D.L. Rowe v. WCAB (County of York)
106 C.D. 2016
| Pa. Commw. Ct. | Dec 16, 2016Background
- Claimant Debra L. Rowe, a Social Service Aide, was injured in a work-related motor vehicle accident on Sept. 26, 2012; Employer initially accepted a cervical strain and paid benefits.
- Employer filed a Termination Petition (May 2013); Claimant filed a Review Petition seeking to add concussion/post-concussion sequelae and cognitive disorder to the accepted injuries.
- WCJ held hearings and considered depositions of Claimant’s treating psychologist (Dr. Frazier) and Employer’s experts: a physiatrist (Dr. Kline) and neuropsychologist (Dr. King).
- WCJ amended the description of injury to include cognitive disorder secondary to concussion, granted termination of benefits for the cervical injury (effective Mar. 12, 2013) and for the cognitive disorder (effective Oct. 23, 2013), finding Dr. King’s testing showed full recovery as of Oct. 23, 2013.
- The Board affirmed, holding Dr. King’s opinion competent and the WCJ’s findings and credibility determinations reasoned and supported by substantial evidence; this Court affirmed the Board.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Competence of employer’s medical opinion when expert disputes recognized injury | Rowe: Dr. King rejected that a concussion occurred, so his testimony cannot prove termination of the work-related cognitive injury | Employer: Dr. King expressly assumed the injury for purposes of opinion and testified Claimant had fully recovered based on objective testing | Held: Expert competent; an expert may assume the accepted injury and still render competent opinion on recovery |
| Sufficiency of evidence to terminate benefits for cognitive disorder | Rowe: Claimant and treating Dr. Frazier testified improvement but ongoing deficits; evidence does not establish full recovery | Employer: Dr. King’s standardized neuropsychological battery showed no objective deficits as of Oct. 23, 2013, supporting termination | Held: Substantial competent evidence (Dr. King’s objective testing) supports termination as of Oct. 23, 2013 |
| Adequacy of WCJ’s reasoned decision when WCJ credited treating testimony of improvement but accepted contrary expert view of full recovery | Rowe: WCJ failed to reconcile irreconcilable conflict and did not explain rejecting parts of Dr. Frazier’s testimony; failed to address alleged confusion by Dr. King | Employer: WCJ adequately explained credibility choices and detailed testing differences and reasons for preferring Dr. King on recovery | Held: WCJ rendered a reasoned decision; credibility and weight are for the WCJ to resolve |
| Reliance on objective testing vs. treating-provider opinion | Rowe: Treating psychologist had ongoing treatment history and is better positioned to assess recovery | Employer: Standardized, empirically validated neuropsychological tests provide objective evidence of recovery | Held: WCJ may favor objective standardized testing over treating-provider opinion when explained; doing so is permissible and supported here |
Key Cases Cited
- Westmoreland County v. Workers’ Compensation Appeal Board (Fuller), 942 A.2d 213 (Pa. Cmwlth. 2008) (expert who denies accepted injury can still be competent if he assumes injury and opines on recovery)
- Jackson v. Workers’ Compensation Appeal Board (Resources for Human Development), 877 A.2d 498 (Pa. Cmwlth. 2005) (employer’s doctor may assume occurrence of injury and opine that it resolved)
- To v. Workers’ Compensation Appeal Board (Insaco, Inc.), 819 A.2d 1222 (Pa. Cmwlth. 2003) (employer expert’s alternative opinion on recovery can be competent despite disagreement about causation)
- Daniels v. Workers’ Compensation Board of Appeals (Tristate Transport), 828 A.2d 1043 (Pa. 2003) (WCJ must issue a reasoned decision explaining credibility and evidentiary weight)
- Hall v. Workers’ Compensation Appeal Board (America Service Group), 3 A.3d 734 (Pa. Cmwlth. 2010) (employer bears burden of proving by substantial evidence that disability ceased)