How Does A Pennsylvania Workers’ Compensation Judge Decide My Case?

The main issue for the Pennsylvania Work Comp Judges is credibility. When writing a Decision which decides a particular issue- for example, whether a work injury took place, the extent of disability, whether a recovery has been reached, whether the injured worker has an earning power, or whether medical treatment is reasonable and necessary- the Judge has to determine which medical expert’s opinion is most credible. Additionally, the Judge will make a determination in most cases as to whether he or she finds the testimony of the claimant (ie, injured worker) to be credible.

Let’s look at a hypothetical case. John Doe hurts his back while lifting boxes at work. The employer/insurer denies his claim, citing a pre-existing condition. John Doe’s attorney files a Claim Petition and litigation ensues. John Doe’s attorney takes the deposition of the treating doctor and also presents his client’s testimony. The insurance company hires an Independent Medical Examiner- who doesn’t treat John Doe, but who merely examines him, takes a history, and reviews medical records- and writes a report with his or her findings. The insurance company’s attorney takes the deposition of the IME doctor who disagrees with the treating doctor, blaming the symptoms on longstanding arthritis while the treating doctor opines that the work activity either caused a new condition and/or aggravated the underlying condition.

The parties are unable to settle the case. The insurer offers $10,000.00- which is about 9 months of work comp checks. John Doe wants $40,000.00. or more so that he can pay his bills and feed his family as he continues to recover.

The parties then have to write Briefs- these are the written arguments from the respective attorneys, with an overview of the applicable law, the facts of the case, and the arguments as to or why not the parties have met their burdens of proof. The litigation takes 12 months.

The Pennsylvania Workers’ Compensation Judge has to review the Briefs and issue a written Decision outlining all the facts, the applicable law, and most importantly, make credibility determinations.

A typical Decision, in this specific regard, might look something like this:

“This Judge finds the testimony of Dr. Smith (John Doe’s doctor) to be more credible and persuasive than that of Dr. Johnson (IME doctor). Dr. Smith had the opportunity to treat Claimant and observe him over many different occasions. Dr. Smith’s testimony is consistent with that of Claimant and supported by the objective, diagnostic studies.”

“This Judge finds the testimony of Claimant to be credible. Claimant’s testimony is supported by his treating physician, the diagnostic studies, and is internally consistent. Claimant admitted his prior back treatment, and even tried working after this injury before he was terminated.”

The credibility determinations are the most critical aspects of a Pennsylvania Workers’ Compensation case in terms of the Judge’s Decision. The Judge is charged with the obligation to issue a “reasoned Decision” so that the parties can make sense of the outcome based on the facts. The Judge has to resolve conflicting testimony and have support in the nature of “substantial evidence” for the findings.

Can The Decision Be Appealed?

Yes, any party can appeal the Decision of the Workers’ Compensation Judge within 20 days. It goes up to the Appeal Board who hears oral arguments in most cases and review appellate Briefs. The written Decision from the Appeal Board can take up to a year or more.

What If I Don’t Like The Appeal Board’s Decision?

You can take an appeal to the Commonwealth Court of Pennsylvania within 30 days. The written arguments and rules are more stringent at this level. Eventually, the Supreme Court of Pennsylvania may decide to review a case but this does not happen too frequently.

Do Many Decisions Get Overturned?

I do not know the statistics. But, in my practice, I find it to be fairly rare for a Decision by the Workers’ Compensation Judge to get overturned. Why is this? The appellate courts give deference to the Workers’ Compensation Judge in terms of credibility determinations and as I’ve said, these are the most crucial aspects of the Decisions. What is not rare is a remand- that is, when the Appeal Board sends the case back to the Workers’ Compensation Judge to issue a new Decision addressing issues that he or she may not have addressed originally. For example, suppose John Doe had an EMG study done which showed an S1 radiculopathy and the Judge failed to address this in the Decision- the Appeal Board may remand the case to the Judge to address the EMG and how it affects the outcome.

Our goal at The Cardamone Law Firm, LLC is not to keep injured workers in the dark about the Pennsylvania Workers’ Compensation process. Our goal is to explain it and make sense of it. I am shocked at how many clients I get from other firms who have failed to explain how things work. The big picture is important to understand.

The Cardamone Law Firm, LLC is a rare firm that only handles PA Work Comp cases- and only for injured workers. If you are tired of being bounced around to different attorneys at a bigger firm, call Michael Cardamone directly at (215) 206-9068 for a free consult 7 days a week.

Certified PA Work Comp Specialist

MyPhillyWorkersComp@Gmail.com

The Cardamone Law Firm, LLC

The Firm For Injured Workers In Pennsylvania

 

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