T E MPORARY INSANIT Y IN ACCE PT ING OR DE NYING A CL AIM IN - - PowerPoint PPT Presentation

T E MPORARY INSANIT Y IN ACCE PT ING OR DE NYING A CL AIM IN T HE POST

• E

DI T RANSACT ION E RA

Judg e Se e lig : Mo de ra to r with Ha rte Pric e r, Jo se ph Hutte ma nn, E sq uire a nd Ba rb a ra Yo ung , E sq uire

WORK E RS’ COMPE NSAT I ON ACT

NT CP: SE CT ION 406.1(D)(1) OF WC ACT

• Ac t 44 o f 1993 c re a te d a no tic e o f te mpo ra ry c o mpe nsa tio n pa ya b le .

Se c tio n 406.1(d) o f the Ac t, 77 P.S. 717.1, a dde d b y Ac t 44 o f 1993 a nd furthe r a me nde d b y Ac t 57 o f 1996 sta te s: I n a ny insta nc e whe re a n e mplo ye r is unc e rta in whe the r a c la im is c o mpe nsa b le . . . o r is unc e rta in o f the e xte nt o f its lia b ility . . . the e mplo ye r ma y initia te c o mpe nsa tio n pa yme nts witho ut pre judic e a nd witho ut a dmitting lia b ility pursua nt to a no tic e o f te mpo ra ry c o mpe nsa tio n pa ya b le a s pre sc rib e d b y the de pa rtme nt.

T HE RE QUIRE ME NT S OF ST OPPING A NT CP SE CT ION 406.1(5)

(i) If the e mplo ye r c e a se s ma king pa yme nts pursua nt . . . a no tic e in the fo rm pre sc rib e d b y the de pa rtme nt sha ll b e se nt to the c la ima nt a nd a c o py file d with the de pa rtme nt, b ut in no e ve nt sha ll this no tic e b e se nt o r file d la te r tha n five (5) da ys a fte r the la st pa yme nt. (ii) T his no tic e sha ll a dvise the c la ima nt, tha t if the e mplo ye r is c e a sing pa yme nt o f te mpo ra ry c o mpe nsa tio n, tha t the pa yme nt o f te mpo ra ry c o mpe nsa tio n wa s no t a n a dmissio n o f lia b ility o f the e mplo ye r with re spe c t to the injury sub je c t to the no tic e o f te mpo ra ry c o mpe nsa tio n pa ya b le , a nd the e mplo ye e must file a c la im to e sta b lish the lia b ility o f the e mplo ye r. T hus, unde r the Ac t, the e mplo ye r/ insura nc e c a rrie r must file two fo rms a nd se nd the m to the c la ima nt within 5 da ys fro m the da te o f la st pa yme nt o f b e ne fits. T he first fo rm (“a no tic e in the fo rm pre sc rib e d b y the de pa rtme nt”) is the No tic e o f Sto pping o f T e mpo ra ry Co mpe nsa tio n (NST C), a nd the se c o nd is the No tic e o f Co mpe nsa tio n De nia l (NCD).

T HE CONSE QUE NCE S OF I MPROPE RL Y ST OPPI NG NT CP

• Se c tio n 406.1(6) pro vide s furthe r c la rity o n the c o nse q ue nc e s o f fa iling to file

the a ppro pria te fo rms a nd a dhe re to the time limita tio ns o f the Ac t:

• I

f the e mplo ye r do e s no t file a no tic e unde r pa ra g ra ph (5) [NST CP] within the nine ty-da y pe rio d during whic h te mpo ra ry c o mpe nsa tio n is pa id o r pa ya b le , the e mplo ye r sha ll b e de e me d to ha ve a dmitte d lia b ility a nd the [NT CP] sha ll b e c o nve rte d to a [NCP].

• T

hus, se c tio n 406.1(6) ma nda te s the a uto ma tic c o nve rsio n to a n NCP unle ss a n e mplo ye r/ insura nc e c a rrie r file s b o th the NST C a nd NCD within 5 da ys fro m the da te o f la st pa yme nt, pursua nt to se c tio n 406.1(5), a nd file s the se do c ume nts within 90 da ys fro m the da te o f o nse t o f te mpo ra ry c o mpe nsa tio n

BURE AU RE GUL AT I ONS

§ 121.7A. NOT ICE OF T E MPORARY COMPE NSAT ION PAYABL E

• (a ) I

f a n e mplo ye r file s a No tic e o f T e mpo ra ry Co mpe nsa tio n Pa ya b le , F

• rm L

I BC- 501, the e mplo ye r sha ll do a ll o f the fo llo wing simulta ne o usly a nd no la te r tha n 21 da ys fro m the da te the e mplo ye r ha d no tic e o r kno wle dg e o f the disa b ility:

(1) Se nd the NT CP fo rm to e mplo ye e ; (2) pa y the c o mpe nsa tio n; (3) F ile the NT CP, F

• rm L

I BC-501, with the Bure a u.

• (b ) A Sta te me nt o f Wa g e s F
• rm sha ll b e file d with e ve ry NT

CP, F

• rm L

I BC-501, e xc e pt fo r sub se c tio n (d) (me dic a l o nly).

§ 121.7A. NOT ICE OF T E MPORARY COMPE NSAT ION PAYABL E

• (c ) T
• mo dify a No tic e o f T

e mpo ra ry Co mpe nsa tio n Pa ya b le , F

• rm L

I BC-501, a n e mplo ye r sha ll file a n a me nde d No tic e o f T e mpo ra ry Co mpe nsa tio n Pa ya b le , F

• rm L

I BC-501, with the Bure a u during the 90-da y te mpo ra ry c o mpe nsa tio n pa ya b le pe rio d. T he a me nde d No tic e o f T e mpo ra ry Co mpe nsa tio n Pa ya b le , F

• rm L

I BC-501, sha ll b e c le a rly ide ntifie d a s “Ame nde d” a nd ma y ha ve o nly the insure r's sig na ture .

• (1) A Sta te me nt o f Wa g e s, F
• rm sha ll b e file d with e ve ry a me nde d NT

CP

• (2) T

his se c tio n do e s no t a pply upo n c o nve rsio n o f the No tic e o f T e mpo ra ry Co mpe nsa tio n Pa ya b le , F

• rm L

I BC-501, to a No tic e o f Co mpe nsa tio n Pa ya b le , F

• rm L

I BC-495.

§ 121.7A. NOT ICE OF T E MPORARY COMPE NSAT ION PAYABL E

(d) I n me dic a l o nly c a se s, whe n a n e mplo ye e ’ s injury ha s no t re sulte d in lo st time fro m wo rk, a n e mplo ye r ma y file a No tic e

• f Co mpe nsa tio n Pa ya b le , F
• rm L

I BC-495. 34 Pa . Co de § 121.7a (d), 34 PA ADC § 121.7a (d) T he re g ula tio n a utho rize s c re a tio n a nd use o f the Me dic a l Only NT CP Ado pte d Aug . 4, 2007.

§ 121.17 CHANGE IN COMPE NSAT ION (L IBC- 502)R

(d) I f te mpo rary c o mpe nsatio n payme nts made unde r §121.7a (re lating to no tic e o f te mpo rary c o mpe nsatio n payab le ) are sto ppe d, the e mplo ye r shall file o ne o f the fo llo wing : (1) A No tic e Sto pping T e mpo ra ry Co mpe nsa tio n, F

• rm L

I BC-502, a nd a No tic e o f Wo rke rs’ Co mpe nsa tio n De nia l, fo rm L I BC-496, within 5 da ys o f the la st pa yme nt a nd within the 90-da y te mpo ra ry c o mpe nsa tio n pa ya b le pe rio d. (2) A No tic e o f Co mpe nsa tio n Pa ya b le , F

• rm L

I BC-495. (3) An Ag re e me nt fo r Co mpe nsa tio n fo r Disa b ility o r Pe rma ne nt I njury, F

• rm L

I BC-336.

CASE L AW

T HE CASE L AW ON NT CP

• Ge r

e ye s v. WCAB (Ne w Knight, Inc .), 793 A.2d 1017 (Pa. Cmwlth. 2002)

• E

mplo ye r vio la te d the Ac t b y unila te ra lly c ha ng ing the c o mpe nsa tio n ra te to pa rtia l disa b ility o n a NT CP whe n Cla ima nt re turne d to wo rk a t a wa g e lo ss c o nc luding tha t the c la ima nt must b e pa id a fixe d ra te until the e mplo ye r de c ide s to c o ntro ve rt the c la im.

• Co urt a lso c o nc lude d tha t the NT

CP ha d no t c o nve rte d to a n NCP b e c a use o f the unila te ra l re duc tio n a s a rg ue d b y Cla ima nt. T his is b e c a use the e mplo ye r file d the NST C a nd NCD within five da ys a fte r pa yme nt o f the la st c o mpe nsa tio n pa yme nt a nd within 90 da ys a fte r the o nse t o f te mpo ra ry c o mpe nsa tio n.

T HE CASE L AW ON NT CP

Chur c h v. WCAB (L andsc aping & F le ming T e r mite ), 135 A.3d 1153 (Pa. Cmwlth. 2016)

DOI: 7/ 29/ 04 NT CP file d on 8/ 10/ 04 with AWW of $973.81 and r ate of $649.21 2nd “Cor r e c te d” NT CP file d also on 8/ 10/ 04 AWW $486.90 with r ate of $345.00 Holding: E mploye r may ame nd NT CPs c iting to Bur e au Re gs: Co mmo nwe a lth Co urt: “T

he e mplo ye r did no t vio la te the Ac t whe n it unila te ra lly issue d a “Co rre c te d” NT CP o n Aug ust 10, 2004 tha t pa id the c la ima nt a lo we r c o mpe nsa tio n ra te b a se d upo n a lo we r pre -injury [AWW]. T his me a ns . . .a T NCP ma y b e unila te ra lly a me nde d to re fle c t the lo we r ra te during the 90-da y pe rio d a nd the la st T NCP in e ffe c t a t the e xpira tio n o f the 90 da ys will b e the do c ume nt c o nve rte d to b e c o me the NCP.

CHURCH V. WCAB

Holding: E mploye r doe s not have to file a NST CP for e ac h NT CP it file s dur ing the 90 days if it c ontinue s paying te mpor ar y c ompe nsation.

Co mmo nwe a lth Co urt: “He re , the 1st NT CP wa s pro pe rly a me nde d a nd the re wa s no c o nve rsio n o f NT CP to NCP. Ac c o rding ly, Cla ima nt's c o nte ntio n tha t the 1st NT CP c o nve rte d to a NCP a nd the re fo re E mplo ye r wa s o b lig a te d to pa y b e ne fits a t the ra te o f $649.21 pe r we e k fo r a ll pe rio ds o f time whe re Cla ima nt wa s no t wo rking is c o mple te ly witho ut me rit.” Co urt disting uishe s Ge re ye s, “as it did no t invo lve the a me ndme nt o r c o rre c tio n o f a NT CP, b ut ra the r wa s a c a se in whic h the e mplo ye r unila te ra lly re duc e d the a mo unt o f c o mpe nsa tio n b e ing pa id the e mplo ye e a fte r his re turn to wo rk with a pa rtia l wa g e lo ss.

CASE L AW ON NT CP

Aldr idge v. WCAB (Kmar t Co r po r atio n), 113 A.3d 861 (Pa. Cmwlth. 2015).

• DOI

: 3/ 7/ 11

• 5/ 9/ 11: NT

CP me dic a l o nly: le ft kne e , sho ulde r, a nd ha nd c o ntusio ns

• 6/ 13/ 11: Bure a u c o nve rts NT

CP me dic a l o nly

• 8/ 4/ 11: NT

CP inde mnity: “le ft la b rum a nd b ic e p te a r” a nd E mplo ye r a sse rts 90 da ys b e g a n o n July 20th whe n it le a rne d o f a dditio na l injury

• 9/ 15/ 11: NST

CP a nd NCD file d

AL DRI DGE

• V. WCAB

Ho lding : Pursua nt to Se c tio n 406.1 o f the Ac t, the e mplo ye r did no t vio la te the Ac t a nd wa s no t pre c lude d fro m issuing a Me dic a l Only T NCP, c o nve rte d to b e a Me dic a l Only NCP a nd the n upo n re c e iving info rma tio n tha t Cla ima nt wa s suffe ring disa b ility a s a re sult o f the sho ulde r injury issuing a NT CP indic a ting tha t it wo uld ma ke pa yme nts fo r b o th me dic a l a nd wa g e lo ss. Pursua nt to Se c tio n 406.1(d )(1) o f the Ac t, b y issuing this se c o nd NT CP, E mplo ye r wa s no t a dmitting lia b ility fo r this injury. F urthe rmo re , sinc e it did file a NCD a nd No tic e Sto pping Co mpe nsa tio n within 90 da ys o f issuing tha t se c o nd NT CP, it wa s no t a dmitting lia b ility fo r tho se a dditio na l injurie s o r fo r wa g e lo ss a s a re sult o f tho se injurie s.

CASE L AW ON NT CP

L ife Que st Nur sing Ctr . v. Wor ke r s' Comp. Appe al Bd. (T isdale ), 190 A.3d 811 (Pa. Cmwlth 2018)

• DOI

: 4/ 23/ 14

• 5/ 9/ 14: I

nde mnity NT CP

• 6/ 2714: Supple me nta l Ag re e me nts file d indic a ting Cla ima nt re turne d

to pa rt-time wo rk within re stric tio ns a nd a dde d to de sc riptio n o f injury

• 7/ 11/ 14: Cla ima nt sto ps wo rking
• 7/ 11/ 14: E

r issue s NST CP a nd NCD

L IF E QUE ST NURSING CE NT E R V. WCAB

• Cla ima nt file s Cla im & Pe na lty a lle g ing E

r vio la te d the Ac t b y disc o ntinuing he r pa rtia l b e ne fits in lig ht o f the Supple me nta l Ag re e me nts.

• WCJ: WCJ g ra nts limite d c la im up to 10/ 9/ 14; no pe na lty; E

r no t b o und b y Supple me nta l Ag re e me nts b e c a use E R file d NST CP a nd NCD w/ i 90 da ys.

• Bo a rd: re ve rse d WCJ o n pe na lty a nd de sc riptio n o f injury sta ting E

r wa s b o und b y Supple me nta l Ag re e me nts

• Co mmo nwe a lth Co urt: F

iling o f Supple me nta l Ag re e me nts we re no t a dmissio n o f lia b ility b e c a use still within 90 da ys o f NT

• CP. E

mplo ye r sho uld ha ve file d a n Ame nde d NT

• CP. “An e mplo ye r do e s no t vio la te the Ac t b y

unila te ra lly filing a n a me nde d NT CP a s re q uire d b y the re g ula tio ns.

CASE L AW ON NT CP

• Mic hae l H. White v. Me tr
• po litan E

diso n Co mpany, WCAB, A17- 1056 De c ide d Nove mbe r 27, 2018

• T

he E mplo ye r issue d a n NT CP with wa g e inde mnity b e ne fits b e ing pa id.

• T

he E mplo ye r the n issue d a me nde d me dic a l o nly NT CPs within the 90 da ys a nd sto ppe d pa ying wa g e b e ne fits.

• T

he E mplo ye r did no t issue a No tic e Sto pping T e mpo ra ry Co mpe nsa tio n o r No tic e o f Wo rke rs’ Co mpe nsa tio n De nia l.

• T

he Bure a u issue d a No tic e o f Co nve rsio n, c re a ting a n NCP

• T

he No tic e o f Co nve rsio n o nly c o nve rts; it do e s no t ide ntify the da te o f the do c ume nt b e ing c o nve rte d; whe n the re is mo re tha n o ne te mpo ra ry do c ume nt, it is no t a lwa ys c le a r whic h o ne is b e ing c o nve rte d.

MICHAE L

• H. WHIT

E

• V. ME

T ROPOL IT AN E DISON COMPANY, WCAB, A17- 1056 (2018)

• Cla ima nt file d Cla im a nd Pe na lty pe titio ns, a lle g ing NT

CP a c c e pting wa g e inde mnity b e ne fits wa s the NT CP tha t c o nve rte d a s no No tic e Sto pping a nd no De nia l we re file d a nd re q ue sting a pe na lty a s wa g e b e ne fits ha d b e e n sto ppe d.

• E

mplo ye r’ s de fe nse wa s tha t E DI a nd the Bure a u g uide line s a utho rize d it to pro c e e d the wa y it did a nd tha t the No tic e Sto pping a nd De nia l we re no t re q uire d.

• WCJ fo und tha t the sta tute a nd re g ula tio ns c o ntro lle d a nd he ld tha t the NT

CP with wa g e pa yme nts ha d c o nve rte d. He de nie d the pe na lty b e c a use it wa s a te c hnic a l vio la tio n a nd the a djuste r ha d re lie d o n Bure a u g uida nc e .

• T

he WCAB a ffirme d WCJ de c isio n.

E DI T RANSACT I ONS

On, Se pte mbe r 16, 2016 the E DI F

• rms So lutio n e nha nc e me nt wa s

imple me nte d into WCAI

• S. As o f tha t da te , the fo llo wing fo rms

c a n o nly b e file d e le c tro nic a lly with the Bure a u b y pro viding da ta tho ug h E DI tra nsa c tio ns:

• L

I BC-495: No tic e o f Co mpe nsa tio n Pa ya b le

• L

I BC-496: No tic e o f Wo rke rs' Co mpe nsa tio n De nia l

• L

I BC-501: No tic e o f T e mpo ra ry Co mpe nsa tio n Pa ya b le

• L

I BC-502: No tic e Sto pping T e mpo ra ry Co mpe nsa tio n

Due to the se c ha ng e s, WCAI S will no t a llo w the uplo a ding o f the se fo rms into WCAI S a nd a ny o f the se fo rms ma ile d to BWC will b e re turne d to the se nde r. Upo n re c e ipt o f a n a ppro pria te E DI tra nsa c tio n, WCAI S will g e ne ra te the fo rm, a tta c h a c o py o f the fo rm to the c la im, a nd fo rwa rd c o pie s o f the fo rm to the T ra nsa c tio n Pa rtne r o r filing e ntity.

A c opy of the syste m g e ne ra te d form must be se nt to the c la ima nt.

• The EDI transaction used to create the form is the official

record of filing.

• It will not be possible for claims representative to issue or file

an NCP, NTCP, NCD or Stopping Notice without having a FROI

• n file establishing a claim in WCAIS.
• For any claim for which an adjuster intends to file bureau

documents, there must be a FROI on record establishing the claim.

ST AT E ME NT OF POL I CY

T he De pa rtme nt o f L a b o r a nd I ndustry a do pte d Cha pte r 123, Sub c ha pte r J (re la ting to Wo rke rs' Co mpe nsa tio n Auto ma tio n a nd I nte g ra tio n Syste m—sta te me nt o f po lic y) Po lic y wa s e ffe c tive Ja nua ry 28, 2017 – pub lishe d in PA Bulle tin Sub missio n o f c e rta in E DI tra nsa c tio ns will g e ne ra te in WCAI S the fo rms re q uire d unde r §§ 121.7, 121.7a , 121.13 a nd 121.17. Spe c ific a lly, F

• rm

L I BC-495 (No tic e o f Co mpe nsa tio n Pa ya b le ), F

• rm L

I BC-496 (No tic e o f Co mpe nsa tio n De nia l), F

• rm L

I BC-501 (No tic e o f T e mpo ra ry Co mpe nsa tio n Pa ya b le ) a nd F

• rm L

I BC-502 (No tic e Sto pping T e mpo ra ry Co mpe nsa tio n) will b e a uto ma tic a lly g e ne ra te d b y the sub missio n o f the a ppro pria te E DI tra nsa c tio n in WCAI S

ADDIT IONAL INF ORMAT ION ON E DI T RANSACT IONS

• https:/ / www.dli.pa .g o v/ Busine sse s/ Co mpe nsa tio n/ WC/ c la ims/ e di/ Pa

g e s/ de fa ult.a spx

• I

mple me nta tio n Guide

• Suppo rting Do c ume nts – Quic k Re fe re nc e Guide fo r Atto rne ys; F
• rms

So lutio n F

• rm to T

ra nsa c tio n Guide ; the Co mmo n F lo w o f a Cla im Guide a nd

• the rs

HYPOT HE T ICAL

• 6/ 30/ 17: DOI
• 7/ 24/ 17: NT

CP (wa g e lo ss)

• 9/ 27/ 17: Ame nde d Me dic a l Only T

NCP

• Ame nde d Me dic a l Only T

NCP c o nve rts

• Cla ima nt a sse rts tha t De fe nda nt/ I

nsure r ne e de d to issue a No tic e Sto pping I nde mnity T NCP b e fo re issuing a Me dic a l-Only T

• NCP. I

t is De fe nda nt/ I nsure r’ s po sitio n tha t b e c a use the WC Ac t do e s no t spe c ific a lly a c kno wle dg e o r re fe re nc e a Me dic a l-Only NT CP the re is no ne e d to issue a NST CP b e c a use the Ac t do e s no t re c o g nize the Me dic a l-Only NCP a s a do c ume nt se pa ra te a nd distinc t fro m a n I nde mnity NCP.

HYPOT HE T ICAL

• NT

CP inde mnity & me dic a l

• Ame nde d NT

CP (inde mnity & me dic a l)

• Ame nde d NT

CP (me dic a l o nly)

• Ame nde d NT

CP (me dic a l o nly) c o nve rts

• Do e s E

mplo ye r ha ve to file a NST CP?

   

• E

mplo ye r a sse rts tha t during E DI F

• rms So lutio n T

ra ining April 2017 (Po we r Po int Pre se nta tio n): “Sa ve yo urse lf a tra nsa c tio n a nd two fo rms b y e nte ring the SROI PD while in T e mpo ra ry Sta tus a nd o b ta in the sa me Me d Only NCP witho ut the De nia l a nd Sto pping No tic e .”

• E

mplo ye r’ s a rg ue whe n mig ra ting fro m a wa g e pa ying NT CP to a Me dic a l Only NT CP, a No tic e Sto pping c a nno t b e g e ne ra te d in this situa tio n. E DI Quic k Re fe re nc e Guide fo r Atto rne ys.

• Pursua nt to the E

le c tro nic Da te I nte rc ha ng e (“E DI ”) Cla ims I mple me nta tio n Guide , issue d b y the Bure a u o f Wo rke rs’ Co mpe nsa tio n in De c e mb e r 2017 , a n L I BC-502 fo rm c a n b e g e ne ra te d thro ug h a n E DI tra nsa c tio n. T he Guide sta te s a s fo llo ws: “to de ny a c la im if a SROI PY (Pa yme nt) tra nsa c tio n with the Ag re e me nt to Co mpe nsa te Co de se t to “L ” wa s initia lly sub mitte d to a c c e pt a Me dic a l Only c la im, the c la im a dministra to r must file a SROI PD (Pa rtia l De nia l) tra nsa c tio n to de ny inde mnity pa yme nts b ut a c c e pt me dic a l pa yme nts to g e ne ra te a n L I BC-502 a nd L I BC-496.”

HYPOT HE T ICAL

• NT

CP (me dic a l o nly)

• Ame nde d NT

CP (inde mnity & me dic a l)

• Ame nde d NT

CP (inde mnity & me dic a l)

• Me dic a l o nly NCP (No NST

CP file d)

• Do e s the Ame nde d NT

CP (inde mnity & me dic a l) a uto ma tic a lly c o nve rt?

• Do e s E

mplo ye r ha ve to file a NST CP?

ARGUME NT S BY T HE PART IE S

• Cla ima nt a rg ue s tha t the Ame nde d NT

CP c o nve rte d to a No tic e o f Co mpe nsa tio n Pa ya b le b y o pe ra tio n o f la w pursua nt to Se c tio n 406.1 a s no NST CP wa s file d.

• T

he E mplo ye r c o unte rs tha t it pro pe rly sto ppe d te mpo ra ry c o mpe nsa tio n pa yme nts pursua nt to Bure a u Re g ula tio n Se c tio n 121.17 (d ), whic h pro vide s “I f te mpo ra ry pa yme nts ma de unde r § 121.7a (re la ting to no tic e o f te mpo ra ry c o mpe nsa tio n pa ya b le ) a re sto ppe d, the e mplo ye r sha ll file one

• f the following: NST

CP a nd NCD; NCP; Ag re e me nt fo r Co mpe nsa tio n.

RE GUL AT ION IN CONF L ICT WIT H ST AT UT E ?

• “Ca se la w ha s e sta b lishe d tha t a re g ula tio n ha s the fo rc e a nd e ffe c t o f la w.”

City o f Pittsb urg h, De pt. o f Pe rso nne l and Civil Se rvic e Co mmissio n v. PA Human Re latio ns Co mmissio n, 630 A.2d 919, 921 n. 4 (Pa . Cmwlth. 1993).

• A re g ula tio n tha t is a t va ria nc e with a sta tute is ine ffe c tive to c ha ng e the

sta tute ’ s me a ning . Ge ising e r He alth Syste m v. Bure au o f Wo rke rs’ Co mpe nsatio n F e e Re vie w He aring Offic e , 138 A.3d 133 (2016).

• “An a g e nc y's inte rpre ta tio n o f its o wn rule s a nd re g ula tio ns is e ntitle d to

g re a t we ig ht unle ss it is c le a rly e rro ne o us o r in c o nflic t with its e na b ling le g isla tio n.” Mile wski v. Co mmo nwe alth, 93 Pa .Cmwlth. 120, 500 A.2d 1261 (1985), pe titio n fo r allo wanc e o f appe al de nie d, 515 Pa . 569, 526 A.2d 1191 (1987).

WORKE RS’ COMPE NSAT ION JUDGE DE CISION

• WCJ: F
• und re g ula tio n wa s a t va ria nc e with the sta tute c iting Ge ising e r

He alth Syste m.

• “Ba se d o n the e vide nc e o f re c o rd, this Wo rke rs’ Co mpe nsa tio n Judg e finds

tha t sinc e the E mplo ye r did no t file a NST C o r a No tic e o b ta ining the info rma tio n de sc rib e d in Se c tio n 406.1 o f the Ac t within the nine ty-da y pe rio d during whic h te mpo ra ry c o mpe nsa tio n wa s pa id o r pa ya b le , the E mplo ye r is de e me d to ha ve a dmitte d lia b ility a nd the pro pe rly Ame nde d NT CP is c o nve rte d to a No tic e o f Co mpe nsa tio n Pa ya b le (“NCP”).”

• WCJ a lso no te d tha t a file d me dic a l o nly NCP do e s no t c o nta in the no tic e

la ng ua g e re q uire d b y the Ac t.