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What's Hot in Workers' Comp

WHAT’S HOT IN WORKERS’ COMP - NEWS AND RESULTS*

What’s Hot in Workers’ Comp, Vol. 27, No. 8, August 2023

August 1, 2023

NEWS

Marshall Dennehey is proud to highlight the firm’s Workers’ Compensation Department attorneys who have been recognized in the 2024 editions of The Best Lawyers in America® and Best Lawyers: Ones to Watch™ and 2024 “Lawyers of the Year” in their respective practice areas and demographic regions. 

Since it was first published in 1983, Best Lawyers® has become universally regarded as the definitive guide to legal excellence. Best Lawyers lists are compiled based on an exhaustive peer-review evaluation. For more information, please visit https://www.bestlawyers.com/.

2024 LAWYERS OF THE YEAR
Pittsburgh: Daniel Deitrick, Workers’ Compensation Law – Employers
Harrisburg: Shannon Fellin, Workers’ Compensation Law – Employers 

2024 BEST LAWYERS IN AMERICA 
Harrisburg, PA

  • Brigid Alford, Insurance Law; Litigation – Insurance 
  • Kacey Wiedt, Workers’ Compensation Law – Employers 

King of Prussia, PA

  • Frank Wickersham, Workers’ Compensation Law – Employers 

Scranton, PA

  • Ross Carrozza, Workers’ Compensation Law – Employers 
  • Michael Sebastian, Workers’ Compensation Law – Employers 

Philadelphia, PA

  • Michele Punturi, Workers’ Compensation Law – Employers 

Pittsburgh, PA

  • Daniel Deitrick, Workers’ Compensation Law – Employers 

Wilmington, DE

  • Keri Morris-Johnston, Workers’ Compensation Law – Employers 

2024 BEST LAWYERS: ONES TO WATCH
Jacksonville, FL

  • Kelly Scifres, Workers’ Compensation Law – Employers 

Wilmington, DE

  • Benjamin Durstein, Workers’ Compensation Law – Employers 


Heather Byrer Carbone (Jacksonville, FL) was a panelist at the Workers’ Compensation Institute (WCI) Annual Conference in Orlando. In “Hot Topics for Attorneys,” representatives from both the claimant and defense bars discussed the most important and controversial case law decided by Florida appellate courts and the most relevant amendments to the law enacted by the Florida Legislature. As the nation’s largest workers’ compensation conference, this event brings together workers’ compensation professionals from across the country for an enhanced learning and educational experience.

Eli Hassinger (Philadelphia, PA) authored the article, “Pa. High Court Doubles Down on the Workers’ Comp Act’s Exclusivity Provision,” for Pennsylvania Law Weekly. You may read the article at this link: Click here. 

Andrea Rock (Philadelphia, PA) presented a webinar as part of the Philadelphia Bar Association Workers’ Comp Compliance Crusher 2023: Update on Important Issues in Workers' Compensation Practice. In “Navigating the Medicare Maze,” Andrea and plaintiff’s counsel co-panelist discussed the basics of Medicare, including who exactly is a Medicare Beneficiary and the reasonable expectation of Medicare enrollment. They highlighted how knowing the Medicare laws, the intricacies of Medicare Set-aside allocations, the effect of conditional payments, and the impact Medicare can have on settlement, are all imperative in the representation of clients.

 

RESULTS*

Tony Natale (Philadelphia, PA) successfully defended a Lebanon, Pennsylvania-based pharmaceutical manufacturer in the litigation of a claim petition. The claimant alleged an injury in the form of a fractured and crushed femur as a result of a fall off the roof of the manufacturing plant. Tony was able to convince the court that the claimant was not in the course and scope of employment at the time of the fall. Despite the claimant’s allegation that he was on the roof of the facility in the middle of the night to perform work duties, the court accepted rebuttal testimony and forensic evidence from the scene of the fall which proved that the claimant was taking a clandestine unauthorized smoke break on the roof of the facility and, therefore, not furthering the interests of the employer. The claimant also tested positive for marijuana after the fall and was ultimately discharged for cause. No benefits of any kind were awarded.

Tony Natale (Philadelphia, PA) successfully prosecuted a review petition on behalf of a 125-year-old manufacturer of power and grounding connectors and accessories, which challenged by way of causation a major surgery the claimant underwent after a work injury. The claimant injured her upper extremity at work. Many months later, she had a major surgery and alleged it was related to the injury. Tony convinced the court that the surgery was due to a genetic condition present prior to the work injury and that the condition was not aggravated by the work injury. All medical bills and disability related to the surgery were dismissed.

Tony Natale (Philadelphia, PA) successfully prosecuted a review petition filed on behalf of a Philadelphia-based insurance company. The underlying claim involved a specific loss amputation injury that was mistakenly accepted as compensable with a Lost Time Bureau document. The specific loss benefit rights expired upon receipt of the requisite number of weeks of benefits related to the claimant’s amputation injuries, but the Lost Time Bureau document remained open. The issue before the court was whether the carrier could challenge an open notice of compensation payable (now many years old) with an allegation that the injury was a specific loss from its inception. After effective legal wrangling, the court granted the review petition and closed out the indemnity benefits by finding the injury was at all times a specific loss.

Michele Punturi (Philadelphia, PA) and Audrey Copeland (King of Prussia, PA) convinced the Pennsylvania Commonwealth Court to affirm the decisions of the Appeal Board and the Workers’ Compensation Judge granting a petition to terminate benefits in favor of the firm’s client, the employer, an international automotive manufacturing corporation. The court found the Board did not err by affirming the judge’s finding that the employer established a change in the claimant’s medical condition, as the judge did not solely rely on the claimant’s testimony, but had credited the testimony of the employer’s medical expert of claimant’s full recovery. 
 
Andrea Rock (Philadelphia, PA) and Audrey Copeland (King of Prussia, PA) obtained a favorable decision from the Commonwealth Court, which affirmed the Appeal Board’s order upholding the judge’s decision denying a claim petition. The court rejected the claimant’s argument that the judge’s decision did not meet the “reasoned decision” requirement of Section 422(a) of the Pennsylvania Workers’ Compensation Act and that the claim petition should be granted for at least a limited period. The court agreed with the employer that the judge did not arbitrarily and capriciously disregard the employer’s medical witness’ testimony, that the claimant had sustained a low back strain and sprain that had resolved at the time of his IME. The court observed that the judge discredited the claimant's testimony and rejected the existence of any work-related injury, and that the employer’s expert’s opinion was based on the false history provided by the claimant and did not constitute an admission or competent evidence that a work-related injury occurred. 

Kristopher Starr (Wilmington, DE) defended a claimant’s petition for compensation, alleging injury to the entire left upper extremity (hand, wrist, elbow, shoulder) and neck from a work accident. The claimant claimed this injury resulted in carpal tunnel to the left wrist, cubital tunnel to the left elbow, internal derangement/injury to the left shoulder and a neck/cervical spine traction/pull injury. The claimant presented two Philadelphia-area orthopedic surgeons/specialists—Dr. Michael Birns, a shoulder specialist, and Dr. Julie Mayberry, a hand specialist. On behalf of the employer, Kris presented Dr. Jonathan Kates, an orthopedic surgeon. The claimant’s petition was denied in all respects. Key to this determination was evidence presented by Kris that the claimant started with complaints and treatment to the bilateral upper extremities for nerve injury well prior to his employment and the alleged work accident. The claimant had undergone a carpal tunnel release prior to his employment with the employer. Also, Kris’s cross-examination of the claimant’s shoulder expert limited his testimony to the left shoulder and produced the doctor’s admission that he was not qualified to address the left wrist, elbow or neck. The employer’s expert medical witness opined that the bilateral upper extremity nerve symptoms likely represented a neck nerve problem that pre-existed the work injury and caused a “double crush syndrome” emanating from the neck. The Board found the employer’s medical expert to be persuasive and credited the testimony of this witness, as well as Kris’s presentation of evidence demonstrating that many of the symptoms pre-existed the alleged work accident. Further, the Board found the cross-examination of the claimants specialist, Dr. Birns, effectively limited any evidence to the left shoulder only, which the Board did not find persuasive. The claimant’s petition was denied. 

John Swartz (Harrisburg, PA) was able to have claim and penalty petitions denied and dismissed in their entirety, and no litigation costs were awarded. The claimant had filed a claim petition seeking indemnity benefits for a low back injury allegedly occurring on April 26, 2022. In order to defend the petition, John presented two medical experts and testimony from the employer. John also presented evidence of failed drug tests of the claimant and criminal conviction records. The judge accepted our evidence and concluded the claimant did not suffer a disabling work injury.

John Swartz (Harrisburg, PA) successfully defended a claim petition seeking benefits. The claimant was injured on December 1, 2021, described as a right hand, right arm, shoulder, upper extremity and rib injury. The claimant underwent two surgeries. The first occurred in December 2021 as an emergency surgery. Then he had a thoracic outlet surgery performed in February 2023. The case was bifurcated on whether the claimant provided notice within 120 days of the injury as required by § 311 of the Act. The claimant testified on several occasions on this issue. John presented testimony from the employer’s witnesses that the claimant never reported a work injury. The claimant admitted he knew the condition was work-related in December 2021. First notice of the injury was when the claim petition was filed in September 2022, well after the 120-day period. The judge accepted the testimony of the employer’s witnesses on the issue of notice. The claim petition was denied and dismissed.

John Swartz (Harrisburg, PA) was successful in defending the claimant’s appeal to the Appeal Board regarding alleged non-payment of medications related to the claimant’s work injury in the amount of $21,319.08. The claimant sought a 50% penalty as well for non-payment of these medications. The Workers' Compensation Judge denied and dismissed the claimant’s penalty petition. The Appeal Board affirmed the Workers' Compensation Judge’s decision, which was based on the argument that the medical expenses were not specifically related to the accepted injury, which was a L4-5 disc herniation. Therefore, these medications were appropriately denied in their entirety.

*Prior Results Do Not Guarantee a Similar Outcome
 

 

What’s Hot in Workers’ Comp, Vol. 27, No. 8, August 2023, is prepared by Marshall Dennehey to provide information on recent legal developments of interest to our readers. This publication is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. We would be pleased to provide such legal assistance as you require on these and other subjects when called upon. ATTORNEY ADVERTISING pursuant to New York RPC 7.1 Copyright © 2023 Marshall Dennehey, all rights reserved. No part of this publication may be reprinted without the express written permission of our firm. For reprints or inquiries, or if you wish to be removed from this mailing list, contact tamontemuro@mdwcg.com.

Firm Highlights

Thought Leadership

New Jersey Expands Family Leave Protections Effective July 17, 2026

On January 17, 2026, Governor Murphy signed into law legislation expanding the New Jersey Family Leave Act (NJFLA). Beginning July 17, 2026, significant amendments to the NJFLA will expand job-protected family leave to smaller businesses and more employees across the state. The new law broadens coverage by lowering the threshold for private employers from 30 employees to 15 employees, meaning many smaller businesses will now be subject to the NJFLA. Employees of state and local government agencies will continue to be covered regardless of the size of the employer. The amendments also make it easier for employees to qualify for leave. Under the revised law, an employee will be eligible after three months of employment and at least 250 hours worked during the preceding 12 months, replacing the previous requirement of 12 months of employment and 1,000 hours worked. Currently, New Jersey's Temporary Disability Insurance (TDI) and Family Leave Insurance (FLI) programs provide eligible employees with wage replacement while they are on leave but do not independently guarantee job protection. The recent amendments to the New Jersey Family Leave Act (NJFLA) expand these protections by extending job-protected leave to additional employees. Under the amended law, employees receiving TDI or FLI benefits may be entitled to return to the same position they held before taking leave, or to an equivalent position with the same seniority, status, pay, and benefits. Although the legislation also states that it does not expand or modify an employee's reinstatement rights under the NJFLA, the amendments appear to provide job protection to eligible employees receiving TDI or FLI benefits without requiring them to separately satisfy the eligibility requirements of the NJFLA or the federal Family and Medical Leave Act (FMLA). As a result, some employees may be entitled to longer periods of job-protected leave than were previously available under existing law. With these amendments, New Jersey continues to strengthen workplace protections by expanding access to job-protected family leave for eligible employees. These changes significantly expand access to job-protected family leave and may require employers to update their leave policies, employee handbooks, and HR practices. Notably, employers who were previously not required to administer NJFLA may need to amend their policies and/or create new protocols to come into compliance with the NJFLA. Failure to do so would prove costly, as the penalties for non-compliance are significant.

Result

No-Cause Jury Verdict Secured in Wrongful Death Trial

We successfully obtained a no-cause jury verdict in a 13-day wrongful death trial. The decedent, a 59-year-old man, was admitted to the emergency room on February 15, 2019, with complaints of abdominal pain, decreased appetite, and constipation, despite the use of laxatives. The patient did not complain of any nausea, vomiting, or diarrhea. He had a significant medical history including diabetes, hypertension, prior coronary artery stenting, morbid obesity (with past gastric bypass surgery), longstanding ventral hernia, and back pain. A CT scan revealed multiple hernias and a potential closed-loop bowel obstruction, leading to a surgery consultation. Our client, an emergency general surgeon, interpreted that the patient did not have a closed loop or any significant obstruction and recommended non-surgical management. The patient was approved to have clear liquids, and had a vomiting incident shortly after, but our client was not notified. The patient was returned to NPO status, and after improving overnight, he was returned to “clears” and additional medical and renal consults were ordered. Our client did not receive any communications from the residents/nurses of any changes in the patient’s condition. On February 18, 2019, two rapid responses were called due to increased heart rate and vomiting. It is believed that the vomiting resulted in aspiration, causing sepsis, ultimately leading to the patient’s death. During the trial, the plaintiff’s sole medical expert highlighted imaging on the wrong hernia, which called into question all of his opinions in the case. We made key objections related to the expert testimony, limiting what the allegations were, and preventing new allegations from being made. After approximately two and a half hours of deliberating, the jury returned a no-cause verdict. 

Thought Leadership

Congress Passes Financial Exploitation Prevention Act

On June 25, 2026, the House passed the Financial Exploitation Prevention Act of 2025 (“the Act”) by a vote of 414 to 2. The Act allows financial advisors and firms to delay suspicious transactions regarding the accounts of clients who are 65 or older, if they believe financial exploitation has occurred or is about to take place. With the advancement of technology and AI, the House’s overwhelming bipartisan passage of the Financial Exploitation Prevention Act represents an important step in strengthening the financial industry’s ability to combat the growing threat of elder financial exploitation. The Act recognizes what advisors have long known that financial professionals are often the first to detect suspicious behavior but have historically lacked clear legal authority to intervene before irreversible financial harm occurs. From the industry’s perspective, the bill accomplishes several important objectives, including the following: (1) Provides a practical “pause button” by allowing financial professionals to temporarily delay certain transaction requests when there is a reasonable belief that a senior or vulnerable adult is being financially exploited; (2) Empowers financial professionals to act by providing greater certainty that firms can act in good faith to protect clients without unnecessary legal risk; and (3) Strengthens investor protection without sacrificing client rights by allowing temporary delays based on a reasonable suspicion of exploitation, which is intended only to allow additional review and not to deny clients access to their money indefinitely. In sum, the Financial Exploitation Prevention Act will equip financial professionals with practical, carefully tailored tools to stop suspected financial exploitation before client assets are lost. By allowing firms to temporarily delay suspicious transactions under defined circumstances, Congress is recognizing the critical role advisors play as the first line of defense against increasingly sophisticated fraud schemes. The Act strikes an appropriate balance between protecting vulnerable investors and preserving individual financial autonomy, while reinforcing collaboration among advisors, families, and law enforcement to combat financial exploitation. The bill now awaits Senate action.

Thought Leadership

SIU Gets a Boost: NJ Supreme Court Affirms Insurers' Right to Litigate, Not Arbitrate, Fraud Claims

In a significant win for insurers' Special Investigation Units, the New Jersey Supreme Court clarified that statutory insurance fraud and racketeering claims may proceed in court rather than through PIP arbitration. At issue was whether insurance fraud claims brought under New Jersey's Insurance Fraud Prevention Act (IFPA) and the state's Anti-Racketeering Act (NJ RICO) are subject to mandatory arbitration under the Automobile Insurance Cost Reduction Act’s (AICRA) PIP dispute-resolution framework. Allstate had sued a network of medical practices, physicians, and related corporate entities, alleging a scheme to extract more than $1.7 million in PIP benefits through fraudulent and misleading billing. The trial court dismissed Allstate's complaint and compelled arbitration, reading AICRA's arbitration clause — which covers "any dispute regarding the recovery of... benefits" under PIP coverage, N.J.S.A. 39:6A-5.1(a) — as sweeping in fraud and racketeering claims along with routine benefit disputes. The Supreme Court affirmed the Appellate Division's reversal, adopting Judge Gilson's opinion below (480 N.J. Super. 566 (App. Div. 2025)) as its own reasoning. The Court held that IFPA and RICO claims fall outside the scope of AICRA's PIP arbitration mechanism because that "streamlined and specialized" process cannot grant the relief those statutes contemplate — treble damages, injunctive relief, broad discovery, and joinder of third parties — and because arbitrators lack authority to award compensatory or treble damages to an insurer. The Court also rejected the argument that Allstate's own Decision Point Review Plans independently compel arbitration, finding those plan provisions no broader than AICRA's own arbitration clause. Notably, the Court expressly disagreed with the Third Circuit's contrary holding in GEICO v. Mt. Prospect Chiropractic Center, 98 F.4th 463 (3d Cir. 2024), concluding it is not bound by that federal interpretation of New Jersey law. Insurers retain the right to pursue IFPA and RICO claims in the Law Division, with a jury trial. For SIU units and NJ insurance carriers, this decision is a significant win: it forecloses defense clinics' primary procedural tool for shunting fraud investigations into limited-scope PIP arbitration, where treble damages, RICO relief, and meaningful discovery were never realistically available. Carriers building cases against fraudulently structured clinics, straw-owned practices, or coordinated billing networks can now proceed with confidence that a well-pleaded IFPA/RICO complaint stays in the Law Division rather than being diverted to arbitration on a motion to compel. Practically, this strengthens SIU's leverage in settlement negotiations, preserves civil discovery tools (subpoenas, depositions, joinder of related corporate entities) critical to unwinding complex ownership and referral schemes, and resolves the split with the Third Circuit in favor of NJ insurers — at least as a matter of state law. Expect increased reliance on IFPA civil actions, rather than PIP arbitration demands, as SIU's primary enforcement vehicle going forward.