Last week, the Pennsylvania Commonwealth Court issued another unfortunate decision in a relatively recent line of cases that is eviscerating the “bureau document” scheme of the Bureau of Workers’ Compensation that litigants have relied upon for decades to guide and protect the rights of both parties. The case of Raymour & Flanigan v. Workers’ Compensation Appeal Board (Obeid), 371 C.D. 2020, essentially does away with an employer’s requirement to file a notice stopping temporary compensation (NSTC) and a notice of compensation denial (NCD) when the employer seeks to cease paying wage loss benefits owed pursuant to notice of temporary compensation payable (NTCP). The case instead sanctions the practice of formally accepting a claim for the payment of medical expenses only, while denying wage loss, by filing a medical only notice of compensation payable. While not specifically mentioned in the decision, this insurance practice developed out of an ostensible necessity created a few years ago, when the workers’ compensation automation and integration system (WCAIS) withdrew from claims adjusters the ability to directly issue bureau documents, instead automatically generating them with the submission of an electronic data exchange (EDI) transaction. This change led to all sorts of interesting bureau document errors, many of which exist to this date, usually due to improper training. Of course, the law is blind to internal claims adjusting errors as the bureau document scheme, which actually was planned to be done away with entirely with the implementation of WCAIS, still controls the status of most cases. As recently as 2006, the court in Sharon Tube v. Workers’ Compensation Appeal Board (Buzard) (Pa. Commw. Ct. 2006) essentially found the “controlling bureau document” to be sacrosanct. This bedrock principle of workers’ compensation law appears to be waning.
While the Commonwealth Court is the primary appellate body charged with interpreting workers’ compensation law and a significant portion of its docket is dedicated to the practice, it would be difficult to recall the last time a workers’ compensation practitioner actually sat on the court. Consequently, the law is often viewed from a theoretical perspective without the benefit of any practical application or experience. That dynamic can often lead to some very interesting decisions and the actual creation of law by both judicial decree and the subsequent promulgation of regulations to implement case law, that the legislative and executive branches may never have intended.
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