U.S. Airways v. Workers' Compensation Appeal Board

854 A.2d 411, 578 Pa. 456, 2004 Pa. LEXIS 1605
CourtSupreme Court of Pennsylvania
DecidedJuly 20, 2004
Docket18 WAP 2003
StatusPublished
Cited by7 cases

This text of 854 A.2d 411 (U.S. Airways v. Workers' Compensation Appeal Board) is published on Counsel Stack Legal Research, covering Supreme Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
U.S. Airways v. Workers' Compensation Appeal Board, 854 A.2d 411, 578 Pa. 456, 2004 Pa. LEXIS 1605 (Pa. 2004).

Opinions

OPINION OF THE COURT

Justice NIGRO.

This workers’ compensation case concerns the scope of a special supersedeas hearing on a claimant’s challenge to an insurer’s notice of suspension of benefits brought pursuant to section 413(c) of the of the Workers’ Compensation Act (the “Act”),1 77 P.S. § 774.2. Specifically, we are asked to resolve whether the workers’ compensation judge (“WCJ”) properly found as part of her decision on such a challenge that in addition to suspending the claimant’s benefits during the term of her re-employment, the insurer was entitled to continue to suspend the claimant’s benefits after her re-employment ended. Based on the factual scenario in the instant case, we hold that the WCJ properly found that the insurer was entitled to such a suspension.

On August 26, 1999, Appellant Linda Rumbaugh (“Claimant”) fell and injured herself while working as a flight attendant for Appellee U.S. Airways (“Employer”).2,3 She sought [460]*460treatment from two different doctors, John Metcalf, M.D. and Brent Ednie, M.D., both of whom found that Claimant could not return to work in any capacity. Employer subsequently issued a notice of compensation payable (“NCP”), agreeing to pay Claimant total disability benefits of $511.02 per week while she remained out of work due to her injuries. According to the NCP, those injuries were limited to an acute cervical trapezius strain and a left shoulder contusion.4 On October 27, 1999, Dr. Ednie released Claimant to return to work without any limitations and two days later, Claimant started working as a flight attendant for Employer again.

Based on Claimant’s full return to work, on November 1, 1999, Employer filed a notice to suspend her benefits pursuant to section 413(c) of the Act, which provides as follows:

Notwithstanding any provision of this act, an insurer may suspend the compensation during the time the employe has returned to work at his prior or increased earnings upon written notification of suspension by the insurer to the employe and the department, on a form prescribed by the department for this purpose. The notification of suspension shall include an affidavit by the insurer that compensation has been suspended because the employe has returned to work at prior or increased earnings. The insurer must mail the notification of suspension to the employe and the department within seven days of the insurer suspending compensation.
(1) If the employe contests the averments of the insurer’s affidavit, a special supersedeas hearing before a workers’ compensation judge may be requested by the employe [461]*461indicating by a checkoff on the notification form that the suspension of benefits is being challenged and filing the notification of challenge with the department within twenty days of receipt of the notification of suspension from the insurer. The special supersedeas hearing shall be held within twenty-one days of the employe’s filing of the notification of challenge.
(2) If the employe does not challenge the insurer’s notification of suspension within twenty days under paragraph (1), the employe shall be deemed to have admitted to the return to work and receipt of wages at prior or increased earnings. The insurer’s notification of suspension shall be deemed to have the same binding effect as a fully executed supplemental agreement for the suspension of benefits.

77 P.S. § 774.2. After filing the notice of suspension, Employer also stopped paying Claimant benefits, as permitted by section 413(c).

On November 13, 1999, Claimant called out sick from work. Nine days later, on November 22, 1999, Claimant filed a challenge to Employer’s notice of suspension pursuant to section 413(c)(1). Subsequently, on December 14, 1999, Employer filed a section 413(a) petition to suspend Claimant’s benefits on the basis that Claimant was fully capable of returning to her position with Employer.5 In its petition, Employer also requested a supersedeas pursuant to section 413(a.2) of the Act, which gives a workers’ compensation judge discretion to suspend a claimant’s benefits pending her decision on the suspension petition if she finds, after a review of any evidence submitted with the petition or any other relevant evidence, that the employer is entitled to such a suspension.6

[462]*462On December 15, 1999, the WCJ held a hearing on Claimant’s challenge to Employer's notice of suspension. During that hearing, Claimant introduced all of her medical records since her August 1999 fall. Claimant also testified, explaining that when she returned to work in October 1999, her neck and shoulder injuries had resolved, but her lower back was sore. See WCJ Hearing, 12/15/1999, at 9. In addition, she stated that her leg became numb while she was working on a flight on November 13, 1999. See id. Accordingly, following the November 13th flight, Claimant called out sick from work and scheduled an appointment with Dr. Metcalf regarding her lower back and leg problems. See id. at 10. After examining Claimant, however, Dr. Metcalf concluded that she remained fully capable of returning to work. See id. Claimant then went to see Dr. Ednie, who also determined that Claimant was capable of returning to work -without limitations. See id. In spite of the doctors’ findings, Claimant testified that she remained on sick leave from work and was being treated by a new doctor for her lower back and leg problems. See id. at 15-16. Based on this testimony, Employer argued that Claimant was no longer disabled due to her August 1999 fall because she was out of work due only to her lower back and leg injuries, which were not referenced in the NCP related to the August 1999 fall. See id. at 18. The WCJ, finding that an issue existed regarding whether Claimant’s lower back and leg injuries were related to her original fall, rescheduled the supersedeas hearing for another date. See id. at 19-20. Neither party objected to the rescheduling.

On February 4, 2000, the WCJ held a second supersedeas hearing on Claimant’s challenge to Employer’s notice of sus[463]*463pension. The WCJ noted at the hearing that she had been assigned Employer’s section 413(a) suspension petition with its section 413(a.2) request for a supersedeas pending her decision on the suspension petition.7,8 Given this new assignment, she stated that she would rule first on Claimant’s challenge to Employer’s notice of suspension and then on Employer’s section 413(a.2) request for a supersedeas. See WCJ Hearing, 2/4/2000, at 10. During the hearing, both Employer and Claimant offered additional medical records regarding Claimant’s treatment since she had been released in October 1999 to return to work. Claimant also testified again and reiterated her earlier testimony that she was not working because of low back pain and numbness in her left leg. See id. at 20-21, 29-31. She further testified that she believed that her back problems stemmed from her August 1999 fall. See id. at 21. Employer, however, continued to contest any relationship between Claimant’s current problems and the August 1999 fall. See id. at 25-30.

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Bluebook (online)
854 A.2d 411, 578 Pa. 456, 2004 Pa. LEXIS 1605, Counsel Stack Legal Research, https://law.counselstack.com/opinion/us-airways-v-workers-compensation-appeal-board-pa-2004.