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Box 4 denial back in play?

Paul Cacciamani

Source: Gumm v. W.C.A.B. (J. Allen Steel), 942 A.2d 222 (Pa.Cmwlth. 2008.)

Analysis

In the wake of the Commonwealth Court’s decision in Jordan v. WCAB (Philadelphia Newspapers, Inc.), the box 4 denial appeared to have seen its last days as an effective instrument for the carrier. However, the Commonwealth Court in Gumm v. WCAB, 942 A.2d 222 (Pa.Cmwlth., 2008.), determined that there are circumstances when a Box 4 denial is still appropriate. In Gumm, the Claimant sustained an ankle injury. The carrier initially issued a Notice of Temporary Compensation Payable. Later, the carrier issued a box 4 denial and a box 6 denial. The Commonwealth Court found a genuine dispute existed as to the nature of Claimant's work injury, the severity of the injury and the description of the injury. The Commonwealth Court held Employer did not “misuse” the Notice of Denial. Rather, it held that the Employer complied with the procedures required by the Act as the denial was used to refute Claimant's claim on the basis that disability did not result from the injury. The Court determined this was consistent with Employer's position that the causes of Claimant's problems were not the work incident but rather the pre-existing ankle problems.

What it Means For You

This is an interesting development for carriers with claims in Pennsylvania. The Commonwealth Court seems to suggest that should a genuine dispute exist, and if the carrier complies with proper procedure, the Box 4 denial is an effective instrument to deny a Claim Petition. However, extreme caution should still be exercised when issuing a Box 4 denial. It appears the Gumm case may be the exception to the rule set forth in Jordan. Contact a C&W workers’ compensation attorney to discuss your options when determining which type of denial is appropriate for your particular claim.

About C&W

Cipriani & Werner is a professional corporation providing civil litigation and workman's compensation legal services to clients throughout Pennsylvania and New Jersey. If you have questions, feel free to contact Paul Cacciamani at (412) 563-2500.

You can also read more about the article's related practice groups:
Workers' Compensation