Workers' Compensation City Firefighter Act 46 Subrogation Lien

City of Phila. v. Workers' Comp. Appeal Bd., PICS Case No. 17-1130 (Pa. Commw. July 3, 2017) Brobson, J. (10 pages).

The Workers' Compensation Appeal Board did not err in its application of Act 46, which designated cancer in firefighters as an occupational disease, since the statute makes clear that any claimant who files a timely claim after the act's effective date is entitled to the benefits of Act 46. The court affirmed the Board's decision affirming in part and reversing in part a workers' compensation judge's ruling.

Claimant worked for the City of Philadelphia as a firefighter. He was diagnosed with cancer in October of 2009. Thereafter, a workers' compensation judge (WCJ) granted his petition for benefits, among other things. Claimant's health insurer, Independence Blue Cross (IBC), asserted a subrogation lien against claimant's medical benefits under the Workers' Compensation Act (Act). The Board affirmed the WJC's finding that IBC submitted sufficient evidence to support the amount of a subrogation lien, i.e., the amount it paid to cover claimant's medical expenses prior to the WCJ's determination on benefits. However, the Board reversed the WCJ's determination that, as a matter of law, only medical expenses for services provided after the effective date of Act 46, which designated cancer in firefighters as an occupational disease, were reimbursable. On appeal, the City argued that IBC's lien could only attach to medical expenses incurred after the effective date of Act 46, i.e., July 7, 2011. Thus, according to the City, IBC could not claim a lien for medical expenses paid for services rendered prior to July 7, 2011, even though such services related to claimant's work-related cancer. The City maintained that the Board erred in applying Act 46 amendments "retroactively." The appellate court rejected this argument and held that the Board properly applied Act 46 as amended. Claimant filed his claim petition on June 13, 2012. Section 4 of Act 46 clearly states that the "provision of this act shall apply to claims filed on or after the effective date of this section." The court found it clear from the statute's language that any claimant who files a timely claim after July 7, 2011, is entitled to the benefits of Act 46. The Board did not apply Act 46 retroactively, as the City asserted. Rather, the Board properly applied the statute prospectively to claimant's claims, which were timely filed after the effective date of the act. The court also rejected the City's challenge to the sufficiency of IBC's evidence of its lien. IBC had relied on a premarked exhibit, a document labelled a "consolidated statement of benefits." This document identified claimant as the "patient" and listed the date of injury as Oct. 18, 2009, which corresponded with claimant's diagnosis date and the date provided in his claim petition. The City waived any hearsay objection to the document at a hearing on the matter and, excepting certain redactions, agreed to the admission of the document as proof of the existence and amount of IBC's lien. Thus, it was both reasonable and lawful for the WCJ to rely on the document as evidence of the existence and amount of IBC's subrogation lien, the court reasoned.