Kramer v. Workers' Compensation Appeal BoardKramer v. Workers' Compensation Appeal Board
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Lead Opinion
These cross-appeals raise two related issues: (1) whether Section 204(a) of the Pennsylvania Workers’ Compensation Act (the “Act”),
Claimant worked for Employer in its Shiremanstown, Pennsylvania facility when she sustained a work-related neck injury on February 20, 1998. Claimant received workers’ compensation benefits for temporary total disability through June 28, 1998, when she returned to work with injury-related restrictions. On March 12, 1999, Employer relocated its Shiremanstown facility to Maryland, and as a consequence, Claimant was laid off. Following the layoff, Employer reinstated Claimant’s workers’ compensation benefits.
On May 14, 1999, Employer sent Claimant a Notice of Compensation Benefits Offset (“Offset Notice”), informing her that it was authorized under Section 204(a) of the Act to treat the severance payment as a credit against Claimant’s workers’ compensation benefits. Section 204(a) states, in relevant part:
The severance benefits paid by the employer directly liable for the payment of compensation and the benefits from a pension plan to the extent funded by the employer directly liable for the payment of compensation which are received by an employe shall also be credited against the amount of the award made under section 108 [occupational disease] and 306 [schedule of compensation for total disability], except for benefits payable under section 306(c) [disability resulting from certain permanent injuries].
On May 20, 1999, Claimant filed an Offset Review Petition alleging that Employer’s offset was unconstitutional, was contrary to the Act, was not timely taken, and that the benefits paid her were not in the nature of severance benefits. Employer denied Claimant’s allegations. The WCJ denied Claimant’s petition on January 21, 2000, holding that the $3,355.02 lump sum Claimant received under the CBA was, in fact, a severance payment as defined in the relevant regulations, see 34 Pa.Code 123.2,
Claimant then appealed to the Commonwealth Court, arguing that: (1) the $3,355.02 payment was not a severance benefit, but was “otherwise earned income;” (2) even if the payment was a severance benefit, it was not subject to a Section 204(a) offset because Employer, who was privately insured, was not “directly liable” for the payment of Claimant’s workers’ compensation benefits;
In workers’ compensation appeals, this Court will affirm the adjudication below unless we find that an error of law was committed, that constitutional rights were violated, that a practice or procedure of a Commonwealth agency was not followed, or that any necessary finding of fact is not supported by substantial evidence of record.
I. Employer’s Appeal: Availability of Severance Beneñt Offset
Employer argues that the language in Section 204(a) is ambiguous at least insofar as it concerns the applicability of the offset provision to privately insured employers. Employer posits that, if the General Assembly had intended to restrict the availability of severance offsets only to self-insured employers, it could have done so easily and explicitly by using the modifier “self-insured.” Indeed, Employer notes that the Act contains a separate provision, Section 305,
Employer further asserts that the only logical interpretation of the phrase “employer directly liable for the payment of compensation” is to understand it as a reference to cases where there are multiple concurrent employers. This asserted construction results in a scheme which would reduce the costs of work injuries by making the offset available only to the employer actually liable for the work injury, and not to any other employer the employee may have. Employer argues that, when this purpose of the offset provision’s language is considered, it is clear that the General Assembly intended that the offset apply to privately-insured as well as self-insured employers.
Employer further argues that its interpretation is supported by settled rules of statutory construction, citing
Claimant responds that Section 204(a) is clear and unambiguous and supports the Commonwealth Court’s conclusion that only self-insured employers are entitled to an offset of severance payments against workers’ compensation benefits, because the offset is only available to those employers who are “directly liable for compensation.” Because Employer here has a private workers’ compensation insurer, Claimant argues, Employer is not directly liable for payment of her workers’ compensation benefits, and thus, is not entitled to the severance offset. Claimant further argues that Employer’s interpretation renders the language “directly liable for compensation” mere surplusage.
Claimant also submits that the terms “employer” and “insurer” are not interchangeable in all instances. Thus, in Claimant’s view, although Section 305 of the Act states that insurers are entitled to all of the employer’s immunities and protections, this Section does not grant an insurer all of the employer’s rights, such as the right to an offset. Claimant also disputes Employer’s assertion that Section 204(c) requires employees to report regularly to the insurer the receipt of other compensation that postdates the compensable injury, asserting that, when properly construed, Section 204(c) in fact requires employees to report this information to their employer.
Claimant further argues that the supposed legislative purpose of precluding double recoveries for the same loss of earnings is not advanced by granting a private insurer a credit for severance pay. Claimant notes that prior to the 1996 amendment’s adoption of a severance offset, the courts had recognized that there was a different intent behind severance
Finally, Claimant argues that allowing an employer’s private insurer to take the offset does not comport with the Pennsylvania Workers’ Compensation Manual of Rules, Classifications, and Rating Values for Workers’ Compensation and Employer’s Liability Insurance (“Manual”), which is published by the Pennsylvania Compensation Bureau. In accordance with this Manual, Claimant asserts that premiums are computed on the basis of the total remuneration paid or payable for employees covered by the policy, but that severance pay is not taken into consideration. Claimant therefore concludes that the goal of reducing workers’ compensation costs would not be furthered by granting a severance offset to a private insurer.
The principles governing this Court’s review are settled. The object of interpretation and construction of Pennsylvania statutes is to ascertain and effectuate the intention of the General Assembly. See
We agree with Employer that Section 204(a) is ambiguous with respect to the specific question presented here, i.e., whether all employers, or only self-insured employers, qualify for purposes of the severance offset. The ambiguity is demonstrated by the plausible but opposing arguments forwarded by the parties. Thus, Claimant notes that the General Assembly easily could have included the word “insurer” if it had intended the offset to apply to insurers as well as employers, while Employer asserts that the General Assembly just as easily could have used the phrase “self-insured employer” if it wanted to make explicitly clear that the offset was intended to be limited only to that class of employers. Moreover, the General Assembly’s use of the word “liable” (“employer directly liable for the payment of compensation”) could be construed either narrowly—as evidencing liability in the sense of the entity who ultimately writes the compensation check, which would suggest that only self-insured employers would be entitled to the offset—or more broadly, as speaking in terms of the legal predicate for the award of workers’ compensation benefits. In the latter instance, a privately insured employer could be said to be “liable” for the payment of compensation, even though, by obtaining private insurance, that employer secured a source for discharging its liability for the actual benefits payment.
The definitional sections of the Act contribute to the ambiguity. On one hand, Article I of the Act includes a definition of employer that provides as follows: “The term ‘employer,’ as used in this act, is declared to be synonymous with master, and to include natural persons, partnerships, joint-stock companies, corporations for profit, corporations not for profit, municipal corporations, the Commonwealth, and all governmental agencies created by it.”
This Court’s plurality opinion in Brown v. Travelers Ins. Co.,
“[Ajrticle I (including section 103) and article IV (including section 401), are neither of them substantive. We have termed them ‘external’ articles, as compared with the legislatively designated substantive articles II and III. In short, the first and fourth articles are ancillary, descriptive, unsubstantive and are both basically procedural in significance. It would have been inappropriate for the legislature to have included the workmen’s compensation insurance carrier as synonymous with employer in section 103 of article I of the act, because that section was delineating the status of employer and employe for the limited purposes of their status as parties to the statutory agreement to accept the compensation system which was set up in article III * * *. Chronologically speaking, it would be pointless and fruitless to discuss the insurance carrier in article I of the act, because the need for insuring could not arise until article III had become operative. It is the ‘master’ alone (who, before he accepts the act, has no need for a compensation insurance carrier), who is concerned with the substantive provisions of articles II and III. The employer not only has the right to reject the act, but frequently has done so____ Article IV set up all of the provisions for every form of process and remedy available to a claimant and the manner in which liability of the employer to him is to be met, satisfied, settled, concluded and released; so that ... the insurance carrier shares every one of the obligations, prerequisites, benefits, and release rights of the employer. Thus, we find the legislature stating in section 401 that the employer, who had to be defined in section 103 solely as the ‘master’ for articles II and III purposes, would, for all remedial or procedural purposes, be taken to be a complex entity, including within its scope the compensation insurer (be it a private company or the State Workmen’s Insurance Fund), and the agent of such ‘master’.”
The plurality then noted three policy considerations weighing in favor of this construction of the Act, which equated the insurer with the employer. First, failing to afford immunity to insurers would lead to a “regrettable discrimination ... between employers who are insured by the State Workmen’s Insurance Fund or are self-insuring employers and those employers who carry private insurance.” The plurality noted that such discrimination “would be inequitable and unjust both to the employers who utilize private insurance and to their employees.” The plurality did not believe that the General Assembly ever intended such discrimination. Second, the plurality noted that a failure to
Although Brown was a plurality decision, it has since been treated as binding authority for the proposition that the term “employer” as used in Section 303 includes insurers. See DeJesus v. Liberty Mutual Ins. Co.,
This case, of course, involves the Section 204(a) severance offset, rather than Section 303 immunity. Nevertheless, both questions have to do with remedial aspects of the Act, and specifically with the rights afforded to employers who participate in the workers’ compensation system and to their insurers. Accordingly, the analysis of the structure of the Act accepted by the Brown plurality and by later decisions of this Court, which equates the employer and its workers’ compensation insurance carrier for remedial purposes (and thus draws no distinction between self-insured and privately-insured employers), remains convincing and ultimately is controlling here.
Our conclusion in this regard is corroborated by the fact that the Brown plurality’s analysis of the Act is consistent with fundamental precepts of statutory construction. Statutory words and phrases are to be interpreted with reference to the context in which they appear.
We also agree with Employer that, considering the Act as a harmonious whole, it is significant that Section 204(c) provides that, “[t]he employe is required to report regularly to the insurer the receipt of ... severance benefits ... which postdate the compensable injury under this act, subject to the fraud provisions of Article XI.”
It is also significant that the Department of Labor and Industry (“Department”) construes this statute, which it administers, as drawing no distinction between self-insured and privately-insured employers for purposes of the severance offset. Section 204(d) of the Act directs the Department to issue rules and regulations to “interpret] the provisions of the act which authorize the offset of workers’ compensation benefits by amounts received in ... severance ... subsequent to the work-related injury.”
... within 30 days of the employe’s receipt of’ such benefits.
After receipt of Form LIBC-756, the insurer may offset workers’ compensation benefits by amounts received by the employe from any of the sources in§ 123.3 (relating to employe report of benefits subject to offset). The offset of workers’ compensation benefits only applies with respect to amounts of unemployment compensation, Social Security (old age), severance and pension benefits received subsequent to the work-related injury.
(a) Workers’ compensation benefits otherwise payable shall be offset by amounts an employee receives in severance benefits subsequent to the work-related injury....
* * #
(e) When the employee receives severance benefits in a lump-sum payment, the net amount received by the employee shall be divided by the weekly workers’ compensation rate. The result is the number of weeks, and fraction thereof, the insurer may offset against future payments of workers’ compensation benefits.
34 Pa.Code 123.11(a), (c) (emphasis added). While the Department’s administrative interpretation does not bind us, it is consistent with our understanding of the Act and we therefore deem it persuasive. See
It follows from our interpretive conclusion that we also agree with Employer that the General Assembly intended the phrase “employer directly liable for compensation” in Section 204(a) primarily to account for situations where a claimant has more than one employer and to clarify that, in that scenario, it is the employer/insurer responsible for the workers’ compensation benefits and the severance payment, who is entitled to a severance offset. Double recovery for the same loss is thus avoided. Making severance offsets available to all liable employers in that position should effectively reduce the cost of work injuries because, contrary to Claimant’s argument, it appears that a reduction in workers’ compensation benefits paid out should reduce future insurance premiums. This is so because premiums for insurance coverage for workers’ compensation are based not only on the classification of the type of business and its annual payroll, but also on the company’s prior “experience modification” or claims history.
The Commonwealth Court’s decision requires insurers to pay benefits above and beyond that which the polieyholders/employers would pay if self-insured. The Commonwealth Court’s limitation of Section 204(a) not only differentiates between types of employers, but also disparately treats their employees. As this Court noted long ago in Brown, we do not believe that the General Assembly intended such a distinction between employers, and between claimants, on questions involving obligations and benefits. For the foregoing reasons, we hold that, in appropriate cases, all “employers” may seek an offset of severance payments against workers’ compensation benefits under Section 204(a), regardless of whether
II. Claimant’s Appeal: Equal Protection
We now turn to the issue posed in the cross-appeal: whether Section 204(a) violates equal protection considerations under the Pennsylvania and/or U.S. Constitutions. This issue, which was properly preserved by Claimant, was reached by neither the workers’ compensation tribunals, which lack authority over such a claim, nor the Commonwealth Court, which ruled in Claimant’s favor on other grounds. Because the parties have fully briefed this purely legal subsidiary issue, and to avoid delaying a final resolution of this litigation, we will decide the issue now rather than remanding it to the Commonwealth Court for initial consideration.
Claimant argues that Section 204(a) violates the Equal Protection Clause of the Fourteenth Amendment of the U.S. Constitution and similar protections found in Article 1, Section 1 of the Pennsylvania Constitution.
Employer responds that the proper level of review of the substance of social welfare legislation is the rational basis test. Employer also notes that Claimant misstates the issue because her severance benefit was not taken from her; rather, her workers’ compensation benefits (benefits her uninjured coworkers did not receive) were reduced by the amount she received as severance. Thus, Claimant received severance pay just as her co-workers did. The legislation therefore makes no distinction among workers whose jobs disappear, nor does it impede a claimant’s right to
Employer further asserts that, when the rational basis test is applied, Section 204(a) easily passes constitutional muster because the General Assembly relied on legitimate economic reasoning in allowing a workers’ compensation offset for severance benefits and the purposes of the legislation are directly-furthered by the offset. Employer argues that Section 204(a) was enacted to curtail the costs of work-related injuries and to eliminate a claimant’s receipt of duplicate benefits for the same loss of earnings. Employer asserts that the offset accomplishes these goals because the employer is responsible for both severance and compensation benefits. Even if an employer is privately insured, its premiums are based in part on experience, including the amount of workers’ compensation benefits paid out in the past. Any reduction in the total amount paid out by the insurer, including reductions resulting from severance benefit offsets, necessarily results in lower costs for the employer.
The Equal Protection Clause of the Fourteenth Amendment provides that
No state shall ... deny to any person within its jurisdiction the equal protection of the laws.
All men are born equally free and independent, and have certain inherent and indefeasible rights, among which are those of enjoying and defending life and liberty, of acquiring, possessing and protecting property and reputation, and of pursuing their own happiness.
The essence of the constitutional principle of equal protection under the law is that like persons in like circumstances will be treated similarly. However ... [t]he right to equal protection under the law does not absolutely prohibit the Commonwealth from classifying individuals for the purpose of receiving different treatment and does not require equal treatment of people having different needs. The prohibition against treating people differently under the law does not preclude the Commonwealth from resorting to legislative classifications provided that those classifications are reasonable rather than arbitrary and bear a relationship to the object of the legislation.
Curtis v. Kline,
Turning to the merits, an initial determination must be made as to whether the statute creates a classification for the unequal distribution of benefits or imposition of burdens. McCusker,
Even if this Court were to assume that the external effect the statute has—i.e., in creating a distinction between injured and non-injured workers in circumstances where the employer later offers severance benefit packages to multiple employees—is sufficient to create a triggering equal protection classification, it is clear that Claimant’s challenge fails. First, we agree with Employer that the perceived distinction is subject to rational basis scrutiny. The determination of the appropriate level of scrutiny (effectively, the standard of judicial review) depends upon the type of interest affected by the classification. Generally speaking, there are three different types of classifications calling for three different standards of review: (1) classifications which implicate a suspect class or a fundamental right are strictly construed in light of a compelling governmental purpose; (2) classifications which implicate an important though not a fundamental right or a sensitive classification are assessed under a heightened standard of scrutiny which seeks an important governmental purpose; and (3) classifications which involve none of these classes or rights are upheld if there is any rational basis for the classification. Clark v. Jeter,
Claimant argues that Section 204(a) affects a fundamental right, the contractually-created property right in her severance payment, requiring this Court to utilize strict scrutiny. But, this assertion is based upon a faulty understanding of the issue at hand. This case does not involve the deprivation of a severance payment. Claimant concedes in her own statement of the facts that she received a check from Employer in the amount of $3,355.02, representing the net amount of severance pay due to Claimant as a result of Employer’s relocating its facility to Maryland. Claimant kept this payment and was never asked or required to return it. Accordingly, she was not deprived of any fundamental right to this property. Nor has Claimant argued that the classification she alleges between non-injured and injured employees is suspect. The strict scrutiny test, therefore, does not apply.
Instead, the effect of the statutory offset was merely to reduce Claimant’s workers’ compensation benefits, an effect which plainly did not implicate a fundamental right.
In applying the rational basis test, this Court has employed a two-step analysis: first, we determine whether the challenged statute seeks to promote any legitimate state interest or public value; and if so, we then determine whether the legislative classification is reasonably related to accomplishing that articulated state interest. Commonwealth v. Albert,
Under a rational basis analysis, the General Assembly need not specifically articulate the purpose or rationale supporting its action. It is enough that some rationale may conceivably be the purpose and policy underlying the enactment. Albert,
In the absence of an explicit statement of legislative purpose, Employer suggests that the General Assembly enacted Section 204(a) to curtail the costs of work-related injuries, and to eliminate a claimant’s receipt of duplicate benefits for the same loss of earnings. See Brief for Employer, at 16 (citing Twp. of Lower Marion v. Workers’ Compensation Appeal Bd. (Tansey),
Claimant concedes that the legislative goals identified by Employer are legitimate state interests as a general matter, and we have no doubt that the Section 204(a) offset is designed to promote legitimate state interests. The general purpose of the Act is remedial in nature, as it is designed to compensate workers and their dependents who have suffered economic loss from work-related injuries. Hannaberry,
The disputed point is whether the legislation at issue accomplishes its salutary purpose, i.e., whether the severance pay offset bears a rational relationship to controlling workers’ compensation costs. Leheny,
We cannot agree. In the case of a self-insured employer— and in reviewing the constitutionality of the severance benefit offset, we cannot lose sight of that circumstance—the offset directly reduces the employer’s costs. Moreover, there is nothing irrational or arbitrary in offsetting severance benefits, irrespective of whether the employer is self-insured or privately insured. The worker experiences only one loss of earnings at a time, even if there is a prospect of compensation for that loss from multiple sources. The offset does not disadvantage the injured worker vis a vis his uninjured colleagues who also receive severance benefits because those workers do not receive a double benefit, in the form of workers’ compensation payments, from the employer. Because the employment relationship is the basis for providing both severance payments and workers’ compensation benefits (whether or not the compensation is paid through an outside insurer), the employer can avoid paying duplicate benefits for the same loss of earnings by using the offset. We conclude that the severance benefit offset bears a rational relationship to achieving the legislative goals.
Furthermore, as we have already concluded in resolving Employer’s appeal, in the case of employers with private insurance, rates are based at least in part on
Accordingly, we agree with Employer that the subject legislation serves a legitimate state interest in reducing the cost of workers’ compensation benefits in Pennsylvania by allowing employers to avoid paying duplicate benefits for the same loss of earnings. Because the subject legislation is reasonably related to accomplishing that interest, the legislation passes equal protection scrutiny under the rational basis test and is constitutionally sound.
Conclusion
For the foregoing reasons, we hold that: (1) Section 204(a) of the Act allows all employers, whether self-insured or privately insured, to take an offset in the amount of a severance benefit against an award of workers’ compensation benefits; and (2) this severance benefit offset does not violate equal protection. Accordingly, we reverse the order of the Commonwealth Court and reinstate the decision of the Workers’ Compensation Judge. Jurisdiction is relinquished.
Notes
. See Section 413 of the Workers’ Compensation Act,
. This severance benefit offset provision was added to Section 204 as part of Act No. 57, § 3, June 24, 1996, P.L. 350 (“Act 57”), which took effect sixty days after its enactment. The remaining portion of Section 204(a) provides for similar offsets against workers’ compensation benefits for unemployment compensation, Social Security old age benefits, and pension benefits.
. Although the Act does not define "severance,” the pertinent regulation does:
Severance benefit—A benefit which is taxable to the employe and paid as a result of the employe's separation from employment by the employer liable for the payment of workers’ compensation, including benefits in the form of tangible property. The term does not include payments received by the employee [sic] based on unused vacation or sick leave or otherwise earned income.
. Claimant did not raise this specific argument before the WCJ or the Board. In seeking review before this Court, however, Employer did not argue that the Commonwealth Court erred in reaching and granting relief upon the claim; nor does Employer argue waiver in its appellate brief.
. In such an instance, the intention of the General Assembly "may be ascertained by considering, among other matters:”
(1) The occasion and necessity for the statute.
(2) The circumstances under which it was enacted.
(3) The mischief to be remedied.
(4) The object to be attained.
(5) The former law, if any, including other statutes upon the same or similar subjects.
(6) The consequences of a particular interpretation.
(7) The contemporaneous legislative history.
(8) Legislative and administrative interpretations of such statute.
. Six Justices participated in the decision in Brown. Justice Cohen concurred in the result without opinion, and Justice O’Brien, joined by Justice Roberts, dissented.
. Section 303 of the Act was rewritten in 1974.
. We note that Judge Barbieri later served as a Judge on Commonwealth Court and, for a short time, as a Justice on this Court, and he also authored a respected treatise on Pennsylvania Workers’ Compensation Law.
. Section 1102 of the Act provides a list of Insurance Fraud Offenses. A claimant commits an offense if he or she:
Knowingly and with intent to defraud any insurer presents or causes to be presented to any insurer any statement forming a part of or in support of a workers’ compensation insurance claim that contains any ... incomplete ... information concerning any fact or thing material to the workers’ compensation insurance claim.
A person who violates Section 1102 shall be guilty of a felony of the third degree and, upon conviction thereof, shall be sentenced to pay a fine of not more than fifty thousand dollars ($50,000) or double the value of the fraud or to undergo imprisonment for a period of not more than seven years, or both.
. See Pennsylvania Insurance Department, Your Guide to Workers' Compensation Insurance (May 2001), available at http://www.ins. state. pa.us/ins/lib/ ins/consumer/brochures /2003_Work_Comp.pdf.
. See, e.g., Murphy v. Duquesne Univ.,
. Claimant also invokes Article I, Section 26 and Article 3, Section 32 of the Pennsylvania Constitution, but fails to explain how they support her equal protection claim. Article I, Section 26 safeguards the right not to be harassed or punished for the exercise of a constitutional right. Probst v. Com.,
. Claimant's equal protection argument has nothing to do with the distinction between privately insured and self-insured employers, but instead challenges the offset itself.
. While the strict scrutiny test is applied in a due process analysis of social welfare legislation, it is settled that rational basis scrutiny is properly employed in an equal protection analysis of the substance of such legislation. Richardson v. Belcher,
. See Pennsylvania Legislative Journal-Senate, June 5, 1996 at 2034 (Sen. Loeper); Id-Senate, June 19, 1993 at 2156 (Sen. Armstrong); Id.-House, June 16, 1993 at 1469 (Rep. Gladeck); see also Torrey & Greenberg, Pennsylvania Workers' Compensation: Law & Practice § 14.A6 (2001) (1996 amendments were economic legislation designed to address increase in cost of claims despite fewer work injuries).
Concurrence Opinion
concurring.
I join the majority opinion, except in two respects. First, I agree with Claimant that it is not wholly apt to characterize the receipt of workers’ compensation benefits and a severance, negotiated under a collective bargaining agreement, as a double benefit or recovery, particularly in light of the legislative compromise between loss-spreading and insulation of employers from tort liability on which the workers’ compensation system is premised. See Lewis v. School Dist. of Phila.,
Second, I differ with the majority opinion to the extent that it can be interpreted as foreclosing an equal protection claim on the basis that no classification is present, because the pertinent statutory language does not specifically address the class of non-injured workers. See Majority Opinion, at 331-35,
Concurrence Opinion
concurring.
I agree with the majority that § 204(a) of the Pennsylvania Workers’ Compensation
I agree that the legislature included the phrase “employer directly liable” in § 204(a) to account for a situation where a claimant has more than one employer. Majority Op., at 328-30,
Thus, I would hold § 204(a) is unambiguous, and it means just what it says, i.e., that the employer directly liable for the payment of compensation or pension benefits—whether the employer pays those benefits himself or contracts with a private insurance company to pay his employees those benefits—is entitled to an offset in the amount of a severance benefit against an award of Workers’ Compensation benefits.