Tuesday, June 3, 2008

New case law on when a Pennsylvania Workers' Compensation Judge can change the description of your work injury

In the case of City of Philadelphia v WCAB (Smith) the Pennsylvania Commonwealth Court issued a decision on April 25, 2008, addressing the issue of when a Workers’ Compensation Judge may amend the description of a work injury. The Court held that the Judge can amend a Notice of Compensation Payable if the description of the work injury is “materially incorrect” as long as the evidence supports such a conclusion. The Judge has the power to do this even if the Claimant has not specifically asked for the amendment in a Review Petition. A Judge can do this during any pending litigation.

Therefore, the WCJ did not commit an error of law upon affirming a WCJ’s denial of the employer’s Petition for Termination where the Notice of Compensation Payable recognized the injury of lumbar strain and the WCJ, upon issuing its second determination following a remand, determined that the Notice of Compensation Payable was materially incorrect at the time it was issued and amended the Notice of Compensation Payable to include “posttraumatic lumbar
radiculopathy and two herniated discs at L5-S1” as part of the original injury".

Ok, so why is this important? Many times the insurance company will deny the payment of bills because the treatment was NOT for the accepted work injury. So, if your doctor tells you that herniated disc surgery is necessary on your lumbar spine, the insurance company might refuse to pay the surgery because the accepted work injury was merely a low back strain.

This is where I come in.....

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