Opinion
No. 1640 C.D. 2014
06-09-2015
Rodney Taylor, Petitioner v. Workers' Compensation Appeal Board (Bloom Engineering Co., Inc. and Arrowood Indemnity Company), Respondents
BEFORE: HONORABLE BERNARD L. McGINLEY, Judge HONORABLE MARY HANNAH LEAVITT, Judge HONORABLE ROCHELLE S. FRIEDMAN, Senior Judge
OPINION NOT REPORTED
MEMORANDUM OPINION BY SENIOR JUDGE FRIEDMAN
Rodney Taylor (Claimant) petitions for review of the August 14, 2014, order of the Workers' Compensation Appeal Board (WCAB) affirming the decision of a workers' compensation judge (WCJ) to dismiss Claimant's petition to review workers' compensation benefits (Review Petition) as moot and deny Claimant's request for unreasonable contest fees under section 440(a) of the Workers' Compensation Act (Act). We affirm.
Act of June 2, 1915, P.L. 736, added by Section 3 of the Act of February 8, 1972, P.L. 25, as amended, 77 P.S. §996(a). Section 440(a) of the Act provides:
In any contested case where the insurer has contested liability in whole or in part, . . . the employe . . . in whose favor the matter at issue has been finally determined in whole or in part shall be awarded, in addition to the award for compensation, a reasonable sum for costs incurred for attorney's fee[s], witnesses, necessary medical examination, and the value of unreimbursed lost time to attend the proceedings: Provided, [t]hat cost[s] for attorney['s] fees may be excluded when a reasonable basis for the contest has been established by the employer or the insurer.77 P.S. §996(a).
On October 23, 1989, Claimant sustained a cervical neck injury while working for Bloom Engineering Company, Inc. (Employer). (WCJ's Findings of Fact, No. 1.) Claimant was out of work from the date of the injury until April 16, 1990, pursuant to a supplemental agreement. (Id., No. 6.) Claimant underwent neck surgery on May 1, 1991, and remained out of work until December 1991. (Id.) Claimant signed a final receipt on December 22, 1991. (Id.)
On December 20, 2011, Claimant's counsel sent a letter to Employer seeking the identity of its workers' compensation carrier as well as the claim number for Claimant's medical claim. (Id., No. 8.) On September 19, 2012, Claimant filed a Review Petition, alleging that he was unable to receive treatment for his work-related injury because his claim was closed and Employer failed to provide the claim information he needed to receive treatment. (Id., No. 1.) Claimant's Review Petition identified EBI/Security Insurance Group (EBI) as Employer's workers' compensation carrier. (Id.)
In his December 20, 2011, letter to Employer, Claimant's counsel identified Claimant's injury as a cervical spine injury sustained "in the late 1980's or early 1990's." (R.R. at 87a.)
"Medical payments for work-related injuries are reimbursable under Section 306(f) of the Act." Fuhrman v. Workmen's Compensation Appeal Board (Clemens Supermarket), 515 A.2d 331, 332 (Pa. Cmwlth. 1986). Section 306(f)(1)(i) of the Act states:
The employer shall provide payment in accordance with this section for reasonable surgical and medical services, services rendered by physicians or other health care providers, including an additional opinion when invasive surgery may be necessary, medicines and supplies, as and when needed.77 P.S. §531(1)(i). The medical-payment provision is not governed by the three-year statute of limitations applicable to the payment of compensation under the Act. Fuhrman, 515 A.2d at 335.
During the course of the litigation, Employer identified Arrowpoint Capital Company (Arrowpoint) as EBI's successor. (Id., No. 3.) The WCJ held hearings on November 16, 2012, and January 18, 2013. At the first hearing, Claimant's counsel stated that Claimant sought an acknowledgment that the medical claim for his work-related injury remained open. (Id., No. 5.) At the second hearing, Claimant's counsel clarified that Claimant only sought a claim number in the event that he seeks additional treatment for his injury. (Id.) Employer's counsel agreed to provide the claim number to Claimant. (Id.)
Both the WCJ and counsel identified Arrowpoint as Employer's workers' compensation carrier. (N.T., 11/16/12, at 6-7.) Arrowood Indemnity Company, which is named in the caption in this matter, is a subsidiary of Arrowpoint.
The Bureau of Workers' Compensation (Bureau) did not maintain the original documents relating to Claimant's 1989 work-related injury. (Id., No. 6.) Claimant offered into evidence the April 19, 1990, supplemental agreement and the December 22, 1991, final receipt. (Id.) Claimant did not offer the original Bureau document recognizing his work-related injury. (Id.)
On May 30, 2013, the WCJ dismissed Claimant's Review Petition as moot because Employer had provided the requested claim information to Claimant. (Id., No. 14.) The WCJ also found that Employer's contest was reasonable in light of the claim's age and the lack of Bureau documents recognizing Claimant's injury. (Id.; WCJ's Conclusions of Law, No. 1.) Therefore, the WCJ denied Claimant's request for counsel fees. Claimant appealed to the WCAB, which affirmed. Claimant now petitions for review of that decision.
Although he denied Claimant's request for counsel fees, the WCJ concluded that Claimant was entitled to reimbursement of his bill of costs because Claimant succeeded in obtaining the requested claim information. (WCJ's Conclusions of Law, No. 2.)
Our review is limited to determining whether constitutional rights were violated, whether the adjudication is in accordance with the law, and whether the necessary findings of fact are supported by substantial evidence. Section 704 of the Administrative Agency Law, 2 Pa. C.S. §704. --------
On appeal, Claimant asserts that the WCAB erred in concluding that Employer's contest was reasonable under the circumstances and in failing to award him unreasonable contest fees. We disagree.
The employer bears the burden of establishing a reasonable basis for contesting liability. City of Philadelphia v. Workers' Compensation Appeal Board (Calderazzo), 968 A.2d 841, 852 (Pa. Cmwlth. 2009). Whether a reasonable contest exists is a question of law fully reviewable by this court. Crouse v. Workers' Compensation Appeal Board (NPS Energy SVC), 801 A.2d 655, 657 (Pa. Cmwlth. 2002). An employer's contest is reasonable if its purpose is "to resolve a genuinely disputed issue, rather than to harass the claimant." Lebanon Valley Brethren Home v. Workers' Compensation Appeal Board (Flammer), 948 A.2d 185, 188 (Pa. Cmwlth. 2008). To determine whether an employer's contest is reasonable, we must consider the totality of the circumstances. Id.
Here, Claimant contends that Employer's delay in providing the requested claim information constituted an unreasonable contest. We cannot agree. Claimant filed his Review Petition 23 years after his work-related injury and 21 years after he last requested medical payment from Employer for his work-related injury. In concluding that Employer's contest was reasonable, the WCJ explained:
I have taken into account the age of the claim and the fact that counsel for [E]mployer did not even have any of the Bureau documents at the time of the first hearing. In fact, the document recognizing the injury is still not in evidence in this case. Claimant appears to rely on the fact that his counsel sent a letter to [E]mployer requesting th[e] identity of the workers' compensation carrier for an injury which at the time was twenty-two years old. Even if someone working for [E]mployer knew that the carrier in 1989 was EBI, I would not necessarily expect someone working for [E]mployer today to know . . . the successor corporation . . . to EBI if [E]mployer has not used that particular company as its insurance carrier for a number of years. I believe that . . . [E]mployer acted reasonably in requesting time to assess the case before ultimately agreeing to provide the claim number at the time of the second hearing.(WCJ's Findings of Fact, No. 14.) The record contains substantial evidence to support these findings. We agree with the WCAB that Employer's delay in providing the requested claim information was reasonable under the circumstances. Therefore, Claimant was not entitled to unreasonable contest fees.
Accordingly, we affirm.
/s/_________
ROCHELLE S. FRIEDMAN, Senior Judge
ORDER
AND NOW, this 9th day of June, 2015, we hereby affirm the August 14, 2014, order of the Workers' Compensation Appeal Board.
/s/_________
ROCHELLE S. FRIEDMAN, Senior Judge