Commonwealth Court Holds That An Injured Worker Must File A Wage Loss Claim Within 3 Years Of The Date Of Injury After Claim Is Accepted By Way Of A Medical-Only Notice Of Compensation Payable
Ryan Zavodnick | October 12, 2015 | Workers' Compensation
In Sloane v. WCAB (Children’s Hospital of Philadelphia), the Commonwealth Court held that an employee whose workers’ compensation claim is granted by way of a Medical-Only Notice of Compensation Payable following his work injury must file a Claim Petition within 3 years of the date of her injury if the employee subsequently becomes disabled. In so doing, the court affirmed the order of the Workers’ Compensation Appeal Board.
The Claimant Sustained Two Injuries, Both Of Which Were Accepted By The Employer
The claimant injured her right elbow on April 20, 2004 while working as a nurse. On December 30, 2004 a Notice of Compensation Payable was issued and wage loss benefits were paid. The injured worker subsequently returned to work for the same employer and her benefits were reduced to partial disability benefits. Shen then suffered a second work injury to her right elbow and right knee on December 3, 2006. The employer accepted liability for this injury by way of a Medical-Only Notice of Compensation Payable, meaning that it did not accept liability for any wage loss resulting from this injury. The employee continued to work light duty while receiving partial disability benefits on account of her 2004 injury until she went out of work in December of 2007 to undergo a right-knee replacement. She has not returned to work since.
Claimant filed a Reinstatement Petition on May 31, 2011 seeking reinstatement of total disability benefits as of November 1, 2007. The workers’ compensation judge granted the petition, concluding that the injured worker was totally disabled as of November 17, 2007 based on both her 2004 and 2006 injuries.
The employer appealed, and the Workers Compensation Appeal Board reversed the part of the judge’s decision granting a reinstatement of benefits, concluding that the claimant was required to comply with the 3 year statute of limitations contained in Section 413(a) of the Workers Compensation Act for modification of a Notice of Compensation Payable rather than the 500 week period for reinstatement of suspended partial disability benefits.
The Commonwealth Court Addressed Whether The Claimant’s Lost Wages Claim Was Timely
The Commonwealth Court addressed the timeliness of the injured worker’s petition. Under Section 413(a) of the Act, a workers’ compensation judge may amend a Notice of Compensation Payable upon proof that the “disability of an injured employee has increased, decreased, recurred, or has temporarily or finally ceased.” A Petition filed under Section 413(a) must be filed within three years after the date of the most recent payment of compensation.
Additionally, the Act provides that where compensation has been suspended because an employee’s earnings are equal to or in excess of his pre-injury average weekly wage, payments made be resumed at any time during the 500 week period for which compensation for partial disability benefits is payable.
The employee’s attorney argued that the issuance of the Medical-Only Notice of Compensation Payable had the same effect as the granting of a Claim Petition with an immediate suspension would, meaning that she would then have the full 500 weeks within which to file for reinstatement of her benefits. The Court disagreed, holding that the issuance of a Medical-Only Notice of Compensation Payable merely acknowledges liability for medical treatment and does not serve to recognize any disability associated with the work injury. Thus, the claimant was required to comply with the 3 year statute of limitations set forth in the Act. Because she did not, her claim was denied. The Court held that the employer’s payment of medical expenses did not serve to toll the statute of limitations.
So What Does This Mean?
This was the first time that an appellate court addressed the issue of what limitations period applies to a petition that seeks to establish disability compensation for an injury that was previously recognized by way of a Medical-Only Notice of Compensation Payable. This is a significant decision affecting hundreds of injured workers whose claims have been accepted as medical-only claims. If you have suffered a work injury and your employer has only accepted liability for medical expenses, you should consult with an experienced workers’ compensation lawyer immediately to find out what your rights are and determine whether time might be running out for you to pursue your lost wages claim.