The Supreme Court holds that a claimant's receipt of pension benefits is not a presumption of retirement but is, instead, an inference that must be considered in connection with the totality of the circumstances.

City of Pittsburgh and UPMC Benefit Management Services, Inc. v. WCAB (Robinson); 18 WAP 2011; decided 3/25/13; by Chief Justice Castille

 

The Pennsylvania Supreme Court clarified the employer's burden of proof with respect to a petition to suspend benefits based on a claimant's retirement. In this case, the claimant started receiving a disability pension after her work injury. The employer then petitioned to suspend benefits, asserting the claimant had voluntarily removed herself from the work force and had not looked for a job in the general labor market. The claimant challenged the petition, presenting evidence that she was registered to work with the Pennsylvania Job Center but was not employed due to the unavailability of work and because the employer had eliminated a light-duty position that she had held.

 

The Workers’ Compensation Judge denied the petition, concluding that the claimant was forced into disability retirement when the light-duty position was eliminated. The Appeal Board affirmed, as did the Commonwealth Court. In affirming the decisions below, the court held that, in a petition based on the retirement of a claimant, the employer must show, by the totality of the circumstances, that the claimant has chosen not to return to the work force. In other words, the mere acceptance of a pension by a claimant does not equate with retirement.

 

The Supreme Court of Pennsylvania agreed with the Commonwealth Court and provided further clarification with respect to the employer's burden of proof in retirement cases. According to the Court, where an employer challenges the entitlement to continuing compensation on the grounds that the claimant has removed himself or herself from the work force by retiring, the employer has the burden of proving that the claimant has voluntarily left the work force. There is no presumption of retirement from the fact that a claimant seeks or accepts a pension. The acceptance of a pension entitles the employer to a permissive inference of retirement, and such an inference, on its own, is not sufficient evidence to establish retirement. The inference that arises from an acceptance of pension benefits must be considered in the context of the totality of the circumstances.

SIDE BAR:This is a beneficial decision from the Supreme Court because it gives employers and their counsel guidance on what evidence is needed to obtain a suspension of benefits on the basis of voluntary removal from the workforce. If a workers' compensation claimant seeks a pension, this should raise a red flag of retirement for employers and they should notify their counsel. A claimant's pursuit or receipt of pension benefits may provide the basis for a suspension petition. But this fact alone will not win the day. As the Supreme Court makes clear, there are other factors that will be considered in determining whether there has been voluntary removal from the workforce, such as the claimant's acceptance of a retirement pension or the acceptance of a pension and refusal of suitable work within the claimant's restrictions.  

For additional information, contact Francis at 610.354.8263 or fxwickersham@mdwcg.com.