Emanuel v. Workmen's Compensation Appeal Board

692 A.2d 1182, 1997 Pa. Commw. LEXIS 192, 1997 WL 194458
CourtCommonwealth Court of Pennsylvania
DecidedApril 23, 1997
Docket2079 C.D. 1996
StatusPublished
Cited by8 cases

This text of 692 A.2d 1182 (Emanuel v. Workmen's Compensation Appeal Board) 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
Emanuel v. Workmen's Compensation Appeal Board, 692 A.2d 1182, 1997 Pa. Commw. LEXIS 192, 1997 WL 194458 (Pa. Ct. App. 1997).

Opinion

RODGERS, Senior Judge.

Joseph Emanuel (Claimant) petitions for review of an order of the Workmen’s Compensation Appeal Board (Board) which affirmed a decision by a workers’ compensation judge (WCJ) granting the modification petition filed by Coco Brothers, Inc. (Employer). The issue before the Court is whether the WCJ erred in applying the net method, rather than the gross method, to determine Employer’s subrogation rights and liabilities with respect to a third-parly settlement.1

Facts

On December 24,1985, Claimant sustained a work-related injury when the scaffold on which he was working collapsed and he fell approximately fifty-six feet to the ground. Employer issued a notice of compensation payable which provided compensation for total disability at the weekly rate of $276.63. On October 12, 1990, Employer filed a petition for termination or suspension of benefits and, after Claimant filed a timely response, the case was assigned to a WCJ.

On February 23, 1993, Employer filed a modification petition, alleging that, on January 20,1993, Claimant had amicably settled a third-party action which resulted in the payment of $725,000.00 to Claimant; Employer sought reimbursement of its subrogation lien and a credit against future benefits to which Claimant may be entitled. Claimant filed an answer in which he acknowledged Employer’s right to subrogation, but averred that calculations should be made employing the gross method, as opposed to the net method suggested by Employer.

The WCJ denied Employer’s petition for termination or suspension based on findings that Claimant remained totally disabled. The WCJ granted Employer’s modification petition and, reasoning that Employer was entitled to choose the method of calculation to be used, applied the net method to calculate Employer’s entitlement.

Claimant appealed to the Board, arguing that the WCJ committed an error of law by not utilizing the gross method of calculation. Claimant argued that there is no provision in the Act and no case law that permits employers to choose the method of calculation.

The Board observed that there is no authority, statutory or otherwise, which addresses the specific issue raised. The Board concluded that the WCJ did not commit reversible error and affirmed the WCJ’s decision.

On appeal,2 Claimant contends that this Court has consistently approved the gross [1184]*1184method as the simplest and fairest method for both parties.

Subrogation under the Act

Section 319 of the Act provides:

Where the compensable injury is caused in whole or in part by the act or omission of a third party, the employer shall be subro-gated to the right of the employe, his personal representative, his estate or his dependents, against such third party to the extent of the compensation payable under this article by the employer; reasonable attorney’s fees and other proper disbursements incurred in obtaining a recovery or in effecting a compromise settlement shall be prorated between the employer and employe, his personal representative, his estate or his dependents. The employer shall pay that proportion of the attorney’s fees and other proper disbursements that the amount of compensation paid or payable at the time of recovery or settlement bears to the total recovery or settlement. Any recovery against such third person in excess of the compensation theretofore paid by the employer shall be paid forthwith to the employe, his personal representative, his estate or his dependents, and shall be treated as an advance payment by the employer on account of any future installments of compensation.

77 P.S. § 671.

A Bureau regulation sets forth the procedures by which the mandate of the statute is carried out:

§ 121.18 Subrogation procedure.
(a) In the event of third party recovery under section 319 of the Workers’ Compensation Act (77 P.S. § 671), Third Party Settlement Agreement, Form [LIBC]-380, shall be executed by parties thereon.
(b) If credit is requested against future compensation payable, Supplemental Agreement, Form LIBC-337, shall also be filed with the Department of Labor and Industry indicating the amount and periodic method of pro rata reimbursement of attorney fees and expenses.

34 Pa.Code § 121.18.

Gross Method

Form LIBC-380 aids in the calculation of an employer’s subrogation entitlement according to the gross method, also referred to as the Bureau method. Under this method, the total recovery is reduced by the amount of the employer’s lien to arrive at the balance of recovery. Next, the employer’s pro rata share of recovery expenses, i.e. attorney’s fees and costs, relative to its hen is determined by dividing the total workers’ compensation hen by the gross recovery. The employer receives immediate reimbursement of its workers’ compensation hen (compensation already paid to the claimant) reduced by the employer’s pro rata share of recovery costs relative to the hen.

The balance of the total recovery is treated as a credit to the employer against future compensation payable. This credit is measured in weeks, referred to as the “grace period.” The number of weeks in the grace period is determined by dividing the balance of the recovery by the claimant’s weekly compensation rate.

Under the gross method, the employer makes no compensation payments during the grace period, but reimburses the claimant, in cash, the amount of costs attributable to that week of compensation. The weekly amount payable to the claimant is determined by dividing the balance of the recovery expenses by the number of weeks in the grace period.

The following reflects the application of the gross method to the facts of the present case. Claimant received a gross recovery of $725,000.00 and Employer’s lien is $203,-003.98. Employer’s pro rata share of recovery expenses is 28% and the total expenses of recovery are $302,192.49. Employer receives immediate payment of $118,390.08 (lien amount less $84,613.90, 28% of recovery expenses). Claimant receives the balance of $304,417.43, after paying attorney’s fees and costs.

Subtracting Employer’s hen from the total recovery results in a credit against future [1185]*1185compensation payable of $521,996.02; dividing that amount by Claimant’s weekly compensation rate of $276.63 results in a grace period of 1887 weeks, or 36-plus years. The balance of the expenses of recovery paid initially by Claimant is $217,578.59 ($302,-192.49 less the $84,613.90 deducted from Employer’s lien payment). During the grace period, Claimant would be reimbursed by receiving a weekly cash payment of $115.30 ($217,578.59 divided by 1887 weeks).

Thus: 725,000.00 - 203,003.98 = 521,996.02 (credit fund)
203,003.98 = 28% (pro rata share of recovery costs) 725,000.00
521,996.02 = 1887 (weeks of grace period)
276.63

Net Method

Under the net method, the total recovery is reduced by the amount of the employer’s lien and by attorney fees and costs to arrive at the balance of recovery, which is the credit for future compensation payable.

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Cite This Page — Counsel Stack

Bluebook (online)
692 A.2d 1182, 1997 Pa. Commw. LEXIS 192, 1997 WL 194458, Counsel Stack Legal Research, https://law.counselstack.com/opinion/emanuel-v-workmens-compensation-appeal-board-pacommwct-1997.