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Workers' Compensation Rights/ Obligations in Light of the Forced Government Shutdown Due to COVID-19

With coronavirus (COVID-19) related mandatory shutdowns in place across Pennsylvania, employers and workers’ compensation insurance carriers will face requests for reinstatement of total or partial disability benefits from employees who have returned to work following work-related injuries. 

  • Pennsylvania courts have held that where a claimant returns to work under a suspension or modification, with restrictions, and is subsequently laid off and seeks a reinstatement of benefits, the claimant is entitled to the presumption that his/her loss of earning power is causally related to the continuing work injury. These workers will be entitled to an automatic reinstatement of benefits.
  • However, where a claimant returns to work with symptoms but without restrictions, and subsequently is laid off for economic reasons, the claimant is not automatically entitled to wage loss benefits. These workers should be required to go through the process of filing a Reinstatement Petition in order to seek a reinstatement of benefits.
  • Workers who are laid off due to the forced government shutdown are entitled to Unemployment Compensation Benefits pursuant to Governor Wolf’s directive. Employers should send LIBC-750, 756 & 760 forms to all individuals who were working light-duty positions prior to the forced government shutdown. Employers should consider awaiting receipt of these completed forms prior to reinstating wage loss benefits so that there are no overpayments made as a result of an employee’s receipt of unemployment compensation benefits.

Usual strategies used by employers and workers’ compensation insurance carriers to suspend wage loss benefits should be re-evaluated in light of the forced government shut down.

  • A refusal to attend an IME typically provides a basis for seeking a suspension of wage loss benefits. In light of the forced government shutdown, it is likely that Workers’ Compensation Judges will find a refusal to attend an IME at this time to be reasonable. In addition, we have been informed that many IME physicians are not performing examinations at this time.
  • A refusal of reasonable and necessary medical treatment may also provide a basis for seeking a suspension of wage loss benefits. In light of the forced government shutdown, it is likely that Workers’ Compensation Judges will find a refusal of reasonable and necessary medical treatment, including but not limited to physical therapy, injections, and non-emergent surgeries, to be reasonable at this time.
  • At this time, elective, non-emergent procedures and diagnostic studies are prohibited by way of Governor Wolf’s order. However, even when this ban is lifted, it is likely that many Workers’ Compensation Judges will be reluctant to force the issue until the pandemic has been officially declared over.
  • Situations should be evaluated on a case-by-case basis. It is recommended that Suspension Petitions be filed only in cases where a refusal of reasonable medical treatment results in clear and convincing evidence that the refusal will result, not only in a lack of improvement but also in an actual deterioration of a claimant’s condition.

Post & Schell’s Workers’ Compensation attorneys will continue to provide guidance for employers and workers’ compensation insurance carriers as this unique situation progresses. If you have questions regarding a specific claim, please contact any of the following of Post & Schell’s Workers’ Compensation Attorneys:

About the Authors

Karyn Dobroskey Rienzi focuses her practice on post-trial and appellate matters, predominantly in the areas of workers’ compensation and casualty. She regularly appears before the Pennsylvania Workers’ Compensation Appeal Board and has argued before the Pennsylvania Commonwealth Court and the Pennsylvania Superior Court.

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Jill A. Gilden is a Principal in the Firm's Workers' Compensation Department. Beginning the practice of workers' compensation defense in 2001, she joined the Firm in 2006. She focuses her practice exclusively in the defense and representation of Pennsylvania employers and insurance companies/third party administrators in workers' compensation proceedings.

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