Refusing Surgery and Treating Conservatively: Can Injured Workers Lose or Forfeit Their Right to Pennsylvania Workers’ Compensation?
The law states that an injured worker who decides to refuse reasonable medical treatment or services may forfeit their right to workers’ compensation for a resulting injury or increases in their disability. In this situation, the Pennsylvania Workers’ Compensation Act provides the employer with the right to file a Suspension Petition (also known as a Muse Petition, based on the case of Muse v. WCAB (Western Electric Co.), 522 A.2d 533 (Pa. 1987)). A Suspension Petition is used by the employer to stop or suspend compensation until the injured worker undergoes the treatment that is at issue.
When a Suspension/Muse Petition is filed by the employer, the burden remains on the employer to show that the treatment would have decreased the injured worker’s disability and increased their earning power. If the employer proves this, a suspension or forfeiture of wage loss benefits may be ordered.
Under the Pennsylvania Workers’ Compensation Act, section 306(f), when an employee refuses reasonable medical services, treatment, and supplies, he forfeits his right to compensation for injuries that result from this refusal. The issue in a Suspension/Muse Petition centers on whether a proposed treatment is “reasonable.” If a recommended treatment has a high probability of success, and there are minimal risks involved with the treatment, it may be deemed “reasonable” for the purposes of a Suspension/Muse Petition. Again, the burden is on the employer to show that the treatment the employee is refusing presents minimal risks and will likely make the worker more employable. When the employer meets their burden, the suspension or forfeiture of wage loss benefits may be granted.
While Suspension/Muse Petitions are typically found in the context of surgery, they may apply to any treatment that falls under the Muse requirements. In a common scenario, an independent medical examination doctor recommends to an injured worker that they undergo surgery as opposed to continuing with their conservative care. This may be because the conservative treatment is expected to be less effective than surgery, or surgery is expected to provide quicker relief for the injury.
In order to overcome a Suspension/Muse Petition, an injured worker must show why their refusal to undergo surgery or treatment is reasonable. It is to the advantage of the employee if the proposed treatment addresses an ailment that may not necessarily be “cured” by the treatment. In the Muse case, the court held that the workers’ compensation statute does not require all “possibility of cure be pursued.”
However, the court made clear that the statute does require that reasonable means are used, and what is reasonable varies with the facts of each case. In the case of a risky procedure, such as back surgery, and a less than 50% chance of making the injured worker more employable, the worker may be likely to overcome a petition to force them to undergo a specific form of treatment.
At Needle Law Firm, our workers’ compensation attorneys are dedicated to helping injured workers throughout Pennsylvania. We have represented injured workers who are facing the suspension or forfeiture of their benefits. If you or a loved one has suffered an injury at work, you may be entitled to legal compensation. Contact us for a free consultation by calling 570-344-1266 or contacting us online.