D. Helt v. WCAB (County of Allegheny and UPMC)
2636 and 2637 C.D. 2015
| Pa. Commw. Ct. | Oct 26, 2016Background
- Claimant (Daniel Helt), a corrections officer, had a serious work injury in 1996 (tibial plateau fracture) and a later incident on September 2, 2008 (assault) that was accepted as a right knee contusion and cervical/lumbar strain.
- Employer initially acknowledged the 2008 injury (medical-only NCPs) but reinstated and suspended benefits at various times; Claimant filed a claim petition (2011) alleging the 2008 injury aggravated his preexisting conditions.
- Employer filed termination petitions for the 2008 injury (asserting full recovery per IMEs) and suspension petitions for the 1996 injury (offering a sedentary modified-duty switchboard operator position).
- Medical testimony split: Drs. Agnew and Abraham (Employer IMEs) concluded the 2008 incident was minor and resolved and that the 1996 fracture caused progressive arthritis necessitating later surgeries; Dr. Lavigne (treating) performed knee replacement but did not review early records and was less persuasive on causation.
- WCJ credited Drs. Agnew and Abraham, denied Claimant’s claim petition for the 2008 injury, terminated benefits for that injury as of May 18, 2011, and suspended 1996-injury benefits as of October 24, 2011 based on the offered modified-duty job; Board affirmed and this appeal followed.
Issues
| Issue | Helt's Argument | County/UPMC Argument | Held |
|---|---|---|---|
| Whether the 2008 incident materially aggravated Helt’s preexisting 1996 knee condition (new injury vs. recurrence) | 2008 assault caused significant aggravation/meniscal tear and led to subsequent surgeries | 2008 injury was minor (contusion/strain) that resolved; 1996 fracture caused degenerative arthritis and surgeries | WCJ/Board found substantial evidence to credit Employer IMEs; 2008 injury did not aggravate 1996 condition; claim petition denied and termination effective May 18, 2011 |
| Competence of Employer medical opinions (reliance on records/hearsay) | Drs. Agnew and Abraham were legally incompetent because they relied on hearsay/insufficient records | IME physicians reviewed records, examined Claimant, gave unequivocal opinions within reasonable medical certainty | Court upheld WCJ credibility findings; Employer physicians were competent and persuasive |
| Whether Employer met Kachinski elements to suspend benefits for the 1996 injury by offering modified-duty work | Job offer failed because initial letter did not state cane/access to narcotics and thus was not truly available/appropriate | Employer provided medically approved job descriptions, clarified accommodations on inquiry, and kept the position open | WCJ/Board concluded Kachinski satisfied; suspension upheld as switchboard position was within restrictions and remained available |
| Whether WCJ issued a reasoned decision and misapplied the Jail Guards Act | WCJ failed to adequately explain credibility findings and misapplied/relied on Jail Guards Act | WCJ provided explanation for credibility findings and only referenced Jail Guards Act as background for salary continuation | Court found the decision reasoned, adequate for appellate review, and no misapplication of the Jail Guards Act |
Key Cases Cited
- Inglis House v. Workmen’s Compensation Appeal Board (Reedy), 634 A.2d 592 (Pa. 1993) (claimant bears burden to prove injury, causation, and duration)
- Coyne v. Workers’ Compensation Appeal Board (Villanova Univ. and PMA Group), 942 A.2d 939 (Pa. Cmwlth. 2008) (burden elements in workers’ compensation)
- Udvari v. Workmen’s Compensation Appeal Board (USAir, Inc.), 705 A.2d 1290 (Pa. 1997) (employer meets termination burden with unequivocal medical testimony of full recovery)
- SKF USA, Inc. v. Workmen’s Compensation Appeal Board (Smalls), 728 A.2d 385 (Pa. Cmwlth. 1999) (distinguishing aggravation of preexisting condition from recurrence; material contribution test)
- Kachinski v. Workmen’s Compensation Appeal Board (Vepco Construction Co.), 532 A.2d 374 (Pa. 1987) (four-prong standard for modification/suspension based on job offers)
- Mancini’s Bakery v. Workmen’s Compensation Appeal Board (Leone), 625 A.2d 1308 (Pa. Cmwlth. 1993) (daily job duties can constitute repeated aggravation — distinguishable on facts)
- City of Philadelphia v. Workers’ Compensation Appeal Board (Kriebel), 29 A.3d 762 (Pa. 2011) (WCJ credibility determinations control on appeal)