Green v. Workers' Compensation Appeal Board
28 A.3d 936
| Pa. Commw. Ct. | 2011Background
- Claimant Susan Nawn Green, a U.S. Airways flight attendant, sustained a knee injury in 1993; initial NCP described as right meniscus tear.
- In 2000 her injury description was amended to include a left knee injury; benefits suspended in 2003; 2006 Board amended NCP to include a lateral femoral condyle defect.
- In 2008 Claimant filed reinstatement and penalty petitions alleging worsening condition and unpaid medical expenses; later penalties claimed nonpayment to Dr. Carson.
- Dr. Carson testified that Claimant had progressive, degenerative knee changes caused or accelerated by work-related trauma; WCJ found him credible but unpersuasive and denied petitions.
- WCJ relied on lay witness Newlin to oppose causation and medical costs; denied reinstatement and penalties in 2009.
- Board affirmed, but the Commonwealth Court vacated, holding the WCJ misinterpreted Dr. Carson’s testimony and that degeneration can be work-related; remanded for a new WCJ decision.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the Board erred by affirming a non-reasoned WCJ decision relying on erroneous medical interpretation | Green argues WCJ misread Dr. Carson and misapplied law, rendering denial unsupported | U.S. Airways contends the WCJ properly weighed evidence and there was adequate basis for decision | Yes; the Board erred; the WCJ misapplied medical causation and the Board erred by affirming |
| Whether the Board failed to address the WCJ's rejection of Dr. Carson's unrebutted testimony | Green contends rejection of uncontradicted medical testimony without countervailing expert was capricious | U.S. Airways argues the WCJ's reasoning was appropriate and supported by evidence | Yes; capricious disregard found; remand necessary |
| Whether the WCJ erred by relying on lay testimony to negate causal connection of medical treatment | Green asserts lay witness misused to deny link between treatment and injury | Airways defends use of lay testimony to explain billing decisions and lack of causation | Yes; lay testimony misapplied; causation analysis flawed |
| Whether the WCJ applied an incorrect burden of proof regarding progressive degeneration and disability | Green argues degeneration does not preclude work-related causation and requires proper analysis | Airways maintains the burden as applied was appropriate | Yes; burden misapplied; need correct causation framework |
Key Cases Cited
- Dorsey v. Workers' Comp. Appeal Bd. (Crossing Constr. Co.), 893 A.2d 191 (Pa.Cmwlth.2006) (requires objective basis for credibility determinations to be reasoned)
- Daniels v. Workers' Comp. Appeal Bd. (Tristate Transp.), 574 Pa. 61, 828 A.2d 1043 (2003) (recognizes need for articulated reasoning on conflicts in medical testimony)
- Sewell v. Workers' Comp. Appeal Bd. (City of Phila.), 772 A.2d 93 (Pa.Cmwlth.2001) (degenerative conditions may be activated by work-related trauma)
- Gaudreau City of Phila. v. Gaudreau, 320 A.2d 424 (Pa.Cmwlth.1974) (degenerative description does not resolve causation; work trauma may cause degeneration)
- Brown v. City of Phila., 830 A.2d 649 (Pa.Cmwlth.2003) (affirmed work-related acceleration of pre-existing degenerative disease)
- Acme Markets, Inc. v. Workmen's Comp. Appeal Bd. (Pilvalis), 142 Pa.Cmwlth. 400, 597 A.2d 294 (1991) (capricious disregard standard; requires rational basis in evidence)
- Higgins v. Workers' Compensation Appeal Board (City of Philadelphia), 854 A.2d 1002 (Pa.Cmwlth.2004) (capricious disregard framework referenced)