W. Merrell v. WCAB (DOC)
W. Merrell v. WCAB (DOC) - 493 C.D. 2016 (OPINION AND ORDER GRANTING RECONSIDERATION)
| Pa. Commw. Ct. | Apr 3, 2017Background
- Claimant Wayne Merrell, a corrections officer trainee, hyperextended his right knee on October 12, 2013 at work and sought medical care; he returned to work but later stopped due to pain and work restrictions.
- Employer denied Heart and Lung Act benefits; an arbitrator (per the parties’ CBA) heard the grievance and awarded Claimant Heart and Lung benefits, crediting Claimant’s testimony and treating physician (Dr. Greene).
- Claimant then filed a workers’ compensation claim seeking disability benefits beginning October 29, 2013; Employer contested causation and disability with medical testimony from Dr. David Cooper.
- At the WCJ hearing Claimant sought to invoke collateral estoppel (issue preclusion) based on the arbitrator’s Heart and Lung award; the WCJ awarded medical benefits but denied disability, finding the arbitrator’s award non-preclusive.
- The Board affirmed; Claimant appealed to Commonwealth Court arguing the arbitrator’s finding of temporary disability precluded relitigation in the workers’ compensation proceeding.
- The court affirmed the Board, holding the arbitration did not have collateral estoppel effect because Employer lacked a full and fair opportunity/incentive to litigate disability in the Heart and Lung arbitration given differences in stakes and procedural safeguards.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the arbitrator’s Heart and Lung award collaterally estops relitigation of disability in the workers’ compensation claim | The arbitrator’s award resolving temporary disability is identical and therefore precludes relitigation under collateral estoppel | Employer lacked a full and fair opportunity to litigate disability in arbitration because Heart and Lung proceedings are temporary and less formal than WC proceedings | No; arbitration award did not have preclusive effect because the full-and-fair-opportunity factor fails |
| Whether the amount at stake in Heart and Lung arbitration is comparable to workers’ compensation | Heart and Lung benefits can be indefinite and are more generous weekly, so stakes are comparable | Heart and Lung benefits are temporary (end when disability is found permanent or claimant returns) while workers’ comp can provide lifetime benefits, so stakes differ | Heart and Lung benefits are temporary and thus the amount in controversy is not comparable to potentially lifetime workers’ compensation benefits |
| Whether arbitration procedures and evidentiary standards are sufficiently formal to permit issue preclusion | The CBA requires written findings and credibility explanation, so procedures are adequate | Arbitration lacks workers’ compensation’s regulated filings, medical-foundation standards, and WCJ’s reasoned-decision requirements | Procedures are materially different and less formal; arbitration did not afford the same standards for medical proof or detailed reasoned decisions |
| Whether Employer had adequate incentive/opportunity to fully litigate causation/disability in the arbitration | Claimant contends Employer litigated medical issues and presented Dr. Cooper’s testimony in arbitration | Employer contends it lacked the same procedural tools, standards, and incentives in arbitration to fully contest long-term disability | Employer did not have a full and fair opportunity or sufficient incentive; collateral estoppel inapplicable |
Key Cases Cited
- Cohen v. Workers’ Compensation Appeal Board (City of Philadelphia), 909 A.2d 1261 (Pa. 2006) (compare amount at risk and procedural formality when assessing preclusive effect)
- Wagner-Stover v. Workers’ Compensation Appeal Board, 6 A.3d 603 (Pa. Cmwlth. 2010) (Act 632 adjudication precluded relitigation where amount at risk and procedures were comparable)
- Rue v. K-Mart Corp., 713 A.2d 82 (Pa. 1998) (a party must have adequate opportunity and incentive to obtain full adjudication for issue preclusion to apply)
- Cerro Metal Prods. Co. v. Workers’ Compensation Appeal Board (PLEWA), 855 A.2d 932 (Pa. Cmwlth. 2004) (standards for admissible, sufficiently definite medical evidence in workers’ compensation)
- Gwinn v. Pennsylvania State Police, 668 A.2d 611 (Pa. Cmwlth. 1995) (Heart and Lung benefits terminate when claimant returns to work or disability is found permanent)