Bur. of Workers’ Comp., Aplt v. WCAB

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Claimant Kevin Ressler suffered a work-related injury in 1995. He received Workers' Compensation benefits. In 2004, Claimant submitted to an independent medical evaluation (IME). The sequence of events since the IME make up the heart of this appeal. In June 2004, Claimant had surgery related with his work-related injury. In July 2004, his employer petitioned to terminate benefits as of the date of the IME. The employer also requested a supersedeas. The Workers' Compensation Judge (WCJ) denied the superseadas in August 2004. In October of that year, the insurer received the invoice for the June surgery and paid the amount by the end of January, 2005. In June 2005, the WCJ granted the employer's petition to terminate benefits. The Workers' Compensation Appeal Bard (WCAB) affirmed that decision. The insurer then requested reimbursement for the 2004 surgery from the Supersedeas Fund. The Bureau of Workers' Compensation challenged the request because Claimant's surgery predated the supersedeas request. The WCJ found that no obligation to pay arose until the bill was submitted to the insurer in October 2004. Because the obligation to pay arose after the denial of supersedeas, reimbursement was appropriate. The WCAB affirmed. The issue of whether the Supersedeas Fund may deny reimbursement of treatment rendered before the insurer requested supersedeas came before the Supreme Court. Upon review of the trial record and the Workers' Compensation Act, the Court concluded that the lower courts appropriately ordered reimbursement to the insurer for undue payments made after the supersedeas request and in direct response to the earlier denial. The Court affirmed the lower court's decision.