Submitted: June 24, 2013
On Appeal from Decision of the Industrial Accident Board
H. Garrett Baker, Esquire, Nathan V. Gin, Esquire, Elzufon, Auston, Tarlov & Mondell, P.A., Attorneys for Appellant
Michael L. Sensor, Esquire, Perry & Sensor, Attorneys for Appellee
This is an appeal by United Dominion Industries ("Employer") of the July 23, 2012 decision ("Decision") of the Industrial Accident Board ("Board"). Joseph Uniatowski's ("Claimant's") filed with the Board a Petition to Determine Additional Compensation Due ("Petition"). In its Decision, the Board awarded to Claimant the medical costs at issue in the Petition as well as attorneys' fees. The Board concluded that Claimant's Petition was not barred by the five-year statute of limitations. Employer maintains that the Board erred as a matter of law when the Board concluded that the medical costs sought in Claimant's Petition were not barred by the statute of limitations.
FACTUAL AND PROCEDURAL CONTEXT
Claimant was working for Employer on August 1, 1999 when his lungs and respiratory system were injured in a compensable work accident ("August 1999 Work Accident"). Claimant received medical treatment and those medical bills were paid by worker's compensation insurance from November 1999 through April 2002. The last payment made for medical expenses during this period was on April 26, 2002. From February 22, 2000 until March 6, 2001, Claimant also received total disability benefits.
On March 7, 2001, Employer's insurance carrier sent Claimant's counsel an "Agreement and Receipt for Compensation Paid." The Receipt stated: "[C]laimant has the right within five years after the date of the last payment to petition the Industrial Accident Board for additional compensation." Eventually, in 2002, Claimant and Employer agreed to commute all Workers' Compensation benefits, except for medical treatment, which was left open.
More than seven years passed before Claimant sought payment for additional medical expenses which he claimed were treatment for injuries related to the August 1999 Work Accident. From August 13, 2009 to February 12, 2011, medical expenses were paid by the insurer without objection. (These payments were compensation for treatment received between August 2009 and April 2010.) However, the insurer denied coverage for medical care submitted by a bill dated October 18, 2011, and refused to pay additional medical expenses. Shortly thereafter, Claimant filed the Petition at issue in this appeal.
Employer argued to the Board that the statute of limitations expired five (5) years after April 26, 2002, the last payment of medical bills before the seven-year gap in a claim received. Employer further argued that medical expenses reimbursed from August 2009 through February 2011 were reimbursed in error and did not operate to revive the statute of limitations. According to Employer, medical expenses reimbursed from August 2009 through February 2011 were the result of error and any additional payments were barred by the statute of limitations.
Employer's contentions were rejected by the Board which concluded that Claimant's medical expenses should be paid because they were not time-barred. Specifically, the Board concluded that the payments made from August 2009 through February 2011were made under a feeling of compulsion which tolled the statute of limitations. The Board rejected the testimony of the insurance adjuster who testified that the later payments were made by mistake, finding that the testimony was not credible under the circumstances presented.
STANDARD OF REVIEW
On appeal from the Industrial Accident Board, the Superior Court must determine if the Board's factual findings are supported by substantial evidence in the record. "Substantial evidence" is less than a preponderance of the evidence but is more than a mere scintilla. It is "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." The Court must review the record to determine if the evidence is legally adequate to support the Board's factual findings. The Court does not "weigh evidence, determine questions ...