R. Mathis v. WCAB (SEPTA)
R. Mathis v. WCAB (SEPTA) - 486 C.D. 2016
| Pa. Commw. Ct. | Mar 29, 2017Background
- Claimant (Mathis), a SEPTA bus operator, slipped and fell on May 24, 2011, injuring head, neck, low back, and left ankle; emergency room treated her and she reported the injury at work.
- Claimant sought workers’ compensation for head, neck, back, left ankle/foot injuries and alleged ongoing disability; Employer denied the claim and submitted IME reports.
- Claimant’s treating primary physician diagnosed cervical and lumbar sprains/strains and radiculopathy, prescribed medications and PT, and referred to a pain specialist (Dr. Lam); MRIs showed degenerative changes and herniations.
- Dr. Lam (pain mgmt.) found limited range of motion, diagnosed herniations and radiculopathy, and opined Claimant could not return to driving work.
- Two IME doctors (neurologist and orthopedist) found no objective radiculopathy, opined any injury was limited to sprain/strain which had resolved, and concluded Claimant could return to work without restrictions.
- WCJ found a compensable cervical and lumbar sprain/strain but concluded those soft-tissue injuries resolved by October 24, 2011; Board affirmed. Claimant appealed, arguing the WCJ’s decision was not a sufficiently reasoned decision under Section 422(a).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether WCJ issued a "reasoned decision" under §422(a) when rejecting parts of Dr. Lam’s testimony | Mathis: WCJ failed to explain why Dr. Lam’s opinions (herniations, radiculopathy, ongoing disability) were rejected, leaving appellate review impaired | SEPTA/WCJ: WCJ provided objective bases — treating records showing resolution, consistency with IME opinions, and Claimant’s failure to disclose prior injuries to treating doctors — sufficient for a reasoned decision | Court: Affirmed Board; WCJ provided an adequate objective basis (treating notes showing resolution, IME consistency, and nondisclosure of prior injuries) so §422(a) satisfied |
Key Cases Cited
- Michel v. Workers' Comp. Appeal Bd. (U.S. Steel Corp.), 966 A.2d 643 (Pa. Cmwlth. 2009) (WCJ must articulate objective basis for credibility determinations involving depositions)
- Daniels v. Workers' Comp. Appeal Bd. (Tristate Transp.), 828 A.2d 1043 (Pa. 2003) (reasoned decision must specify evidence relied upon and reasons for acceptance/rejection)
- Dorsey v. Workers' Comp. Appeal Bd. (Crossing Constr. Co.), 893 A.2d 191 (Pa. Cmwlth. 2006) (WCJ cannot reject uncontroverted evidence without adequate explanation)
- Gumm v. Workers' Comp. Appeal Bd. (Steel), 942 A.2d 222 (Pa. Cmwlth. 2008) (Section 422(a) does not require line-by-line analysis; decision must permit meaningful appellate review)
- A&J Builders, Inc. v. Workers' Comp. Appeal Bd. (Verdi), 78 A.3d 1233 (Pa. 2013) (WCJ has broad authority over credibility and evidentiary weight)
- Empire Steel Castings, Inc. v. Workers' Comp. Appeal Bd. (Cruceta), 749 A.2d 1021 (Pa. Cmwlth. 2000) (medical witness may rely on medical records not in evidence under hearsay exception)
- Peterson v. Workmen's Compensation Appeal Bd. (PRN Nursing Agency), 597 A.2d 1116 (Pa. 1991) (Workers' Compensation Act construed liberally to effectuate humanitarian objectives)