McGaffin v. Workers' Compensation Appeal Board

903 A.2d 94, 2006 Pa. Commw. LEXIS 391
CourtCommonwealth Court of Pennsylvania
DecidedJuly 19, 2006
StatusPublished
Cited by33 cases

This text of 903 A.2d 94 (McGaffin 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
McGaffin v. Workers' Compensation Appeal Board, 903 A.2d 94, 2006 Pa. Commw. LEXIS 391 (Pa. Ct. App. 2006).

Opinions

OPINION BY

Judge COHN JUBELIRER.

In this appeal, Laurence A. McGaffin (Claimant) asks this Court to address whether a Workers’ Compensation Judge (WCJ) may terminate benefits when, seven months earlier, Claimant was found to have a whole-person physical impairment rating of 26% based on an examination under Section 306(a.2) of the Workers’ Compensation Act (Act), Act of June 2, 1915, P.L. 736, added by the Act of June 24, 1996, P.L. 340, 77 P.S. § 511.2(1). However, because Claimant failed to raise this issue before the WCJ and did not include the issue in his appeal to the Workers’ Compensation Appeal Board (Board), we must conclude that he has not preserved this issue for review. Accordingly, we dismiss Claimant’s petition for review.

Claimant was employed by Employer “as a field data collector for the purpose of assessing real estate values.” (WCJ Decision Finding of Fact (FOF) ¶ 7.) His job responsibilities required him to do a great deal of driving and “to do extensive walking over uneven terrain in all types of weather.” (FOF ¶ 7.) On February 8, 1999, during the course of his employment, Claimant injured “his neck, upper back, low back and left shoulder” in a slip-and-fall accident. (FOF ¶ 7.)

On March 8, 1999, Employer issued a Notice of Temporary Compensation Payable (NTCP) for “Strain” of Claimant’s “Low Back” in the amount of $294.00 per week, based on an average weekly wage of $330.00. (NTCP, 3/8/99 at 1.)

Section 306(a.2)(l) of the Act requires an employee who has been receiving total disability benefits for 104 weeks to submit to an independent medical examination, upon employer’s timely request, for the purpose of determining an impairment rating evaluation (IRE). Section 306(a.2)(l) directs that “[t]he degree of impairment shall be determined based upon an evaluation [by a qualified examiner] pursuant to the most recent edition of the American Medical Association (AMA) ‘Guides to the Evaluation of Permanent Impairment.’” 77 P.S. § 511.2(1).

On August 7, 2001, Employer requested that Claimant undergo an IRE. On August 22, 2001, Nenad Janicijevic, M.D., F.A.C.E.P., a qualified examiner, completed an IRE of Claimant, finding that he had an impairment rating of “26% impairment of the whole person.”1 (IRE at 8.) Section 306(a.2)(2) provides that an impairment rating of 50% or above results in a presumption that the employee is totally disabled. 77 P.S. § 511.2(2). An impairment rating of less than 50% results in the employee “receiv[ing] partial disability benefits” under Section 306(b) of the Act, 77 P.S. § 512.

Employer subsequently issued a Notice of Compensation Payable (NCP) on April 9, 2002, in the amount of $294.002 for “CONTUSIONS AND SPRAINS” of the “CERV/THOR/LUMBAR SPINE & L [96]*96SHDR” that Claimant sustained by slipping down an embankment as he was measuring a house. (NCP, 4/9/02 at 1.)

On May 31, 2002, Employer filed a Termination Petition seeking to stop payment of workers’ compensation benefits as of March 12, 2002.3 In support of its Termination Petition, Employer presented the Expert Report and Deposition of Roger Ferguson, M.D.4 Dr. Ferguson physically evaluated Claimant in “all areas described in the notice of compensation payable” (FOF ¶ 8a), and concluded that Claimant had a “normal physical evaluation in all examined areas.... ” (FOF ,¶ 8b.) Dr. Ferguson opined that Claimant had “fully recovered from the 1999 surgery” that had been performed to address the injury, and Claimant showed “symptom magnification and subjective complaints without objective findings.” (FOF ¶ 8d.)

Claimant produced the deposition and report of his treating physician, Anna Mathew, M.D., who testified that Claimant has continued to have “constant complaints of cervical spine, left shoulder, chest, low back and mid back pain.” (FOF ¶ 9a.) Dr. Mathew opined that Claimant has “myofascial pain syndrome related to his work injury.... ” (FOF ¶ 9a.)

Additionally, Claimant testified during hearings before the WCJ that he was unable to return to work because of ongoing pain he was having in his chest, left shoulder, back and leg. (Test. 3/19/03, 12-14.)

Claimant did not argue before the WCJ that she needed to consider the effect the IRE might have on the termination. Employer offered the IRE into evidence, not as a medical opinion, but merely as a Bureau document that contained background history. Claimant’s counsel even questioned the relevancy of the IRE, wondering if the IRE, and other Bureau documents, were “relevant to the termination [petition].” (Test. 3/19/03, 5.) The WCJ admitted the IRE for the limited purpose that Employer offered it.5

The WCJ weighed the testimony and concluded that Employer met its “burden of proof ... that the claimant has fully recovered from the physical sequela of his work injury based upon the substantial, competent and credible medical evidence of the testimony of Dr. Roger Ferguson, which was adopted as credible and as fact.” (FOF ¶ 13.) The WCJ rejected Dr. Mathew’s opinions to the extent they contradicted Dr. Ferguson. The WCJ did not [97]*97address what effect the IRE might have on the termination, which issue had not been raised for her consideration.6

Claimant appealed the WCJ’s decision to the Board. Claimant did not mention the IRE in his notice of appeal form filed with the Board, which included the Appeal from the WCJ’s Findings of Fact and Conclusions of Law and also detailed Claimant’s Specific Exceptions which were attached thereto.7 The focus of Claimant’s arguments in his appeal was that the WCJ’s [98]*98conclusions of law were not supported by substantial evidence and that “[t]he Judge erred in accepting the testimony of Roger Ferguson, M.D. over the testimony of Anna Mathews, M.D.” (Claimant’s Specific Exceptions at 1.) Claimant does not include a reference to either Dr. Janicijevic or the IRE in his appeal.

The Board heard argument on January 19, 2005. In the reproduced, record, Claimant has included a brief,8 filed June 22, 2005, which, for the first time, raises the question of whether the IRE rating of 26% precludes the WCJ from granting Employer’s Termination Petition.9 Four months later, the Board filed its Opinion.

The Board affirmed the WCJ’s decision, addressing the issues raised in Claimant’s appeal documents, and not discussing the effect of the IRE. In doing so, the Board noted that “[w]ith regard to a termination petition, the defendant has the burden of establishing that the claimant’s disability has ceased and that the claimant has fully recovered from his work injury, or that any remaining disability is no longer the result of the work injury. Benson v. WCAB (Haverford State Hosp.), 668 A.2d 244 (Pa.Cmwlth.1995).” (Bd. Decision at 4.) The Board concluded that “because the WCJ accepted as credible Dr. Ferguson’s testimony that Claimant fully recovered from his work injury and could return to work without restrictions, [Employer] met its burden of proving its entitlement to a termination of Claimant’s benefits.” [99]*99(Bd. Decision at 7 (citation omitted).) Claimant appeals from the Board’s decision.

Before this Court,10

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Bluebook (online)
903 A.2d 94, 2006 Pa. Commw. LEXIS 391, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mcgaffin-v-workers-compensation-appeal-board-pacommwct-2006.