The Pennsylvania Supreme Court provided some guidance in Whitmoyer v. WCAB. In Whitmoyer, in 1993, the injured worker suffered a work-related injury, which led to the amputation of his arm. The employer paid disability and medical benefits related to the injury, and the complainant sued a third-party negligence case that resulted in a recovery of $US 300,000. At the time of the third-party recovery, the employer had paid $110,583 in work benefits to the injured worker and therefore had a right of pledge against the third party`s recovery. Third-party recovery was reduced to take into account the attorneys` fees associated with obtaining third-party recovery, resulting in a net right of pledge of USD 81,627 paid by the claimant to the workers` compensation body. As part of this payment, the claimant and the employer entered into a third settlement agreement (PST). The GST recalled the payment of past benefits and calculated, on behalf of the employer, a future credit for future medical benefits (at that time, lost wages benefits were terminated) based on the balance of the claimant`s clawback. In other words, the employer asserted that the complainant was responsible for paying a percentage of his future medical expenses, which were based on his reinstatement of the charge of negligence by a third party. At the time of the performance of the TPSA, the Claimant argued that any future credit would only apply to “future compensation rates” as set out in section 319. This is a right that, incredibly, is not denied by the inability of the employer/insurer to cooperate in the prosecution of the third-party case in order to ensure such recovery by third parties. This requires us to apply the reimbursement rate to future indemnification liability, with recovery costs shared by the full amount of recovery by third parties, so that the employer/insurer is responsible for paying a percentage of future weekly benefits and medical expenses in order to fulfil its obligation to reimburse its proportionate share of attorneys` fees and expenses, Which were created by securing the carrier`s claim. this percentage is paid by the employer/insurer until the interest on the transfer of claims is exhausted.
In 2012, the insurer filed a claim to amend the claims and requested an adaptation of the third-party settlement agreement to reflect the medical expenses paid since its execution. The Workers` Compensation Judge up to the amendment and, inter alia, decided that the reimbursement rate and future credit, calculated on the basis of a third party`s settlement agreement, applied to future medical expenses. . . .