Two PA Appellate Court Decisions affirm the denial of Claim Petitions where the WCJ authored a reasoned decision.

Two Recent Commonwealth Court decisions provide similar reasoning for the affirmation of the denial of claim petitions by the Workers Compensation Judge.

The Commonwealth Court emphasized that the "Reasoned Decision" standard for review of live testimony does not require the articulation of specific reasons for rejection of testimony that was found to be not credible.

Also the WCJ does not err in failing to make a specific credibility determination of the Employer medical evidence – where the claimant does not meet his/her burden of proof.

Beristain v. WCAB (Broadcom Inc.): No. 46 C.D. 2021;  Memorandum Opinion filed: November 15, 2021

In Beristain, the Claimant appealed the Workers' Compensation Appeal Board (WCAB) order which affirmed the Workers' Compensation Judge (WCJ) denial of Claim petition. The issue on appeal was whether the WCJ failed to issue a reasoned decision under Section 422(a) of the Act. upon review, the Commonwealth Court affirmed the claim denial.

The Claimant petition alleged he suffered a work injury of lumbar disc protrusions caused by the repetitive nature of his job. Claimant’s job duties consisted of polishing and grinding lightweight silicon wafers, which required that he stand and lean forward while rotating his upper body.

The WCJ rejected Claimant’s testimony as not credible based on his personal observation of Claimant. Claimant's medical witness - Dr. Grodofsky was also deemed not credible to establish a causal connection between work duties and Claimant's lumbar spine condition.The WCJ noted that Dr.Grodofsky’s knowledge of Claimant’s work duties came exclusively from Claimant, whose testimony was discredited. The WCJ reasoned that Dr. Grodofsky lacked sufficient knowledge of Claimant’s work duties to support his opinion that their repetitive nature caused the alleged work injury.

Employer's medical expert was Dr. Componovo. In his IME report he stated a MRI showed a disc protrusion at the L5-S1 level but he did not believe this finding was responsible for Claimant’s symptoms. The MRI findings were “extremely mild,” and he did not correlate this finding with Claimant’s subjective complaints. Further, Dr. Componovo was not aware of any mechanism of injury or work exposure that would have caused Claimant’s symptoms. He felt that Claimant’s symptoms were “more likely than not” unrelated to his job.

On Appeal, Claimant argued the WCJ failed to issue a reasoned decision as: (1) the WCJ did not articulate his reasons for finding Claimant’s testimony not credible, and (2) he did not make any credibility determinations with regard to the testimony of Employer’s expert, Dr. Componovo. .

Commonwealth Court Reasoning

The Commonwealth Court analysis began with a review of the well established principle that the burden of proof in an original claim petition rests on the claimant to prove all the elements necessary to support an award of benefits under the Act. Inglis House v. WCAB (Reedy) (Pa. 1993). The claimant’s burden to prove disability never shifts to the employer. See: Morrison v. WCAB (Rothman Inst.) (Pa. Cmwlth. 2010).

An equally well established legal standard is the Section 422(a) requirement that the WCJ issue a decision that allows for adequate review by the appellate courts. Daniels v. WCAB (Tristate Transp.)(Pa. 2003). When the WCJ has the advantage of seeing the witnesses testify and assessing their demeanor, a mere conclusion as to which witness was deemed credible is sufficient to render the decision adequately reasoned under Section 422(a).

In the instance case, Claimant argued, without citation to relevant legal authority, that the WCJ’s rejection of Claimant’s live testimony necessitated additional fact finding beyond the standard articulated in Daniels. The Commonwealth Court stated there is no merit to Claimant's argument. The WCJ is not compelled to specify the basis for his rejection of Claimant’s testimony.

Claimant also argued the WCJ erred when he failed to address Dr. Componovo’s testimony. Claimant asserted this testimony corroborates his evidence that he suffered a compensable work injury.

The Commonwealth Court concluded that the WCJ did not err when he failed to render a credibility determination regarding the testimony of Dr. Componovo. Although Section 422(a) required the WCJ to make “findings of fact and conclusions of law based upon the evidence as a whole,” he was not required to address all the evidence presented. See: Montgomery Tank Lines v. WCAB (Humphries), 792 (Pa. Cmwlth.2002). The WCJ only had to make the findings necessary to resolve the issues raised by the evidence and relevant to the decision. 

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A second recent Commonwealth Court reported at Sufran v. WCAB (C&S Wholesale);  Memorandum Opinion filed November 15, 2021, articulated a similar analysis and reasoning in the affirmation of another claim petition denial. 

In Sufran, the Claimant appealed WCAB order which affirmed the WCJ decision to deny a Claim petition. The WCJ found that she failed to establish she sustained a work injury. The Claim petition alleged a work-related injury, in the nature of: a rotator cuff sprain; right and left knee pain; upper right arm pain; a knee sprain, which she allegedly sustained while working as a selector for Employer.

The WCJ denied the Claim petition, rejecting Claimant’s live testimony as not credible. This credibility determination was the basis for the WCJ’s rejection of Dr. Levinstein’s testimony, as his understanding of the alleged work injury was based on information Claimant provided. TheWCJ found the testimony of Dr. Levinstein was not credible as his testimony that Claimant did not return to work after February 24, 2017, was contradicted by Claimant’s testimony. Dr. Levinstein opined that Claimant’s alleged work injury was caused by the repetitiveness of her work duties; however, no evidence was presented that established the repetitive nature of those duties. Dr. Levinstein diagnosed and treated Claimant, even though his initial examination failed to reveal any objective findings.

The WCJ rejected Claimant’s and Dr. Levinstein’s testimony as not credible. On this basis,  the WCJ did not address the credibility of Employer medical witness, Dr. Mauthe. The WCJ found there was no credible evidence that Claimant suffered a work injury in the course and scope of her employment. Claimant failed to meet her burden of proof

On appeal Claimant argued: (1) the WCJ failed to issue a reasoned decision as the WCJ did not adequately explain his credibility determinations with respect to Claimant’s and Dr. Levinstein’s testimony; (2) the WCJ’s brief statement rejecting Claimant’s live testimony does not permit adequate appellate review; (3) the WCJ’s credibility findings as to Dr. Levinstein cannot be properly reviewed absent further explanation regarding Claimant’s credibility, given that Dr. Levinstein’s testimony was rejected in part because it relied on Claimant’s information; (4) the WCJ erred when he failed to make any findings or render a credibility determination of Dr. Mauthe’s testimony.

The Commonwealth Court affirmed the denial of the Claim petition and explained that as Claimant testified live before the WCJ - who assessed Claimant’s demeanor and concluded that “Claimant’s live testimony was not credible" -  under the Daniels standard , the WCJ’s conclusion that Claimant lacked credibility is sufficient, and, therefore, the reasoned decision requirement under Section 422(a) was satisfied.

In regards to Claimant's argument with respect to Dr. Levinstein’s testimony, the WCJ clearly articulated multiple objective bases for his credibility determination. While Dr. Levinstein opined that Claimant’s alleged work injury was caused by the repetitive nature of her work duties, Claimant presented no evidence in this regard. Finally, the WCJ found that Dr. Levinstein diagnosed and treated Claimant despite an apparent lack of objective findings in his initial examination.

The Court reasoned, that once the WCJ rejected the testimony of Claimant and Dr. Levinstein as not credible, there was no further evidence of record that Claimant could have relied on to satisfy her burden of proof. Because Claimant failed to offer credible evidence in support of her claim petition, it was not necessary for the WCJ to assess Dr. Mauthe’s credibility to render a reasoned decision.

Practice Pointers:

1. Yes, it is possible to succeed in the litigation of a Pennsylvania workers compensation claim petition. 

One must present sufficient evidence to allow the Workers' Compensation Judge to conclude that the Claimant's medical expert opinion is not based upon the facts established by the evidence.

One may also prevail when conflicting medical expert opinions are presented. If the Employer presents an unequivocal medical expert opinion - which is found to be credible by the Workers' Compensation Judge -  then conflicting evidence may be resolved in favor of the Employer's position. 

2. A successful claim petition litigation result begins with an investigation of the accident circumstances, followed by the discovery of all pertinent medical records and the retention of a medical expert, who will review and address all of the issues presented.