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Injured employee loses penalty dispute over disability date

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Injured employee loses penalty dispute over disability date

An employee’s payment for a full day of work on the day of his injury set the day of his disability as the following work day, resulting in the affirmation of his employer’s denial of penalty payments, according to a decision from the Commonwealth Court of Pennsylvania.

An employee claimed he sustained a low back strain at work on March 27, 2015, according to the decision in Stairs v. Workers Compensation Appeal Board released on Thursday. He was transported to the hospital by ambulance and did not return to work that day or the following day. He received full pay from his employer on the day of the injury, and his employer sent a notice of temporary compensation payable from March 30, 2015, through June 27, 2015, which entitled the employee to a maximum of 90 days of compensation or until the employer controverted the claim.

On June 28, 2015, the employer filed a notice of denial of the workers comp claim, alleging that the employee failed to give proper notice of his injury and had not suffered any wage loss. The employee filed a penalty petition, arguing that he became disabled on the day of his accident — not the following Monday — and that, as a result, his employer failed to file its notice of denial within the 90-day window of his accident and he was entitled to penalties for violation of the state’s Workers Compensation Act.

The employee argued that the company effectively violated the act by stopping payment of compensation benefits after his claim had already converted into a fully compensable claim, otherwise known as a notice of compensation payable. The employer alleged that since the worker received his full pay on March 27, 2015 — the day of the injury — that he had no loss of earning power and no “disability” as of that date. The employee, however, argued that because he was treated at a hospital on the day of the injury, that his benefits were not only payable, but paid, because the employer paid for his medical treatment.

The workers compensation judge held that because the employee received his full pay for the day of the injury, his disability commenced on March 30, 2015, the day he began receiving indemnity benefits, and therefore held that the employer’s notice stopping temporary conversion was filed on the 90th day of his disability. As a result, the judge concluded that the employee failed to prove a violation of the act and denied the penalty petition.

The employee appealed, and the Workers Compensation Appeal Board reversed, finding that the fact that the employer paid the worker his full wages in lieu of workers compensation benefits on the day of the injury was irrelevant, but that he “clearly sustained a loss of earning power and did not complete his work day.”

The employer petitioned for review, and the Commonwealth Court of Pennsylvania reversed the decision after noting that neither the workers comp statute nor Pennsylvania case law addressed how or if the calculation of time was affected when an employer paid a claimant his full wages on the first day of disability. However, it found that since the bureau’s interpretation states that payment is to be made “on the date the claimant is unable to continue work by reason of injury unless he is paid full wages for the day” that the disability is considered to have commenced on the work day following the injury. This meant that the claimant’s first day of disability was March 30, 2015, the court said, with the 90-day period ending June 29, 2015.

The commonwealth court ruled that the employer’s notice stopping temporary compensation payable was timely filed and the notice of conversion issued by the bureau was void.

 

 

 

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