Pennsylvania State Police v. Workers' Compensation Appeal Board

149 A.3d 118, 2016 Pa. Commw. LEXIS 452, 2016 WL 6242718
Commonwealth Court of Pennsylvania·Decided October 26, 2016·No. No. 2426 C.D. 2015·Published·Cited by 10 cases

Opinion

OPINION BY

JUDGE COVEY

Pennsylvania State Police (Employer) petitions this Court for review of the Workers’ Compensation (WC) Appeal Board’s (Board) November 3, 2015 order reversing the Workers’ Compensation Judge’s (WCJ) decision approving the Stipulation of the Parties entered into between Joseph Bushta (Claimant) and Employer (Stipulation). Employer presents two issues for this Court’s review: (1) whether the Board erred by finding that the parties were not bound by their Stipulation because Claimant was not aware of case law which existed before the Stipulation’s execution; and (2) whether the Board erred by reversing the WCJ’s decision because it was contrary to the holding in Stermel v. Workers’ Compensation Appeal Board (City of Philadelphia), 103 A.3d 876 (Pa. Cmwlth. 2014). .After review, we affirm. .

On February 25, 2011, Claimant 'suffered a work-related injury in the course of his employment when his state vehicle was hit by a tractor-trailer. On March 18, 2011, Employer issued a Notice of Compensation Payable (NCP) accepting com-pensable injuries described as cervical, thoracic and lumbar strains. The NCP provided for $858.08 weekly indemnity benefits, but indicated that Claimant was receiving salary continuation under what is commonly referred to as the Heart and Lung Act.1

On January 21, 2014, Claimant entered into a Settlement and Indemnity Agreement and Release of All Claims (Settlement Agreement), wherein, Claimant and his spouse acknowledged ■ receipt of $1,070,000.00 as a- full compromise settlement of any and all claims they may have against Winston J. Whitney, U.S. Trailer Relocators, LLC, USTR Freight, LLC, Rental Trailers of Laredo, Property & Casualty Ins. Co. of Hartford, James C. Hilton, Greatwide Dedicated Transport, III, LLC, GE Business Financial Services, Inc., as well as any other person, corporation, insurer, association or partnership responsible for Claimant’s February 25, 2011 injuries. Pursuant to the Settlement Agreement, $200,000.00 of the $1,070,000.00 third-party recovery was apportioned for Claimant’s spouse’s loss of consortium claim. The total amount attributed solely to Claimant was $870,000.00.

The Settlement Agreement reflected that- Claimant “will reimburse any lien holder, known or unknown, for any liens as a result - of the above incident.” Reproduced Record (R.R.) at 43a. In signing the Settlement Agreement, Claimant acknowledged his understanding that he was “solely responsible for the payment of any ... workers’ compensation liens ... incurred as a result of the accident.” Id. Before executing the Settlement Agreement, [120] Claimant had entered into a Contingent Fee Agreement with Powell Law in which it was agreed that Claimant’s attorneys would receive 33 1/3% of the recovery as their fee. The attorney’s fee attributable solely to Claimant’s recovery totaled $290,000.00. Further, Claimant and his spouse incurred $18,723.68 in litigation costs. On February 4, 2014, Employer filed a Petition for Review with the WC Office of Adjudication asserting a right of subro-gation -against the proceeds of Claimant’s third-party recovery.

On November 19, 2014, Claimant and his counsel signed the Stipulation and Employer’s-counsel signed it on November 20, 2014. According to the Stipulation, Employer “[paid] Heart and Lung Act wage loss benefits beginning with a pay dated [sic] occurring on [March 3, 2011].” R.R. at 110a. It further provided that Claimant initially accepted his full salary in the amount of $1,417.20 per week (or $2,834.40 bi-weekly) as Heart and Lung Act benefits. However, these payments increased as Claimant obtained raises, until he started collecting his normal pay as of June 22, 2012. In total,- Claimant was paid $94,166.64 in Heart and Lung Act wage loss benefits. The Stipulation also reflected that $56,873.13 in WC indemnity benefits were remitted to Claimant under the Workers’ Compensation Act (WC Act)2 from February 26, 2011 until June 3, 2012.

Further, the Stipulation provided that “a medical payment history revealed treatment billed as of [February 25, 2011] through and including payment remitted for dates of service occurring on [February 18, 2013]. The aggregate amount of medical benefits, paid by Employer totaled $110,869.53.” R.R. at 111a. Employer and Claimant also executed a Third Party Settlement Agreement calculation sheet which reflected that Employer was entitled to reimbursement of a net lien, calculated based upon the indemnity and medical benefits payable under the WC Act in the amount of $56,873.13 and $110,869.53, respectively. The accrued lien expense reimbursement rate was 19.2801%. The parties stipulated that the accrued lien was $167,742.66, and did not include $37,293.51 which Employer characterized as Heart and Lung Act wage loss benefits.

On December. 4, 2014, the WCJ issued his decision approving the Stipulation. On December 22, 2014, Claimant appealed to the Board, arguing that since all Employer provided benefits were paid pursuant to the Heart and Lung Act, Employer is not entitled to subrogation and, therefore, the Stipulation was contrary to Stermel. On November 3, 2015, the Board agreed, and reversed the WCJ’s decision. Employer appealed to this Court.3

Employer first argues that the Board erred by finding that the parties were not bound by their Stipulation because notwithstanding Claimant’s lack of knowledge, Stermel was decided before the Stipulation’s execution. Although Claimant’s execution of the Stipulation on November 19, 2014 occurred after Stermel was decided (on November 13, 2014),. Stermel was decided before the WCJ issued his decision approving the- Stipulation, and before the matter was appealed to the Board.

In Cipcic v. Workers’ Compensation Appeal Board (Consolidation Coal Co.), 693 A.2d 1009 (Pa. Cmwlth. 1997), this Court [121] was presented with the issue of whether the Board erred by retroactively applying Republic Steel v. Workmen’s Compensation Appeal Board (Petrisek), 537 Pa. 32, 640 A.2d 1266 (1994) (decided on April 22, 1994 which was after the WCJ’s decision but before the Board’s decision) to the claimant’s case.- The Cipcic Court held:

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Pennsylvania State Police v. Workers' Compensation Appeal Board, 149 A.3d 118, 2016 Pa. Commw. LEXIS 452, 2016 WL 6242718 (Pa. Ct. App. 2016).

149 A.3d 118 (Pennsylvania State Police v. Workers' Compensation Appeal Board) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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