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Home My WebLink About08-0998,~ r~ .~ LINDA ANTONETTY, Plaintiff v. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Civil Action -Law UNITED CHURCH OF CHRIST HOMES and ~ No. PMA INSURANCE, Defendants PRAECIPE FOR ENTRY OF DEFAULT JUDGMENT PURSUANT TO SECTION 428 OF THE WORKERS' COMPENSATION ACT, 77 P.S. §921 Pursuant to section 428ofthe Workers'CompensationAct, 77P.S. 921, enterjudgment against Defendants in the amount of $6,197.20 as provided by the Workers' Compensation Act, together with interest from 11/27/2007, as specified by section 406.1 of the Workers' Compensation Act, based upon the following: 1. On 11/27/2007, Workers' Compensation Judge Brian Eader issued a Decision and Order directing Defendants to pay the sum of $4,274.35 to Plaintiff, and to pay counsel fees in the amount of $1,800.00 and litigation expenses in the amount of $122.85 to Plaintiff's counsel. The total amount awarded was $6,197.20. A certified copy of that Decision is being filed along with this Praecipe. 2. By operation of section 428 of the Workers'CompensationAct, Defendant is in default for failing comply with the order of the Workers' Compensation Judge within thirty (30) days of the date of the decision. Respectfully submitted, Smigel, Anderson & Sacks, LLP Attorneys for Plaintiff By Fred H. Hait, ID # 34 1 River Chase Office Center 4431 North Front Street Harrisburg, PA 17110 (717) 234-2401 234-3611 (fax) fhait@sasllp.com LINDA ANTONETTY, Plaintiff v. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Civil Action -Law UNITED CHURCH OF CHRIST HOMES and No. PMA INSURANCE, Defendants AFFIDAVIT I verify that I have personal knowledge of all facts not of record set forth in the foregoing Praecipe, and that such facts are true and correct, to the best of my knowledge, information, and belief. I acknowledge that any false statements herein are made subject to the penalties of 18 Pa. C. S. 4904, relating to unsworn falsification to authorities. Date ~' ~ ~ Fred H. Hait ~Y 1~ V ' a `~ N Q n 1 (V ^\1 ~ ~ vrn` , ^ 5' W ( ~1 C'S "~ ~ a ~, ~ ~ ~ -r~ ~~ :-` ^,.~ r J ~ `~ .~ T / ~ W ~ ~/ ~ ~-'~ ... . _.J f r - .... tiv ~ ~ . J .N ~_ ~ \` ,.L ~ , \~.1 1 't ~ Y LABOR & INDUSTRY COMMONFEALTH OF PENNSYLVANIA BUREAU OF WORKERS' COMPENSATION 1171 SOUTH CAMERON STREET, ROOM 103 HARRISBURG, PA 17104-2501 U ~' 77 ~ G~+'t 17UM. www.dli.state.pa.us January 31, 2008 The foregoing is hereby certified to be a true and correct copy of Judge Brian Eader's decision circulated 11/27/2007 in the case of Linda L. Antonetty v. United Church of Christ Thornwald, BWC# 2597388, Injury Date 10/05/03 as full, entire and complete as the same remains on file in the Bureau of Workers' Compensation of the Department of Labor and Industry. Certified this 31st day of January, 2008 ~~~ Chief Claims Management Division ATTEST: I hereby certify that Thomas L. Dinsmore, who signed the foregoing, was at the time of signing, Chief, Claims Management Division, Bureau of Workers' Compensation, and as such, was the legal custodian of the above-described records. IN TESTIMONY WHEREOF, I have hereunto - ~ ~ ~ ~ set my hand and caused the seal of the Department ''` `~` ` - of Labor and Industry to be affixed on this ~_ ~lst day of January, 2008 Seal of the Department ' of Labor and Industry _~ Hannah attingly "An Equal Opportunity Employer" 'Auxiliary aids and services are available upon request to individuals with disabilities" Received. BWC 7,1/29/2007 ' LTR-0OS REV 09/05/00 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF LABOR AND INDUSTRY WORKERS' COMPENSATION OFFICE OF ADJWICATION 717-783-4414 BRIAN BADSR HARRISBURG JQDGES OFFICE EAST GATE C8NT8[t 1010 NORTH SEVENTH STREET HARRISBURG PA 17102-1400 DECISION RENDERED COVER LETTER Bureau Claim Number: 2597388 Circolatian Date: 11/27/2007 Iu~ury Date: 10/05/2003 Insurer Claim Number: Petitlons• Penalty-Pet LINDA L ANTONETTY 603 BENTON STREET HARRISBURG, PA 17104 FRED H. HAIT, ESQUIRE SMIGEL ANDERSON 8t SACKS LLP ~ RIVER CHASE OFFICE CTR 3RD FL 4431 N FRONT ST HARRISBURG, PA 17110 Vs Judge: Brian Each East Gate Curter 1010 North Seventh Street Ham'tsburg, PA 17102-1400 The attached Decision of the Judge is final unless an meal is takes to the Workers' Compe~usation Appeal Hoard as provided bylaw. UNITED CHURCH OF CHRIST HOMES THORNWALD 442 WALNUT BOTTOM RD CARLISLE, PA 17013 PMA CORPORATE PROCESSING CENTER PO BOX 25250 LEHIGH VALLEY, PA 18002-5250 UNITED CHURCH OF CHRIST 442 WALNUT BOTTOM ROAD CARLISLE, PA 17013 MAURA B. MUNDY, ESQUIRE LAW OFFICES OF SCOTT A FLEISCHAUER 500 N 12TH ST STE 100 LEMOYNE, PA 17043 PMA CORPORATE PROCESSING CENTER PO BOX 25250 LEHIGH VALLEY, PA 18002-5250 If you do not agree with this Deasion, an appeal must be filed with We Workers' Compensation Appeal Board within 20 days from but not including the date of this notice. Forms for as appeal may be obtained from the Workers' Compensation Appeal Board, Capital Associates Building 901 North Seventh Street. Third Floor South Harrisburg, PA 17102 OPEN ~ SUSPENDED CLOSED ~ UNKNOWN TO WCJ Auxiliary aids and services are available upon request to individuals with disabilities. Equal Opportunity Employer/Program Page 1 of 3 Received b'vJC 11i`29/2007 LINDA L ANTONETTY - 2597388 THORNWALD NURSING HOME WALNUT BOTTOM RD CARLISLE, PA 17013 PAUL C MCAFEE 7505 OSLER DR STE 104 BALTIMORE, MD 21204 COMMONWEALTH OF PENNSYLVANIA BWC LEGAL DN 1171 S. CAMERON STREET ROOM 327 HARRISBURG, PA 17104-2501 LINDA ANTONETTY 603 BENTON ST HARRISBURG, PA 17104 Auxiliary aids and services are available up~t request to individuals with disabilities. Equal Opportunity Employer/Pro~am n....e 1 ..F 2 Received. BWC 11/29/2007 LIIVDA L ANTONETTY - 2597388 Emolovee Wifiesses & Exhibits: C-O1 medical bills C-02 costs C-03 Quantum Meruit Empb~Witnesses & Exhibits• None Jadge Witnesses & Exhibits: B-O1 Bureau documents B-02 Record closing letter Hearin¢s• 8/8!2007 09:00:00 8/7/2007 09:05:00 7iloi2oa7 !4:00:00 6/4/2007 10:00:00 4/25/2007 15:30:00 Postponed by Employee Counsel on 07/19/07 Held Held Held Canceled by Employee Counsel on 04/25/07 Auxiliary aids and services are available upon request to individuals with disabilities. Equal Opportunity EmployerlProgram Page 3 of 3 Received B/JC 11;29/2007 Linda !.. Antonetty BWC #2597388 Penalty Petition Page 1 of 4 FINDSNf 5 ClF FACT: 1. On April 4, 2007 daimant filed a petition for Penalties in which she. asserted that defendant Fwd unilaterally stopped paying eampu+settion in violation of Section 413(b} of the Act on or about March 5, 2007, and that defendant had refused to pay for reasonable and necessary medical care for surgical disc surgery related to her work injury that had talon place on or about June 24, 2006. 2. The parties have amicably resolved the issue of defendarnt's having stopped paying compensation to claimamt. 3. At the April 25, 2007 hearing Mauro Mundy, Esquire who had a~cared on behalf of defendant coned having received from claimant's counsel that day a packet of unpaid n-edioal bills. Attorney Mundy at that time alleged that the bills might not have boon submitted properly but #hnt she would contact the providers to arrange for proper submission. In response claimant's counsel stated that he needed to know what was submitted because "improper submission' is a common excuse for non-payment of medical biNs but without evidence of wharf was submitted it is not possible to know where flu problem lies. 4. At the June 4, 2007 hearing Scott Fteischaruer, Esquire appearing on behalf of defendant, represented that his off ice would provide to claimant's counsel copies of medical bills that it had denied since May 24, 2006, together with any supporting information received from the health care providers in question, and that the adjuster in charge of the case would be available to testify with regard to the unpaid bills. 5. At the next heAring, held July 10, 2007 the docun-entation had not been provided and the adjuster was not available to testify. Claimant's counsel stated on the record that there were four health care providers whose bills were at issue, Mid-Atlantic Neuro-monitoring, Pinnacle Health, St. Joseph Medical Center, and First Colonial Anesthesia, arnd he roquested that this Judge direct that the adjuster be present in parson ~ flu next hearring in order to testify about the medical bills in questoor-. This Judge directed Carol Cingronelli, Esquire who had oppeatred on bahaif of defendant, to contact the adjuster and tell him or her to be present at the next hearing. Attorney Cingranelli agreed to do so. Received- BVJC 7.1/29/2007 Linda L. Antonttty BWC #2597388 Penalty Petition Page 2 of 4 6. At the next hearing on August 7, 2007 the adjuster was not present. Mauro Mundy, Esquire who had appeared on behalf of defendant represented that it was not possible to provide paper copies of the information claimant's counsel had requested. She also represented that all the medical bills in question had been paid, "...even the ones that were improperly submitted." Defendant did not present any evidence as to what bills it alleged were improperly submitted, nor did it present any other evidence as to why it had taken Mare than a year to pay the bi{Is in question. 7. Claimant has submitted evidence of medical expenses of at least $8,548.71 from the four healthcare providers listed above. At least one of those accounts had been submitted to a collection agenry. One of the providers, Mid Atlantic Neuro-monitoritxl, provided a handwritten notation "PMA has not responded, claim was in review in 2006, we have left messages with no response." 8. I cannot accept as credible defendant's assertion that it could not provide copies of information received from the healthcare providers in question, nor can I accept as credible defendant's counsel's unsupported assertions that bills were not properly submitted. In this regard, I emphasize that counsel for defendant repeatedly asserted that the information would be provided. From defendant's refusal to produce the information about tlu bills in question, and from the adjuster's failure to appear to testify, I infer that all of the bills at issue were submitted properly and that defendant had simply refused to make payment until its feet were held to the fire. 9. Claimant has incurred litigation costs in the amount of $122.85. Claimant's counsel has advanced these costs. 10. Claimants counsel has submitted a quantum mcruit fee exhibit in which he seeks a fee in the amount of $1800.00 in the event of an unreasonable corrtest. I find that the number of hours is reasonable and that the hourly rate of $200.00 is reasonable for an attorney of Mr. Hails ability, reputation, and experience. Received BWC 11,'29/2007 Linda L. Antonetty BWC #2597388 Penalty Petition Page3of4 Once it is determined thot an employer is lisle for an injury under the Act the employer is required to pay a c~imant's medical b'rNs within thirty dates of receipt. Westinghouse Electric Co. v WCAB (1Neaver), 823 A.2d 209 (Pa Cmwlth 2003 An employer is sula ject to perwlties if it unilaterally refuses to pay medionl expenses without having sought utilimtion n~view or without seeking a determination that the e~cp~es are not work rekited ~stino v 659 A.2d 45 (Pa Cmwlth.1995): l~s v. WCAg tJohn H Smith A~ St~ior0, 641 A.2d 491(Pa. Cmwlth.1991). 2. In this case the employer contended in its defense that the bills in question had not been properly submitted, but it submitted no evidence to support that bald assertion by its counsel. It is not~northy that cbintasrt's counsel made repeated attempts to obtain information from rkfendant about' what had been submitted by the health care providers in question, so that he could attempt to remedy stir deficiencies in tlx biging process, but defendant refused to provide the infa~mation despite repeatedly promising to do so. In the recent cease of Ih v W'n.,~Cas, 973 A•2d 1i73 (Pa. C~Ith. 2007) the cast hald'that a Workers' CoMpensertion Judge has discretion to t of medical bigs and award psnplties even if the bills were sat submttted on the propu' foMns, citing Yil . v WGA6 jeer). fl23 A.2d 209 {Pa. Cmwlth 203). ~n this oatd, I have inferred from defendant's asduct that the bills in question evidently were submitted properly and simply not paid, but even if they were not, because there is no issue of causation or reasawbleness and necessity, aid because the defendarrt''s conduct in refusing to provide the requested information is egregious, I conclude that a 5096 peswlty is cgspropriate. 3. Section 444 of the Act pray+des fro a~n awa'd of counsel fees in all contested cases where the claimant prevails ur~ess ddf~eriderit is able to prove a reasorwbk basis for having uontested the cam. Fculure to pay what is due is itself a contest. In this oase dcfendawrt con~vunded its already illegal and unreasonable conduct by refusing to supply necessary documerrtatian about the medical bills in question. Therefore, I conclude that defendant's contest has been unreasonable throughout this litigation, and that n counsel fee in the amount of X1800.00 shall be assessed against defendant. Received BWC 11/29/2007 ,~ f.inda !.. An#onetty BWC #2597388 Penalty Petition Page 4 of 4 4. Having prevailed in her petition, claimant is entitled to reimbursement of litigation costs in the amount of X122.85 ORCER; ANO NOW, this 27'x' day of November 2007, the claimant's petition is GRANTED in the event that any of the bills of health care providers in question have not beta paid, defendant shall pay them forthwith, together with interest at the statu#ory rate of 10~° per annum. Defendant shall pay claimant a penalty in the amount of X4,274.35, which is 50% of the amounts shown in Exhibit C-1. Defendant shall pay claimant's counsel a fee in the amount of X1,800.00 due to its unreasonable contest. Defendant shall reimburse claimant's counsel far litigation costs in the amount of $122.85. Brian G. Eader, Workers' Compensation Judge Harrisburg District Office BGE/bmw Item Index - dr~cament Item Type - CIMS_DOCUMENT CLAIM_NUME,ER USER ID FORM_CODE LAST_NAME FIRST_NAME DATE_OF_INJURY SCANNED_TIMESTA CURRENT BASKET ssN BATCH ID Item Name 259?388 mengerer DECISION ANTONETTY LINDA L 1a/5/2aa3 zaa~-11-29-1a.49.19.aaaaaa zaa~-12-1a-13.s~.53.aaaaaa 16646450a 2333aa32 r.~ C ~„~ . R'x! ~ -' r^-.^ u ~-T., L.! ~~ Ge3 ' - T ^,.. ~ ~ -f _ :: r~ =- +.ra =-t -. FltfD-~~~'rl{~ TAf~Y o s~P - s Pry 4:05 SMIGEL, ANDERSON & SACKS, L.L.P. Fred H. Hait, Esq. 4431 North Front Street .. fhait sash com Harrisburg, PA 17110-1778 +~~~~~t'" ;`R' ~`"~ ~~J~~ Joseph B. D'Amico (717) 234-2401 ~~~~"~~~ jdamico@sasllp.com Attorneys for Plaintiff LINDA ANTONETTY, IN THE COURT OF COMMON PLEAS Plaintiff, CUMBERLAND COUNTY, PENNSYLVANIA v. NO. 08-998 CIVIL TERM UNITED CHURCH OF CHRIST CNIL ACTION -LAW HOMES and PMA INSURANCE, Defendants. PRAECIPE TO SATISFY 3UDGMENT TO THE PROTHONOTARY: Please mark the judgment in the above-referenced action "satisfied." Date: September 8, 2010 SMIGEL, ANDERSON & SACKS, L.L.P. By: L~---- Jo eph B. D'Amico, Esquire I.D. Number: 72653 River Chase Office Center 4431 North Front Street Harrisburg, PA 17110-1778 (717) 234-2401 Attorneys for Plaintiff CERTIFICATE OF SERVICE JOSEPH B. D'AMICO, ESQUIRE, attorney for the within named party, certifies on September 8, 2010 I filed the original Plaintiff's Praecipe to Satisfy Judgment with the Cumberland County Prothonotary, Carlisle, Pennsylvania and has served a true and correct copy of the same by First Class United States Mail, postage prepaid on the following on September 9, 2010: Sohn E. Feather, Jr., Esquire FEATHER AND FEATHER, P.C. 22 West Main Street Annville, PA 17003 PMA Insurance Company P.O. Box 25248 Lehigh Valley, PA 18002-5248 SMIGEL, ANDERSON & SACKS, LLP By: ~ ` JO EPH B. D'AMICO, ESQUIRE Attorneys for the Claimant