INJURY SEMINAR

Injury is defined by the Pennsylvania Workers' Compensation Act as:

"The terms "injury" and "personal injury", as used in this act, shall be construed to mean an injury to an employee, regardless of his previous physical condition, arising in the course of his employment and related thereto, and such disease or infection as naturally results from the injury or is aggravated, reactivated or accelerated by the injury; and wherever death is mentioned as a cause for compensation under this act, it shall mean only death resulting from such injury and its resultant effects, and occurring within three hundred weeks after the injury." . . . Section 301(c)(1)

Injury is thus broadly defined per the remedial purposes of the Act as contained in the preamble to the Act. The phrase "regardless of his physical condition" defines what is sometimes referred to as the "eggshell" claimant who may have severe physical conditions as the individual comes to the workplace. Also, the language of "aggravated, reactivated or accelerated by an injury" defines a mere worsening of the condition as being an injury.

The broadness of the definition of injury is also reflected in the compensability of occupational diseases as defined in the Occupational Disease Act. Act of 1939 P.L. 566, No. 284. See Act Section 301(c)(2). This related law defines injuries which are also considered as part of our workers' compensation system. The occupational diseases are defined by particular chemical exposures or conditions which may arise in a dangerous work environment. Examples include: silicosis, anthraco-silicosis, coal workers pneumoconiosis or asbestosis, or by silicosis, anthraco-silicosis, coal workers pneumoconiosis, or asbestosis, when accompanied by active pulmonary tuberculosis. Section 301(e).

Additional occupational diseases are defined in a different section of the Pennsylvania Occupational Disease Act and include an array of exposures such as: poisoning by arsenic (Section 108(a); radium poisoning (Section 108(f); anthrax (Section 108(j); asbestosis (Section 108(l); and tuberculosis (Section 108(m).

Mental injury is also compensable under the Act.

Physical/mental. Donovan v. WCAB (Academy Med. Realty), 739 A.2d 1156 (Pa. Commow. 1999). For example, a disabling back injury could lead to depression.

Mental/mental. Claimant often has a difficult time proving actual, objective, abnormal working conditions causing mental injury. Martin v. Ketchum, 568 A.2d 159 (Pa. 1990).

Mental/Physical. Psychological stress may result in conditions such as angina or abdominal pains. Davis v. WCAB (Swarthmore Borough), 751 A.2d 169 (Pa. 2000).

An injury may be the result of repetitive trauma. Roberts v. WCAB (Double Renters), 719 A.2d 847 (Pa. Commow. 1998). The date of injury is generally defined in these injuries as the last day of employment. WCAB (Young) v. Bethlehem Steel Corp., 352 A.2d 571 (Pa. Commow. 1976).

When the employer learns of an injury, or possible injury, the employer is required to submit a Bureau from entitled Employer's Report of Occupational Injury or Disease, LIBC-344. An insurance contract generally requires the employer to promptly report injuries to a workers' compensation insurance carrier.

The employer/insurer has twenty-one (21) days from the date of notice to accept or deny an injury. Importantly, current law clearly indicates that even if the allegations are only of medical care, without disability, we are obligated to promptly accept or deny. Lemansky v. WCAB (Hagan Ice Cream Company), 738 A.2d 498 (Pa. Commow. 1999). Acceptance may be in the form of a Notice of Compensation Payable, a Temporary Notice of Compensation Payable or an Agreement for Compensation.

Disability is distinct from injury. Disability under the Pennsylvania Workers' Compensation Act is defined by wage loss. Section 306. Claimant may be fully disabled and qualify for temporary, total disability benefits. Claimant may be partially disabled. Claimants are compensated at two-thirds of the wage loss as defined by the Average Weekly Wage. Section 306. Partial disability benefits are limited to five hundred (500) weeks. Section 306(a.2)(7).

No compensation shall be allowed for the first seven (7) days after disability begins, except as provided in this clause (e) and clause (f) of this Section. If the period of disability lasts fourteen (14) days or more, the employee shall also receive compensation for the first seven (7) days of disability. Section 306(a.2)(e).

The benefits under the Workers' Compensation Act include payment of medical bills with repricing, and payment of wage loss benefits. The third category of benefits is specific loss. A specific schedule of number of weeks for loss of certain body parts is specified via the Act, with healing periods also as compensable. Section 306(a.2)(c). One of the enumerated specific losses is payment for serious and permanent disfigurement of the head, face or neck. Section 306(a.2)(22).

The compensability of an injury often arises in the context of recurrence/old injury vs. an aggravation/new injury. When an intervening work-related incident materially contributes to disability thereafter, that intervening incident constitutes a new injury. City of Williamsport v. WCAB (Schmuck), 423 A.2d 817 (Pa. Commow. 1980). If medical evidence concludes that disability is due to both a recurrence/old injury and an aggravation/new injury, the second employer/insurer is liable for payment. Ease West Equip. Co. v. WCAB (Monarch Circuit Industries), 562 A.2d 958 (Pa. Commow. 1989). Nevertheless, Section 322 of the Act now provides for the apportionment or splitting of liability between successive employers/insurers. The Act describes a pro rata split based on the ratio of the wages of the two different employments.

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