.

What's Hot in Workers' Comp

What's Hot in Workers' Comp - News and Results*

February 1, 2021

NEWS

Angela DeMary (Mount Laurel, NJ) was a featured speaker in the Camden County Bar Association CLE program, “Practicing Workers’ Compensation Law Remotely and COVID-19 Type Cases.” The webinar was held on January 27 and focused on the process of managing a workers’ compensation claim; what is an essential worker and who is considered a first responder; and recent legal and legislative updates based on the Governor’s Orders. The usage of DocuSign and remote forms as well as Zoom settlements and trials were also discussed.

 

 

RESULTS*

Judd Woytek (Allentown, PA) was successful in receiving a decision denying a penalty petition. The claim had settled by Compromise & Release. The claimant had undergone three surgeries to her wrist while litigating her review petition to expand the accepted injury. As part of the C&R, the claimant agreed that the carrier would not be responsible for any medical bills related to her second and third wrist surgeries. The carrier agreed to pay her $5,000 to cover her out-of-pocket expenses related to those surgeries. Her private health insurance carrier later retracted payments it had made for her follow-up care and physical therapy post-surgery. The claimant then filed a penalty petition against the workers’ compensation carrier when it refused to pay the bills on which the private insurance carrier had retracted payment. The judge denied and dismissed the penalty petition, finding that the claimant had negotiated away her right to seek payment from the workers’ compensation carrier with regard to any bills related to the subsequent wrist surgeries as she had accepted $5,000 in exchange and was bound by the C&R. The workers’ compensation carrier had no obligation to pay the bills.

Judd also received a decision denying a reinstatement petition in a claim where the claimant, who was working under restrictions, sought reinstatement of temporary total disability for a closed period of time when he was laid off due to Governor Wolf’s Order issued in March 2020 directing that all non-life-sustaining businesses close. The judge agreed with our position that the claimant’s loss in earnings was unrelated to the work injury and was due solely to the Governor’s Order. The reinstatement petition was denied and dismissed.

Judd was again successful in receiving a decision denying a widow’s claim for Federal Black Lung benefits. The deceased miner worked in underground coal mining for 11 years. His lifetime claim for benefits was denied after numerous claim filings and appeals. The widow then sought survivor’s benefits based upon the opinion of her medical expert, who opined that the miner’s death was hastened by coal workers’ pneumoconiosis. The judge rejected the widow’s expert in favor of our expert, who testified that the miner’s death was not caused or hastened by pneumoconiosis. The widow requested reconsideration and attempted to submit additional evidence (an additional medical report and 12 medical journal articles) that she had not submitted during the litigation of the widow’s claim. The judge again rejected the claim on reconsideration and found that, even if the employer’s medical expert testimony were rejected, the testimony of the widow’s medical expert was insufficient to sustain her burden of proving by a preponderance of the evidence that the miner’s death was caused by or hastened by pneumoconiosis. The judge also agreed with our argument that the additional evidence submitted in conjunction with the request for reconsideration was impermissible and should be stricken from the record.

Tony Natale (Philadelphia, PA) was successful in dismissing the employer and insurer from a fatal claim as a result of COVID-19 infection. The claimant-widower filed the claim on behalf of his deceased wife, alleging she contracted COVID-19 while working in the capacity of a caretaker for a sick client. Tony argued that the correct employer for workers’ compensation purposes was the claimant’s client, not the named employer. The Workers’ Compensation Judge agreed and dismissed the named employer and insurer as party defendants.

Tony also successfully defended a Philadelphia-based university in litigation surrounding both a claim and reinstatement petitions. The claimant sustained a non-disabling injury in the form of right thumb CMC joint arthritis from her repetitive job duties. After several years of employment, she alleged that her work injury forced her out of the labor market, and she requested disability benefits. The Workers’ Compensation Judge accepted as credible, by preponderance of the medical evidence, that the claimant did not suffer a work-related disability of any kind. A big part of the rationale for this determination was Tony’s cross examination of the claimant’s medical expert, which exposed that the claimant’s disability may have been due to a variety of non-work-related conditions to the left hand and upper extremity.

Tony also successfully defended a Delaware County machine shop before the Workers’ Compensation Appeal Board with reference to the claimant’s appeal from a Workers’ Compensation Judge’s decision denying work-related disability arising from an alleged head injury and a full recovery conclusion of law. Tony was able to have the appeal quashed based on its untimely filing. The Board also adjudged the appeal on the merits (which is unusual) and further found that the appeal lacked merit on all grounds.

Ashley Eldridge (Philadelphia, PA) was successful in defending a claim petition for an alleged spine injury on behalf of a construction company. The claimant was employed as a construction worker for the employer, and a week after being hired, he was allegedly injured while using a jackhammer. He filed a claim petition for multilevel disc injuries in the lumbar spine. Ashley presented the medical testimony of an orthopedic expert who explained how the injury was soft tissue in nature and had resolved as of an independent medical examination. While there was significant, multilevel disc bulges and herniations, which the opposing expert attempted to ascribe as work-related, the judge agreed these findings to be degenerative rather than acute. This conclusion was further supported by an ongoing factual investigation, which uncovered 17 prior low back injuries, the majority of which were denied by the claimant. Ultimately, the judge accepted the defense’s evidence over that of the claimant and granted the full relief requested by the employer.

Michele Punturi (Philadelphia) successfully prosecuted a termination petition and defended the claimant’s petition to review to expand the nature of the accepted injury on behalf of a well-known hospital. The injury was accepted as a right distal bicep strain, which included a partial tear resulting in surgery. The claimant asserted the injury should be expanded to also include right carpal tunnel, right elbow sprain and trigger fingers. A detailed cross-examination of the claimant established the complaints referable to right carpal and trigger fingers began six months after the injury, which was corroborated by the claimant’s treating physician’s records. The IME expert, a board-certified orthopedic surgeon with specialized training in hand surgery, had the opportunity to perform a comprehensive physical examination and review the diagnostic studies, post- and pre-injury medical records and the claimant’s family physician’s records. These records revealed non-work-related carpal tunnel risk factor conditions, including obesity, post-menopausal, non-insulin dependent diabetes and testing for hypothyroidism. It was further argued that the claimant’s medical expert did not have expertise in the surgery involved in the case and failed to review the claimant’s testimony and diagnostic films. Ultimately, the judge found the defense medical expert to be competent, credible and persuasive. This case highlights the importance of a defense expert having the opportunity to review all medical records, diagnostic films, claimant’s testimony and claimant’s expert’s testimony to develop a timeline for claimant’s complaints consistent with the medical evidence.

*Prior Results Do Not Guarantee A Similar Outcome

 

 

What’s Hot in Workers’ Comp is prepared by Marshall Dennehey Warner Coleman & Goggin 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 © 2021 Marshall Dennehey Warner Coleman & Goggin, 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

Court Allows Recklessness and Punitive Damages Claims to Proceed After Work‑Zone Crash

In a case where a defendant filed preliminary objections against allegations of recklessness and punitive damages, the Susquehanna County Court of Common Pleas denied these preliminary objections. This case stems from a motor vehicle accident, where the defendants car struck the plaintiffs car after the defendant allegedly fell asleep at the wheel, going at a high rate of speed, through a construction work zone. Defendant first objected to the general allegations throughout the plaintiff’s complaint pertaining to “reckless” conduct contending that there were insufficient factual allegations to support the claim of reckless conduct. Defendant next objected to the plaintiffs claim for punitive damages, as punitive damages may only be assessed against a motorist for falling asleep while driving if there is further evidence to prove driver was aware of their drowsiness and risk of falling asleep. Lastly, defendant objected to plaintiffs complaint, claiming it lacked specificity. The court here found that the plaintiff had included in the complaint specific allegations related to the defendant’s alleged recklessness, including allegations regarding speeding in a work zone, almost striking the flagger, falling asleep at the wheel, and striking the plaintiffs vehicle which was stopped. Additionally, the court noted that falling asleep does not come without warning. The court found that these allegations were sufficient to support an allegation of recklessness at the pleadings stage.

Thought Leadership

New Jersey Appellate Division Affirms Exclusion of Legal Malpractice Expert as Impermissible Net Opinion

Jack Slimm and Jeremy Zacharias obtained a favorable decision on behalf of their client in a case centering on the admissibility of expert testimony in legal malpractice actions. In Martin v. Loury, the New Jersey Appellate Division affirmed the exclusion of a plaintiff's legal malpractice expert, holding that the expert's opinions on causation and damages were too speculative to support the malpractice claim. The legal malpractice action arose from an underlying employment dispute involving claims for damages stemming from the breach of an employment agreement. The plaintiff alleged that defense counsel committed malpractice during a second trial by failing to recall the plaintiff as a rebuttal witness after the employer's CEO testified. According to the plaintiff's expert, additional rebuttal testimony would have bolstered the plaintiff's damages claims and led to a more favorable result. Both the trial court and the Appellate Division rejected that theory. The courts found that the expert could not explain how the proposed rebuttal testimony would have altered the outcome of the underlying case or resulted in any additional recoverable damages. Notably, the trial judge in the underlying employment matter had already rejected the CEO's testimony as not credible and had accepted the damages analysis advanced by the plaintiff. The court had also determined that the amount of damages was not genuinely disputed. As a result, the expert's opinion that additional rebuttal testimony would have produced a better outcome was unsupported by the record and based on speculation rather than evidence. The Appellate Division agreed that neither the plaintiff nor the expert could identify any actual damages attributable to the alleged malpractice or demonstrate the required element of proximate causation. The court further upheld the trial court's application of New Jersey's net opinion doctrine, finding that the expert failed to provide the necessary "why and wherefore" supporting his conclusion that the attorney's conduct caused a compensable loss. Because the opinions rested on unquantified possibilities rather than demonstrable facts, they were inadmissible. Key Takeaway for Legal Malpractice Defendants For attorneys and firms defending legal malpractice claims, Martin v. Loury underscores the importance of closely scrutinizing an opponent's expert report on the critical elements of proximate causation and damages. The decision demonstrates that a malpractice claim cannot survive where an expert merely speculates that different litigation tactics might have produced a better result. Instead, the plaintiff must present admissible expert testimony grounded in the record that explains how the alleged attorney error probably changed the outcome of the underlying matter and resulted in measurable damages.

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

Supreme Court of Pennsylvania Holds That Public Policy Does Not Prevent Insurance Coverage for Sex Trafficking Claims

On July 21, 2026, the Supreme Court of Pennsylvania issued an opinion emphasizing the limited circumstances in which courts may invoke public policy to bar insurance coverage, holding in Samsung Fire & Marine Insurance Co., Ltd. (U.S. Branch) v. RI Settlement Trust that Pennsylvania public policy does not preclude coverage for claims alleging that insureds enabled or profited from human sex trafficking. The decision rejects a line of federal district court decisions predicting otherwise and reinforces that Pennsylvania courts will invoke the public policy doctrine only in the clearest of circumstances. RI Settlement is particularly significant because it arose on certified questions from the United States Court of Appeals for the Third Circuit, giving the Supreme Court the opportunity to resolve an issue on which federal courts had predicted Pennsylvania law differently. RI Settlement arose out of four separate civil complaints in which the underlying plaintiffs alleged that, as minors, they were the victims of human sex trafficking at various hotels in Philadelphia. The plaintiffs claimed that the hotel owners were negligent in failing to stop the sex trafficking from happening at their hotels. After the filing of the lawsuits, the hotel owners sought coverage under their Commercial General Liability policies. The insurers initially defended the hotels under Reservation of Rights letters, though the carriers later filed Declaratory Judgment actions seeking declarations that they did not owe a duty to defend or indemnify. In short, the insurers argued in the alternative that they did not owe any obligation to provide coverage based upon Pennsylvania public policy (because the claims violated the Human Trafficking Law – 18 Pa.C.S. § 3011) and the terms and conditions of the policy. On motions for judgment on the pleadings, the District Court found for the insurers on the basis of public policy: There is no duty to defend or indemnify against actions arising out of an insured's criminal conduct related to the sex trafficking of minors. The Court appreciates that it may make public policy the basis of a judicial decision only in “the clearest of cases.” See Minnesota Fire & Cas. Co. v. Greenfield, 589 A.2d 854, 868 (Pa. 2004) (quoting Hall v. Amica Mut. Ins. Co., 648 A.2d 755, 760 (Pa. 1994)). Yet, the Court strains to imagine a clearer case than the one presented here in which the facts alleged indicate that Policyholders engaged in criminal conduct in violation of Pennsylvania's Human Trafficking Law. The hotel owners appealed the matter to the Third Circuit, which petitioned the Supreme Court of Pennsylvania to grant review of two certified questions of law: (1) whether Pennsylvania law had an “overriding public policy” against sex trafficking, such that an insurer’s duty to defend and/or indemnify is abrogated when an insured is alleged to have enabled or profited from such trafficking; and (2) if yes, is that duty abrogated whenever the insured’s alleged conduct would constitute a violation of the Pennsylvania Human Trafficking statute. Importantly, the certified questions did not ask the Supreme Court to determine whether the policies afforded coverage under their terms. Rather, the court was asked only whether Pennsylvania public policy independently barred coverage. As a result, the court assumed for purposes of answering the certified questions that the insurers otherwise owed a duty to defend and addressed only the public policy issue, leaving all policy-based coverage defenses for further proceedings. Because the court concluded that the answer to the first certified question was “no”, it did not reach the second issue. In reaching its determination that Pennsylvania public policy does not prohibit insurance coverage for sex trafficking claims, the court limited the impact of its decision in Minnesota Fire & Cas. Co. v. Greenfield, 855 A. 2d 854, 855 (Pa. 2004), which the RI Settlement opinion emphasized as having been an “Opinion Announcing Judgment of the Court” – or a plurality opinion. In Greenfield, the insured homeowner was sued by the estate of his houseguest who overdosed from heroin that he sold to her. The matter wound its way to the Supreme Court, which determined that the insurer did not owe a duty to defend or indemnify based upon Pennsylvania public policy, which criminalized the sale and use of heroin as a Schedule I narcotic. In RI Settlement, the court “decline[d] the invitation” to extend the rationale of the three-justice plurality in Greenfield beyond cases involving Schedule I controlled substances. In so holding, the justices in RI Settlement refused to “divine an overriding public policy pronouncement by the General Assembly by virtue of its enactment of the Human Trafficking Law.” The opinion further states that it is not “within the purview of this Court to rank the magnitude of the public policy underlying the various crimes defined in the Crimes Code. It is sufficient for the work of the courts to know that the General Assembly has identified conduct it deems harmful and dangerous to the maintenance of an orderly society and criminalized it.” While the court declined to declare that Pennsylvania public policy prohibits coverage for sex trafficking claims, the opinion in RI Settlement expressly states that insurers are free to include appropriate exclusionary language for such causes of actions in their policies if they desire to do so. It will certainly be interesting to see whether the insurance industry accepts the court’s invitation, or perhaps whether the Pennsylvania legislature steps in to clarify that sex trafficking claims are indeed of the type or magnitude that they should not be covered by insurance. In any event, we will, of course, continue to monitor this and other insurance coverage issues that arise before courts in Pennsylvania, New Jersey and throughout our firm’s geographic footprint and around the country.