Arbitrator’s Decision in PA Heart and Lung Hearing is Not Binding on Workers’ Compensation Judge

While issue preclusion generally applies to the decisions of Workers’ Compensation Boards and Commissions, just as it does generally to court decisions [see, e.g., Larson’s Workers’ Compensation Law, § 127.07], the rule does not apply as broadly to decisions of arbitrators. Accordingly, an award of benefits by an arbitrator assigned to hear a Pennsylvania correction officer’s grievance of the denial of his Heart and Lung Act [53 Pa. Stat. Ann. §§ 637–638] did not collaterally estop a state workers’ compensation judge from making her own determination as to the claimant’s disability under the Workers’ Compensation Act [see Merrell v. Workers’ Comp. Appeal Bd. (Commonwealth Dept. of Corr.), 2017 Pa. Commw. LEXIS 94 (Apr. 3, 2017)].

Background

Claimant, a Pennsylvania correction officer trainee, awkwardly bent his right knee while carrying food trays down a flight of steps. X-rays were negative. After Claimant was given a knee immobilizer and pain medication, he returned to work to complete his shift. Two days later, Claimant saw another physician who ordered an MRI. A few weeks later, Claimant met with an orthopedic surgeon, who prescribed pain medication and suggested physical therapy. The surgeon released Claimant to return to work with restrictions. Claimant returned to work for a few days but could not continue, because of knee pain. Claimant returned to the surgeon, who again restricted him to sedentary work, which Employer did not have available.

Claimant filed a claim for benefits under the Heart and Lung Act, which generally allows police officers and other public safety employees, including corrections officers, to collect full salary benefits for temporary injuries sustained in the performance of their duties. Eventually, the arbitrator issued a decision granting heart and lung benefits.

Claimant subsequently filed a petition for workers’ compensation benefits, alleging his right knee hyperextension and medial compartment arthrosis were caused by the work incident and left him unable to work. Claimant argued that the arbitrator’s award was binding on the WCJ under the doctrine of collateral estoppel. The WCJ denied Claimant’s motion for an award of disability benefits, holding that she was not collaterally estopped by the arbitration award. The WCJ found that Claimant sustained a work injury,, but he did not prove a wage loss caused by the work injury. The WCJ granted Claimant’s claim petition for medical benefits only and Claimant appealed to the Board.

Before the Board, Claimant argued that the arbitration award resolved the issue of his disability and was binding in the workers’ compensation proceeding. The Board rejected this argument. The Board reasoned that the workers’ compensation case dealt with a potentially indefinite period of disability, whereas the Heart and Lung arbitration dealt only with temporary disability. The Board stressed that the stakes were lower in the previous proceedings and could not have a preclusive effect. Claimant appealed.

Appellate Decision

The Commonwealth Court observed that the sole issue was whether Employer had a full and fair opportunity to litigate the extent of Claimant’s disability. According to the Court, the arbitration proceeding mandated by a collective bargaining agreement was more ad hoc and informal than a proceeding governed by the Workers’ Compensation Act. The Court added that workers’ compensation was “highly regulated,” with substantially more oversight than the Heart and Lung Act. Most critical in a disputed workers’ compensation claim was medical evidence on causation, which must be sufficiently definite to render it admissible. The introduction of medical evidence in a Heart and Lung claim was much easier. Nor was an arbitrator’s decision required to exhibit the level of reasoning and explanation mandated in the Workers’ Compensation Act.

Because an arbitration and a workers’ compensation proceeding were “substantially different,” Accordingly, the arbitrator’s award of Heart and Lung benefits did not collaterally estop the WCJ from making her own determination as to Claimant’s disability. The Court affirmed the Board’s Order.

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