S. Sloane v. WCAB (Children's Hospital of Philadelphia)

124 A.3d 778
CourtCommonwealth Court of Pennsylvania
DecidedOctober 1, 2015
Docket1213 and 1399 C.D. 2014
StatusPublished
Cited by28 cases

This text of 124 A.3d 778 (S. Sloane v. WCAB (Children's Hospital of Philadelphia)) 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
S. Sloane v. WCAB (Children's Hospital of Philadelphia), 124 A.3d 778 (Pa. Ct. App. 2015).

Opinion

OPINION BY

Senior Judge JAMES GARDNER COLINS.

Before this Court are cross-petitions for review filed by Sandra Sloane (Claimant) and her employer, Children’s Hospital of Philadelphia 1 (Employer), of an order of the Workers’ Compensation Appeal Board (Board) that affirmed in part and reversed in part the decision and order of a Workers’ Compensation Judge (WCJ) granting a petition for reinstatement of benefits (Petition) filed by Claimant. Claimant seeks review of the portion of the Board’s order that reversed the WCJ’s reinstatement of total disability benefits arising from work injuries sustained in 2004 and 2006. Employer seeks review of the Board’s order to the extent it upheld the WCJ’s determination that Claimant’s 2007 right-knee replacement surgery and related treatment were compensable medical expenses related to the 2006 work injury. For the reasons that follow, we affirm the order of the Board.

On April 20, 2004, Claimant injured her right elbow during the course and scope of her employment as a nurse for Employer while moving cervical traction weights for a patient. (WCJ Decision and Order, Finding of Fact (F.F.) ¶ 5; December 30, 2004 Notice of Compensation Payable (2004 NCP), Reproduced Record (R.R.) at 6a-7a.) Employer accepted the injury and resulting wage-loss disability through a Notice of Compensation Payable (2004 NCP), which described the injury as lateral epicondylitis of the right elbow. (WCJ Decision and Order, F.F. ¶ 5; 2004 NCP, R.R. at 6a-7a.) Claimant began receiving partial disability benefits pursuant to a series of supplemental agreements entered into by the parties and returned to work in a light-duty position with reduced wages. (WCJ Decision and Order, F.F. ¶¶ 6, 13.)

Claimant suffered a second work-related injury to her right elbow and right knee on December 3, 2006 while attempting to restrain a patient. (WCJ Decision and Order, F.F. ¶ 5; December 28, 2006 Notice of Compensation Payable (2006 NCP), R.R. at 8a-9a.) Employer accepted this injury through a medical-only NCP (2006 NCP) that did not recognize compensation for loss of wages. (WCJ Decision and Order, F.F. ¶ 5; 2006 NCP, R.R. at 8a.) The injury was described in the 2006 NCP as an “exacerbation of right elbow epicondyli-tis and flare up of preexisting [degenerative joint disease in her] right knee.” (2006 NCP, R.R. at 9a.) Following the injury, Claimant returned to light-duty work while continuing to receive partial disability for the 2004 injury until November 16, 2007 when she ceased working in anticipation of right-knee replacement surgery. (WCJ Decision and Order, F.F. ¶ 6.) *782 The surgery was performed by Dr.'Robert Booth in December 2007. (M) Claimant has not returned to work following this surgery. (Id.) ■■■

Claimant filed the Petition on May 31, 2011 seeking the reinstatement of total disability benefits as of November 1, 2007. (Petition, R.R. at la-3a.) Employer filed an answer to the petition denying Claimant’s entitlement to a reinstatement of benefits, and the-matter was assigned to a WCJ. (Answer, R.R. at 4a-5a.) Claimant testified by deposition and at a hearing before the WCJ, and Claimant also submitted the deposition of her physician, Thomas J. Mercora, D.O. The evidence presented by Employer included the deposition testimony of Barry Ruht, M.D., who performed an independent medical examination.of Claimant on December 22, 2011.

In a May 15, 2012 decision and order, the WCJ granted the Petition, concluding that Claimant was totally disabled as of November 17, 2007 based on both her 2004 and 2006 work injuries. (WCJ Decision and Order, F.F. ¶ 16, Conclusions of Law (C.L.) ¶¶ 1-3.) The WCJ further concluded that Employer was liable for payment of medical services provided or prescribed as a result of the 2004 and 2006 work injuries, including the December 2007 right-knee replacement surgery and subsequent treatment provided by Dr. Mercora. (Id., F.F. ¶ 17, C.L. ¶¶ 7-8.) The WCJ found 'Claimant credible and found Dr. Mercora more credible than Dr. Ruht on the basis that Dr. Mercora was Claimant’s treating physician. (Id., F.F. ¶¶ 13-14.)

Employer appealed the WCJ’s decision and order and the Board affirmed in part and reversed in part. The Board reversed the portion of the WCJ’s order that had granted total disability benefits based on the 2006 work injury, concluding that Claimant was required to comply with the three-year limitations period of Section 413(a) of the Workers’ Compensation Act (Act) 2 for modification of an NCP rather than the 500-week period for reinstatement of suspended partial disability benefits. (Board Op. at 2-4, 7-9.) As Claimant did not file the Petition within three years of the issuance of the 2006 NCP, the Board determined that Claimant 'was barred from receiving total disability benefits for the 2006 injury. (Id. at 8-9.) The Board concluded that the Petition was timely filed with respect to the 2004 work injury because Claimant continued receiving partial disability payments through the date of filing of the Pétition; the Board, however, reversed the WCJ’s award of total disability benefits for the 2004 injury, concluding that the credible medical evidence of Claimant’s own witness, Dr. Mer-cora, rebutted Claimant’s testimony that she was totally disabled as a result of the 2004 injury and instead- showed that the disability was a result of the 2006 injury. (Id. at 9-10 & n.,6.) The Board also affirmed the WCJ’s order to the extent it found Employer liable for Claimant’s 2007 right-knee replacement-, surgery and Dr. Mercora’s treatment related to the 2006 work injury, holding that Dr. Mercora’s testimony provided substantial evidence for this determination and that the WCJ did/not err in crediting him though he did not begin treating Claimant until July 2011. (Id. at 10-11.)

Claimant and Employer each petitioned this Court for review of the Board’s order. 3 *783 Claimant argues on appeal that the Board erred in- holding that her request for disability benefits for the 2006 injury was barred by the three-year limitations period of Section 413(a) and that the issuance of the medical-only 2006 NCP put her disability in suspended status which could be reinstated within 500 weeks of the 2006 NCP. Claimant further argues that the Board erroneously reversed the WCJ’s determination that Claimant was rendered totally disabled on November 17, 2007 as a result of her 2004 work injury to her right elbow, upsetting the WCJ’s credibility determinations. . In its appeal, Employer challenges the Board’s determination that Employer was liable for Claimant’s 2007 right-knee replacement surgery and other, medical expenses relating to the 2006 injury, arguing that Dr. Mercora’s testimony was not sufficient to support this conclusion and that the Board erred in crediting him as her treating physician.

We first address whether the Petition was timely filed with respect to the request for total disability benefits based on the 2006 work injury. Section 413(a) of the Act provides a WCJ with broad discretion to amend an award of benefits, an NCP or an agreement of the parties. 77 P.S. §§ 771; 772, 773.

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Bluebook (online)
124 A.3d 778, Counsel Stack Legal Research, https://law.counselstack.com/opinion/s-sloane-v-wcab-childrens-hospital-of-philadelphia-pacommwct-2015.