Leonard v. Workmen's Compensation Appeal Board

687 A.2d 16, 1996 Pa. Commw. LEXIS 533
CourtCommonwealth Court of Pennsylvania
DecidedDecember 23, 1996
StatusPublished

This text of 687 A.2d 16 (Leonard 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
Leonard v. Workmen's Compensation Appeal Board, 687 A.2d 16, 1996 Pa. Commw. LEXIS 533 (Pa. Ct. App. 1996).

Opinion

DOYLE, Judge.

Delores Leonard (Claimant) appeals an order of the Workmen’s Compensation Appeal Board (Board) which affirmed a decision of a Workers’ Compensation Judge (WCJ) which denied Claimant’s penalty petition.

On November 7, 1986, Claimant sustained a shoulder injury during the course of her employment with Germantown Savings Bank (Employer). Thereafter, Claimant received $194.73 per week in workers’ compensation benefits pursuant to a notice of compensation payable.

On March 14, 1990, Employer filed a review petition alleging that, as of November 3, 1989, Claimant’s medical treatment was unreasonable, unnecessary, and unrelated to Claimant’s work injury. Thereafter, on June 21, 1991, Employer filed a suspension petition alleging that, as of November 8, 1990, Claimant had recovered from her work-related injury to the extent that she could return to work at an available position within her physical restrictions and that Claimant failed to make a good faith effort to follow-up on job referrals. Claimant then filed a petition for penalties on July 8, 1991, alleging that Employer’s insurance carrier failed to pay Claimant’s medical bills.

The three petitions were then consolidated. After a series of hearings, the WCJ made the following pertinent findings of fact:

8. Dr. Iannotti [Employer’s medical expert who twice examined Claimant] opined, within a reasonable degree of medical certainty, that Claimant could return to work, albeit, in a sedentary or light duty position. ...
9. Based upon this opinion, Dr. Iannot-ti reviewed and approved the sedentary positions which were presented to him by the rehabilitation counselor Sherry Kris-tal-Turetsky. He opined that these jobs would not exacerbate Claimant’s condition. ...
11. In further support of its Petitions, [Employer] submitted the testimony of Sherry Kristal-Turetsky, M.Ed., a Certified Rehabilitation Counselor, who was assigned by [Employer’s] insurance carrier to assist Claimant in finding light duty work on September 24,1990....
12. Ms. Kristal-Turetsky testified that she attempted to contact Claimant through her attorney, both by letter and telephone, in order to arrange an interview. However, she never received a response....
13. Ms. Kristal-Turetsky testified that she managed to determine suitable positions for Claimant by contacting her pre-injury employer and did on-site job analysis. She reviewed Claimant’s employment application and medical reports. In partic[18]*18ular, she followed the estimated functional capacities form completed by Dr. Iannot-ti....
14. Ms. Kristal-Turetsky found three sedentary positions (i.e. lifting up to ten pounds with occasional bending and squatting) for Claimant with her pre-injury employer. These three job possibilities were bank reconciliation clerk, credit investigator and teleservice representative_
15. Ms. Kristal-Turetsky testified that Claimant never returned to work to any of these jobs_ In fact, Claimant responded that she was unable to return to work due to her disabling work injury....
17. Mr. Molnar [Employer’s Assistant Vice President of Human Resources] testified that, upon notice from the insurance carrier that Claimant was able to return to work, he assisted Ms. Kristal-Turetsky in locating and evaluating positions at [Employer] that would be suitable for Claimant. ...
18. Mr. Molnar testified that he informed Claimant in a letter dated November 8, 1990, that there were three sedentary positions available (reconciliation clerk, credit investigator and teleservice representative) at [Employer] that matched Claimant’s vocational background and were within her medical restrictions. ...
19. In opposition to [Employer’s] Petitions, Claimant testified in her own behalf twice....
22. In further opposition to [Employer’s] Petition, Claimant submitted the testimony of her treating physician, John J. Bowden, Jr., D.O., a board eligible general practitioner, who first examined Claimant on September 15,1987....
25. Dr. Bowden opined that Claimant’s condition was related to her work injury....
26. Dr. Bowden opined that, since she is totally disabled (by her condition and by the medication needed for pain relief and muscle relaxation), Claimant cannot return to work, whether it be to her pre-injury employment or any other type of job....
27.Dr. Bowden further opined that Claimant’s injury was ‘permanent’ and he offered a prognosis of ‘poor.’ ...

(WCJ’s Decision at 3-6, Findings of Fact (F.F.) No. 8-9,11-16,18-19, 22, 25-27.) (Citations omitted.)

The WCJ accepted the testimony of Dr. Iannotti, Ms. Kristal-Turetsky, and Mr. Molnar as credible and rejected the testimony of Claimant, stating:

The testimony of Claimant is found to be neither credible nor persuasive, and, accordingly, it is rejected. Claimant’s (and her attorney’s) stonewalling of the vocational process (i.e. the interview) and her refusal to try these light duty tasks tell a tale of ‘bad faith’ on Claimant’s part. Accordingly, modification should be granted.

(WCJ’s decision at 7, F.F. No. 30(d).)

The WCJ concluded that Employer met its burden of proving that work was available to Claimant within her medical restrictions effective November 8,1990. Hence, by a decision and order circulated on December 12, 1994, the WCJ granted Employer’s suspension petition, modifying Claimant’s benefits to $97.11 retroactive to November 8, 1990.

Significantly, the WCJ also concluded that “[a]ll medical treatment and services provided by Dr. Bowden and other medical providers, on or after November 3,1989, are unreasonable and unnecessary for treating the continuing residual disability of Claimant.” (WCJ’s decision at 7, Conclusion of Law (C.L.) No. 3.) Thus, the WCJ granted Employer’s review petition effective November 3,1989.

Finally, the WCJ concluded that “[w]hile [Employer] is responsible for medical services provided before November 3, 1989, this [WCJ] will impose no penalty for services which Dr. Iannotti finds to be ‘inappropriate,’ ” (WCJ’s decision at 7, C.L. No. 4.), and, therefore, denied Claimant’s penalty petition.

Claimant appealed to the Board which affirmed. The instant appeal followed.

Claimant presents two issues for our review: (1) Whether the WCJ erred in terminating Employer’s obligation to pay Claimant’s medical bills effective November 3, 1989, rather than December 12, 1994, the [19]*19date on which the WCJ’s decision was circulated; and (2) Whether the WCJ erred in dismissing Claimant’s penalty petition.

Medical Bills

Under the Workers’ Compensation Act,1 an employer is only liable for payment of benefits, both compensation and medical, arising out of work-related injuries. Mulholland v. Workmen’s Compensation Appeal Board (Bechtel Construction), 669 A.2d 466 (Pa.Cmwlth.1995). For this reason, Pennsylvania courts have held that where an employer challenges the reasonableness and necessity of a claimant’s work-related medical bills, the employer must pay those bills up until the date of the WCJ’s decision to terminate benefits.

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687 A.2d 16, 1996 Pa. Commw. LEXIS 533, Counsel Stack Legal Research, https://law.counselstack.com/opinion/leonard-v-workmens-compensation-appeal-board-pacommwct-1996.