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Gentex Corporation v. Workers’ Compensation Appeal Board (Morack): Adequate Notice of Injury

C. Vodzak Pennsylvania Supreme Court Case Summaries, Workers' Comp 0

Gentex Corporation v. Workers’ Compensation Appeal Board (Morack), No. 33 MAP 2010 (Pa. July 20, 2011)

Morack worked as a product inspector for Gentex Corporation for 45 years. She informed her supervisor on the day that she left work early that it was because of pain in her hands. She delivered a doctor’s excuse to the guardhouse according to policy and kept Gentex updated for the next five days by telephone. During this time, she completed a short-term disability form in which she indicated that she did not believe her disability was work-related.

When Morack learned from her doctor that her injury was indeed work-related, she left at least one telephone message for the human resources manager. Her doctor released her to return to work, with restrictions, but when no position was made available, she was terminated.

Morack received workers’ compensation benefits, and the award was affirmed on appeal to the Board. Gentex then appealed to Commonwealth Court which reversed based on its finding that Morack did not provide a reasonable description of her injury to her employer. Morack appealed to Pennsylvania Supreme Court.

The question of whether Morack provided her employer with adequate notice of her injury in accordance with Section 312 of the Pennsylvania Workers’ Compensation Act is a mixed question of law and fact.  [Because statutory interpretation is a question of law, a de novo standard of review was applied to the construction of Section 312. -cv]

Section 312 of the Pennsylvania Workers’ Compensation Act addresses the content of notice to an employer:

The notice referred to in section 311 shall inform the employer that a certain employe received an injury, described in ordinary language, in the course of his employment on or about a specified time, at or near a place specified.

Noting that the statute is silent about the sufficiency of notice to an employer, the Court examined several cases, beginning with its 1979 opinion in Katz v. The Evening Bulletin. In Katz, the only time the Court interpreted Section 312, the court found that although the notice was not flawless, it satisfied the statute’s requirements. The Court reasoned that meritorious claims should not be defeated for technical reasons.

The Court concluded that a totality of the circumstances test should be applied to the determination of whether adequate notice has been given to an employer. A reasonably precise description is sufficient; an exact diagnosis is not required. In instances where a claimant does not immediately know the nature of his injury, a series of communications over time may be considered rather than a isolated conversation. The context and setting of the injury and communications are relevant.

Unlike the Commonwealth Court, the Court fully considered Morack’s communication to her supervisor the day she left. Finding that Morack provided adequate notice based on her collective communications with Gentex, the Pennsylvania Supreme Court reversed the Commonwealth Court.

Bureau of Workers’ Compensation v. Workers’ Compensation Appeal Board (Crawford & Company): Date of Treatment Is Not Relevant to Reimbursement

C. Vodzak Pennsylvania Supreme Court Case Summaries, Workers' Comp 0

Bureau of Workers’ Compensation v. Workers’ Compensation Appeal Board (Crawford & Company), No. 102 MAP 2009 (Pa. July 19, 2011)

In 1995, Ressler began receiving Workers’ Compensation benefits and medical bill coverage.  Nine years later, he underwent an independent medical evaluation and surgery. The employer filed a petition to terminate benefits as of the date of the evaluation. It also requested supersedeas, which a Workers’ Compensation Judge denied.

The surgery bill was then submitted to and paid by the insurer. Later, a Workers’ Compensation Judge granted the employer’s petition to terminate benefits. The Workers’ Compensation Appeal Board affirmed the decision.

The insurer then requested and received reimbursement from the Supersedeas Fund. The Workers’ Compensation Appeal Board affirmed and so did the Commonwealth Court. The Bureau of Workers’ Compensation then appealed to the Pennsylvania Supreme Court.

Section 443 (a) of the Workers’ Compensation Act sets out the required elements for reimbursement:

If, in any case in which a supersedeas has been requested and denied under the provisions of section 413 or section 430, payments of compensation are made as a result thereof and upon the final outcome of the proceedings, it is determined that such compensation was not, in fact, payable, the insurer who has made such payments shall be reimbursed therefor.

Because statutory interpretation is a question of law, the Pennsylvania Supreme Court exercised a de novo standard of review.

The Court found that all of the elements were met, including the one in dispute, “payments of compensation are made as a result thereof.” The Court noted that the surgery bill arrived after supersedeas was denied. The denial mandated that the insurer pay the bill, while the insurer’s obligation before the denial was uncertain. Since the surgery did not mandate the payment, the date of the surgery was irrelevant.

To make reimbursement dependent on the date of the event giving rise to the bill is to insert an additional element into the statute.

In affirming the Commonwealth Court, the Court concluded that the insurer may be reimbursed for payment even though the medical treatment was rendered before the supersedeas request and denial.