Gorman v. Workers' Compensation Appeal Board

952 A.2d 748, 2008 Pa. Commw. LEXIS 316
CourtCommonwealth Court of Pennsylvania
DecidedJuly 9, 2008
StatusPublished
Cited by2 cases

This text of 952 A.2d 748 (Gorman v. Workers' 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
Gorman v. Workers' Compensation Appeal Board, 952 A.2d 748, 2008 Pa. Commw. LEXIS 316 (Pa. Ct. App. 2008).

Opinion

OPINION BY

Senior Judge McCloskey.

William Gorman (Claimant) petitions for review of an order of the Workers’ Compensation Appeal Board (Board), affirming a decision of a Workers’ Compensation Judge (WCJ) awarding Kirkwood Construction (Employer) $71,191.00 for its subrogation lien. We affirm.

Claimant was injured at work on October 27, 2000, when a nail was ejected from a nail gun and hit him in the right eye. Employer accepted liability through a notice of compensation payable and Claimant began receiving benefits pursuant to the Pennsylvania Workers’ Compensation Act [749]*749(Act).1 Claimant’s benefits were suspended as of August 31, 2001, when he returned to work without a loss of wages.

On September 4, 2001, Claimant filed a claim petition seeking compensation for the loss of his right eye and disfigurement of his head and neck. Claimant later amended the claim petition to a petition to approve a compromise and release agreement (C & R).

A hearing was held before the WCJ. At the hearing, the parties entered the C & R into evidence. Paragraph 11 of the C & R asked, “Is there a lien or potential lien for subrogation under Section 319?” (R.R. at 129a). A box to check yes or no was provided. The box marked “no” was checked. Paragraph 11 then continued with the statement “If there is a lien, then attach a fully-executed Third Party Settlement Agreement, demonstrating the total of credit to be allowed and the formula by which credit will be taken.” Id. The space to include the information was left blank and the parties did not attach any additional information.

Following the hearing, the WCJ approved the C & R and ordered that Claimant receive a lump sum payment of $90,000.00. It was further ordered that $10,000.00 of the lump sum award be paid directly to Claimant’s counsel.2

On January 13, 2005, Employer filed a petition to review compensation benefit offset seeking a subrogation credit due to a third party recovery. Employer alleged that after receiving approval of the C & R in 2002, Claimant filed a third party action. Employer alleged that it was not informed of the third party action until September, 2004.

A hearing was held before the WCJ. Claimant testified that at the time he entered into the C & R, he had not retained counsel to represent him in the third party action. Claimant explained that in 2000, he discussed his eye injury with Greg Mitsch, Esq., a family friend. Attorney Mitsch said he “would try to look into” filing a third party action against the manufacturer and/or seller of the nail gun used in Claimant’s injury. (R.R. at 12a). At that time, Attorney Mitsch also referred Claimant to Joseph Huttemann, Esq., a workers’ compensation attorney. Claimant stated that he did not remember ever discussing a possible third party action with Attorney Huttemann.

Claimant explained that Attorney Mitsch never contacted him regarding the possibility of a third party action. Claimant stated that “[t]wo years passed. I had no one representing me and I assumed that was the end of it.” (R.R. at 12a-13a). Then, in October, 2002, he was contacted by Robert Mongeluzzi, Esq. Attorney Mongeluzzi had learned of Claimant’s injury through Attorney Mitsch. Claimant than retained Attorney Mongeluzzi in his third party lawsuit and a lawsuit was filed against D & M Home Builders, Home Depot and Stanley Bostich, in December, 2002. In December, 2004, Claimant received a settlement of $100,000.00 from one the defendants. The case against the other defendants remained pending.

Employer presented testimony from Peter Hnylanski, its workers’ compensation claims adjuster at the time of Claimant’s work injury, and Michael Herrold, Employer’s current workers’ compensation claims adjuster. Mr. Hnylanski testified that he was never informed of a possible third party action prior to the approval of [750]*750the C & R. Mr. Herrold testified that he first learned of the third party action in September, 2004. Claimant’s attorney in the third party action contacted him and asked if Employer had waived its right to recover a lien in a third party action. Mr. Herrold stated that he reviewed the file and the file did not contain any indication as to a discussion involving a potential third party case:

Employer also admitted into evidence its claim log notes and correspondence from Claimant’s workers’ compensation attorney. (R.R. at 141a-162a). The log notes and correspondence discuss settlement based on Claimant’s disfigurement. The notes and correspondence do not contain any discussion of a third party action or waiver or the subrogation lien.

Following the hearing, the WCJ determined that Employer’s witnesses were credible and that there was no evidence that a potential third party action was considered by the parties when negotiating the C & R. The WCJ also accepted Claimant’s testimony that he was not aware that there was a possibility of a third party recovery until after the C & R was approved. As such, the WCJ determined that the parties were mistaken in averring in Paragraph 11 that there was no potential subrogation hen. Due to a mutual mistake upon the material and substantial issue of the existence of a potential subrogation hen, the WCJ set aside the C & R. The WCJ found that Employer was entitled to a credit based upon the amount paid pursuant to the C & R and that Employer could enforce a subrogation hen against the funds Claimant received in his third party action.

Claimant and Employer both appealed to the Board. Both parties alleged that the WCJ erred in setting aside the C & R. The Board agreed. The Board noted that a C & R can only be set aside on the theory of mutual mistake when the mistake was in existence at the time the agreement was executed. The Board determined that as the mistake was not in existence when the parties entered into the C & R, it should not be set aside.

The Board next addressed whether or not Employer waived its right to subrogation. The Board determined that Employer had not waived its right to subrogation as Employer was not aware of the possibility of the third party action until after the C & R was approved. As such, the Board vacated the WCJ’s ruling to set aside the C & R, affirmed the WCJ’s grant of the review petition and remanded for additional findings of fact and conclusions of law as to the amount of the subrogation hen.

On remand, Claimant submitted two statements of distribution as to his third party action. The first statement of distribution indicated that Claimant received a third party settlement of $100,000.00. This included attorney fees of $22,735.09 and costs of $27,264.91. Therefore, the amount paid to Claimant was $50,000.00. The second statement of distribution indicated that Claimant received an award of $125,000.00. This award included attorney fees of $41,666.67 and costs of $2,132.00. Thus, Claimant actually received $81,201.33. Based on the total award of $131,201.33 to Claimant, the WCJ determined that Employer was entitled to be reimbursed $71,191.00.

Claimant appealed to the Board. In his appeal to the Board, Claimant argued that the WCJ erred in granting Employer’s review petition because Employer had waived its right to subrogation pursuant to the C & R. The Board noted that it had already decided this issue in its prior opinion.

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952 A.2d 748, 2008 Pa. Commw. LEXIS 316, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gorman-v-workers-compensation-appeal-board-pacommwct-2008.