Form (Literally) Over Substance

Shirley Hilton worked as a second-grade teacher for the School District of Philadelphia at Frances D. Pastorius Elementary School, overseeing a class of students with behavioral problems.

On March 3, 2009, Hilton went to see Dr. Wilfreta Baugh, complaining of heart palpitations, headaches, dizziness and nausea after a particularly difficult day with her challenging classroom.

The doctor's office then telephoned the school and informed the school that Hilton would not be returning to work due to the overly stressful environment.

In June 2009, the school district assigned Hilton to teach at the Jay Cooke Elementary School starting that September, but she did not report for duty as she was still undergoing treatment for her job-related stress from the Pastorius assignment.

Hilton filed a claim petition in October 2009, alleging that due to stress from an abnormal working environment at Pastorius, she was totally disabled.

She specifically alleged that she had sustained a vocal cord injury and had aggravated her pre-existing lupus and heart murmur in March 2009. Hilton requested payment for medical bills and the loss of wages from March 3, 2009, to May 21, 2009, and from May 28, 2009, into the future.

A workers' compensation judge granted Hilton's claim petition as to the period from March 3, 2009, until Sept. 30, 2009, which was the day the teaching job at Cooke would have become available.

The Workers' Compensation Appeal Board affirmed the WCJ's award of benefits, but reversed the part of the decision suspending benefits as of Sept. 30, 2009.

The school district then sought judicial review, and the Commonwealth Court in January ruled that the WCJ was correct in cutting off Hilton's benefits.

The court reasoned that Hilton was not disabled from working as a teacher “as long as she did not work somewhere like Pastorius school,” so she was not entitled to benefits after September 2009, when she could have begun working at the less stressful Cooke school.

The court also said that the school district did not need to issue Hilton a notice that it perceived her as being able to work at this new assignment since the reassignment had not been based on a change in her medical condition, and she was not yet receiving benefits at the time the district offered her the position.

Hilton appealed to the Supreme Court, arguing that she was entitled to get a Notice of Ability to Return to Work before her benefits could be suspended, and that the medical evidence did not establish that she was able to return to work as of Sept. 30, 2009.

The Supreme Court granted review of Hilton's case last Wednesday.

At issue is a conflict in the law.

The Commonwealth Court previously held that an employer must provide a worker with an LIBC Form 757 as a prerequisite to suspending benefits.

The form, called a Notice of Ability to Return to Work, informs the worker that her employer considers her able to resume some form of employment and advises her that she has an obligation to look for work if she is able to work, otherwise benefits may be lost.

Section 306(b)(3) of the Workers' Compensation Act requires an insurance carrier to issue a notice to an injured worker any time it receives medical evidence indicating that the worker is able to resume any form of employment. But it does not predicate an employer’s ability to suspend a worker's benefits based on her ability to return to work.

By contrast, Section 413(a.1) expressly says that a carrier must provide notice to a worker, on the form designated by the Department of Labor & Industry, before seeking a suspension of benefits based on the worker's return to work at her prior or increased earnings.

This is all very good and well from a technical legal aspect, but the case glosses over the fact that Hilton didn't go back to work in any capacity. And reading between the lines it doesn't seem there is any intention to do so.

The Supreme Court will review and decide a procedural matter, but the substance of the case - that a teacher did not go back to work even though medically there was a qualifying job - is ignored.

The story is in WorkCompCentral this morning (payment/subscription required).