04/29/2016

Client Alert

Narrowly defining the scope of a claimant’s work-related injury reduces an Employer’s liability. Injured workers in Pennsylvania typically seek to increase the value of their workers’ compensation claims by seeking an expansive definition of injury. When recently faced with such a case, the Court in Proum v. JBS held that a Stipulation drafted by Hill Wallack LLP attorneys limited the definition of the work injury to a right small finger condition and precluded the claimant from adding bilateral upper extremity pathology, thereby saving Employer more than $100,000. 

Immediately after the claimant was injured at work, Employer’s counsel drafted a Stipulation that acknowledged liability for a work-related right small finger injury. The Stipulation included language that limited the claimant’s ability to expand the definition of injury. Both the claimant and his counsel reviewed and signed the Stipulation, which was then submitted to a Workers’ Compensation Judge (WCJ) for approval. After the Stipulation was approved, the claimant filed a petition seeking to expand the definition of injury to include bilateral upper extremity pathologies which required surgical intervention. The claimant demanded that Employer pay his medical bills, which totaled tens of thousands of dollars. In addition, because the surgery left him unable to work, the claimant sought an award of ongoing wage loss benefits. Employer argued that the claimant was barred by the principles of res judicata and collateral estoppel from adding the bilateral upper extremity pathologies to the description of the work injury. Further, Employer argued that the claimant had fully recovered from the right small finger injury. More than $100,000 of Employer’s money was at stake.

During trial, Employer’s counsel presented evidence that, prior to the execution of the stipulation, the claimant had actual knowledge of the bilateral upper extremity pathologies he sought to add to the description of injury and that the claimant knew those pathologies were possibly work-related. Employer’s counsel also presented evidence, in the form of expert medical testimony, that the claimant had fully recovered from the right small finger injury.

Relying on the language of the Stipulation drafted by Employer’s counsel, and citing the Commonwealth Court’s holding in Weney v. WCAB (Mac Sprinkler), 960 A.2d 949 (Pa. Cmwlth. 2008), the WCJ held that the claimant was precluded by the doctrines of res judicata and collateral estoppel from adding to the description of injury diagnoses of which he had actual knowledge when he executed the Stipulation prepared by Employer’s counsel. The WCJ further held that Employer had carried the burden of proving that the claimant had fully recovered and therefore terminated Employer’s liability. The WCJ’s decision allowed Employer to save more than $100,000.

Employers in Pennsylvania are reminded that involving counsel early on in the claims process can significantly reduce workers’ compensation costs. The workers’ compensation attorneys at Hill Wallack LLP provide Pennsylvania and New Jersey employers with creative and efficient solutions to their workers’ compensation problems.