What is a “medical-only” workers’ compensation claim?
In October, 2015, the
Pennsylvania Commonwealth Court analyzed a pivotal injury claim case, leading it to distinguish between a “Medical-Only Notice of Compensation Payable” and a full award of disability benefits including lost wages – two concepts with vastly different implications for the injured, out-of-work claimant.
In the case, known as Sloan v. W.C.A.B, an employee of the Children’s Hospital of Philadelphia injured her elbow while moving cervical traction weights for one of her patients. She made a workers’ compensation claim, which was accepted as a lateral epicondylitis of the right elbow. The injury was accepted by the employer as a Notice of Compensation Payable, and she was placed on partial disability with reduced pay.
In 2006, the claimant endured a second injury to her elbow and knee while attempting to restrain a patient. This time, however, the employer recognized her injury and provided for medical compensation only, as opposed to medical compensation and lost wages – a classification known as “medical-only NCP.”
In 2007, the claimant went through a total knee replacement, which she attributed to the 2006 incident causing her knee injury. In 2012, she filed for full disability benefits and the workers’ compensation judge found her totally disabled, and awarded her full disability compensation plus lost wages.
On appeal, to the Workers’ Compensation Board (WCB), the employer asserted that the claimant missed the 3-year statute of limitations for filing an injury claim. The claimant countered this argument by asserting that she was merely seeking a Reinstatement of Benefits (as opposed to an initial claim for benefits) – which allows for a 500-week statute of limitations from the date of the injury or the last payment of compensation. In rebuttal, the employer asserted that it never actually awarded full benefits in 2007, so there would be nothing to “reinstate” under the rules – and the 500-week statute of limitations was inapplicable.
In the end, the Commonwealth Court agreed: the statute of limitations for seeking lost wages in a “medical only NCP” case is 3 years from the date of the injury, and the NCP is not considered full “compensation” which would trigger reinstatement rules under the workers’ compensation guidelines.
To learn more about the distinction between a medical-only NCP case and the granting of full disability benefits, contact a
personal injury attorney knowledgeable in the field of workers' compensation.