Palaschak v. Workers' Compensation Appeal Board

DISSENTING OPINION BY

Judge PELLEGRINI.

I respectfully dissent from the majority’s decision to affirm the Board’s denial of benefits for Richard Palaschak (Claimant) because 500 weeks had passed when he filed his reinstatement petition. He was on light-duty work when more than 500 weeks had passed from the suspension of his benefits, and he was forced to leave his job, both distinctions that the majority discounts when denying benefits.

*1254The pertinent facts of this case are that Claimant was injured at work in 1987 while working for U.S. Airways (Employer). He aggravated the injury in 1992 and 1993 and had surgery. He returned to work in a light-duty capacity on February 5, 1996, at which time his benefits were suspended because he returned to work at equal or greater pay than he had made before his injury. Claimant continued to work for Employer, and in February 2005, there was a reorganization of the workplace. Claimant’s light-duty position was modified and his position required crawling and turning causing increased pain in his neck. His treating physician restricted him to bench work, and in March 2006, due to pain, his physician placed an additional work restriction on him. Employer notified Claimant that it could not accommodate this restriction and that it had no more work available for him.

As a result, on April 19, 2006, Claimant filed a reinstatement petition alleging that his 1992 work injury had caused him a loss of earning power as of March 2006. He also filed a modification petition stating without explanation that “Claimant did not receive indemnity benefits for time missed as a result of work injury.” (Reproduced Record at 13a.) The WCJ denied both of Claimant’s petitions finding that Claimant did not suffer a new injury and that his previous condition had not worsened. Claimant appealed to the Board, which affirmed the WCJ’s decision. He then appealed only the Board’s denial of the reinstatement petition to this Court.

On appeal, Claimant contends the Board erred by dismissing his reinstatement petition under Sections 306(b) and 413(a) of the Workers’ Compensation Act (Act)1 because 500 weeks had passed since his return to work. Claimant argues that the 500-week restriction does not run when a claimant is removed from a light-duty position.2 In response, Employer contends that the 500-week statute of repose acts as an absolute bar to any reinstatement or modification petition filed after it has elapsed in situations such as the present in which workers’ compensation benefits were suspended following a return to work with no loss of earnings. Employer further argues that even if Claimant’s reinstatement petition was not time-barred, the WCJ found that Claimant’s condition had not worsened, requiring denial of his reinstatement petition.

The majority agrees with Employer, first reciting Section 413(a) of the Act for *1255the proposition that Claimant’s reinstatement petition was not timely filed within 500 weeks after returning to work with no loss of wages, i.e., the suspension of his benefits. The majority then goes on to address Claimant’s argument that payments for total disability are not limited to 500 weeks but are payable for the duration of the total disability. “Because a claimant on partial disability can have his total disability compensation reinstated up to three years after expiration of 500 weeks of partial disability, Claimant argues that, likewise, a claimant whose benefits have been suspended should be able to seek reinstatement within that deadline.” (Majority opinion at 1249.) The majority discounts this argument stating that Claimant did not receive 500 weeks of partial disability payments because he did not receive any disability compensation since February 1996 when he returned to work with no wage loss.

Several of this Court’s opinions have dealt with this issue under the same or similar factual scenarios, all coming to the conclusion that the claimant was not eligible for benefits because his reinstatement petition was time-barred. The majority relies on Edgewater Steel Co. v. Workmen’s Compensation Appeal Board (Beers), 719 A.2d 812 (Pa.Cmwlth.1998), because it is factually on point with this case. See also Bellows v. Workmen’s Compensation Appeal Board (Shabloski), 663 A.2d 267 (Pa.Cmwlth.1995); Deppenbrook v. Workmen’s Compensation Appeal Board (Republic Steel Corporation), 655 A.2d 1072 (Pa.Cmwlth.1995); Roussos v. Workmen’s Compensation Appeal Board (St. Vincent Health Center), 157 Pa.Cmwlth. 584, 630 A.2d 555 (1993).

Not disagreeing with the majority that Edgewater Steel Co. is on point, subsequent to that case and the others mentioned, our Supreme Court decided Stewart v. Workers’ Compensation Appeal Board (Pa. Glass Sand/US Silica), 562 Pa. 401, 756 A.2d 655 (2000), upon which Claimant relies.

Stewart dealt with a different factual scenario, in which the claimant had been out of work on partial disability for more than 500 weeks. He sought to modify his benefits to total disability based on a deterioration of his condition which rendered him completely unable to work. In addressing this different factual scenario, however, our Supreme Court embarked on a global examination of prior jurisprudence interpreting Section 413(a) and criticized much of the prior case law. Included in this examination was a detailed discussion of Edgewater Steel upon which the majority relies. To understand that discussion, it is necessary to quote from Stewart at some length:

In interpreting the final sentence of Section 413(a),. the Commonwealth Court has long drawn a distinction between claimants who have received the full statutory allotment of partial disability benefits, and those whose benefits were suspended during the applicable 500-week period based upon their ability to generate a pre-injury wage. As to the former category (those who have received partial disability benefits for 500 weeks) [that is, the facts in Stewart ], the Commonwealth Court’s published opinions consistently indicate that total disability benefits are in fact available upon demonstration of deterioration in the claimant’s condition, and subject to Section 413(a)’s three-year limitation commencing upon receipt of the final payment of partial disability compensation. [Citations omitted.] With respect to the latter category (suspension because the claimant has regained the ability to generate his pre-injury earnings) [that is, the facts in the instant matter], *1256the Commonwealth Court has consistently found that expiration of the 500-week period operates as a bar to the assertion of a subsequent claim for total disability benefits. See, e.g., Edgewater Steel Co. v. WCAB (Beers), 719 A.2d 812, 814 (Pa.Cmwlth.1998); Deppenbrook v. WCAB (Republic Steel Corp.), 655 A.2d 1072, 1075-76 (Pa.Cmwlth.1995); Roussos v. WCAB (St. Vincent Health Center), 157 Pa.Cmwlth. 584, 587-88, 630 A.2d 555, 557 (1993).
[W]e are unable to discern a sound policy reason for distinguishing between employees who are partially disabled but whose post-injury earnings ability requires a suspension of benefits, and those who are also partially disabled but whose earnings result in the affordance of partial disability benefits, in terms of who should be deemed entitled to seek total disability compensation after the expiration of 500 weeks. Additionally, such distinction would appear difficult to maintain in cases in which the claimant has received partial disability benefits as well as experienced suspension of benefits in various time increments throughout the pertinent 500-week period. Nevertheless, we are not free to disregard the express limitation in scope attached to the final sentence of Section 413(a) under the pretext of pursuing the spirit of the enactment. 1 Pa.C.S. § 1921(b). As important, we are not convinced that the legislative purpose underlying Section 413(a) would support Employer’s interpretation. Indeed, the unexplained disparity in treatment between claimants based upon the extent to which their disabilities have abated during the 500-week period would seem to present a more appropriate basis for questioning those decisions which interpret the expiration of the 500-week period as a bar to the assertion of total disability claims by employees who have experienced a suspension of benefits (for example, Edgewater, Deppenbrook and Roussos), since such construction is less solidly grounded in the plain meaning of Section 413(a).5

Stewart at 405-07, 756 A.2d at 657-58.

In footnote five, the Supreme Court went on to explain:

The final sentence of Section 413(a) expressly indicates what is permissible during the 500-week period related to claims in suspension, namely, resumption of benefits. Thus, its primary direct application is to permit a claimant whose benefits are in suspension to avoid the effect of Section 413(a)’s three-year limitations period applicable to claimant whose benefits have been terminated. [Emphasis in original.] ... Certainly by implication, the statute also requires that periods of suspension be included within the 500-week calculation for purposes of determining when partial disability benefits have expired. [Citations omitted.] A further inference is required, however, to support the conclusion that all post-500-week claims (including those for total disability) on the part of a claimant whose benefits have been suspended are precluded. Moreover, as noted, this would not appear to be as reasoned an inference, as we perceive no apparent sound policy justification for distinguishing between partially-disabled claimants who have received a full complement of partial disability benefits and those who have experienced some period of suspension, in terms of the effect of the expiration of 500 weeks upon potential future claims. We decline to resolve this question in the present appeal, however, since the appropriate facts are not before us; we merely note that the opinion in this case should not be read as an endorsement of *1257the pertinent reasoning from Edge-water, Deppenbrook, and, Roussos.

Id. at 407 n. 5, 756 A.2d at 658 n. 5 (emphasis added). It appears, then, that the Supreme Court went as far as it could to disavow Edgewater et al. given that it could not explicitly overturn them because the necessary facts were not before it.

While it did not explicitly overturn those cases, in the paragraph immediately following its criticism of this Court’s relevant jurisprudence, the Supreme Court laid out its global template for dealing with post-500-week reinstatement or modification petitions depending on the disability level and work status of the claimant:

Significantly, an employee with a fixed and stable, but partially-disabling, condition may receive the protection of a substantial period of subsidy (approximately nine and one-half years), within which to adjust to his disability and maximize his earning capacity consistent with his physical limitations. At a minimum, assuming no worsening of the employee’s condition, the employee retains his physical capacity to generate the amount of earnings previously subject to supplementation. The same cannot be said, however, where an employee’s condition deteriorates to the point of total disability, or work within the claimant’s restrictions ceases to be available, such that the employee no longer retains the ability to support himself and his dependents in any fashion. Since these circumstances diverge substantially in terms of the impact of cessation of benefits upon the injured employee, it is not surprising that the legislative scheme of compensation allows for differential treatment.

Id. at 408-09, 756 A.2d at 659 (emphasis added).

In instructing us how to deal with the 500-week rule, our Supreme Court laid out how Section 413(a) applied to three different scenarios. First, claimants who received partial disability payments during the 500-week period and who were still on partial disability at the end of that period had their benefits terminated at the end of 500 weeks. Second, claimants whose conditions deteriorate to the point of total disability were not subject to the 500-week restriction.3 Third, relevant to this case, claimants whose light-duty positions ceased to be available, as in the instant matter, were also not subject to the 500-week restriction.

The rationale for exempting claimants whose light-duty jobs were eliminated from the 500-week limitations period also flowed logically from the Act and was consistent with its remedial purposes. Light-duty jobs are remedial in nature, designed to allow employees who are partially disabled as a result of a work injury to retain some level of economic productivity. However, these jobs are often specially created for the injured employee, and may or may not exist in the marketplace at large. This means that the earning power of light-duty employees is untested and unknown; it may (or may not) be zero, just the same as for a totally disabled individual, who is also not subject to the 500-week limitation.

The majority ignores all of this language and instead states: “Nevertheless, this Court has continued to rely upon the plain language of Section 413(a) as we did in Edgewater. In Cicchiello v. Workmen’s Compensation Appeal Board (Frank L. *1258Markel Corporation), 761 A.2d 210 (Pa.Cmwlth.2000), appeal denied, 566 Pa. 649, 781 A.2d 148 (2001), which was filed three months after Stewart, we held that the 500-week limit for filing for reinstatement after a suspension is a ‘statute of repose [which] not only limits a remedy, but also completely and totally extinguishes a claimant’s right to benefits in the first instances.’ ” The majority, however, correctly notes that in that case, the claimant had a history of suspensions and partial disability and those facts are not present here. Notably, our Supreme Court declined to grant allocatur in Cicchiello.

In this case, contrary to the majority’s decision, I believe the Board erred in dismissing Claimant’s reinstatement petition because more than 500 weeks had passed since the suspension of his benefits and that limitation does not apply because a light-duty position was removed. That does not necessarily mean, however, that Claimant is entitled to have his compensation reinstated. At the same time, there is no doubt that Claimant remains partially disabled. Both Claimant’s treating physician and Employer’s physician, whom the WCJ deemed credible, agreed on this, and Employer’s physician specifically stated that Claimant was limited to light-to-selected-medium-duty work in the same manner as he had been limited ever since he returned to work in 1996. Moreover, Claimant never quit his employment. He continued working through his pain (whether it had increased or not) until the moment he was placed on unpaid occupational injury leave, and there was never any indication that he planned to do otherwise in the future had he not been involuntarily placed on unpaid leave.

It is necessary to remand to the Board to determine if Claimant is capable of performing his job as it had been modified in 2005 and 2006 under his work restrictions as they were since his return to work in a light-duty capacity in 1996. If it is found upon remand that Claimant cannot perform the duties of his job as it had been modified in 2005 and 2006 under his 1996 work restrictions, he is entitled to workers’ compensation payments at the pre-Febru-ary 5, 1996 level retroactive to March 23, 2006, and continuing into the future. If it is found upon remand that Claimant is capable of performing that job under those conditions, Employer must offer Claimant his job back, and he is not entitled to workers’ compensation benefits in the future unless Employer refuses to offer Claimant his old job. If Employer does offer Claimant his job back under this scenario, he still would be entitled to workers’ compensation payments at the pre-February 5, 1996 level retroactive to March 28, 2006, until the date he returns to work or declines the job offer. Under either scenario, Employer also has the option, as always, of finding suitable alternative work for Claimant, who is only partially disabled.

For the foregoing reasons, I would reverse the Board and remand the matter to the Board for further proceedings.

Accordingly, I respectfully dissent.

Judge SIMPSON joins in this dissenting opinion.'

. Act of June 2, 1915, P.L. 736, as amended, 77 P.S. § 512(1). Section 306(b) of the Act provides, in relevant part: “For disability partial in character caused by the compensable injury or disease.... This compensation shall be paid during the period of such partial disability ... but for not more than five hundred weeks.”

Section 413(a) of the Act, 77 P.S. § 772, in turn provides, in relevant part, "That where compensation has been suspended because the employe’s earnings are equal to or in excess of his wages prior to the injury that payments under the agreement or award may be resumed at any time during the period for which compensation for partial disability is payable.”

. Claimant couches the relief he seeks as "total disability” arguing that Section 413(a) only applies to cases of partial disability. While it is true that the Act treats post-500week partial and total disability differently, Claimant uses the term "total disability” to mean that his light-duty position was removed, not that his earning ability has been reduced to zero because his injury had worsened to such an extent that he could never work again. On the contrary, Claimant never disputes that he could have continued to work in the same light-duty position he had from 1996 to early 2005. These are two different scenarios requiring different analyses. What Claimant describes as "total disability” is more accurately characterized as loss of employment due to the removal of light-duty work, and we will refer to it as such.

. The Board relied on Stanek v. Workers’ Compensation Appeal Board (Greenwich Collieries), 562 Pa. 411, 756 A.2d 661 (2000), decided simultaneously with Stewart. Stanek is not applicable to this case because it is under the second scenario while the present case falls under the third scenario.