Romansky v. Shalala

885 F. Supp. 129, 1995 U.S. Dist. LEXIS 10036, 1995 WL 310508
CourtDistrict Court, W.D. Pennsylvania
DecidedMay 15, 1995
DocketCiv. A. No. 94-1153
StatusPublished
Cited by2 cases

This text of 885 F. Supp. 129 (Romansky v. Shalala) is published on Counsel Stack Legal Research, covering District Court, W.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Romansky v. Shalala, 885 F. Supp. 129, 1995 U.S. Dist. LEXIS 10036, 1995 WL 310508 (W.D. Pa. 1995).

Opinion

[130]*130 MEMORANDUM

LANCASTER, District Judge.

Plaintiff, Alex Romansky, appeals the Secretary of Health & Human Services’s decision to reduce his social security disability benefits by the full amount plaintiff received from a commuted lump sum settlement of a workers’ compensation award. The Secretary reduced plaintiffs social security disability benefits pursuant to the “offset” provision of the Social Security Act. 42 U.S.C. § 424a.

Plaintiff challenges that portion of the offset that reduced his benefits by the amount he received for a permanent facial disfigurement under section 306(c) of the Pennsylvania Workers’ Compensation Act. 77 Pa. Cons.Stat. % let seq. Plaintiff contends that a facial disfigurement does not cause a loss of earning power, and therefore, a workers’ compensation award for a facial disfigurement is not a disability award under Pennsylvania law. Based on his claim that the award for his facial disfigurement is not a disability award, plaintiff further argues that it does not fall within the offset provision of the Social Security Act. Plaintiff now seeks reimbursement for that amount of the offset attributable to his facial disfigurement award.

Before the court are the parties’ cross motions for summary judgment. For the reasons that follow, the court holds that a workers’ compensation award for a permanent facial disfigurement under section 306(c) of the Pennsylvania Workers’ Compensation Act is a disability benefit, and thus is properly offset against a social security disability award. Accordingly, we enter judgment in favor of the Secretary and against plaintiff.

I. BACKGROUND

The material facts in this case are neither complicated nor disputed. In February of 1985, plaintiff was injured in a work-related accident, leaving him with a partial disability that is manifested by severe headaches, numbness in his right leg, pain in his right shoulder, and numbness on the right side of his head. He also suffered a permanent facial disfigurement. As a result of his injuries, plaintiff began receiving benefits under the Pennsylvania Workers’ Compensation Act. Additionally, in January of 1989, plaintiff began receiving disability insurance benefits under Title II of the Social Security Act.

In September of 1991, the Pennsylvania Workers’ Compensation Appeal Board approved a settlement that commuted plaintiffs workers’ compensation benefits. As a result, plaintiff received $91,314.80 for his partial disability (representing payments of $265.45 per week for 344 weeks) and $16,184.50 for his facial disfigurement (representing payments of $323.69 per week for fifty weeks). After counsels’ fees were deducted, plaintiff received a lump sum settlement of $100,-000.00.

Thereafter, the Secretary offset the entire lump sum of $100,000.00 against plaintiffs social security disability benefits. Plaintiff requested and received a hearing before an administrative law judge (“ALJ”) to challenge the offset. Plaintiff did not dispute the Secretary’s decision to reduce his social security disability benefits for that portion of his workers’ compensation award that was attributable to his partial disability; rather, plaintiff disputed the decision to offset that portion of the award that was attributable to his facial disfigurement.

The ALJ upheld the Secretary’s decision to offset plaintiffs social security disability benefits by the entire lump sum. The Appeals Council affirmed; accordingly, the ALJ’s decision became the final decision of the Secretary.

Plaintiff contends that the ALJ erred as a matter of law because the offset provision only allows the Secretary to offset state workers’ compensation benefits that are awarded to compensate an individual on account of a “disability.” According to plaintiff, under Pennsylvania case law a work-related injury is disabling only if it causes a loss of earning power. Plaintiff argues that a facial disfigurement does not cause a loss of earning power; therefore, his workers’ compensation award for his facial disfigurement is not a disability award under Pennsylvania law. Based on this argument, plaintiff contends that the award does not fall within the offset provision of the Social Security Act.

[131]*131II. STANDARD OF REVIEW

When reviewing whether the Secretary of Health and Human Services applied the proper law to calculate the social security disability benefit offset, the court must “decide all relevant questions of law, interpret constitutional and statutory provisions, and determine the meaning or applicability of the terms of [the Secretary’s] action.” 5 U.S.C. § 706. The court’s review of whether the Secretary applied the proper law is plenary. Wilkerson v. Bowen, 828 F.2d 117, 119 (3d Cir.1987); 5 U.S.C. § 706.

III. DISCUSSION

The issue presented is whether the Secretary erred in determining that the portion of the lump sum awarded for plaintiff’s permanent facial disfigurement is a “periodic benefit! ] on account of [an individual’s] total or partial disability” under the Pennsylvania Workers’ Compensation Act and, therefore, falls within the offset provision of the Social Security Act. 42 U.S.C. § 424a. The court holds that the Secretary did not err.

Congress enacted the offset provision to prevent a claimant from receiving disability benefits in excess of 80% of his pre-disability earnings. See Camevali v. Heckler, 616 F.Supp. 1500, 1503 (W.D.Pa.1985). Toward this end, the offset provision requires the Secretary to reduce a claimant’s social security disability benefits for any month during which the claimant receives “periodic benefits on account of [such individual’s] total or partial disability (whether or not permanent) under ... a workmen’s compensation law or plan of the United States or a State.... ” 42 U.S.C. § 424a(a). The Act makes clear that workers’ compensation benefits that have been commuted to a lump sum award remain “periodic benefits” within the meaning of the offset provision. 42 U.S.C. § 424a(b).

The question at issue, therefore, reduces to whether the portion of the lump sum plaintiff received for his facial disfigurement was awarded “on account of a disability.” To answer this question we must determine whether an award for a facial disfigurement is an award for a disability under the Pennsylvania Workers’ Compensation Act. The court concludes that it is.

The Pennsylvania Workers’ Compensation Act separates work-related injuries into three statutory classifications depending upon the type of injury: total disabilities are governed by section 306(a); partial disabilities are governed by section 306(b); and disabilities resulting from permanent injuries, including permanent disfigurement and the loss of a body part, are governed by section 306(c).

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Bluebook (online)
885 F. Supp. 129, 1995 U.S. Dist. LEXIS 10036, 1995 WL 310508, Counsel Stack Legal Research, https://law.counselstack.com/opinion/romansky-v-shalala-pawd-1995.