Welliver McGuire, Inc. v. Workers' Compensation Appeal Board

834 A.2d 668, 2003 Pa. Commw. LEXIS 753
CourtCommonwealth Court of Pennsylvania
DecidedOctober 22, 2003
StatusPublished
Cited by1 cases

This text of 834 A.2d 668 (Welliver McGuire, Inc. v. Workers' 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
Welliver McGuire, Inc. v. Workers' Compensation Appeal Board, 834 A.2d 668, 2003 Pa. Commw. LEXIS 753 (Pa. Ct. App. 2003).

Opinion

FLAHERTY, Senior Judge.

Welliver McGuire, Inc. (Employer) petitions for review from an order of the Workers’ Compensation Appeal Board (Board) which affirmed the decision of a Workers’ Compensation Judge (WCJ) granting the petition to review compensation benefits and penalty petition filed by Richard Padgett (Claimant). We reverse and remand in part and affirm in part.

[669]*669Claimant sustained a work-related injury on February 4, 1998 and commenced receiving temporary total disability at a rate of $449.53 per week. In May 2001, Claimant began receiving pension benefits in the amount of $803.92. In June, Claimant completed LIBC Form 756, Employee’s Report of Benefits, which had been sent to him by Employer stating that he started receiving his pension benefits in May. On October 16, 2000, Employer sent Claimant LIBC Form 761, Notice of Workers’ Compensation Benefit Offset. The form advised Claimant that his current wage loss benefits of $449.53 per week would be reduced to $211.20 per week effective October 15, 2000. The reduction reflected Employer’s assertion of a credit for the full amount of the Claimant’s pension benefit of $803.92.

Claimant thereafter filed a review petition alleging that Employer was not entitled to an offset and also filed a penalty petition claiming that Employer unilaterally modified his benefits in violation of the Workers’ Compensation Act (Act).1 Employer filed an answer denying the allegations.

At the WCJ’s hearing, the parties stipulated that 46.3% of the money in Claimant’s pension plan is the result of contributions made by Employer. The parties also stipulated that although Employer is insured by Travelers Insurance Company (Travelers) for purposes of claimants workers’ compensation wage loss indemnity benefits, Employer has a $250,000.00 aggregate deductible for such benefits. As such, the first $250,000.00 of workers’ compensation benefits paid to Claimant and other employees is paid directly by Employer. Between February 4,1998 and June 1, 2000, all workers’ compensation benefits paid to Claimant were monies paid by Employer. All benefits after June 1, 2000 were paid by Travelers inasmuch as the $250,000.00 aggregate limit had been exceeded.

Claimant also testified at the hearing that his workers’ compensation benefits were reduced four days before being notified by Employer of the reduction. The LIBC Form 761 sent by Employer informing Claimant of the reduction stated that “this form is to provide you with at least 20 calendar days notice of this offset prior to a change in your workers’ compensation benefits.”

Based on the above, the WCJ granted Claimant’s review and penalty petitions. The WCJ concluded that based on this court’s recent decision in Kramer v. Workers’ Compensation Appeal Board (Rite Aid Corporation), 794 A.2d 953 (Pa. Cmwlth.2002), petition for allowance of appeal granted, 573 Pa. 32, 820 A.2d 700 (2003), Employer was not entitled to an offset for pension benefits issued to Claimant because Claimant’s workers’ compensation benefits were paid by Employer’s insurance carrier and not by Employer. On appeal the Board affirmed.

Initially, we observe that the set-off provisions of the Act, set forth in Section 204(a), 77 P.S. § 71(a), provide in pertinent part:

The severance benefits paid by the employer directly liable for the payment of compensation and the benefits from a pension plan to the extent funded by the employer directly liable for the payment of compensation which are received by an employee shall also be credited against the amount of the award made under section 108 and 306, except for benefits payable under section 306(c).

In Kramer, the claimant incurred a work-related injury and received benefits until [670]*670she returned to work with injury-related restrictions. Thereafter, the employer relocated its facility and the claimant was laid-off and her workers’ compensation benefits reinstated. The employer then forwarded the claimant a severance check of approximately $3300.00 which was fully funded by the employer. The employer also sent the claimant a notice of compensation benefits offset informing her that the employer, in accordance with Section 204(a) of the Act, intended to use the $3300.00 severance as a credit against the claimant’s workers’ compensation benefits. As a result, the claimant did not receive workers’ compensation benefits for approximately nine weeks, at which time her benefits were reinstated.

The claimant filed an offset review petition alleging that the employer’s offset was unconstitutional and contrary to the Act. The claimant argued that because the employer’s insurance carrier, Travelers and not the employer was liable for the payment of the claimant’s workers’ compensation, the employer could not take a credit for those payments. This court agreed with the claimant.

We observed that the plain language of Section 204(a) of the Act provides that “the severance benefits paid by the employer directly liable for the payment of compensation and the benefits from a pension plan to the extent funded by the employer directly liable for the payment of the compensation ... which are received by an employee shall also be credited against the amount of the award made....” In interpreting the above, we stated that the plain language dictated that an offset is afforded to an employer only if the employer is directly liable to a claimant for compensation. Because Travelers was responsible for the payment of the claimant’s workers’ compensation, and not the employer, we determined that the employer was not entitled to a credit.

In this case, Employer argues that, in contrast to the employer in Kramer, Employer here was self-insured up to an aggregate of $250,000.00.2 Between February 4, 1998 and June 1, 2000, Employer, not Travelers, paid workers’ compensation benefits directly to Claimant. As such, Employer was directly liable to Claimant as provided in Section 204(a) of the Act. Employer argues that it is entitled to a credit against weekly wage loss benefits for workers’ compensation disability benefits paid to Claimant. We agree that Employer is entitled to a credit based on this court’s decision in Hulmes v. Workers’ Compensation Appeal Board (Rite Aid Corporation), 811 A.2d 1126 (Pa.Cmwlth. 2002).

In Hulmes, similar to Kramer, the claimant incurred a work-related injury, returned to a light-duty job and then was laid-off when the employer relocated its facility. Employer sent a severance check to the claimant and also reinstated her total disability benefits. However, the employer suspended the claimant’s workers’ compensation benefits for two months claiming that the Act authorized a credit in the amount of the severance against the disability benefits owed the claimant.

This court observed that in Kramer, the employer was not entitled to a credit under Section 204(a) because its insurance company was the party directly responsible for the payment of compensation. In Hulmes, however, we determined that the [671]

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834 A.2d 668, 2003 Pa. Commw. LEXIS 753, Counsel Stack Legal Research, https://law.counselstack.com/opinion/welliver-mcguire-inc-v-workers-compensation-appeal-board-pacommwct-2003.