PA Court: Issuance of a Medical-Only NCP in Workers Compensation differs from Acceptance and Subsequent Suspension of Benefits

The Pennsylvania Commonwealth Court recently distinguished between a Medical-Only Notice of Compensation Payable and an acceptance of a work injury and a subsequent Suspension of benefits, in Sloane v. W.C.A.B (Children’s Hospital of Philadelphia)  No 1399, C.D. 2014(Pa. Cmwlth. 2015).

CommCt

The relevant time lines are this:  An injured worker has three years after the date of the injury to file a Claim Petition to seek workers’ compensation benefits for the injury.  If a Notice of Compensation Payable (NCP) is issued and wage loss benefits are later suspended, the injured worker has 500 weeks, or three years from the date of last payment, whichever is later, to file for a reinstatement of disability benefits.   Do the same rules apply to a Medical-Only NCP that apply to a regular NCP with subsequent suspension?  That is the issue addressed in this case.

Claimant argued that the issuance of a Medical-Only NCP would have the same has the same effect as if a WC Judge issued an Order granting a claim petition with an immediate suspension of disability benefits in cases where medical treatment is required but there is no immediate wage loss.  Therefore, the Claimant argued the appropriate Bureau form would be a Reinstatement Petition, which would make the Petition timely if filed within 500-week period in which an injured workers is eligible for partial disability benefits.

The Workers Compensation Appeal Board rejected the argument, distinguishing between the granting of disability benefits and the issuance of a medical-only acceptance.  The Board’s rationale on a Medical-Only NCP is that the defendant only accepted the injury on a medical basis, not on a earning loss basis.  Essentially, by issuing a Medical-Only, the Employer never accepts wage loss as a result of the work injury.  Since no disability benefits were ever accepted, there are no disability benefits to be reinstated.

The Commonwealth Court agreed.  The Court stated,

Despite the apparent ambiguity relating to the proper form of the Petition, we need not resolve this issue because Claimant’s request for disability benefits for the 2006 injury would be untimely under the limitations periods of Section 413(a) or Section 315. Under Section 413(a), a reinstatement petition must be filed “within three years after the date of the most recent payment of compensation made prior to the filing of such petition.” 77 P.S. § 772. The payment of medical benefits by an employer does not constitute “compensation” for the purposes of Section 413(a) that would act to toll the liability period . . . Since no disability compensation had been paid for the 2006 injury, Claimant was required to establish an entitlement within 3 years of the date of the injury. The Petition filed on December 31, 2011 was therefore untimely under Section 413(a) . . .  Employer made its intent expressly clear that it would pay Claimant’s medical expenses but accepted no liability for wage-loss benefits. Thus, the Petition would also be untimely under Section 315.

The moral of this story.  If a Medical-Only NCP is issued in your case, you have a three year statute of limitation to file a Claim Petition alleging loss of wages as a result of the work injury.  After three years, your claim for wage loss benefits will be barred.  The even stronger moral of this story is, if you have been injured at work, contact a workers compensation Attorney right away.  Use the Mooney & Associates three step procedure when injured at work:  1) tell you employer about your injury right away; 2) seek medical attention immediately; and 3) contact Mooney & Associates at 1-877-632-4656 or email me at mab@mooney4law.com.  Workers Compensation is too complex and your rights in workers compensation are too important to go it alone against an insurance carrier.

What does it cost you to have a consultation with me regarding your workers compensation claim?  NOTHING.  We have full-time offices in Chambersburg, Carlisle, Shippensburg, Hanover, Gettysburg, Harrisburg, and York.  We have other meeting offices throughout South Central Pennsylvania.  We will meet you at the office closest to you.