91 A.3d 297
Pa. Commw. Ct.2014Background
- Claimant, a mechanic for uninsured Employer, injured on July 14, 2008 and sought workers’ compensation benefits.
- Claimant filed a claim petition for disability on September 26, 2008; Employer did not respond.
- Bureau notified Claimant that Employer may not have workers’ compensation insurance on October 3, 2008; Claimant filed a claim against Employer and Fund on October 28, 2008.
- Fund answered and raised a Section 1603(b) notice defense; WCJ held untimely notice to the Fund.
- WCJ granted the claim against Employer but denied against the Fund due to untimely Fund notice; Board reversed to the extent it held timely Fund notice.
- This Court affirms the Board’s conclusions on the timing of knowledge of uninsured status and the timeliness issue.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the Board correctly substituted findings of fact | Lyle argues Board properly reviewed credibility but cannot substitute WCJ findings | Fund contends Board cannot substitute credibility determinations | Board improperly weighed credibility on the legal knowledge issue |
| Whether Claimant knew Employer was uninsured before Oct 3, 2008 | Claimant knew earlier, via Progressive/Geico communications | Board held knowledge only upon Oct 3 letter | Fact question; knowledge could be earlier than Oct 3, 2008 |
| Whether untimely Fund notice should bar or delay claims | Untimely notice should not forever bar; timing tied to knowledge | Untimely notice bars recovery until cured | The timing rule depends on knowledge; upheld that timely LIBC-551 notice sufficed |
Key Cases Cited
- Lahr Mech. v. Workers’ Comp. Appeal Bd. (Floyd), 933 A.2d 1095 (Pa.Cmwlth.2007) (review of WCJ credibility; substantial evidence standard)
- Dorsey v. Workers’ Comp. Appeal Bd. (Crossing Constr. Co.), 893 A.2d 191 (Pa.Cmwlth.2006) (credibility findings not to be second-guessed)
- Griffiths v. Workers’ Comp. Appeal Bd. (Red Lobster), 760 A.2d 72 (Pa.Cmwlth.2000) (WCJ credibility embraced if supported by record)
- 3D Trucking Co., Inc. v. Workers’ Comp. Appeal Bd. (Fine & Anthony Holdings Int'l), 921 A.2d 1281 (Pa.Cmwlth.2007) (substantial evidence standard on WCJ findings)
- Sell v. Workers’ Comp. Appeal Bd. (LNP Eng’g), 565 Pa. 114, 771 A.2d 1246 (2001) (limitations on appellate reweighing of evidence)
- Univ. of Pa. v. Workers’ Comp. Appeal Bd. (Hicks), 16 A.3d 1225 (Pa.Cmwlth.2011) (factfinder credibility due to exclusive province of WCJ)
- World Kitchen, Inc. v. Workers’ Comp. Appeal Bd. (Rideout), 981 A.2d 342 (Pa.Cmwlth.2009) (scope of review for Board decisions)