On March 12 2026, the Pennsylvania Commonwealth Court held in the matter of Save A Lot v. W.C.A.B. (Sonia Morales), No. 1363 C.D. 2024, that workers’ compensation judges have jurisdiction to award penalties for unpaid or untimely paid medical bills without the need of Fee Review.
By way of background, Sonia Morales (Claimant) sustained a work-related injury on August 1 2021, for which Save A Lot (Employer) paid her workers’ compensation benefits. Later, Claimant and Employer entered into a Compromise and Release Agreement, pursuant to which Employer was to remain liable for her medical bills through May 30 2022. On December 6 2022, Claimant filed a Penalty Petition for failure to pay medical bills, seeking penalties and unreasonable contest attorney’s fees.
The litigation of this Penalty Petition before the Workers Compensation Judge (WCJ) took 5 hearings over the scope of 10 months, during which Employer’s counsel confirmed that the unpaid bills were in fact payable. At the onset of litigation, the medical bills in dispute were $6,365.00 by Dr. Qu, and $3,882.58 by Alikai Health, all of which were properly billed months before. By the second hearing, Employer paid some of the bills, at a reduced re-priced rate. Employer argued that to the extent that the amount of the payment was an issue, said issue was reserved for Fee Review. By the third hearing, the only outstanding balance was $2,325 for Dr. Qu’s dates of services on 12/3/21 and 5/5/22. The carrier had paid for other identical services by Dr. Qu but failed to pay for the remaining dates of service. Employer’s counsel confirmed on the record that those unpaid bills were payable and that he recommended those be paid. Again, at the final hearing, Employer’s counsel reiterated that he had continuously advised the carrier to pay the remaining bills without success. The record closed with the submission of the unpaid and untimely paid bills. Employer presented no evidence. Ultimately, the WCJ granted the Penalty Petition ordering Employer to pay Dr. Qu’s unpaid balance, 50% penalty on all bills initially submitted, and reimbursement of Claimant’s attorney’s fees.
Employer appealed to the WCAB arguing that the WCJ lacked jurisdiction because Dr. Qu failed to go through the fee review process. The WCAB affirmed the WCJ’s decision, noting that according to Hough v. WCAB (AC&T Cos.), 928 A.2d 1173 (Pa. Cmwlth. 2007), “the fee review process is available to providers [but it] does not limit or place any condition on claimant’s right to pursue a penalty petition for late payment or failure to pay medical expenses”. In response, Employer appealed to the PA Commonwealth Court presenting the same arguments for lack of jurisdiction.
The Commonwealth Court focused on the two unpaid dates of services, holding that the WCAB properly affirmed the WCJ’s award for penalties and counsel fees. Specifically, the Court pointed out that the Insurance’s denial (EOB) for dates of service 12/3/21 and 5/2/22 noted “Claims not eligible for medical payment”, however the carrier had voluntarily paid other dates of services by this same provider, for the same identical treatment. Consequently, the Court ruled that Employer failed to timely pay for these dates of services, and paid the others dates of services late, violating the act, and subjecting them to the Penalty Petition. As supportive caselaw, the Court pointed to Hough (involving failure to timely pay provider) and Enterprise Rent-A-Car (involving dispute over the amount due to provider), explaining that both decisions recognized that there is no language in the fee review provision that limits an employee’s right to pursue a penalty petition for late payment of medical bills. Notably, this Court did not discuss the argument over the WCJ jurisdiction to determine the amount due, as the providers in this case accepted the adjusted reduced amount paid as accurate.
Although unreported, this case highlights the importance of paying medical bills timely. Failure to do so could result in the imposition of penalty interest and unreasonable contest attorney fees. If you are facing a Penalty Petition, attorneys at Carpenter McCadden & Lane are available to assist you.