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Commercial Credit Claims v. Workmen's Compensation Appeal Board3/26/1999
[ J-54-1998]
ARGUED: March 9, 1998
This Court granted review in order to decide whether an employer seeking to terminate a claimant's workers' compensation benefits must disprove a causal relationship between the work-related injury and a subsequently alleged psychiatric injury where the employer accepted liability in the Notice of Compensation Payable only for the physical injuries suffered from the work-related accident. We find that in these circumstances, the employee, not the employer, shoulders the burden of establishing a causal relationship between the work-related injury and a subsequently alleged psychiatric injury. Accordingly, we reverse the Order of the Commonwealth Court.
On July 28, 1983, appellee John Lancaster ("claimant") fell approximately twenty-eight feet from a catwalk while taking photographs in the course of his employment as a claims adjuster for appellant Commercial Credit Claims ("employer" or "appellant"). On December 22, 1983, employer and its insurance carrier issued a Notice of Compensation Payable (NCP) voluntarily accepting liability for physical injuries described as "cervical syndrome, sprain right sternoclavicular joint," and agreed to pay claimant total disability benefits at the rate of $205.33 per week based on claimant's weekly wage of $308.00 per week.
On July 7, 1986, employer filed a petition to terminate claimant's benefits alleging that as of April 28, 1986, claimant had fully recovered from the work-related injury for which employer had accepted liability. At subsequent hearings on this petition, claimant testified in his own behalf as to his ongoing pain. Employer presented the expert deposition testimony of James P. Valeriano, M.D., a board-certified neurologist. Dr. Valeriano testified that he had examined claimant twice. When asked if the physical symptoms of which claimant complained were causally related to the injuries sustained in 1983, Dr. Valeriano responded, "I don't think they physically could have caused the problems he had." Instead, Dr. Valeriano testified that "the main component of claimant's problem was a psychiatric problem," and that he could not ascertain any physical cause for the pain of which claimant complained. When asked if the psychological component was itself related to the 1983 accident, Dr. Valeriano responded that "there is almost no way that I can say that because I didn't know him before."
In 1995, the Workers' Compensation Judge (WCJ) issued an opinion in which he found both claimant and Dr. Valeriano to be credible and in which he denied employer's termination petition. In doing so, the WCJ made the following finding of fact:
"While it is true that Dr. Valeriano never stated to a degree of medical certainty that claimant's disabling psychiatric condition was related to his July 28, 1983 work-related injury, he certainly did not rule out the nexus between the claimant's work injury and the disabling condition." WCJ Opin. at 5, Finding of Fact No. 6.
Based upon this finding of fact, the WCJ concluded as a legal matter that:
"When the [employer's] medical witness himself raises the possibility that claimant was suffering from a psychological disability caused by the work injury, that physician's testimony cannot be be (sic) found to be unequivocal with regard to full and complete recovery." Id. at 6, Conclusion of Law No. 2.
Accordingly, the WCJ denied employer's termination petition. On appeal, the Workmen's Compensation Appeal Board affirmed the WCJ. The Commonwealth Court affirmed the Board in an unpublished opinion. Subsequently, this Court granted allocatur. Commercial Credit Claims v. WCAB, 701 A.2d 579 (Pa.
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