In Lewis v. W.C.A.B. (Giles & Ransome, Inc.), 919 A.2d 922 (2007), the Pennsylvania Supreme Court issued an opinion detailing the high burden of proof employers face in attempting to terminate an injured employee’s workers’ compensation benefits. In general, a workers’ compensation judge may modify or terminate a claimant’s benefits when it has been demonstrated that the claimant’s disability (loss or earnings power) has changed.
In Lewis, the employer had unsuccessfully attempted to terminate the Claimant’s benefits on three prior occasions. The employer subsequently filed another Termination Petition. In support of its fourth Termination Petition, the employer presented expert testimony from a medical witness who acknowledged that Claimant was suffering from the same condition and the same disorders which had previously been diagnosed. The employer’s medical expert merely attempted to recharacterize the cause of Claimant’s condition.
Where there have been prior petitions to modify or terminate workers’ compensation benefits, the employer seeking modification or termination of benefits must demonstrate a change in physical condition since the last disability determination. Because the employer did not produce evidence that Claimant’s medical condition had improved,the Lewis Court held that the employer’s Termination Petition was barred by issue preclusion.
The Lewis decision precludes an employer from re-litigating the cause of a claimant’s condition or symptoms. Once it has been determined that a claimant is disabled due to a particular condition or symptoms, the only way an employer can subsequently terminate or modify the claimant’s benefits is to produce expert medical testimony establishing an improvement in claimant’s physical condition which results in an increase in Claimant’s earnings power.
John P. Finnerty, Esquire