Case Law Update

August 4, 2014

J. Cucchi v WCAB (Robert Cucchi Painting, Inc.), __ A.3d __ (Pa. Cmwlth, No. 108 C.D. 2014, filed July 17, 2014).


The claimant had settled the indemnity portion of his workers’ compensation claim via compromise and release agreement. The employer then requested a utilization review of medical treatment provided by the claimant’s physical therapist. The utilization review found all aspects of treatment unreasonable and unnecessary. The claimant filed a UR petition. During the UR proceedings, the WCJ appointed an independent physical therapist to conduct an independent UR. The claimant’s UR petition was ultimately denied. The Board affirmed. The claimant appealed arguing that the WCJ had failed to issue a reasoned decision because he failed to adequately explain the reasons for his credibility determinations. The Commonwealth Court agreed.       


In reviewing the WCJ’s decision, the Court observed that the WCJ had failed to articulate any objective basis for deeming the opinions of the independent physical therapist or the employer’s medical expert more credible and persuasive than those of the claimant’s medical expert. While the WCJ stated that the opinions of claimant’s medical expert were “not convincing,” the WCJ failed to provide any explanation as to why nor did the WCJ resolve any conflicts between the clinical observations of claimant’s medical expert and the independent physical therapist. The WCJ had also failed to render any credibility findings with respect to claimant’s testimony about his positive response to treatment. Furthermore, while the WCJ relied on testimony that there was no evidence that claimant had objectively or functionally improved , the Court observed that functional improvement is not required for palliative treatment to be deemed reasonable or necessary.


Based on the Court’s finding that the WCJ had failed to issue a reasoned decision under Section 422(a) of the Act, the Board’s order was vacated and the matter was remanded back to the WCJ for (1) an explanation of his credibility determinations; (2) credibility determinations about claimant’s testimony; and (3) a determination as to whether the treatment under review was reasonable and necessary as palliative treatment.


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