimate denial of Employer’s termination petition.” Id. at 305.2

Judge Friedman, joined by Judge Pellegrini, dissented. The dissent noted that the WCJ had “made no attempt to explain, much less to adequately explain, her reasons for rejecting or discrediting competent evidence,” as required by the 1996 amendment to Section 422(a) of the Act. Id. at 307. Although the dissent did not dispute that the WCJ was authorized to make credibility determinations, in the dissent’s view the WCJ’s failure to explain the basis for her credibility determination where the evidence was conflicting did not [67]*67satisfy the reasoned decision requirement. The dissent also acknowledged Employer’s argument that the fact that the WCJ had listed her findings and pointed to “telling portions of the record,” made it “not hard to imagine how the WCJ reached her conclusions.” But, the dissent noted that this argument merely illustrated the dissent’s point: “the 1996 amendments have cleared any doubt as to the legislature’s intent to prevent the parties from having to ‘imagine’ why certain credibility determinations were made.” Id.

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Bluebook (online)
828 A.2d 1043, 574 Pa. 61, 2003 Pa. LEXIS 1271, Counsel Stack Legal Research, https://law.counselstack.com/opinion/daniels-v-workers-compensation-appeal-board-pa-2003.