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Johnson v. T. K. Stanley2/28/2001
s also silent regarding the extent of his work, as well as his wages, during this uncertain period of time, thus precluding our determination of whether he may be entitled to workers' compensation benefits other than TTDs. Accordingly, we remand the case to the WCJ to conduct a hearing on these issues.
Attorney's Fees
An employee is entitled to penalties and attorney's fees when the employer arbitrarily, capriciously, or without probable cause fails to timely pay workers' compensation benefits. In effect, this law describes an employer which fails to reasonably controvert the employees' claim. An employer is deemed to have reasonably controverted a claim when it possessed sufficient factual and medical information to rebut the employee's factual and medical assertions.
Accordingly, an employer may not deny an injured employee's benefits on the basis of inconclusive medical reports. Instead, the employer must undertake a reasonable effort to ascertain the extent of the employee's medical condition. Further, an employer may not blindly rely on optimistic medical reports when presented with medical information showing disability. Such reliance will result in the imposition of penalties and attorney fees.
In the case sub judice, the WCJ awarded Mr. Johnson $3,500.00 in attorney's fees, although it found that TK did not act arbitrarily and capriciously. TK contends that the WCJ erred in this decision because an employee may only recover attorney's fees upon showing that the employer acted arbitrarily, capriciously, or without probable cause. We agree.
Nevertheless, after reviewing the record de novo, and in light of our earlier findings, we conclude that TK did act arbitrarily and capriciously when handling Mr. Johnson's claim. In fact, had TK ascertained the chronology of Mr. Johnson's complaints, it would not have rested on its unsupported belief that his injuries were related to accidents pre-dating or post-dating the 1997 accident. Further, Dr. Lee and Dr. Cobb, whom Mr. Johnson chose for treating physicians, both related Mr. Johnson's condition to his 1997 accident. Accordingly, when it relied on Dr. Mayer's findings to deny Mr. Johnson's workers' compensation benefits, TK did so at its own peril and exposed itself to the assessment of attorney's fees. Therefore, albeit for different reasons, we affirm the WCJ's attorney's fee award.
CONCLUSION
We affirm the WCJ's decisions, finding Mr. Johnson to be entitled to medical benefits and attorney's fees and awarding him TTDs from the time he stopped working for TK in 1998 to the time he would reach maximum medical improvement after undergoing Dr. Cobb's recommended surgery. However, we reverse the decision to award such TTDs from September of 1997 to some time in 1998 when Mr. Johnson stopped working and remand the case to the WCJ to determine the exact period of time which Mr. Johnson worked in 1998, as well as whether Mr. Johnson could be entitled to indemnity benefits other than TTDs during that period. We cast TK with costs of this appeal.
AFFIRMED IN PART, REVERSED IN PART, AND REMANDED.
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