Helms Express v. Workmen's Compensation Appeal Board

525 A.2d 1269, 106 Pa. Commw. 287, 1987 Pa. Commw. LEXIS 2174
Commonwealth Court of Pennsylvania·Decided May 21, 1987·No. Appeal, 1877 C.D. 1986·Published·Cited by 15 cases

Opinion

Opinion by

Senior Judge Narick,

Helms Express (Petitioner) appeals from an order of the Workmen's Compensation Appeal Board (Board) *289 which reversed a referees decision granting Petitioner a right of subrogation pursuant to Section 319 of The Pennsylvania Workmen's Compensation Act. (Act), Act of June 2, 1915; P.L. 736, as amended, 77 P.S. §671. For the reasons set forth below, we reverse the decision of the Board denying subrogation.

Grover Lemonds (Claimant) was a truck driver for Petitioner. On September 4, 1981, while in the course of his employment, Claimant suffered a fall which caused a severe skull fracture. Claimant was admitted to Geisinger Medical Center for this injury. During the course of his hospital stay, Claimant developed a gastrointestinal hemorrhage and this condition eventually led to Claimants death on September 22, 1981.

Claimants widow, Jessie S. Lemonds, filed a Petition for Compensation on July 14, 1982. At the hearing before the referee, Claimant presented the deposition testimony of Dr. George J. Paul, who testified that the trauma of the head injury created stress which led to gastrointestinal hemorrhaging and finally death. Petitioner proffered no evidence to contradict Dr. Paul. The referee concluded that Claimants death was work-related. This decision was initially appealed by Petitioner but the appeal was withdrawn.

Claimants widow subsequently entered into a settlement agreement with Geisinger Medical Center regarding a medical malpractice claim she had instituted against the hospital. In settlement of her claim, Claimants widow received two hundred seventy-five thousand dollars ($275,000); however, the settlement agreement contained no admission of negligence or liability on the part of Geisinger Medical Center.

Based on this settlement agreement, Petitioner filed a petition claiming a right of subrogation. The referee concluded that Claimants death was a result of complications of the skull fracture and that Petitioner was enti *290 tied to subrogation. The Board took no additional evidence but reversed the referee concluding that “the negligent conduct of the health providers was separate and distinct from Claimants injury at work and the negligent conduct did not occur on the employers premises” and, therefore, as a matter of law Petitioner was not entitled to subrogation.

On appeal, Petitioner contends that (1) the referees decision to award subrogation was supported by substantial evidence and, therefore, the Boards order denying subrogation improperly exceeded its scope of review; (2) an employer has a right of subrogation when an employee receives a medical malpractice recovery regarding a compensable injury; and (3) the employer need not prove the third party’s negligence in order to enforce its right of subrogation.

Our scope of review is limited to a determination of whether constitutional rights were violated, an error of law was committed, or whether necessary findings of fact are supported by substantial evidence. Section 704 of the Administrative Agency Law, 2 PaC. . S. §704; Estate of McGovern v. State Employees’ Retirement Board, 512 Pa. 377, 517 A.2d 523 (1986). Pursuant to Section 423 of the Act, 77 P.S. §854, the Board unless it chooses to hear new evidence is bound by the referee’s findings of fact unless the findings are not supported by substantial competent evidence. See Universal Cyclops Steel Corp. v. Workmen's Compensation Appeal Board, 9 Pa. Commonwealth Ct. 176, 305 A.2d 757 (1973). An employer’s right to subrogation is a question of law based upon findings of fact. Thus, we must determine whether the referee’s findings were based upon substantial competent evidence and in accordance with the law.

The subrogation rights of an employer are set forth in Section 319 of the Act, 77 P.S. §671, which reads in pertinent part:

*291 Where the compensable injury is caused in whole or in part by the act or omission of a third party, the employer shall be subrogated 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; . . .

The right of subrogation is founded on principles of equity which seek (1) to prevent double recovery for the same injury by a claimant, (2) to ensure that the employer is not compelled to make compensation payments necessitated by the negligence of a third party, and (3) to prevent a third party tortfeasor from escaping liability for his negligence. See Heiser v. Workmen's Compensation Appeal Board, 95 Pa. Commonwealth Ct. 350, 505 A.2d 1060 (1986) and Stark v. Posh Construction Co., 192 Pa. Superior Ct. 409, 162 A.2d 9 (1960). In order for an employer to establish a right of subrogation, the employer must show he is compelled to make payments by .reason of the negligence of a third party and the fund to which he seeks subrogation was for the same compensable injury for which he is liable under the Act. Dale Manufacturing Co. v. Workmen's Compensation Appeal Board (Bressi), 491 Pa. 493, 497, 421 A.2d 653, 655 (1980), citing Dale Manufacturing Co. v. Workmen's Compensation Appeal Board (Bressi), 34 Pa. Commonwealth Ct. 31, 35, 382 A.2d 1256, 1259 (1978).

Hence, where a third party’s negligent conduct results in injury to an employee while in the course of his employment there is a clear right to subrogation. In Heiser, subrogation was granted where a claimant injured in an automobile accident while in' the course of employment received a third party recovery against the driver responsible for the accident. However, Section 319 of the Act does not permit reduction in compensa *292 tion liability for the compensable injury because of a third party recovery which occurs after the original injury is incurred, particularly if the subsequent injury is not “in whole or in part” a contributing factor in the original “compensable injury”. Maitland Brothers Co., Inc. v. Workmen's Compensation Appeal Board (Moser), 92 Pa. Commonwealth Ct. 421, 425, 499 A.2d 713, 715 (1985). In Maitland, an employer was found not entitled to subrogation where an employee who suffered a work-related back injury was in an automobile accident nine months after the original injury.

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Helms Express v. Workmen's Compensation Appeal Board, 525 A.2d 1269, 106 Pa. Commw. 287, 1987 Pa. Commw. LEXIS 2174 (Pa. Ct. App. 1987).

525 A.2d 1269 (Helms Express v. Workmen's Compensation Appeal Board) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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