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Reported Cases:

Barbara Gardner v. WCAB (Genesis Health Ventures), 585 Pa. 366, 368 (Pa. 2005)

This Pennsylvania Supreme Court case makes the important clarification regarding the procedures for modifying a workers’ compensation claimant’s benefits based on an Impairment Rating Evaluation (“IRE”).

Previously, it was understood that an IRE must be requested within 60 days of a claimant’s receipt of 104 weeks of total disability benefits, and that, if requested outside of that 60-day window, the modification would not be permitted.  The Supreme Court recognized the hardship this placed on employers, and established that employers may still require a claimant to submit to an IRE outside of the 60-day window, as well as request a modification based on such an IRE by filing a Petition to Modify Compensation Benefits.

School District of Philadelphia v. WCAB (Davis), 38 A.3d 992 (Pa. Commw. Ct. 2011)

This case makes the important ruling that claimants who contest pension benefit offsets are required to present some credible evidence to counter an employer’s expert actuarial testimony.

Previously, the loophole existed whereby claimants who wanted to contest pension benefit offsets, or WC Judges who wanted to deny them, could simply argue that the employer’s actuary was not credible.  Thus, the burden remained solely on the employers’ side: employers had to hire an actuary to prove they were entitled to take an offset, but claimants did not have to hire any expert and risk expending money to contest an offset.

The Commonwealth Court recognized this imbalance and now prevents claimants from merely sniping from afar at employers trying to take a statutorily-mandated pension offset.

Now, claimants who wish to contest pension offsets must present their own actuarial evidence to counter an employer’s.  Moreover, WC Judges must now base their decisions regarding pension offsets on the weight of the evidence that each side presents.  That is, WC Judges may no longer simply discredit an employer’s actuary in the absence of credited testimony by a claimant’s actuary.