Results – Our Cases Change the Law – In the Pa. Commonwealth Court

Cases That Change The Law – A Record of Results That Help Accident Victims & Protect Rights

Other law firms follow the leaders. We are The Leaders. Attorney Daniel J. Siegel’s precedent-setting Workers’ Compensation and personal injury cases have assured or increased the benefits of more injured persons than any law firm in Pennsylvania. Here are some of our Pennsylvania Commonwealth Court victories:

Caldwell v. Towanda (Workers’ Comp. Appeal Board), 337 A.3d 991 (Pa.Cmwlth. 2025)

The Commonwealth Court held the proper analysis of whether a worker is a “seasonal employee” must focus on the nature, scope, and duration of the claimant’s duties and employment relationship. The WCJ, however, focused on the period the work was performed rather than the character of the work.

Pioneer Constr. Co. v. Insight Pharm., LLC, 338 A.3d 234 (Pa.Cmwlth. 2025)

The Pennsylvania Commonwealth Court held that (1) the Workers’ Compensation Judge lacked subject matter jurisdiction to join a provider as a party to the Review Petition and to order it to reimburse an insurer because the Workers’ Compensation Act does not provide a reimbursement remedy for insurers that overpay providers; (2) the trial court erred by not striking the judgment against the provider because Section 428 of the Workers’ Compensation Act authorizes only employees or dependents to seek judgment against employers or insurers, not insurers against pharmacies; and (3) the WCJ’s subject matter jurisdiction can be challenged at any time and cannot be waived, even when a party fails to appeal the WCJ’s decision.

L.F.V. v. S. Phila. High School, 340 A.3d 395 (Pa.Cmwlth. 2025)

Counsel for Amicus Curiae Pennsylvania Association for Justice. The Pennsylvania Commonwealth Court held that political subdivisions are not immune under the Political Subdivision Tort Claims Act from a student’s lawsuit alleging negligence in supervising and protecting her from sexual assault by other students, applying the “sexual abuse exception” to governmental immunity and affirming the trial court’s denial of the District’s immunity-based preliminary objections.

Brown-Boyd v. Southeastern Pennsylvania Transportation Authority, 320 A.3d 872 (Pa.Cmwlth. 2024)

The Pennsylvania Commonwealth Court held that where a party suffered injuries while attempting to exit a public bus, the claim was within the vehicle exception under 42 Pa.C.S.A. § 8522(b)(1), because the bus driver was operating the public bus when she stopped to allow the decedent to exit.

Philadelphia Surgery Center v. Excalibur Insurance Management Services, LLC. (Bureau of Workers’ Comp. Fee Review Hearing Office), 289 A.3d 157 (Pa.Cmwlth. Jan. 27, 2023)

The Pennsylvania Commonwealth Court held that the Workers’ Compensation Fee Review Section Hearing Officers may determine the fact and amount of an overpayment. In the absence of legislative authority permitting the Bureau to direct a provider to reimburse an insurer for an overpayment of fees for medical services, neither the Hearing Office nor a Court may create such authority in contravention of the Act.

UPMC Ben. Mgmt. Servs. v. United Pharmacy Servs. (Bureau of Workers’ Comp. Fee Review Hearing Office), 287 A.3d 474 (Pa.Cmwlth.. Dec. 15, 2022)

The Pennsylvania Commonwealth Court held that, although liability for a claimant’s prescribed treatment may only be disputed through a utilization review, when an employer or insurer also seeks to render a provider’s fee review application premature, a dispute regarding the causal connection between the prescribed treatment and the underlying work injury must be reframed as a challenge to the reasonableness and necessity of the treatment through the utilization review process.

Omni Pharmacy Services, LLC v. Bureau of Workers’ Comp Fee Review Hearing Office (American Interstate Insurance Co.), 241 A.3d 1273 (Pa.Cmwlth. 2020)

The Pennsylvania Commonwealth Court held that insurers may not deny payment for medical care to injured workers under the Workers’ Compensation Act based upon causal relatedness without requesting a Utilization Review; the denial for causal relatedness is for all intents and purposes (a fortiori) a denial that the treatment, medication, etc. is not reasonable or necessary.

Workers First Pharmacy Services, LLC v. Bureau of Workers’ Comp Fee Review Hearing Office, 225 A.3d 613 (Pa.Cmwlth. 2020)

The Pennsylvania Commonwealth Court held that insurers may not deny payment for medical care to injured workers under the Workers’ Compensation Act based upon causal relatedness without requesting a Utilization Review.

Workers First Pharm. Servs., LLC v. Bureau of Workers’ Comp. Fee Review Hearing Office (Cincinnati Ins. Co.), 216 A.3d 544 (Pa.Cmwlth. 2019)

The Pennsylvania Commonwealth Court held that the parties to a Compromise and Release Agreement cannot use the Agreement to release themselves from liability to a provider who did not participate in the agreement.

Armour Pharm. v. Bureau of Workers’ Comp. Fee Review Hearing Office (Wegman’s Food Markets, Inc.), 206 A.3d 660 (Pa.Cmwlth. 2019)

The Pennsylvania Commonwealth Court held that it offended due process under Pa. Const. Art. V, § 9 and the Workers’ Compensation Act’s scheme for resolving fee disputes to place the question of whether a putative provider was actually a “provider” beyond the reach of judicial review. Accordingly, when an employer challenges a fee determination of the Medical Fee Review Section for the stated reason that the medical service was not rendered by a “provider” within the meaning of the Act, that threshold question must be decided by the Hearing Office.

Armour Pharm. v. Bureau of Workers’ Comp. Fee Review Hearing Office (National Fire Ins. Co. of Hartford), 192 A.3d 304 (Pa.Cmwlth. 2018)

The Pennsylvania Commonwealth Court held – for the first time – that medical providers who treat injured workers under the Workers’ Compensation Act are entitled to due process and that the parties to a Compromise and Release Agreement may bind each other, but cannot release themselves from liability to a person who is not a party to the Agreement who has been given neither notice nor opportunity to be heard on the Agreement.

Holy Redeemer Health Sys. v. Workers’ Comp. Appeal Board (Lux), 163 A.3d 498 (Pa.Cmwlth. 2017)

The Pennsylvania Commonwealth Court held that a claimant suffered a loss of earning power attributable to her work-related injury when she returned to work in a modified-duty position with her pre-injury employer and thereafter accepted a permanent position specifically created and offered to her at a loss of wages.

Verizon Pennsylvania Inc. v. Workers’ Compensation Appeal Board (Ketterer), 87 A.3d 942 (Pa.Cmwlth. 2014)

The Pennsylvania Commonwealth Court held that a physician must have an active clinical practice, i.e., the physician must provide preventive care and the evaluation, treatment, and management of medical conditions, at least 20 hours per week, in order to be qualified to perform Impairment Rating Evaluations under Section 306(a.2)(1) of the Workers’ Compensation Act, 77 P.S. § 551.2(1).

Philadelphia Gas Works v. Workers’ Compensation Appeal Board (Amodei), 964 A.2d 963 (Pa.Cmwlth. 2009)

This en banc Pennsylvania Commonwealth Court decision held that when an employer seeks an offset from workers’ compensation benefits for pension benefits paid to an injured employee, the offset must be calculated based upon the net amount of the benefits received by the worker.

Denny’s v. Workmen’s Compensation Appeal Board (Stanton), 142 Pa.Cmwlth. 531, 597 A.2d 1241 (Pa.Cmwlth. 1991)

The Pennsylvania Commonwealth Court held that actions by employees that are in furtherance of an employer’s business, thus requiring an employer to provide worker’s compensation benefits to employees injured under the circumstances.

Results – Our Cases Change the Law – In the Pa. Superior Court

Insurance companies know that we will fight – and win – cases, no matter how hard the battle. That’s why they often settle with us for greater amounts to avoid the appeal.

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