Daniels v. WCAB (Tristate Transport)

• Court: Pennsylvania Supreme Court
• Writing for the Court: FLAHERTY, C.J., and ZAPPALA, CAPPY, CASTILLE, NIGRO, NEWMAN and SAYLOR, JJ.
• Citation: Daniels v. WCAB (Tristate Transport), 828 A.2d 1043, 574 Pa. 61 (Pa. 2003)
• Decision Date: 22 July 2003
• Parties: Wayne DANIELS, Appellant v. WORKERS' COMPENSATION APPEAL BOARD (TRISTATE TRANSPORT), Appellee.

828 A.2d 1043

574 Pa. 61

Wayne DANIELS, Appellant v. WORKERS' COMPENSATION APPEAL BOARD (TRISTATE TRANSPORT), Appellee.

Supreme Court of Pennsylvania.

Argued October 15, 2001.

Decided July 22, 2003.

Kathy Kennedy, for Wayne Daniels, Appellant.

Amber Marie Kenger, Mechanicsburg, for W.C.A.B., Appellee.

Jonathan F. Ball, for Tristate Transport, Appellee.

Before: FLAHERTY, C.J., and ZAPPALA, CAPPY, CASTILLE, NIGRO, NEWMAN and SAYLOR, JJ.

OPINION OF THE COURT

JUSTICE CASTILLE.

This Court granted allowance of appeal to determine whether the Workers' Compensation Judge ("WCJ") in this case failed to adequately explain on the record why she rejected claimant/appellant's conflicting medical evidence pursuant to Section 422(a) of the Workers' Compensation Act ("the Act"). See 77 P.S. § 834 (effective August 23, 1996). For the following reasons, we vacate and remand to the WCJ for proceedings consistent with this opinion.

On December 13, 1990 appellant was involved in a motor vehicle accident while in the course and scope of his employment with his employer, Tristate Transport. He filed a claim petition for workers' compensation benefits alleging injury to his lumbosacral spine and continuing lower back pain with radiation into his lower extremities. On August 10, 1991 the WCJ found that appellant had sustained a work-related injury and awarded benefits at the rate of $200 per week as of December 14, 1990. On January 9, 1992 Employer filed a termination petition, alleging that as of November 7, 1991 appellant's disability had ceased and he was able to return to work without restrictions. On February 19, 1992 appellant filed an answer denying Employer's allegations and claiming that he remained temporarily totally disabled.

The medical expert evidence concerning the status of appellant's work injury was disputed. Employer submitted the deposition testimony of John T. Williams, M.D., a board-certified orthopedic surgeon, who had examined appellant on November 7, 1991. Dr. Williams opined that appellant had sustained an acute lumbosacral strain and sprain that had since resolved and, thus, appellant was able to return to work without restrictions. In reaching his diagnosis, Dr. Williams did not review the x-rays, CAT scan, and nerve conduction tests which had been previously performed on appellant sometime between mid-December 1990 and November 7, 1991.

Appellant rebutted this evidence by submitting the deposition testimony of Dr. Steven Fabian, M.D., a family physician and appellant's treating physician, who first examined appellant on the date of his work injury. During this examination, Dr. Fabian determined that appellant suffered from spasms in the paraspinal muscles of the cervical and lumbar regions, and that appellant had a 45% limitation of motion in his cervical spine and a 50% limitation of flexion, extension, and rotation in the lumbar region of his back. After nine months of physical therapy, Dr. Fabian found that appellant had hit a plateau of a 20-25% limitation of motion. Dr. Fabian had last examined appellant on October 16, 1992, at which time appellant complained of pain in his lumbar spine and legs. Based upon that examination Dr. Fabian opined that appellant's limitation of cervical flexion, extension, and rotation had improved substantially, i.e., it was now at 15%. Dr. Fabian also opined that appellant suffered from post-traumatic cervical and lumbar sprain with a protruding disc at L-4-5 level. Dr. Fabian reviewed the CAT scan, which revealed a mildly concentrically protruding disc at level L-4-5 and a normal EMG. Dr. Fabian opined that appellant could not return to his duties as an ambulance driver with Employer, or to any other employment at that time, as he still experienced pain which was exacerbated by physical activity. Dr. Fabian also noted that appellant had limited mobility in his back which precluded him from doing any active physical work, sitting for periods of more than fifteen to twenty minutes, or walking more than short distances.

Appellant testified before the WCJ on December 10, 1992 and claimed that his lower back and legs had continued to bother him since the work injury. Appellant stated that he still could not stand or sit for more than one hour; he experienced pain in his lower back when he walked; and he could lift only twenty pounds. Due to his continued pain and limited mobility, appellant testified, he did not think he could return to work with Employer in his pre-injury capacity as an ambulance driver, a job which required him to lift patients and equip ambulances with items such as oxygen tanks weighing up to one hundred pounds. Appellant further testified that he was receiving physical therapy three times a week, that he sees Dr. Fabian once a week, and that he takes Tylenol with codeine for pain.

The WCJ filed her decision on March 14, 1997, finding in favor of Employer and ordering the termination of appellant's benefits as of November 7, 1991.¹ After summarizing the testimony of Dr. Williams, Dr. Fabian, and appellant, the WCJ made the following, determinative findings:

16. Based upon a review of the evidentiary record as a whole, this Judge finds the testimony of the Claimant is not credible or persuasive.

17. Based upon a review of the evidentiary record as a whole, this Judge finds the opinions of Dr. Williams to be more credible and persuasive than the opinions of Dr. Fabian. Accordingly, the opinions of Dr. Fabian are rejected wherever inconsistent with the opinions of Dr. Williams.

18. This Judge finds Claimant was fully recovered from his December 13, 1990 work injury as of November 7, 1991.

WCJ's Decision at 4.

Appellant appealed to the Workers' Compensation Appeal Board ("WCAB"), which affirmed the WCJ's termination decision. Upon further appeal, the Commonwealth Court, sitting en banc, affirmed by a 5-2 vote. Daniels v. Workers' Compensation Appeal Bd. (Tristate Transport), 753 A.2d 293 (Pa.Cmwlth.2000). On the salient question presented here—i.e., the contours of the "reasoned decision" requirement set forth in Section 422(a) of the Act in a case where the WCJ is presented with conflicting evidence—the majority opinion by Judge Kelley noted that questions of credibility and weight of the evidence fall within the exclusive province of the WCJ as fact-finder. Id. at 303. The majority then found that the WCAB had "properly determined that the WCJ provided an adequate explanation for her determination by outlining all of the evidence considered, stating the credible evidence on which she relied, and setting forth the reasons for the ultimate denial of Employer's termination petition." Id. at 305.²

Judge Friedman, joined by Judge Pellegrini, dissented. The dissent noted that the WCJ had "made no attempt to explain, much less to adequately explain, her reasons for rejecting or discrediting competent evidence," as required by the 1996 amendment to Section 422(a) of the Act. Id. at 307. Although the dissent did not dispute that the WCJ was authorized to make credibility determinations, in the dissent's view the WCJ's failure to explain the basis for her credibility determination where the evidence was conflicting did not satisfy the reasoned decision requirement. The dissent also acknowledged Employer's argument that the fact that the WCJ had listed her findings and pointed to "telling portions of the record," made it "not hard to imagine how the WCJ reached her conclusions." But, the dissent noted that this argument merely illustrated the dissent's point: "the 1996 amendments have cleared any doubt as to the legislature's intent to prevent the parties from having to `imagine' why certain credibility determinations were made." Id. at 308. Accordingly, the dissent would have remanded the matter for the WCJ to provide an adequate explanation of the reason(s) for discrediting appellant's competent evidence. Id. at 309.

In workers' compensation appeals, this Court must affirm the adjudication below unless we find that an error of law was committed, that constitutional rights were violated, that a practice or procedure of a Commonwealth agency was not followed or that any necessary finding of fact is not supported by substantial evidence of record. 2 Pa.C.S. § 704; Mitchell v. Workers' Compensation Appeal Bd. (Steve's Prince of Steaks), 572 Pa.380, 815 A.2d 620, 623-24 (2003); Reinforced Earth Co. v. Workers' Compensation Appeal Bd. (Astudillo), 570 Pa.464, 810 A.2d 99, 104 (2002) (plurality opinion). The specific question for this Court is a purely legal one, i.e., the proper construction of Section 422(a)'s reasoned decision requirement in a case with conflicting evidence. Our review of this question is plenary. See Murphy v. Duquesne Univ. of the Holy Ghost, 565 Pa. 571, 777 A.2d 418, 429 (2001) (citation omitted).

Section 422(a) provides, among other things, that the parties in a workers' compensation case are "entitled to a reasoned decision containing findings of fact and conclusions of law based upon the evidence as a whole which clearly and concisely states and explains the rationale for the decisions so that all can determine why and how a particular result was reached." 77 P.S. § 834. The statute also requires the WCJ to specify the evidence upon which he or she is relying, and to state the reasons for accepting that evidence. Id. In 1996, the General Assembly amended Section 422(a) to further elucidate the requirement for a reasoned decision, by adding the following two sentences:

When faced with conflicting evidence, the workers' compensation judge must adequately explain the reasons for rejecting or discrediting competent evidence. Uncontroverted evidence may not be rejected for no reason or for an irrational reason; the workers' compensation judge must identify that evidence and explain adequately the reasons for its rejection.

Id. Section 422(a) concludes by noting that the WCJ's adjudication shall "provide the basis for...