Luzerne County v. D. Allford (WCAB)

CourtCommonwealth Court of Pennsylvania
DecidedApril 13, 2022
Docket443 C.D. 2021
StatusUnpublished

This text of Luzerne County v. D. Allford (WCAB) (Luzerne County v. D. Allford (WCAB)) 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
Luzerne County v. D. Allford (WCAB), (Pa. Ct. App. 2022).

Opinion

IN THE COMMONWEALTH COURT OF PENNSYLVANIA

Luzerne County, : : Petitioner : : v. : No. 443 C.D. 2021 : Submitted: November 19, 2021 Dean Allford (Workers’ : Compensation Appeal Board), : : Respondent :

BEFORE: HONORABLE PATRICIA A. McCULLOUGH, Judge HONORABLE MICHAEL H. WOJCIK, Judge HONORABLE ELLEN CEISLER, Judge

OPINION NOT REPORTED

MEMORANDUM OPINION BY JUDGE WOJCIK FILED: April 13, 2022

Luzerne County (Employer) petitions for review of the order of the Workers’ Compensation Appeal Board (Board) that affirmed a decision of a Workers’ Compensation Judge (WCJ) granting Dean Allford’s (Claimant) Review Petition and medical aspects of his Claim Petition. Employer argues that the WCJ and Board erred in concluding that Claimant’s Claim Petition was not barred by the statute of limitations because Claimant was lulled into a false sense of security that his claim had been accepted; by relying upon Claimant’s testimony regarding an improperly admitted record; and by not finding that Claimant had fully recovered from his alleged work injury. Upon review, we affirm. I. Background The incident giving rise to this appeal occurred on February 13, 2013 (2013 Injury), but another work injury occurring on March 16, 2015 (2015 Injury) is pertinent to the procedural history and Employer’s defense. Claimant has worked for Employer as a correctional officer at the Luzerne County Correctional Facility for over 32 years. On January 30, 2018, Claimant filed a Claim Petition for the 2015 Injury alleging that he sustained a work- related injury while in the course and scope of his employment when he was assaulted by an inmate on March 16, 2015. Employer filed an Answer denying all of the material allegations. Employer also filed Petitions to Terminate and Suspend Compensation Benefits. On May 24, 2018, during the pendency of the 2015 Injury claim, Claimant filed a Review Petition relative to the 2013 Injury on the basis that Employer refused to pay for reasonable medical treatment. In the Review Petition, Claimant acknowledged that “there appears to have been a denial of benefits initially” but asserted that he never received notice of the same. Certified Record (C.R.) at 8.1 Claimant also noted that Employer covered all his medical bills for the 2013 Injury until December 12, 2017. C.R. at 8. At the WCJ hearing held on June 12, 2018, the parties withdrew the Claim, Termination, and Suspension Petitions relative to the 2015 Injury, and these petitions were dismissed, leaving only Claimant’s Review Petition for the 2013 Injury. WCJ’s 2/4/19 Op., Finding of Fact (F.F.) No. 6; Reproduced Record (R.R.) at 6a, 10a. In defense of the Review Petition, Employer produced a Notice of Workers’ Compensation Denial (Notice of Denial) dated February 21, 2013,

1 Because the Certified Record was filed electronically and was not paginated, the page numbers referenced in this opinion reflect electronic pagination. 2 acknowledging the 2013 Injury in the form of contusions to the knees and legs, but denying any disability related thereto. Employer did not accept liability for the injury because Claimant was not disabled as a result of the incident. F.F. No. 7; C.R. at 410. On August 6, 2018, Claimant filed a Claim Petition relative to the 2013 Injury asserting ongoing partial disability from February 13, 2013, onward. Claimant described the injury as a cervical sprain/strain, left shoulder impingement syndrome, pain in the left shoulder, and a sprain of the left rotator cuff capsule. C.R. at 18. Employer filed a timely Answer denying all material allegations and advancing several defenses including, inter alia, that Claimant’s claims were barred by the statute of limitations. F.F. Nos. 9-10. The WCJ held evidentiary hearings on Claimant’s Review and Claim Petitions. In support, Claimant testified that he sustained an injury on February 13, 2013, when an inmate ran towards him in an aggressive manner necessitating Claimant to restrain the inmate and defend himself by using force. In the process, Claimant fell and injured the left side of his neck, as well as his shoulder and his knees. Claimant completed an accident report immediately after the incident. F.F. No. 13. Claimant further testified that he was treated by workers’ compensation panel physicians and continued to treat with them throughout 2013. They prescribed medication for his neck, and he was also treated for his knees. Claimant resumed full-duty work shortly after the injury, but in August 2013 he was placed on modified duty, which involved more paperwork and less interaction with inmates. Since April 2014, Claimant has continuously treated with John Kline, Jr., M.D. (Dr. Kline).

3 Under Dr. Kline’s care, Claimant has received numerous injections in his neck and shoulder area and physical therapy for the 2013 Injury. F.F. No. 13. Claimant testified that he never received a Notice of Denial from Employer. Claimant identified Debbie Marinelli (Marinelli)2 from Employer’s workers’ compensation insurance carrier, Excalibur Insurance Management Services, LLC (Excalibur), as his claims representative. Claimant testified that he regularly communicated with her regarding his claim and that she never once indicated that his claim had been denied. Shortly after the injury, Claimant received correspondence from her and a prescription card to use for prescriptions for the 2013 Injury. On November 29, 2017, Claimant received an updated prescription card. Claimant testified that Marinelli advised him early on that any work absences related to the 2013 Injury would be covered by “comp” time. Claimant testified that whenever he needed time off for medical appointments, “comp time” was applied; he never used any of his own vacation, sick, or personal leave time. F.F. No. 13. Claimant presented the testimony of Erin Pinto (Pinto), Excalibur’s Vice President of Claims, on cross-examination. Pinto testified that she was involved in Claimant’s claim since inception. She testified that the 2013 Injury claim was denied because Claimant did not miss any time from work. F.F. No. 14; C.R. at 150. She conceded that Employer had paid for all medical bills related to this injury. She testified that it is common practice for a prescription card to be sent out months after a claim is denied explaining, “just because we’re paying medical bills does not mean it’s acceptance of an injury.” Id. at 152. Although she

2 Claimant requested a subpoena for the appearance of Marinelli to appear and testify live at the September 7, 2018 hearing, which the WCJ approved. Despite the subpoena, Marinelli did not appear. Employer’s counsel was unable to explain her absence. Claimant’s counsel was unable to verify service of the subpoena. F.F. Nos. 11-12. 4 acknowledged that Claimant treated with workers’ compensation panel physicians for the 2013 Injury, she denied that Claimant was paid wage loss benefits for any time missed attending those medical appointments. Id. at 152-55. As for the Notice of Denial, she testified that there was a “diary note” indicating that Excalibur had mailed the Denial to Claimant on February 21, 2013, but she could not confirm whether it was actually mailed, noting Marinelli would have been responsible for mailing it. F.F. No. 14; C.R. at 151. Claimant testified again before the WCJ and once again explained that whenever he went to a doctor or sought treatment for his 2013 Injury, he would notify Employer and the time would be marked off as using a workers’ compensation day. Claimant did not use any of his own leave time for such appointments. Employer did not deduct time from Claimant’s vacation, sick, or personal time for these absences. In support, Claimant offered into evidence as Claimant’s Exhibit No.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Bailey v. Workers' Compensation Appeal Board
717 A.2d 17 (Commonwealth Court of Pennsylvania, 1998)
Pistella v. Workmen's Compensation Appeal Board
633 A.2d 230 (Commonwealth Court of Pennsylvania, 1993)
McDevitt v. Workmen's Compensation Appeal Board
525 A.2d 1252 (Commonwealth Court of Pennsylvania, 1987)
Guthrie v. Workers' Compensation Appeal Board
854 A.2d 653 (Commonwealth Court of Pennsylvania, 2004)
Rox Coal Co. v. Workers' Compensation Appeal Board
807 A.2d 906 (Supreme Court of Pennsylvania, 2002)
Pitt Ohio Express v. Workers' Compensation Appeal Board
912 A.2d 206 (Supreme Court of Pennsylvania, 2006)
Kelly v. Workmen's Compensation Appeal Board
669 A.2d 1023 (Commonwealth Court of Pennsylvania, 1995)
Ductmate Industries, Inc. v. Unemployment Compensation Board of Review
949 A.2d 338 (Commonwealth Court of Pennsylvania, 2008)
Commonwealth, Department of Transportation v. Workers' Compensation Appeal Board
38 A.3d 1037 (Commonwealth Court of Pennsylvania, 2011)
Keystone Dedicated Logistics, Inc. v. JGB Enterprises, Inc.
77 A.3d 1 (Superior Court of Pennsylvania, 2013)
Workmen's Compensation Appeal Board v. Griffith
368 A.2d 1371 (Commonwealth Court of Pennsylvania, 1977)
Dudley v. Workmen's Compensation Appeal Board
471 A.2d 169 (Commonwealth Court of Pennsylvania, 1984)

Cite This Page — Counsel Stack

Bluebook (online)
Luzerne County v. D. Allford (WCAB), Counsel Stack Legal Research, https://law.counselstack.com/opinion/luzerne-county-v-d-allford-wcab-pacommwct-2022.