Health Carrier's Subrogation Lien Properly Established


Category: Pennsylvania

In Evans v. WCAB (Highway Equipment And Supply Company), the Commonwealth Court of Pennsylvania addressed the issue of what is required to preserve a third party medical subrogation lien and to whom those payments should be made. The case involved work related medical expenses paid by Highmark from Geisinger Medical Center in the amount of $29,995.59. The claimant argued that the workers’ compensation carrier should pay these sums directly to the claimant with interest and filed a penalty petition when the payment was not made.
After a complex procedural history, the Commonwealth Court ultimately confirmed that because Highmark’s subrogation lien had been established before the close of the record (a requirement under the law) that it was properly preserved and should be repaid. The Court explained that if the claimant had preserved the lien, the money could have been paid to the claimant. In this case, however, Highmark’s lien was protected by a third party entity, Healthcare Recoveries, and even though that lien letter was introduced by the claimant, this did not entitle the claimant to have the money paid to him.
While a workers’ compensation lien against a third party recovery is technically absolute under the Act (with some exceptions such that you should always be aggressive in protecting), a medical subrogation lien is not absolute and is only payable if protected before the close of the record. A good understanding of this issue is important during litigation as it can affect litigation management and exposure reduction strategies.

For more information, please contact Peter Weber at or 215.972.7901.

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Lexi Burchmore

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