M. Burkett v. Jimi Enterprises, Inc. (WCAB) ( 2023 )

IN THE COMMONWEALTH COURT OF PENNSYLVANIA
Mark Burkett, :
:
Petitioner :
:
v. : No. 41 C.D. 2022
: Submitted: August 5, 2022
Jimi Enterprises, Inc. (Workers’ :
Compensation Appeal Board), :
:
Respondent :
BEFORE: HONORABLE MICHAEL H. WOJCIK, Judge
HONORABLE CHRISTINE FIZZANO CANNON, Judge
HONORABLE STACY WALLACE, Judge
OPINION NOT REPORTED
MEMORANDUM OPINION
BY JUDGE WOJCIK FILED: June 26, 2023
Mark Burkett (Claimant) petitions for review of the order of the
Workers’ Compensation Appeal Board (Board) affirming the decision of a workers’
compensation judge (WCJ) that granted Jimi Enterprises, Inc.’s (Employer) Petition
to Modify Compensation Benefits (Modification Petition) based on an Impairment
Rating Evaluation (IRE), and modified Claimant’s indemnity benefits from total to
partial disability. Claimant challenges as unconstitutional the retroactive application
of Act 111 of 2018 (Act 111), which added Section 306(a.3) of the Workers’
Compensation Act (Act),1 altering the criteria for determining a claimant’s disability
status and providing that an impairment rating of less than 35% constitutes a partial
1
Act of June 2, 1915, P.L. 736, as amended, added by the Act of October 24, 2018, P.L.
714, No. 111 (Act 111), 77 P.S. §511.3.
disability, and providing a credit for disability payments already made. Claimant
maintains that Act 111 cannot be constitutionally applied to workers whose injuries
occurred before October 24, 2018, the effective date of Act 111. We affirm.
The facts are not in dispute. On June 9, 2005, Claimant sustained a
work-related injury in the nature of a neck strain while in the course and scope of
his employment. Pursuant to an August 2, 2005 Notice of Compensation Payable,
Employer paid Claimant more than 104 weeks of temporary total disability (TTD)
benefits for the injury. In 2012, Employer had Claimant undergo an IRE under the
former Section 306(a.2) of the Act,2 which resulted in a WCJ decision granting a
modification of Claimant’s benefits to partial disability as of March 15, 2012. See
Reproduced Record (RR) at 7a. Claimant did not appeal the WCJ’s decision.
On June 28, 2017, Claimant filed a Petition to Review Compensation
Benefits (Review Petition) seeking a change in his disability status from partial to
total disability based on the Pennsylvania Supreme Court’s opinion in Protz v.
Workers’ Compensation Appeal Board (Derry Area School District), 161 A.3d 827(Pa. 2017) (Protz II).3 Initially, TTD benefits were reinstated by the WCJ effective
2
Added by the Act of June 24, 1996, P.L. 350, formerly, 77 P.S. §511.2, repealed by Act
111.
3
As this Court has recently explained:
On September 18, 2015, our Court issued a decision in Protz v.
Workers’ Compensation Appeal Board (Derry Area School
District), 124 A.3d 406 (Pa. Cmwlth. 2015), aff’d in part, rev’d in
part, 161 A.3d 827 (Pa. 2017) (Protz I). In Protz I, we held that
former Section 306(a.2) of the Act, which permitted IREs to be
conducted based on “the most recent edition” of the American
Medical Association’s Guides to the Evaluation of Permanent
Impairment (AMA Guides), was an impermissible delegation of
legislative authority in violation of the non-delegation doctrine in
(Footnote continued on next page…)
2
June 20, 2017, by a WCJ decision dated January 26, 2018. See RR at 53a-58a.
However, Employer appealed and the matter was remanded to the WCJ by the Board
by opinion and order mailed February 28, 2019. See id. at 111a-17a. On May 1,
2020, the WCJ issued another decision granting Claimant’s Review Petition and
Claimant’s disability status remained at total disability effective June 20, 2017. See
id. at 147a-51a.4
While the foregoing Board appeal was pending, on January 8, 2020,
Claimant submitted to an IRE performed by Jeffrey Moldovan, D.O. Thereafter, on
October 26, 2020, Employer filed the instant Modification Petition seeking to reduce
Claimant’s status to partial disability based on Dr. Moldovan’s determination
following the IRE that “Claimant’s whole-person impairment is less than 35%.” RR
[article II, section 1 of] the Pennsylvania Constitution[, Pa. Const.
art. II, §1]. In Protz I, we remanded to the Board to apply the Fourth
Edition of the AMA Guides, which was the version of the AMA
Guides in effect at the time the IRE provisions were enacted. Protz
I, 124 A.3d at 416-17. On June 20, 2017, our Supreme Court issued
Protz II, in which it agreed with our Court that the legislature
unconstitutionally delegated its lawmaking authority when it
enacted former Section 306(a.2) of the Act. The Supreme Court
further determined, however, that the violative language of former
Section 306(a.2) of the Act could not be severed from the rest of that
section, and it struck the entirety of former Section 306(a.2) from
the Act. Protz II, 161 A.3d at 841. Following Protz II, the
legislature enacted new provisions of the Act, which require IREs to
be performed using the AMA Guides, Sixth Edition (second printing
April 2009). See Section 306(a.3) of the Act, 77 P.S. §511.3.
City of Philadelphia v. Yeager (Workers’ Compensation Appeal Board) (Pa. Cmwlth., Nos. 709
C.D. 2021, 736 C.D. 2021, 739 C.D. 2021, filed August 4, 2022), appeal denied, 292 A.3d 848(Pa. 2023), slip op. at 7 (footnote omitted).
4
Employer discontinued its appeal of the WCJ’s decision to the Board. See RR at 185a.
3
at 187a.5 At a hearing before the WCJ on its Modification Petition, Employer
submitted into the record Dr. Moldovan’s report and testimony, which the WCJ
5
Section 306(a.3)(1), (2), and (7) of the Act states:
(1) When an employe has received total disability compensation . . .
for a period of [104] weeks, unless otherwise agreed to, the employe
shall be required to submit to a medical examination which shall be
requested by the insurer within [60] days upon the expiration of the
[104] weeks to determine the degree of impairment due to the
compensable injury, if any. The degree of impairment shall be
determined based upon an evaluation by a physician who is . . .
chosen by agreement of the parties, or as designated by the
[D]epartment, pursuant to the [AMA Guides], 6th [E]dition (second
printing April 2009).
(2) If such determination results in an impairment rating that meets
a threshold impairment rating that is equal to or greater than [35%]
impairment under the [AMA Guides], 6th [E]dition (second printing
April 2009), the employe shall be presumed to be totally disabled
and shall continue to receive total disability compensation
benefits. . . . If such determination results in an impairment rating
less than [35%] impairment under the [AMA Guides], 6th [E]dition
(second printing April 2009), the employe shall then receive partial
disability benefits . . . : Provided, however, That no reduction shall
be made until [60] days’ notice of modification is given.
***
(7) In no event shall the total number of weeks of partial disability
exceed [500] weeks for any injury or recurrence thereof, regardless
of the changes in status in disability that may occur. In no event
shall the total number of weeks of total disability exceed [104]
weeks for any employe who does not meet a threshold impairment
rating that is equal to or greater than [35%] impairment under the
[AMA Guides], 6th [E]dition (second printing April 2009), for any
injury or recurrence thereof.
77 P.S. §511.3(1), (2), and (7).
4
determined to be credible.6 Specifically, Dr. Moldovan testified that, upon physical
examination and review of Claimant’s records, he determined that Claimant was at
maximum medical improvement. In addition, Dr. Moldovan stated that he
determined that Claimant sustained injuries in the nature of cervical sprain and
strain, left elbow strain, and cubital tunnel syndrome, and that Claimant’s
impairment based on the charts in the AMA Guides, 6th Edition (second printing
April 2009), were a 0% impairment rating as a whole person, and 0% for each body
part, the neck, and the elbow. On cross-examination, Dr. Moldovan agreed that he
assumed that an injury existed, and that he did not assess Claimant’s condition for
treatment or work capacity purposes. Dr. Moldovan conceded that his rating could
differ if the injury diagnoses were different, and acknowledged that a prior doctor
found an 8% rating on her evaluation several years earlier. See RR at 231a-32a. The
WCJ also noted that “Claimant presented no contrary medical evidence,” and
“submitted and orally referred to a Motion to Dismiss, based on constitutional
challenges.[7]” Id. at 232a.
6
In workers’ compensation cases, the WCJ is the ultimate factfinder and has exclusive
province over questions of credibility and evidentiary weight. A&J Builders, Inc. v. Workers’
Compensation Appeal Board (Verdi), 78 A.3d 1233, 1238 (Pa. Cmwlth. 2013). The WCJ may
accept the testimony of any witness, including a medical witness, in whole or in part. Id. We are
bound by the WCJ’s credibility determinations. Id.7
Specifically, Claimant argued that: “Act 111 is unconstitutional because it permits a
retroactive application of the statute by permitting a credit for benefits which were received by []
Claimant prior to January 8, 2020”; his “receipt of ‘prior partial disability benefits’ which were
categorized by a previous invalid IRE, as held by the Pennsylvania Supreme Court [in Protz II],
violates the Pennsylvania Constitution (due process and due course of law rights)”; and Act 111
substantively “changed how disability benefits are determined and limits an injured worker to the
receipt of no more than 500 weeks of future benefits,” so that it “may only be applied
prospectively, i.e., after October 24, 2018, the effective date of Act 111” because it is “affecting a
vested benefit.” RR at 201a-02a.
5
Ultimately, the WCJ concluded that Employer “has met its burden of
proof under its petition to establish that Claimant has less than a 35% rating for
whole-person impairment under the AMA Guides, 6th Edition [(second printing
April 2009)],” because “Claimant has 0[%] impairment, which is under the threshold
for modification from total disability to partial disability.” RR at 232a. As a result,
the WCJ also concluded that “indemnity benefits are modified from total disability
to partial disability status as of January 8, 2020, with a credit to [Employer] against
the 500 weeks limit for partial disability benefits for prior periods of partial
disability.[8]” Id. Accordingly, the WCJ issued an order granting Employer’s
Modification Petition; modified Claimant’s benefits “to be partial in nature as of
January 8, 2020”; and granted Employer “a credit for previous period of partial
disability toward the 500 total weeks of partial disability entitlement.” Id. at 233a.
On July 1, 2021, Claimant appealed the WCJ’s decision to the Board,
arguing that the WCJ erred in granting Employer’s Modification Petition, and in
granting Employer a credit for the weeks of Claimant’s partial disability benefits that
he received prior to the January 8, 2020 IRE, because they were paid pursuant to an
8
Section 3(2) of Act 111 states:
(2) For the purposes of determining the total number of weeks of
partial disability compensation payable under [S]ection 306(a.3)(7)
of the [A]ct, an insurer shall be given credit for weeks of partial
disability compensation paid prior to the effective date of this
paragraph.
77 P.S. §511.3, Historical and Statutory Notes.
6
IRE performed under the former unconstitutional Section 306(a.2) of the Act.9 The
Board rejected Claimant’s constitutional claims, and Claimant filed this appeal.
On appeal,10 Claimant asserts that the Board erred in affirming the
WCJ’s decision because a retroactive application of Protz II invalidates the weeks
of partial disability benefits paid under the unconstitutional 2013 IRE so that no
weeks of partial disability benefits accrued so that they cannot be lawfully credited
under Section 3(2) of Act 111. Claimant also contends that his right to a remedy
that was vested by Protz II, as guaranteed by the Remedies Clause of article I, section
11 of the Pennsylvania Constitution,11 is violated by the credit provided for in
Section 3(2). We do not agree.
With respect to the retroactive application of the credit provisions of
Section 3(1) and (2) of Act 111, this Court has previously observed:
9
See RR at 249a (“[I]t is respectfully requested that th[e Board] reverse [the WCJ’s]
decision to grant [Employer’s] Modification Petition, as it relates to permitting a credit for partial
disability prior to October 24, 2018, and hold that as of January 8, 2020, Claimant has 500 weeks
of available partial disability benefits.”).
10
As we have observed:
Our review is limited to determining whether the WCJ’s
findings of fact were supported by substantial evidence, whether an
error of law was committed, or whether constitutional rights were
violated. Department of Transportation v. Workers’ Compensation
Appeal Board (Clippinger), 38 A.3d 1037, 1042 n.3 (Pa. Cmwlth.
2011). As to questions of law, our standard of review is de novo and
our scope of review is plenary. Pitt-Ohio Express v. Workers’
Compensation Appeal Board (Wolff), 912 A.2d 206, 207 (Pa. 2006).
Hender-Moody v. American Heritage Federal Credit Union (Workers’ Compensation Appeal
Board) (Pa. Cmwlth., No. 166 C.D. 2021, filed February 15, 2022), appeal denied, 284 A.3d 119(Pa. 2022), slip op. at 3 n.3.
11
Pa. Const. art. I, §11. The Remedies Clause states: “[E]very man for an injury done him
in his lands, goods, person or reputation shall have remedy by due course of law, and right and
justice administered without sale, denial, or delay.”
7
The plain language of Section 3 establishes a
mechanism by which employers/insurers may receive
credit for weeks of compensation previously paid. First,
Section 3(1) provides that an employer/insurer “shall be
given credit for weeks of total disability compensation
paid prior to the effective date of this paragraph” for
purposes of determining whether the 104 weeks of total
disability had been paid. This 104 weeks is important
because, under both the former and current IRE
provisions, a claimant need not attend an IRE until after
the claimant receives 104 weeks of total compensation.
[Section 306(a.3)(1) of the Act, 77 P.S. §511.3(1), former
Section 306(a.2)(1) of the Act, 77 P.S. §511.2(1)].
Therefore, pursuant to Section 3(1), an employer/insurer
will receive credit towards this 104 weeks for any weeks
of total disability benefits that were previously paid prior
to Act 111’s enactment. Second, an employer/insurer will
be given credit for any weeks of partial disability
compensation paid prior to enactment of Act 111 “[f]or the
purposes of determining the total number of weeks of
partial disability compensation payable under [S]ection
306(a.3)(7) of the [WC A]ct.” Section 3(2) of Act 111. In
short, any weeks of partial disability previously paid will
count towards the 500-week cap on such benefits.
Accordingly, Section 3 of Act 111 does not
evidence clear legislative intent that the entirety of Act 111
should be given retroactive effect. Instead, it appears the
General Assembly intended that employers and insurers
that relied upon former Section 306(a.2) to their detriment
by not pursuing other methods of a modification should
not bear the entire burden of the provision being declared
unconstitutional. Through the use of very careful and
specific language, the General Assembly provided
employers/insurers with credit for the weeks of
compensation, whether total or partial in nature,
previously paid. However, for the benefit of claimants, the
General Assembly also specifically reduced the
impairment rating necessary for a claimant’s status to be
changed from 49% or lower to 34% or lower, making it
more difficult for employers to change total disability
status to partial disability status. That the General
8
Assembly used specific language to give retroactive effect
to these carefully selected individual provisions does not
make the entirety of Act 111 retroactive as the amendment
lacks clear language to that effect.
Rose Corporation v. Workers’ Compensation Appeal Board (Espada), 238 A.3d
551, 561-62 (Pa. Cmwlth. 2020) (citation and footnote omitted).
Nevertheless, as in this case, the claimant in DiPaolo v. UPMC Magee
Women’s Hospital (Workers’ Compensation Appeal Board), 278 A.3d 430, 433-34
(Pa. Cmwlth. 2022), argued that “by permitting employers to use weeks of TTD
accrued under the previous, unconstitutional IRE statute, Act 111’s credit provisions
violate the Pennsylvania Constitution’s due process and due course of law principles
[of the Remedies Clause] . . . .” Specifically, we noted that “at issue here is whether
[the c]laimant has a vested right in the TTD status restored to her as of February
2016 after the Protz cases struck the prior IRE statute, but before the enactment of
Act 111 in October 2018.” Id. at 434-35.
In rejecting the claimant’s Remedies Clause claim, we stated, in
relevant part:
This Court squarely addressed this question in
Pierson [v. Workers’ Compensation Appeal Board
(Consol Pennsylvania Coal Company, LLC), 252 A.3d
1169 (Pa. Cmwlth.), appeal denied, 261 A.3d 378 (Pa.
2021)]. There, the claimant sustained a work-related
injury in 2014. 252 A.3d at 1172. In light of the Protz
cases, the claimant was not subject to an IRE and therefore
was on TTD status until December 2018, when the
employer sought an IRE after Act 111 became effective.
Id. The IRE returned an impairment rating of 3% and the
claimant’s status was modified to [temporary partial
disability (TPD)] as of the IRE date. Id. The claimant
preserved due process and due course of law challenges to
Act 111, which the WCJ and Board did not rule on,
recognizing their jurisdictional limitations. Id. On the
claimant’s appeal to this Court, we rejected the claimant’s
9
constitutional claims, holding that while a workers’
compensation claimant does have a “certain right to
benefits until such time as he is found to be ineligible for
them,” there are also “reasonable expectations under the
Act that benefits may change.” Id. at 1179. We explained
that claimants did not “automatically lose anything by the
enactment of Act 111,” which “simply provided
employers with the means to change a claimant’s
disability status from total to partial by providing the
requisite medical evidence that the claimant has a whole-
body impairment of less than 35%, after receiving 104
weeks of TTD benefits.” Id. at 1179.
Following our decision in Pierson, this Court has
consistently held that Act 111 does not abrogate or
substantially impair a claimant’s vested rights in workers’
compensation benefits because there is no right to ongoing
TTD status. See, e.g., Hutchinson v. Annville T[ownship]
(Workers’ Comp[ensation] Appeal B[oard]), 260 A.3d
360, 367 (Pa. Cmwlth. 2021)[, appeal denied, 279 A.3d
1180 (Pa. 2022)] (relying on Pierson to dismiss claimant’s
constitutional claims against Act 111). In Sochko v.
National Express Transit Service (Workers’
Compensation Appeal Board) [(Pa. Cmwlth., No. 490
C.D. 2021, filed March 16, 2022)], we explained further:
[E]ven during the time when the previous
IRE provisions had been invalidated by the
Protz cases but before Act 111 became
effective, employers were not devoid of a
means to modify a claimant’s benefit status.
Section 413(a) of the Act, which has been
part of our workers’ compensation legislation
since its beginning over 100 years ago, has
always provided employers (as well as
claimants) with the general ability to seek a
change in benefits at any time based on
“proof that the disability of an injured
employe has increased, decreased, recurred,
or has temporarily or finally ceased.” 77 P.S.
§772. Section 306(b) of the Act, which also
has roots in the early decades of workers’
compensation law, specifically enables
10
employers to modify a claimant’s disability
status from total to partial by showing that the
claimant has regained some earning power.
77 P.S. §512(2). Since the 1996 onset of
more cost-efficient IREs, employers were
less likely to challenge a claimant’s status via
litigation, but the option was always
available. Thus, while it is true that “a
claimant retains a certain right to benefits
until such time as he is found to be ineligible
for them,” claimants do not acquire a vested
right in total disability status at any given
time because that status has always been
subject to potential litigation by employers
Id., slip op. at 12-13 [] (citations omitted). Notably, the
claimant is not without recourse, because Act 111
“specifically provides that a claimant placed in partial
disability status based on an IRE may challenge the change
in his or her status by either presenting a subsequent IRE
reflecting a 35% or more impairment rating or establishing
through litigation that his or her earning power has
decreased.” Id., slip op. at 13 n.10 [] (citing 77 P.S.
§511.3(3), (4)).
DiPaolo, 278 A.3d at 435-36 (citation to record and footnote omitted).12 Likewise,
we rely on the rationale of the foregoing authority that has continually and
12
See also DiPaolo, 278 A.3d at 438, wherein we noted:
[The c]laimant’s assertions rest on the proposition that when our
Supreme Court struck the previous IRE provisions in Protz [II], that
provision was void ab initio, as though it had never been enacted in
1996, and any claimant who underwent an IRE prior to the Protz
decisions was automatically restored to pre-IRE status. However,
our courts have never held that to be the case, and several decisions
have placed temporal limits on the application of Protz II. . . . Thus,
contrary to [the c]laimant’s assertions, we have never held that any
IRE preceding the Protz cases was automatically erased in its
entirety, including the weeks of benefits paid by employers for
claims arising prior to Act 111.
(Footnote continued on next page…)
11
consistently rejected claims such as those raised by Claimant herein to invalidate a
credit for the partial disability benefits paid under Section 3(2) of Act 111.
Accordingly, the Board’s order is affirmed.
MICHAEL H. WOJCIK, Judge
(Citations omitted.)
12
IN THE COMMONWEALTH COURT OF PENNSYLVANIA
Mark Burkett, :
:
Petitioner :
:
v. : No. 41 C.D. 2022
:
Jimi Enterprises, Inc. (Workers’ :
Compensation Appeal Board), :
:
Respondent :
ORDER
AND NOW, this 26th day of June, 2023, the order of the Workers’
Compensation Appeal Board dated December 22, 2021, is AFFIRMED.
__________________________________
MICHAEL H. WOJCIK, Judge