Did Attempt to Terminate WC Benefits Require Employer to Pay Worker’s Legal Fees?

What Do You Think?

Employers that try to terminate an individual’s workers’ compensation benefits based on their voluntary withdrawal from the workforce need to think carefully before taking that step. Filing a petition to end that person’s benefits could end up saddling the employer with even more financial burden, as a Pennsylvania case shows.

In 1989, the claimant in that case slipped on the step of an airport passenger shuttle that she was operating for the employer and injured her right knee. She underwent surgeries as a result, including knee replacement surgery in 1995.

In 2007, the employer unsuccessfully sought to suspend benefits on the basis that the claimant had voluntarily removed herself from the workforce. The claimant successfully argued that she had not retired, pointing out that she had not accepted a retirement pension, continued to look for suitable work, and had not refused suitable work. She was not collecting social security retirement benefits and she had applied for jobs which she did not get.

In 2015, the employer again sought to suspend benefits on the basis that the claimant had voluntarily withdrawn from the workforce. Itpointed to a recent independent medical examination which showed that the claimant’s condition had slightly changed since the last petition to end benefits. It also pointed out that, per the doctor who examined the claimant, the claimant continued to have knee pain restricting her to light duty work. She also had non-work-related health conditions, including diabetes and obesity.

The WCJ again denied the employer’s petition, allowing the claimant to continue receiving her weekly payments. But the WCJ rejected the claimant’s request to require the employer to pay her legal fees for the case. The claimant challenged that decision in court.

The workers’ compensation act affords a claimant the ability to receive a reasonable sum for attorney fees, when an employer pursues an unreasonable contest.  The employer bears the burden of establishing the reasonable basis for a contest.

Was the claimant entitled to attorney’s fees?

A. Yes. Some of the claimant’s circumstances relevant to the injury and her ability work had changed.

B. No. The employer had already litigated the same issue. It was not reasonable to repeat those efforts.

If you selected A, you agreed with the court in Ogden Corp. v. Workers' Compensation Appeal Board, Nos. 200 C.D. 2019, 201 C.D. 2019 (Pa. Commw. Ct. 02/04/25), which affirmed the WCJ’s denial of attorney’s fees.

The court conceded that the employer filed a similar suspension petition in 2007 on the same basis–that the claimant had retired or removed herself from the workforce. Nevertheless, it affirmed the WCJ’s finding that the contest was reasonable. 

The court noted that the employer had obtained an updated independent medical examination which showed a change in the claimant's condition since the last litigation. 

“The WCJ further found that, given the lapse of time since Employer's last petition, Claimant's age, and the combination of her work-related and non-work-related medical conditions, Employer's contest under the circumstances was reasonable,” the court wrote. 

The court affirmed the decision, thus denying the claimant attorney’s fees.

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