Grimm Ex Rel. Grimm v. Workers' Compensation Appeal Board

176 A.3d 1045
CourtCommonwealth Court of Pennsylvania
DecidedJanuary 4, 2018
Docket1982 C.D. 2016
StatusPublished
Cited by22 cases

This text of 176 A.3d 1045 (Grimm Ex Rel. Grimm 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
Grimm Ex Rel. Grimm v. Workers' Compensation Appeal Board, 176 A.3d 1045 (Pa. Ct. App. 2018).

Opinion

OPINION BY

JUDGE SIMPSQN

This appeal involving a fatal claim petition implicates only benefits for a surviving spouse; there is no dispute as to benefits for surviving children.

In particular, Petitioner Gerard Grimm (Claimant), on behalf of Katherine A. Grimm (Decedent), petitions for review of an order of the Workers’ Compensation Appeal Board (Board) that affirmed a Workers’ Compensation Judge’s (WCJ) denial of his fatal claim petition. Claimant raises substantial evidence and capricious disregard challenges to the WCJ’s critical findings of fact. In addition, Claimant con-tends the WCJ erred by misinterpreting the spousal dependency requirements in Section 307(7) of Workers’ Compensation Act (Act) 2 and the applicable case law construing those provisions. For the reasons that follow, we affirm.

I. Background

Claimant and Decedent were married in November 1988. They had three children. Claimant and Decedent separated in August or September of 2010. On February 2, 2012, Decedent suffered a heart attack while delivering packages in the course of her employment as a truck driver/delivery person for the Federal Express Corpora-, tion (Employer).

In April 2012, Claimant filed a fatal claim petition on behalf of himself as widower/husband and the couple’s children as dependents. Reproduced Record (R.R.) at 3a-4a. Employer initially filed an answer denying the material allegations of the petition. R.R. at 5a-7a. However, during the proceedings, Employer acknowledged Decedent’s work-related death and her children’s entitlement to benefits. In July 2013, the parties executed an agreement for compensation for death (compensation agreement). See R.R. at 61a-63a. Pursuant to the compensation agreement, Employer agreed to pay dependency benefits to Decedent’s children in accord with Section 307(1) of the Act, 77 P.S. § 561(1). Pursuant to Section 307(7) of the Act, 77 P.S. § 561(7), Employer agreed to pay Claimant up to $3,000 for Decedent’s burial expenses. R.R. at 63a.

However, the parties were unable to settle the issue of whether Claimant was entitled to dependency benefits as a widower because he had been separated and living apart from Decedent, although they were not divorced. Nonetheless, Claimant maintained he was substantially dependent on Decedent at the time of her death. See WCJ’s Op., 6/12/15, Finding of Fact (F.F.) No. 1.

Before the WCJ, Claimant testified on his own behalf and submitted joint tax returns he filed with Decedent and other documentary evidence showing the health insurance benefits Decedent provided to Claimant and the children. Claimant testified that at the time of her death, Decedent resided in the family home with her three children. F.F. No. 2b. The home had no mortgage at the time Claimant and Decedent separated. IA Decedent paid for the home insurance. Id. Claimant, however, acknowledged that he paid the utilities, which included water, gas and electric. Id. Claimant also paid most of the children’s expenses. Id. In particular, Claimant admitted he contributed to Decedent’s and the children’s monthly expenses, and not the other way around. Id.

Claimant further testified that following his separation from Decedent, he rented a townhouse. F.F. No. 2c. After moving out of the marital residence, Claimant was solely responsible for his rent, utilities and food. Claimant owned a car with no payment. Id. Claimant also paid for his car insurance. Id. Claimant and Decedent continued to have a joint checking account, which Claimant basically used as his personal account. Id. Claimant also acknowledged that Decedent did not provide him with any monetary support or contribute to any of his daily living expenses. Id.

Further, Claimant testified that he is self-employed and that health insurance is expensive. F.F. No. 2d. However, Decedent continued to provide her family, including Claimant, with health insurance through Employer, even after their separation. Id.

Claimant also submitted joint income tax returns for himself and Decedent for the years of 2009 through 2013. F.F. No.' 3. For the years 2009 and 2010, Claimant and Decedent had negative adjusted gross income because of Claimant’s business losses. Id However, for 2011, the year prior to Decedent’s death, Claimant and Decedent had an adjusted gross income of $80,600. Claimant’s total wages were $50,527 and Decedent’s total wages were $18,690. Id.

In addition, Claimant submitted documentation showing Decedent paid for health insurance coverage through payroll deductions by Employer from November 13, 2010 through January 28, 2012. F.F. No. 4. Id Employer’s health insurance covered not only her children, but also Claimant. Id.

Based on the evidence presented, the WCJ found that Claimant was not living with Decedent and that he was not dependent on her or receiving a substantial portion of support from her at the time of her death. F.F. No. 5a. In reaching this conclusion, the WCJ observed that the only support Decedent provided to Claimant was the health care benefits she obtained through Employer. Id.

The WCJ further found the record established that Claimant provided the majority of support for Decedent’s and the children’s household. F.F. No.' 5a. Claimant continued to pay the utilities for the marital residence, the children’s expenses and half of the real estate taxes. Id,

The WCJ also rejected Claimant’s argument that his 2009 and 2010 tax returns show that he relied on Decedent for substantial support during those years. F.F. No. 5b. Although their joint tax returns show negative income, they reflect numerous deductions based on Claimant’s business losses. Id. Also, Claimant and Decedent’s joint tax return for 2011 shpws that Claimant’s income recovered and that he earned substantially more than Decedent at the time of her death. Id.

Most importantly, the WCJ emphasized that Decedent’s payment of her family’s health coverage, through Employer did not by itself establish that she substantially contributed to Claimant’s support. F.F. No. 5c. Rather, the evidence shows Claimant provided substantial support for Decedent and the children. Id.

The WCJ also rejected Claimant’s argument that he was living with Decedent for purposes of receiving compensation under Section 307(7) of the Act, 77 P.S. § 561(7) (“[n]o compensation shall be payable under this section to a widow[er], unless he was living with his deceased [spouse] at the time' of [her] death, or was then actually dependent upon [her] and receiving from [her] a substantial portion of [his] support”). 3 F.F. No. 5d. The WCJ reasoned that Section 307(7)’s concept of “living with” could not be construed in anyway to find that Claimant and Decedent were living together at the time of Decedent’s death. Id. Rather, the WCJ found the evidence clearly established that Claimant and Decedent lived in separate residences for over a year-and-a-half at the time of Decedent’s death. Id.

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Cite This Page — Counsel Stack

Bluebook (online)
176 A.3d 1045, Counsel Stack Legal Research, https://law.counselstack.com/opinion/grimm-ex-rel-grimm-v-workers-compensation-appeal-board-pacommwct-2018.