In a recent Pennsylvania Superior Court case, the court allowed a tort claim for intentional infliction of emotional distress against a workers’ compensation insurance company to proceed, despite the exclusivity provision of the Pennsylvania Workers’ Compensation Act. Charlton v. PMA Insurance Group, Pennsylvania Superior Court, November 6, 2015. Visit the Pennsylvania Workers’ Compensation Law Library.
The plaintiff was an injured worker who was receiving workers’ compensation benefits for a work injury in 1986. That accident left him with physical and emotional injuries. The workers’ compensation insurance company, PMA, had been providing mental health treatment, as well as medical benefits and indemnity (wage loss). During the mental health treatment, the plaintiff disclosed that he had been sexually abused during childhood. Several years later, a PMA claims representative reviewed the mental health treatment provider’s notes while conducting an eligibility review.
The claims rep contacted the plaintiff and referenced the child sexual abuse, stating that PMA was tired of paying for “something that happened…as a child.” PMA then demanded that the plaintiff settle his workers’ compensation claim.
Plaintiff filed a claim against PMA alleging intentional infliction of emotional distress. He alleged that he suffered further mental harm because he believed that the claims rep’s comments were meant to shame him.
Workers’ Compensation Exclusivity in Pennsylvania Work Accident Cases
The workers’ compensation insurance company argued that the plaintiff’s claims were barred by the exclusivity provision of the workers’ compensation law. The exclusivity provision bars any negligence (injury/accident) lawsuits which result from a work injury. In a nutshell, under PA law, an employer is immune (i.e., workers’ compensation is the exclusive remedy against the employer) from a lawsuit brought by an injured employee due to a work hazard.
For example, a worker is injured due to the employer’s failure to provide a safe work place. In general, the worker is barred from bringing suit against the employer for the unsafe condition that caused the work accident in the first place; workers’ compensation benefits are the exclusive remedy. It’s important to note that there are several exceptions to the exclusivity rule, such as the employer’s wrongful, intentional conduct.
The trial court agreed with the insurance company. On appeal, the court reversed, finding in favor of the injured worker. The Pennsylvania Superior Court held that because the alleged injury was aggravation of a non-work related injury, the exclusivity provision did not apply. Conversely, if the alleged injury was aggravation of a work related injury, the exclusivity provision would have applied.
This recent workers’ compensation case is a very interesting one and represents a unique set of circumstances. These kinds of cases are rare—lawsuits filed directly against a workers’ compensation insurance company. Courts generally construe the workers’ compensation exclusivity provision pretty broadly. If the injury has anything to do with the nature of the work or the job, workers’ compensation is usually the exclusive remedy.
Compensation for Work Injuries in Pennsylvania – Laffey, Bucci & Kent
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