Mosgo v. Workmen's Compensation Appeal Board

480 A.2d 1285, 84 Pa. Commw. 316, 1984 Pa. Commw. LEXIS 1613
CourtCommonwealth Court of Pennsylvania
DecidedAugust 1, 1984
DocketAppeal, No. 2795 C.D. 1983
StatusPublished
Cited by27 cases

This text of 480 A.2d 1285 (Mosgo 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
Mosgo v. Workmen's Compensation Appeal Board, 480 A.2d 1285, 84 Pa. Commw. 316, 1984 Pa. Commw. LEXIS 1613 (Pa. Ct. App. 1984).

Opinion

Opinion by

Judge Barbieri,

Petitioner, Stephen Mosgo (Claimant), appeals from the action of the Workmen’s Compensation Appeal Board (Board) in sustaining a referee’s decision sanctioning the discontinuance of benefit payments.

Claimant, a driver-salesman for Tri-Area Beverage, Inc. (Employer), suffered a heart attack while delivering half barrels of beer, each weighing 170 pounds, to a customer of the Employer on November 23, 1979, in what he described as “double work” because of the holiday, when he suffered pains in his chest and arms, became weak and was sweating. He was relieved of duty and reported to his physician, Glenwood B». Schreiner, M.D., who promptly sent him to Hazleton State General Hospital where he was admitted to the Intensive Care Unit and treated for “his [318]*318coronary heart attack. ’ ’ Dr. Schreiner, in response to an inquiry from the insurance carrier’s adjuster as to whether the heart attack was “as a result of strenuous activity,” replied, “I feel that the attack occurred as a result of strenuous activity.” The insurer, having begun its investigation on November 28, 1979,. obtained a signed statement from the Claimant on December 12, 1979, and having received Doctor Schreiner’s report dated December 20, 1979; made payments of’compensation due for the period November 24, 1979 to January 4, 1980, stating in a memorandum to Claimant dated December 28,1979 “ [w]e have not yet completed our medical investigation of your case. However, we are issuing an initial compensation-check due to the length of time since injury occurred. We reserve the right to deny the claim if future medical reports show case is not compensable.” The insurer states that payments were discontinued because of a report received by it from a physician, Dr. F. Gazek, stating “Mr. Mosgo’s type of work was not related to his heart attack.” The date of receipt of Dr. G-azek’s communication is uncertain, but the request therefor was dated December 19,1979 and the insurer’s witness testified that he had no date when Dr. Gazek’s report was received; only that it was “after Dr. Schreiner’s report.” A Notice of Workmen’s Compensation Denial, as required under the third paragraph of Section 406.1 of The Pennsylvania Workmen’s Compensation Act (Act),1 and mandated under 34 Pa. Code §121.13 to be filed within twenty-one days after notice or knowledge of the employe’s disability, was not filed until January 16,1980.

The insurer took none of the statutory steps required in order to discontinue compensation pay[319]*319ments, such as a petition for termination under Section 413 of the Act, 77 P.S. §771. Claimant, however, in an effort to have the payments reinstated, filed a petition entitled “PETITION TO REVIEW NOTICE OP COMPENSATION,” averring therein: “Stephen Mosgo, Claimant/Employee petitions for a review of the Notice of Compensation Payable in the above-captioned matter in accordance with Paragraph 413 of the Workmen’s Compensation Ant.” Claimant averred also that he had “sustained a compensable accident on November 23, 1979 while in the course of his employment with the Defendant Employer;” that the “Defendant Employer and/or its workmen’s compensation insurance carrier paid Claimant temporary total disability benefits for. the period November 24, 1979 through January 4, 1980;” and that “Defendant and/or its workmen’s compensation carrier, unilaterally and in violation of the Workmen’s Compensation Act, suspended payment of any further total disability benefits;” requesting relief in the nature of “an Order . . . directing the Defendant and/or workmen’s compensation insurance carrier to resume payments in accordance with the Notice of Compensation under which Claimant was previously paid. ’ ’

Defendant’s answer admitted payment stating “said payments were made pending investigation as to compensability of accident,” requesting “that an order be entered directing that claimant did not sustain a compensable accident,2 and that Employer and Workmen’s Compensation Insurance Carrier are not liable for payment of benefits.” (Footnote added.) On this Petition and Answer a hearing was held at [320]*320•which, no medical witness was called., bult at which Claimant and Eugene Semeheski, the latter employed by the insurer to investigate the claim, were the sole witnesses. A statement written by Semeheski and signed by Claimant was also made part of the record. The only medical evidence in the record consists of the one line statements of Drs. Schreiner and G-azek previously mentioned. There is also a copy of the records of Hazleton State General Hospital on Claimant’s confinement there from November 23, 1979 to December 7,1979. The EKG at the hospital “disclosed acute inferior wall myocardial infarcation. ’ ’

On this sparse record the referee rendered his decision3 in which after reciting the principal events detailed above, made the following conclusions in his findings of fact:

5. The Eeferee has now reviewed the evidence and still finds that the Defendant has acted in good faith and not contrary to the Workers’ Compensation Act. The Claimant’s statement does not prove the cause of his heart attack and the medical evidence supplied by Dr. Glazek states unequivocally that the Claimant’s type of work was not related to his heart attack. Based upon this information, it was unusual for the Defendant to withhold further payments of compensation until it was established that the Claimant’s heart attack was work-related.
6. It is significant that no Notice of Compensation Payable was ever filed by either the Claimant or the Defendant, nor was any Claim Petition filed by the Claimant. Therefore, it is still the burden of the Claimant to show by com[321]*321petent evidence, that his heart attack was related to his employment.

His dispositive conclusion of law reads:

2. The Claimant, .Stephen Mosgo, has failed to prove that the Defendant, Tri-Area Beverage, Inc., has acted contrary to the Workers ’ Compensation Act, or that they have wrongly terminated payments to the Claimant. Therefore, the Claimant’s Petition to Review should be dismissed.

He therefore entered the following order: “ AND NOW, this 1st day of March, 1982, the Claimant’s Petition to Review is dismissed.” The Board on appeal affirmed stating: “We also again note that no notice of compensation payable was ever filed with the Bureau in this case. Therefore, it is still claimant’s burden to show that his heart attack was in fact related causally to his employment.”

Claimant’s principal contention here is that the insurer, having accepted liability by making payments under the Act, may not discontinue payments, and excuse its failure to seek termination as provided in Section 413 of the Act, on the basis of its non-compliance with the procedures mandated in Section 406.1; neither filing a Notice of Compensation Payable nor, until after it has ceased making payments, a Notice of Compensation Denial.4

[322]*322The question at issue as we see it is whether a referee in such a case may require the Claimant to assume the burden of proof for the continuation of benefits when a proper Notice of Compensation Payable would have put the burden to terminate payments upon the Employer or its insurer.

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Cite This Page — Counsel Stack

Bluebook (online)
480 A.2d 1285, 84 Pa. Commw. 316, 1984 Pa. Commw. LEXIS 1613, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mosgo-v-workmens-compensation-appeal-board-pacommwct-1984.