Workers' Compensation

NEWS

Michele Punturi (Philadelphia), Director of our Workers’ Compensation Department, in collaboration with Faith Mason and Holli Charles, presented “Building a Better Business, Achieving a More Diverse Future” at the CLM Alliance (Claims and Litigation Management Alliance) Annual Conference in Tampa last month. The panel explored hiring practices that attract, retain and create an inclusive environment within the insurance industry. 

Michele’s article “Why Contest Mental Health Claims in Workers’ Comp When You Can Prevent Them to Begin With?” was published in the March 28, 2023, edition of Risk & Insurance. You can read the article here: https://marshalldennehey.com/articles/why-contest-mental-health-claims-workers%E2%80%99-comp-when-you-can-prevent-them-begin#. 

Bill Murphy’s (Roseland) article “Under the Influence of the Intoxication Defense” was published in the April 2023 edition of CLM Magazine. You read Bill’s article here: https://736506f6.flowpaper.com/CLMApril2023/#page=12. 

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RESULTS*

Tony Natale (Philadelphia) successfully prosecuted a termination petition, securing a full recovery opinion from the court with reference to a Medicare eligible claimant who worked for a local Philadelphia financial institution. The claimant suffered a knee injury during the course and scope of employment. She ultimately required knee surgery for a torn meniscus. Tony made the decision to present evidence from the claimant’s treating surgeon, coupled with evidence from an independent expert, to produce an evidence record that demonstrated by preponderance of the evidence that the knee injury fully resolved.

Kacey Wiedt (Harrisburg) successfully prosecuted a termination petition on behalf of a multi-national manufacturing corporation. Kacey presented medical evidence, including a record review of all diagnostic study films and medical records from a Board Certified physiatrist, to established that the claimant had physiological complaints that were unrelated to a work injury. The judge accepted our evidence as fully competent, persuasive, and credible and terminated the claimant’s benefits. 

Kacey also successfully defended the Bureau’s dispute of the insurer’s Application for Supersedeas Fund Reimbursement. The parties submitted written legal argument before the Workers’ Compensation Judge to support the insurer’s entitlement to reimbursement. The judge found that the underlying decision against the insurer was erroneously issued. The judge reversed on appeal before the Appeal Board, allowing the insurer to recover the monies paid on behalf of the claimant. 

Judd Woytek (King of Prussia) received a favorable decision granting the employer’s termination petition. The claimant had suffered a work-related head injury when she walked into a pole. The judge credited the opinions of our medical expert over those of the claimant’s treating physician and found the claimant to be fully recovered. 

Kristopher Starr (Wilmington) successfully argued that the claimant removed himself from the active labor market before his surgeon granted his out-of-work status. Through investigation, Kris established that the claimant quit working for the employer and had applied for Social Security Disability Insurance benefits for multiple disabilities, including the left shoulder, prior to being taken out of work by his treating surgeon. Kris argued that the timing sequence of the claimant’s actions evidenced a deliberate, affirmative act on the claimant’s part that demonstrated his intent to discontinue working in the active labor market PRIOR to an out-of-work note being issued by his treating surgeon, thus invalidating the claimant’s arguments of reliance on his surgeon’s out-of-work note for indemnity benefits, pursuant to the Delaware Supreme Court holding in Gilliard-Belfast v. Wendy’s and its progeny. As the claimant affirmatively removed himself from the active labor market before being granted out-of-work status by his surgeon, he was not entitled to indemnity benefits for wage replacement. 

*Prior Results Do Not Guarantee a Similar Outcome

 

_{What’s Hot in Workers’ Comp, Vol. 27, No. 4, April 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.}