Mooney Law won a 50% penalty case for a unilateral cessation of payment of wage loss benefits to a Chambersburg client. The Workers’ Compensation Judge’s (WCJ) decision was appealed to the Pennsylvania Workers’ Compensation Appeal Board (WCAB). The WCAB affirmed the decision today.
In this case, we represented a Chambersburg injured worker who suffered a burn and subsequent nerve injury in his arm while performing welding activities at work. The claim was denied by the employer. We filed a Claim Petition and litigated the petition to Judge’s decision. The WCJ granted the Claim Petition and awarded past as well as ongoing weekly wage loss benefits to our client. The insurance carrier promptly paid benefits as directed by the decision.
At some point, a few months later, our client stopped receiving his weekly wage loss benefits. There was no communication from the insurance carrier as to why benefits stopped. No explanation at all. They just stopped. We filed a Penalty Petition based upon the unilateral stopping of wage loss benefits. The Pennsylvania Court has made clear in Robb, Leonard, & Mulhill v. WCAB that a workers’ compensation insurance carrier has no right to self-help. That means they can’t simply take action on their own. There are legal remedies to stop a claimant’s receipt of workers’ compensation benefits, and simply stopping benefits is not one of them.
We agree with the Board and find that to “grant [Petitioners] reimbursement from the date [Petitioners] unilaterally and summarily stopped making payments would endorse and encourage employers/insurers to unilaterally cease paying benefits in direct violation of the Act.” (Board’s Decision at 4.)
The fact an insurance carrier cannot unilaterally stop paying wage loss benefits is well settled law.
In this case, the Defendant also appealed the WCJ decision to award a maximum 50% penalty. The law is also clear that when an ‘unreasonable or excessive delay’ can be proven, the WCJ at his/her discretion may award up to a 50% penalty. In our case, by the time we were handed the WCJ decision on the Penalty, the insurance carrier had already gone more than a year without paying wage loss benefits to our client, a direct violation of the Act and of a previous WCJ decision. The WCAB affirmed the 50% penalty award.
The point here is that wage loss benefits are so important to injured workers that are out of work due to a work-related injury that an insurance carrier must follow proscribed legal remedies to stop wage loss checks. Those remedies are through filing a Modification, Suspension, or Termination Petition. However, even the filing of one of those petition still does not permit an insurance carrier to stop paying wage loss benefits. Only a WCJ can stop benefits, other than an injured worker’s return to work.
If you are having difficulty with your wage loss benefits being stopped, untimely, or erratic, you have the right to pursue penalties against the insurance carrier. Injured workers are already suffering from lower wages, pain from their work injury, and the emotional toll that a work injury takes on them and their family. Worrying about timely receipt of wage loss benefits should not happen. Call Mooney Law today for an absolutely free consultation. We can help. Call today at 717-200-HELP or 717-632-4656. You can also drop us an email at info@mooney4law.com. Finally, you can visit our website and complete the Schedule a Consultation form.
