The Department of Labour and Industry cannot be considered a party to an agreement to terminate proceedings before an arbitrator or upon notification of the agreement by merely complying with its rules and, therefore, the Commonwealth is not bound by the decision or time limit for appeal. Bureau of Workers Compensation v. Workmens Compensation Appeal Board (Insurance Company of North America), 516 A.2d 1318 (Pa. Cmwlth. 1986). The Tribunal ultimately set aside the underlying decision following an analysis of the language described in section 319 and found that, for the purposes of the transfer of receivables, the future credit/repayment rate would apply to future benefits, not future medical expenses. The Tribunal held that the inclusion of the term « compensation rate » in section 319 referred only to the payment of disability benefits, since medical expenses could not theoretically be paid in instalments. In addition, medical expenses were not characterized as regular and periodic, as was the payment of compensation. The Tribunal found that the concepts of compensation and « compensation rate » were indeed different and that recovery by third parties going beyond transfer duty was considered to be a down payment of the benefits referred to in section 319 of the Act. This pre-financing envisaged by the General Assembly was intended to cover future disability benefits and not medical expenses. This is a right that, incredibly, is not denied by the inability of the employer/insurer to cooperate in the prosecution of the third-party case in order to ensure such recovery by third parties. The Supreme Court approved the worker`s interpretation of Section 319 and held that the « instalment payments » were limited to lost wages benefits, given that future medical payments were « unknown at the time of the agreement. » The court found that there was no certainty that the medical benefits would be paid, let alone that they would be paid in the form of « future payments » that the court found to be stable and predictable.
Thus, the Tribunal found that after paying a third-party claim, a carrier could not claim credit on future medical payments, since they were not « payments » within the meaning of the law. Where work allowances have been paid and there is a tempting idea that a third party is responsible for causing those payments, the following calculations come into play in this case if the person to whom you paid work allowances proves that a third party was responsible for those benefits to include: (a) Where an employee is recovered by third parties in accordance with section 319 of the Act (77 P.S. § 671), the parties execute a transaction agreement with third parties, Form LIBC-380. If you have been injured as a result of third party negligence that has resulted in a right to compensation, you should speak with an experienced attorney in Pennsylvania to discuss your options. The Pennsylvania Supreme Court provided some guidance in Whitmoyer v. WCAB. In Whitmoyer, in 1993, the injured worker suffered a work-related injury, which led to the amputation of his arm. The employer paid disability and medical benefits related to the injury, and the complainant sued a third-party negligence case that resulted in a recovery of $US 300,000. At the time of the third-party recovery, the employer had paid $110,583 in work benefits to the injured worker and therefore had a right of pledge against the third party`s recovery. Third-party recovery was reduced to take into account the attorneys` fees associated with obtaining third-party recovery, resulting in a net right of pledge of USD 81,627 paid by the claimant to the workers` compensation body.
As part of this payment, the claimant and the employer entered into a third settlement agreement (TPSA). . . .