The “micro-hospital,” also known as a “neighborhood hospital,” will be a fully licensed medical center. Patients will have access to the general services of a traditional hospital in a more local, and convenient, setting.

Though specific details have not yet been provided, these types of facilities generally have 10 to 15 inpatient beds (for short stays), and an emergency room which will be open around the clock.

An employer may post a “panel” of healthcare providers for an injured worker to use in the case of a work injury.  For a panel posting to be valid, it must include at least six healthcare providers (at least three of which must be physicians).  No more than four of the healthcare providers can be part of a coordinated care organization.  Though it may seem obvious, the providers must be geographically accessible for the injured worker.  The panel listing must contain the name and specialty of each provider, the address and phone number, and any ownership relationship.

Those requirements are just pertaining to the content of the panel posting.  For a panel posting to be valid and binding, more is required.  The panel must be “conspicuously” posted in an employee-accessible area (such as a breakroom, locker room, first aid station or time clock area).  Additionally, employees must receive a written copy of the panel at the time he or she is hired, as well as either immediately after, or as soon as possible after, an injury.

Much like the UEGF, it is well settled that the Fund is not an “insurance company,” and therefore immune from penalties for a violation of the Act.  The Fund also cannot be assessed counsel fees for maintaining an unreasonable contest.  But, the Fund, like the UEGF, is responsible for paying for wage loss and medical treatment related to a work injury, and for the reimbursement of reasonable costs of litigation incurred by the injured worker in procuring such benefits.

On this blog, we discussed the landmark Lorino case, where the Supreme Court of Pennsylvania held that a Workers’ Compensation Judge (WCJ) can order a payment to an injured worker’s attorney of a counsel fee, even in there was a reasonable contest, and that such a fee is considered a litigation cost.

But, mental/mental is only one of three types of mental injuries we see in PA workers’ comp.  We also see physical/mental (where a physical cause leads to a mental injury) and mental/physical (where a mental stimulus causes a physical reaction).

Recently, the Commonwealth Court of PA dealt with both the physical/mental and mental/mental situations in the matter of Russo v. Upper Darby Township (Workers’ Compensation Appeal Board).

There should not be much surprise, then, that many cases have dealt with whether a particular fact pattern reaches the standard of “abnormal working conditions.”  This determination is very dependent on the exact facts of each case.  And, of course, what would be expected in that particular job.  What a police office, fire fighter or EMT might expect on a normal day at work is very different from that of an accountant, warehouse worker or a secretary.

Recently, the Commonwealth Court of Pennsylvania dealt with this issue in Ganley v. Upper Darby Township (Workers’ Compensation Appeal Board).  Here, the injured worker was a firefighter/EMT, who was forced to perform CPR on infants twice in less than two years (with neither infant surviving).  As a result of those events, the injured worker suffered post-traumatic stress disorder (PTSD).

As the Commonwealth Court of Pennsylvania indicated in the recent case of Day-Timers, Inc. v. Rhonda Horton (Workers’ Compensation Appeal Board), a WCJ does, indeed, have jurisdiction to address the nonpayment of medical bills.  But, initially, let’s examine the confusion.

Under the Act, a PA workers’ compensation insurer has 30 days to either pay a medical bill related to a work injury, or file for Utilization Review (UR), which challenges whether such treatment was reasonable and necessary.  If a healthcare provider is not satisfied with the timing or amount of the payment for medical treatment, the provider has the ability to file for Fee Review.  This statutory scheme could lead an insurance carrier to argue that an injured worker cannot file a Petition for Penalties, for the nonpayment of a medical bill, since that is a subject solely for Fee Review.

Essentially, Weney stood for the proposition that if a work injury is in litigation, and there is an aspect of the injury that was either raised, or should have been raised, the injured worker is barred from trying to bring it up in a subsequent litigation (what the court calls “technical res judicata”).  The consequence of barring a condition from being added in the future, even if it was never even litigated in the past, is both a great fear and a terrible injustice to us in the workers’ comp Claimant bar.

However, the Commonwealth Court of Pennsylvania does recognize limits to this concept.  This was addressed by the Court in the recent case of Michael N. Lewis, Sr. v. City of Philadelphia (Workers’ Compensation Appeal Board).  The injured worker here was a police officer, who in 2017, sustained injuries to his hand/wrist, low back, chest wall, and thoracic spine while attempting to subdue a burglary suspect.  The injury was properly accepted by issuance of a Notice of Compensation Payable (NCP).

Erica Burry, Esquire and Robert Rachlin, Esquire, will each begin training in June, 2025.  Each will then be hearing cases in the Philadelphia hearing office.  Meaning, Robert Rachlin, Esquire, will also begin his training in June, 2025, but will be assigned to preside over cases in the Williamsport hearing office.

We welcome these additions to the PA workers’ compensation bench, and wish them well in their careers as Workers’ Compensation Judges!

In City of Philadelphia and PMA Management Corp. v. John Bell (Workers’ Compensation Appeal Board), the injured worker was a firefighter for the City of Philadelphia who was diagnosed with colon cancer.  Believing his cancer was caused by exposure to toxic fumes and compounds over his 17-year career, the injured worker reported this suspected work injury to his employer, as required under the law.

The City of Philadelphia investigated the allegation and then decided to deny the claim.  However, an inexperienced adjuster accidentally caused a Medical-Only Notice of Compensation Payable (MONCP) to be issued, which accepted a work-related injury in the nature of colon cancer.

Just to refresh your recollection, an IRE is a tool available to PA workers’ compensation insurance carriers, which allows the status of workers’ comp benefits to be switched from “total” (for which there is no specific time limit) to “partial” (for which there is a maximum of 500 weeks available), if the “whole body impairment” (WBI) of the injured worker is found to be less than 35% (an extremely difficult standard to reach).  More detail on the IRE process can be found on our website here.

In a recent case, the Commonwealth Court of Pennsylvania faced this issue again, though in a slightly different context.  In the Turner case, the only medical evidence was the IRE physician, who was presented by the workers’ comp insurer.  Since that physician did not consider all conditions he believed to be “due to” the work injury, the Court was able to simply affirm the decision of the WCJ, and find that the insurer failed to meet its burden under the Pennsylvania Workers’ Compensation Act.