PLEASE NOTE: The below warning now appears on WCAIS: Final decisions rendered (including C & Rs), signed agreements, and LIBC-751s must have an EDI transaction to reflect the acceptance, modification, suspension, or closure of the claim in WCAIS. This is nothing...
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Workers’ Compensation
What records must an IRE physician review in order for his or her opinion to be valid?
The Commonwealth Court addressed this question (as well as yet another constitutional issue) in the case of Conrad v. Department of Transportation (Workers’ Compensation Appeal Board), No. 557 C.D. 2022, filed February 26, 2024. The short answer is: “whatever...
Reimbursement of Prescription Drugs in Pennsylvania Workers Compensation
In one of the first decisions this year, the Commonwealth Court has addressed the use of the Red Book in calculating payment owed for prescription medications. Specifically, the Workers’ Compensation Act provides that payment for prescription drugs and professional...
When is employment truly concurrent?
The Miriam-Webster Dictionary defines ”concurrent” as: operating or occurring at the same time. “Not necessarily so!” says the Commonwealth Court. The definition is not to be strictly applied when defining employment under the Pennsylvania Workers’ Compensation Act....
Commonwealth Court Holds That Employer Is Not Liable to Contribute to Purchase of a New One Story Home for Paraplegic Claimant
Ralph Martin Construction and Lackawanna American Insurance Co. v. Miquel Castaneda- Escobar (WCAB) ___ A.3D___, No. 341 C.D.2021 (Pa. Cmwlth filed 8/1/22). In a case of first impression, the Court addressed Employer’s appeal from the WCAB Decision which held that the...
NEW COMMONWEALTH COURT CASE CONFIRMS THAT EMPLOYER ACTED PROPERLY IN REFUSING TO PAY FOR PRESCRIPTIONS NOT CAUSALLY RELATED TO THE WORK INJURY DESPITE UNCHALLENGED UTILIZATION REVIEW (UR) DETERMINATION THAT FOUND PRESCRIPTIONS TO BE REASONABLE AND NECESSARY
Theresa Skay v. Borjeson & Maizel LLC(WCAB) ___A.3D___ (Pa. Cmwlth. filed 5/10/22; reported 7/26/22) No 999 C.D. 2021. As we know Employers have been in a quandary since the 2020 Commonwealth Court’s decision in Workers’ First Pharmacy Services, LLC v. Bureau of...
Notification of Suspension or Modification (LIBC-751) Revised
PLEASE NOTE: The following important Notice was published via WCAIS on 01/14/2022: Notification of Suspension or Modification (LIBC-751) Revised On Dec. 22, 2021, Governor Tom Wolf signed Act 95 (House Bill 1837) into law. This act amended Section 413(c) & (d)...
Social Security Off-Sets, Vocational Disclosure Rules and a Felony Conviction
On January 7, 2022, a three judge panel of the Commonwealth Court of Pennsylvania issued a decision in the case of Sadler v. Philadelphia Coca-Cola (WCAB), 1294 C.D. 2020, which addressed four primary legal issues. The court’s opinion was extremely lengthy and...
Employer Credit for Pandemic Compensation Denied
On January 3, 2022, a panel of the Commonwealth Court of Pennsylvania issued its Opinion in the case of Carbon Lehigh Intermediate Unit No. 21 v. Kimberly Waardal (WCAB), 750 C.D. 2021, in which the employer requested a credit against workers’ compensation benefits...
PA Employers and Insurers to be Adversely Impacted by Section 440 Counsel Fees
Section 440(a) of the Pennsylvania Workers’ Compensation Act provides: In any contested case where the insurer has contested liability in whole or in part, including contested cases involving petitions to terminate, reinstate, increase, reduce or otherwise modify...