Whitmoyer v. Workers' Comp. Appeal Bd.
186 A.3d 947
Pa.2018Background
- In 1993 Whitmoyer suffered a work injury (partial arm amputation); his employer/insurer (MCM/Selective) paid disability benefits and ongoing medical expenses.
- Whitmoyer's disability benefits were commuted to a lump sum in 1994; Selective continued to pay medical expenses thereafter.
- In 1999 Whitmoyer settled with third parties for $300,000; a Bureau-form TPSA allocated a net subrogation lien to Selective and left a "balance of recovery" for Whitmoyer.
- Whitmoyer's counsel asserted in contemporaneous letters that Selective could not apply the TPSA balance against future medical expenses because section 319's phrase "future instalments of compensation" excludes medical benefits; Selective cashed the check but did not accept that interpretation.
- Selective paid medical bills without taking credit until 2012, when it petitioned to apply credits against the balance; the WCJ and Board allowed credit for future medicals and the Commonwealth Court affirmed.
- The Pennsylvania Supreme Court granted review to decide whether "instalments of compensation" in 77 P.S. § 671 includes future medical expenses or is limited to periodic disability payments; it reversed the Commonwealth Court, holding the phrase excludes medical expenses.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether "instalments of compensation" in § 319 includes future medical expenses | Whitmoyer: phrase means periodic disability payments only; medicals are paid "as and when needed" and not "installments" | MCM/Selective: "compensation" historically includes medicals; excluding medicals would undermine §319's purposes and permit double recovery | Court: "instalments of compensation" unambiguous and limited to periodic disability benefits; does not include future medical expenses |
| Whether insurer waived subrogation/right to credit for future medicals by conduct/letters/inaction | Whitmoyer: counsel's letters and Selective's conduct created a waiver/equitable estoppel | Selective: no authorized waiver; retained subrogation rights; TPSA form and Bureau instructions show intent to preserve credit | Not decided: Supreme Court resolved statutory issue and did not reach waiver question |
Key Cases Cited
- Heckendorn v. Consolidated Rail Corp., 465 A.2d 609 (Pa. 1983) (WCA liability attaches irrespective of employer negligence)
- Dale Mfg. Co. v. W.C.A.B. (Bressi), 421 A.2d 653 (Pa. 1980) (three purposes of §319: prevent double recovery, protect non-negligent employer, hold third party liable)
- Giant Eagle, Inc. v. W.C.A.B. (Givner), 39 A.3d 287 (Pa. 2012) ("compensation" may require case-by-case interpretation)
- Rollins Outdoor Advertising v. W.C.A.B., 487 A.2d 794 (Pa. 1985) (distinguishing accrued lien at recovery from distribution of excess proceeds)
- Staller v. Staller, 21 A.2d 16 (Pa. 1941) (commutation of periodical payments inapplicable to medical/hospital expenses)
- P & R Welding & Fabricating v. W.C.A.B. (Pergola), 701 A.2d 560 (Pa. 1997) (employer's "grace period" when charging future instalments against recovery)
- Peterson v. W.C.A.B. (PRN Nursing Agency), 597 A.2d 1116 (Pa. 1991) (WCA is remedial and construed liberally for worker's benefit)
- Deak v. W.C.A.B. (USX Corp.), 653 A.2d 52 (Pa. Commw. 1994) (discussing medical expenses as "compensation" under §319)
