Commonwealth Court says employer not obligated to pay Workers' Comp claimant's medical bills

By Nicholas Malfitano | Apr 6, 2016

Commonwealth Court Judge Rochelle S. Friedman  

HARRISBURG – The Commonwealth Court of Pennsylvania recently denied the penalty petition of a chiropractor and his firm in the case of claimant who aggravated a work-related injury in 2009.

Judge Rochelle S. Friedman authored the Court’s March 30 opinion, affirming the Sept. 18 denial of the Workers Compensation Appeal Board (WCAB) towards Dr. Peter Schatzberg and Philadelphia Pain Management.

Claimant Eric Green allegedly aggravated a work-related injury while employed with Bemis Company, Inc. on Nov. 13, 2009, and Bemis filed a timely notice of Workers’ Compensation denial on Nov. 25, 2009. Three weeks later, on Dec. 16, 2009, Green began treatment with Schatzberg.

On July 1, 2010, Green filed a claim petition due to the alleged work injury the prior November and Bemis responded denying Green suffered a work injury.

On March 14, 2011, at a hearing before the Workers' Compensation judge, Green amended his claim petition to ask for approval of a compromise and release (C&R) agreement reached between Green and Bemis. The C&R agreement described Green’s alleged injury as an “injury to the neck, thoracic spine and lumbar spine”, and acted as a resolution of wage loss and medical benefits.

The C&R agreement further stated, “In exchange for a C&R of all liability, Bemis shall agree to pay Green $86,944 subject to a 20 percent attorney fee, chargeable to Green’s share. The instant agreement covers all injury dates. The purpose of the C&R agreement was “to resolve this case on a full and final basis.”

Green understood Bemis “will never have to pay any other workers compensation benefits for the injury” and “this agreement is a C&R of a workers compensation claim, and is not considered an admission of liability by Bemis.”

The Workers' Compensation judge concluded, “Claimant understands the full legal significance of the C&R agreement and has knowingly and voluntarily entered into the agreement.” The WCJ granted the petition seeking approval of the C&R agreement, a decision which was not appealed.

On Feb. 6, 2013, Schatzberg filed a penalty petition alleging Bemis violated the Workers’ Compensation Act (WCA) by resolving this case through a C&R agreement with Green without giving Schatzberg notice and an opportunity to intervene. Schatzberg alleged Bemis violated the WCA when it failed to pay Green’s medical bills pursuant to the C&R agreement.

The Workers' Compensation judge ruled Schatzberg failed to establish Bemis was required to pay Green’s medical bills because the C&R agreement does not obligate Bemis to pay them. Thus, the workers compensation judge denied and dismissed Schatzberg’s penalty petition.

Schatzberg then appealed to the WCAB, which affirmed the judge’s ruling. Schatzberg then petitioned the Commonwealth Court for further review.

“Provider argues that employer’s failure to pay claimant’s medical bills in accordance with the C&R agreement is a violation of the Act. We disagree,” Friedman said. “Section 449(b) of the Act provides that an employer or insurer may submit a proposed C&R agreement stipulated to by both parties to the WCJ for approval. Here, employer and claimant entered into a C&R agreement that was approved by the WCJ.” 

“The C&R agreement stated that it was not an admission of liability by employer. Additionally, the C&R agreement did not require employer to pay any past or future medical expenses. Thus, contrary to provider’s assertion, nothing in the C&R agreement obligates employer to pay claimant’s medical expenses,” Friedman added.

Friedman concluded Bemis was never at any point obligated to pay Green’s medical bills.

“Here, employer denied that claimant suffered a work injury and never admitted liability. Further, there was no finding or adjudication that claimant’s injury was work-related. Thus, employer was not obligated at any time to pay claimant’s medical bills. Accordingly, we affirm,” Friedman said.

Commonwealth Court of Pennsylvania case 1914 C.D. 2015

From the Pennsylvania Record: Reach Courts Reporter Nicholas Malfitano at

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