Gumm v. Workers' Compensation Appeal Board

942 A.2d 222, 2008 Pa. Commw. LEXIS 36
CourtCommonwealth Court of Pennsylvania
DecidedJanuary 28, 2008
StatusPublished
Cited by44 cases

This text of 942 A.2d 222 (Gumm 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
Gumm v. Workers' Compensation Appeal Board, 942 A.2d 222, 2008 Pa. Commw. LEXIS 36 (Pa. Ct. App. 2008).

Opinion

OPINION BY

Judge SIMPSON.

In these workers’ compensation appeals, Chris Gumm (Claimant) petitions for review of an order of the Workers’ Compensation Appeal Board (Board) insofar as it reversed an award of a penalty and unreasonable contest attorney fees against J. Allan Steel Company, and its workers’ compensation carrier, Old Republic Insurance Services (collectively, Employer). Claimant asserts Employer’s failure to file an appropriate document accepting his work injury as compensable constituted an unreasonable contest of his claim petition and violated the Workers’ Compensation Act (Act). 1

*225 In its cross petition for review, Employer asserts the Board erred in upholding the order insofar as it granted Claimant’s claim petitions and awarded him ongoing total disability benefits. Specifically, Employer asserts the Board erred in holding the Workers’ Compensation Judge’s (WCJ’s) decision satisfied the “reasoned decision” requirement of Section 422(a) of the Act, 77 P.S. § 834, and the WCJ’s determination that Claimant sustained a disabling work injury is not supported by substantial evidence.

For the following reasons, we affirm.

I. Background

A. Work Injury

Claimant worked for Employer as a crane man. On February 3, 2003, Claimant sustained a work injury when his right foot became lodged between two steel beams. He wrenched his right ankle and noticed immediate pain and swelling. Claimant was treated at a local hospital. Thereafter, Employer referred him to its panel physician, an orthopedic specialist who diagnosed a right ankle sprain. On February 17, Employer issued a notice of temporary compensation payable (NTCP) for a right ankle sprain. See Reproduced Record (R.R.) at 14a.

Thereafter, on April 15, 2003, Dr. Jeffrey N. Kahn, an orthopedic surgeon (Employer’s First Physician), examined Claimant. He believed Claimant’s work accident temporarily aggravated a pre-existing condition. Employer’s First Physician released Claimant to modified duty as of April 15, and to full duty as of April 21.

On April 21, Employer, pursuant to Section 406.1 of the Act, 2 simultaneously filed a notice stopping temporary compensation and a notice of compensation denial (NCD). See R.R. at lla-13a. The notice stopping temporary compensation indicated Employer decided not to accept liability for Claimant’s injury and advised him to file a claim petition. Id. at 13a. On the NCD, Employer placed an “x” next to the following reasons on the Workers’ Compensation Bureau’s NCD form for declining to pay Claimant workers’ compensation benefits:

4. Although an injury took place, the employee is not disabled as a result of this injury within the meaning of the [Act].
6. Other good cause_ CLAIMANT HAS BEEN RELEASED TO FULL-DUTY AS OF 4/21/03. INSURED IS DOWNSIZING DUE TO ECONOMIC FACTORS; THUS NO JOB FOR CLAIMANT TO RETURN TO. TEMPORARY TOTAL DISABILITY BENEFITS ARE BEING DISCONTINUED BASED ON FULL-DUTY RELEASE.

Id. at 11a (emphasis added). The first reason, number 4, is one of five pre-print-ed reasons on the NCD form. The second reason, number 6, carries the pre-printed statement “Other good cause” and requires a full explanation in the space below.

B. Claimant Petitions

In May 2003, Claimant filed a claim petition (first claim petition) alleging he sustained a work injury in the nature of a right ankle sprain and aggravation of previously asymptomatic right ankle degenerative joint disease as a result of the February 2003 incident. R.R. at 3a-4a. Claimant later orally amended this petition to include additional claims for traumatic and post-traumatic arthritis secondary to the injury. In February 2004, *226 Claimant filed a second claim petition alleging the same disabling condition (aggravation of asymptomatic right ankle arthritis) not as a result of a discrete work injury but as the result of repetitive and cumulative trauma due to climbing, and walking on concrete and gravel. Id. at 7a-8a. Employer filed timely answers denying Claimant’s allegations.

In May 2004, Claimant filed a penalty petition alleging Employer violated Section 406.1 of the Act by improperly filing an NCD, as opposed to a notice of compensation payable (NCP), where the medical evidence indicated a compensable injury. Claimant also requested a 50% penalty on unpaid compensation from the date of the injury to the date of the penalty petition. Id. at 9a-10a.

C. Evidence

Claimant testified on his own behalf. Employer later cross-examined him by deposition. Claimant’s crane man duties included moving steel in and out of buildings and loading it on trucks and train cars. At the time of the accident, Claimant’s toe caught on a steel beam, which violently bent his right foot upward. He immediately noticed pain and swelling, and was transported to a hospital. Although Claimant complained of a broken ankle, the hospital x-rays showed no fracture.

Claimant acknowledged pre-existing right leg problems. He fractured his tibia and fibula in a sledding accident at age 17. He also suffered a work-related right knee injury in 1999. However, Claimant denied having right ankle problems prior to the February 2003 accident.

In addition, Claimant submitted the deposition testimony of Dr. Gerald W. Pifer (Claimant’s Physician), a board-certified orthopedic surgeon. In May 2003, Claimant’s Physician examined Claimant concerning his right ankle injury, reviewed his medical records and took a history of the work accident. Claimant’s Physician diagnosed Claimant’s condition as a chronic sprain of his right ankle, and traumatic joint disease of the right ankle. He opined the February 2003 incident aggravated a pre-existing traumatic arthritis of the ankle. Although the degenerative arthritis began as early as 2000, the February 2003 incident created Claimant’s current symptoms and his disability. Claimant’s Physician advised Claimant he could not perform his pre-injury job.

Employer submitted deposition testimony from two board-certified orthopedic surgeons. As noted above, Employer’s First Physician opined Claimant’s work-related ankle injury temporarily aggravated a pre-existing, non-work-related, degenerative condition. He released Claimant to modified duty as of April 15; and to full duty as of April 21, 2003.

Dr. Jon B. Tucker (Employer’s Second Physician), examined Claimant’s right ankle in October 2003. He opined Claimant suffered a mild ankle sprain as a result of the February 2003 incident, which fully resolved as of his examination. Employer’s Second Physician also observed Claimant had pre-existing degenerative ankle problems. He testified Claimant’s work-related ankle sprain did not play any role in causing his ongoing ankle problems.

D. WCJ’s Decision

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Cite This Page — Counsel Stack

Bluebook (online)
942 A.2d 222, 2008 Pa. Commw. LEXIS 36, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gumm-v-workers-compensation-appeal-board-pacommwct-2008.