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Giant Eagle

March 13, 2012

GIANT EAGLE, INC., APPELLANT
v.
WORKERS' COMPENSATION APPEAL BOARD (GIVNER), APPELLEE



Appeal from the Order of the Commonwealth Court entered November 18, 2009 at No. 813 CD 2009, affirming the Order of the Workers' Compensation Appeal Board entered March 31, 2009 at No. A08-1066. The opinion of the court was delivered by: Mr. Justice McCAFFERY

CASTILLE, C.J., SAYLOR, EAKIN, BAER, TODD, McCAFFERY, ORIE MELVIN, JJ.

SUBMITTED: October 13, 2010

OPINION ANNOUNCING THE JUDGMENT OF THE COURT

In this appeal, we consider whether "compensation," as the word is used in Section 314(a) of the Workers' Compensation Act ("Act"),*fn1 77 P.S. § 651(a), must include medical benefits as well as wage loss benefits. Because we conclude that it does not, we affirm the order of the Commonwealth Court.

Quila Givner ("Claimant") suffered a work-related injury on June 4, 1998, while in the employ of Appellant, Giant Eagle, Inc. ("Employer"). Pursuant to a notice of compensation payable, she received workers' compensation benefits that were ultimately calculated to be $266.87 weekly for a partial disability.

On October 29, 2007, Employer filed a suspension petition pursuant to Section 314(a), alleging that Claimant had failed to attend a physical examination scheduled by Employer. Section 314(a) relevantly provides:

§ 651. Examination of injured employee; refusal or neglect to submit to

(a) At any time after an injury the employe, if so requested by his employer, must submit himself at some reasonable time and place for a physical examination or expert interview by an appropriate health care provider or other expert, who shall be selected and paid for by the employer. If the employe shall refuse upon the request of the employer, to submit to the examination or expert interview by the health care provider or other expert selected by the employer, a workers' compensation judge assigned by the department may, upon petition of the employer, order the employe to submit to such examination or expert interview at a time and place set by the workers' compensation judge and by the health care provider or other expert selected and paid for by the employer or by a health care provider or other expert designated by the workers' compensation judge and paid for by the employer. ... The refusal or neglect, without reasonable cause or excuse, of the employe to submit to such examination or expert interview ordered by the workers' compensation judge, either before or after an agreement or award, shall deprive him of the right to compensation, under this article, during the continuance of such refusal or neglect, and the period of such neglect or refusal shall be deducted from the period during which compensation would otherwise be payable.

77 P.S. § 651(a).

Following a hearing held on December 3, 2007, the workers' compensation judge ("WCJ") issued an order directing Claimant to attend a physical examination on December 12, 2007, with Employer making the transportation arrangements to facilitate her attendance. The order also provided that, should Claimant fail to attend the examination without good cause, such failure could "result in suspension of [C]laimant's wage loss benefits." WCJ Order, dated 12/3/08, at 1.

At the hearing, Claimant agreed to attend the December 12th physical examination. However, she failed to do so, and Employer filed another suspension petition on December 17, 2007, again requesting a suspension of benefits pursuant to Section 314(a) of the Act.

On March 3, 2008, the WCJ held a hearing on the petition, which hearing Claimant failed to attend although notice was sent to her. The WCJ permitted Employer to submit its evidence, and thereafter, by Decision and Order dated May 16, 2008, the WCJ suspended Claimant's wage loss benefits effective December 12, 2007, because of her failure to attend the scheduled physical examination. The WCJ further ordered such suspension to remain in effect until such time as Claimant submitted to a physical examination by a physician of Employer's choice.

Employer appealed to the Workers' Compensation Appeal Board ("WCAB"), contending that the WCJ had erred by suspending only wage loss benefits and not medical expense benefits as well. The WCAB rejected Employer's arguments, citing O'Brien v. Workers' Compensation Appeal Board (Montefiore Hospital), 690 A.2d 1262, 1265 n.6 (Pa.Cmwlth. 1997), for the proposition that case law has recognized a distinction concerning the nature of "compensation" depending on whether an employer's liability has or has not been established. The WCAB interpreted O'Brien as supporting the determination that medical expenses are included as "compensation" under the Act when the employer has not yet been determined to be liable, but medical expenses are not included as compensation when liability has been established, as it had been in the case sub judice.*fn2 Finding no authority in the Act that required the adoption of Employer's interpretation of compensation under Section 314(a), the WCAB concluded that the WCJ had committed no error.

On further appeal, the Commonwealth Court affirmed in a published opinion. Giant Eagle, Inc. v. Workers' Compensation Appeal Board (Givner), 984 A.2d 1034 (Pa.Cmwlth. 2009). The Commonwealth Court, like the WCAB before it, principally relied upon the O'Brien footnote, ultimately concluding: "As case law is otherwise silent on this issue, and the [WCAB's] decision is perfectly logical, we decline to hold that in making such a finding the [WCAB] committed an error of law." Giant Eagle, supra at 1036. The Commonwealth Court then extended its holding by determining that a WCJ could, within her or his discretion, suspend both medical and wage loss benefits pursuant to Section 314(a) as the case required. The court stated in this regard: "Noting the humanitarian purposes of the Act, we hold that where a WCJ would suspend both wage loss benefits and medical benefits, the WCJ must expressly state that medical benefits are suspended in addition to wage loss benefits." Id.

We accepted review of this case, limited to consideration of the following issue, which we rephrased for clarity:

Whether "compensation" must include medical benefits as well as wage loss benefits under section 314(a) of the Workers' Compensation Act.

Giant Eagle, Inc. v. Workers' Compensation Appeal Board (Givner), 994 A.2d 1083 (Pa. 2010) (per curiam).

Our standard of review of an agency decision is limited to determining whether there has been a constitutional violation, an error of law, or a violation of agency procedure, and whether necessary findings of fact are supported by substantial evidence. Section 704 of the Administrative Agency Law, 2 Pa.C.S. § 704; Pieper v. Ametek-Thermox Instruments Division, 584 A.2d 301, 303 (Pa. 1990). When, as here, the issue is the proper interpretation of a statute, it poses a question of law; thus, our standard of review is de novo, and the scope of our review is plenary. Borough of Heidelberg v. Workers' Compensation Appeal Board (Selva), 928 A.2d 1006, 1009 (Pa. 2007).

"The object of all interpretation and construction of statutes is to ascertain and effectuate the intention of the General Assembly. Every statute shall be construed, if possible, to give effect to all its provisions." 1 Pa.C.S. § 1921(a). "In giving effect to the words of the legislature, we should not interpret statutory words in isolation, but must read them with reference to the context in which they appear." Mishoe v. Erie Insurance Co., 824 A.2d 1153, 1155 (Pa. 2003) (quoting O'Rourke v. Department of Corrections, 778 A.2d 1194, 1201 (Pa. 2001)).

Further, "[o]ur basic premise in work[ers'] compensation matters is that the Work[ers'] Compensation Act is remedial in nature and intended to benefit the worker, and, therefore, the Act must be liberally construed to effectuate its humanitarian objectives." Hannaberry HVAC v. Workers' Compensation Appeal Board (Snyder, Jr.), 834 A.2d 524, 528 (Pa. 2003) (quoting Peterson v. Workmen's Compensation Appeal Board (PRN Nursing Agency), 597 A.2d 1116, 1120 (Pa. 1991)). "Accordingly, borderline interpretations of the Act are to be construed in the injured party's favor." Id.

(quoting Harper & Collins v. Workmen's Compensation Appeal Board (Brown), 672 A.2d 1319, 1321 (Pa. 1996)).

Here, we are to determine whether the word "compensation" in Section 314(a) of the Act must include medical benefits as well as wage loss benefits. The Act does not define "compensation" and, as the WCAB and Commonwealth Court each noted below, the Act uses the term variously. Thus, one section of the Act will clearly evidence that the term only pertains to wage loss benefits, but another section of the Act will imply that the term encompasses medical benefits as well as wage loss benefits. For this reason, we have recognized that the definition of "compensation" as used in the Act must be decided on a section-by-section basis. Berwick Industries v. Workmen's Compensation Appeal Board (Spaid), 643 A.2d 1066, 1067 (Pa. 1994).

Standing on its own, Section 314(a) provides no concrete answer to whether its use of the term "compensation" must include medical benefits. It states in relevant part:

The refusal or neglect, without reasonable cause or excuse, of the employe to submit to such examination or expert interview ordered by the workers' compensation judge, either before or after an agreement or award, shall deprive him of the right to compensation, under this article, during the continuance of such refusal or neglect, and the period of such neglect or refusal shall be deducted from the period during which compensation would otherwise be payable.

77 P.S. § 651(a) (emphases added).

Section 314(a) requires that we determine what the General Assembly means by "the right to compensation, under this article." "[T]his article" references Article III of the Act, addressing issues of "Liability and Compensation," and providing the proper context for interpreting Section 314(a), which is found in Article III. However, the General Assembly specifically provided in Section 314(a) that "the period of such neglect or refusal shall be deducted from the period during which compensation would otherwise be payable." This language signals a focus on wage loss benefits, not medical benefits. Medical benefits are payable "as and when needed." 77 P.S. § 531(f.1). Wage loss benefits, by contrast, may be time-limited.*fn3 Thus, whether the General Assembly intended an exclusive focus on wage loss benefits as "compensation" is a possibility we must consider.

When we examine Article III of the Act, the shifting and sometimes uncertain nature of the General Assembly's use of the term "compensation" is readily apparent. In general, however, Article III uses the word "compensation" most frequently to denote wage loss benefits. We shall begin by examining some of those provisions.

The first section of Article III (Section 301), establishes an employer's liability to pay "compensation." It provides in pertinent part:

Every employer shall be liable for compensation for personal injury to, or for the death of each employe, by an injury in the course of his employment, and such compensation shall be paid in all cases by the employer, without regard to negligence, according to the schedule contained in sections three hundred and six and three hundred and seven of this article. .

77 P.S. § 431 (footnote omitted).

Section 301 specifically identifies two other sections of Article III as establishing the employer's liability for "compensation:" Sections 306 and 307. Section 307 provides for expenses for burial and a schedule of "death compensation" based on the deceased employee's wages. Medical expenses ...


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