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December 03, 2009

Liability For Replacement Of Prosthesis

In Bowlaway Lanes, the Claimant sustained a work-related injury in 1975 while employed by Eleventh Frame Lounge. The injury resulted in the replacement of Claimant’s hip with a prosthesis. Claimant subsequently became employed by Bowlaway Lanes, where, in 1979, he suffered a stress fracture to his artificial hip joint, necessitating the replacement of the damaged hip joint with a new prosthesis. The referee held that the 1979 incident resulted in a new injury and ordered Bowlaway Lanes to pay benefits and medical expenses related to the replacement of Claimant’s damaged hip implant. The WCAB and Court affirmed, holding that where the replacement of a prosthesis has been necessitated due to a second work-related injury, as defined in Section 301(c) of the Act, 77 P.S.§ 411, the second employer shall be responsible for the costs of replacing the damaged prosthesis. 90 Pa.Cmwlth. 534. 496 A.2d. 99 (1985).

Bowlaway Lanes was upheld in Thiele, Inc. v. WCAB, where the Claimant sustained an original work-related injury to his right knee in 1973, requiring a prosthesis. In 1973, the Employer was insured by Pennsylvania National and in 1981 the Employer was insured by Westmoreland. In 1981, Claimant reinjured his right knee, necessitating the replacement of the prosthesis. The Judge ordered Pennsylvania National to pay only those medical expenses related to the replacement and care of the prosthesis necessitated by the 1981 injury and ordered Westmoreland to pay all other medical expenses. Westmoreland subsequently filed a Review Petition, joining Pennsylvania National as a party. The Judge found that the replacement of the Claimant’s knee prosthesis in 1981 was necessitated by a new injury and he ordered Westmoreland to pay all medical expenses incurred by Claimant as a result of the 1981 Decision. The WCAB applied Bowlaway Lanes and affirmed. Westmoreland appealed to the Commonwealth, which also affirmed, holding that the Judge had substantial evidence in support of his finding that the replacement of Claimant’s knee prosthesis, as well as the subsequent treatments of his right knee, were all necessitated by a new injury suffered in 1981. 

What It Means to You

When an employee requires a new prosthesis due to damage or an injury sustained while working for another employer, the employer as of the date of the new injury is responsible for the cost of replacing the damaged prosthesis. The employer who originally provided the prosthesis, however, is responsible for the cost of replacing the prosthesis if the replacement is required because of normal wear or tear or obsolescence. See 77 P.S.§ 531(4). Please contact a Cipriani & Werner workers’ compensation lawyer to help you evaluate the facts of your specific case.
 

Sources

Bowlaway Lanes v. WCAB, 496 A.2d. 99 (Pa.Cmwlth 1985); Thiele, Inc. v. WCAB, 586 A.2d 489 (Pa.Cmwlth. 1991)