Frank Martz Coach Company v. WCAB (Avila), Frank Martz Coach Company v. WCAB (Avila)

Background

Claimant Julio Avila sustained a work injury on January 19, 2013; Employer issued an NTCP and paid temporary benefits at $824.84/week (90‑day temporary period stated).
On March 12, 2013, Claimant and Employer signed and filed a Supplemental Agreement reciting recurrence of disability on February 28, 2013 and agreeing to pay total disability "for uncertain weeks."
On April 22, 2013 Employer filed a Notice Stopping Temporary Compensation (NSTC) and a Notice of Compensation Denial (NCD), asserting inadequate medical proof. Claimant filed a penalty petition alleging unlawful unilateral termination.
WCJ found the Supplemental Agreement converted Employer’s provisional NTCP acceptance into an ongoing acceptance of liability and awarded penalties; the Board affirmed.
Employer argued on appeal the Supplemental Agreement was the wrong form (an Amended NTCP should have been used), that it did not intend to admit liability beyond 90 days, and that the record lacks evidence of the parties’ intent. The Commonwealth Court vacated and remanded for development of a factual record about the parties’ intent and the timeliness/propriety of Employer’s NCD/NSTC.

Issues

Issue	Claimant's Argument	Employer's Argument	Held
Whether the Supplemental Agreement converted NTCP provisional payments into an admission of ongoing liability	Supplemental Agreement admitted liability and therefore Employer could not unilaterally stop benefits	Supplemental Agreement was the wrong form or a mutual mistake and did not evidence intent to admit liability beyond the NTCP	Court concluded record is inadequate to resolve parties’ intent; vacated Board order and remanded for fact development
Whether Employer’s April 22, 2013 NSTC/NCD was timely under the 90‑day NTCP rule	N/A before hearing; Claimant argued NCD was untimely because 90 days expired April 19	Employer contended 90‑day period began Jan 24, 2013 (later date) and thus NCD might be timely	Remanded to develop record and resolve timeliness of NSTC/NCD
Whether the Bureau’s rejection of the Supplemental Agreement as an improper form is dispositive	Arguably irrelevant; substance over form governs—parties’ agreement should control	Bureau’s notice shows Supplemental Agreement was improper for modifying an NTCP and Employer should have used an Amended NTCP	Court declined to resolve; noted the Bureau notice was not in WCJ record and remanded for full record
Whether penalties were properly awarded for unilateral termination	Penalties appropriate if Employer unlawfully terminated payments after accepting liability	Employer denied acceptance of liability and claimed procedural/form error; penalty improper if NCD timely or agreement did not admit liability	Vacated penalty award and remanded for further proceedings to develop evidence

Key Cases Cited

Sharon Tube Co. v. Workers’ Comp. Appeal Bd. (Buzard), 908 A.2d 929 (Pa. Cmwlth.) (supplemental agreement binds parties as to facts stated, limiting later modification)
Gereyes v. Workers’ Compensation Appeal Board (New Knight, Inc.), 793 A.2d 1017 (Pa. Cmwlth.) (employer may not unilaterally reduce NTCP benefit rate without agreement)
Beissel v. Workmen’s Compensation Appeal Board (John Wanamaker, Inc.), 465 A.2d 969 (Pa.) (an NCP filed by employer can operate as an admission of liability and limit later contrary claims)
Dixon v. Workers’ Comp. Appeal Bd. (Medrad, Inc.), 134 A.3d 518 (Pa. Cmwlth.) (agency regulations and notices have force and effect of law; procedural form requirements matter)