Paula Robinson's Blog for Workers Compensation & Disability

What is a Workers’ Compensation Claim Denial?

file for a workers comp claim

What is a Workers’ Compensation Claim Denial?

Have you received a claim denial for your workers’ compensation claim? After you suffer a work injury and give Notice to your employer, your employer will forward the claim to their workers’ compensation carrier. From the date of receipt, the assigned workers’ compensation adjustor has 21 days to either accept or deny your claim for workers’ compensation benefits.  If your claim has been denied, you will not be receiving workers’ compensation benefits- medical or wage loss. If you receive a Denial you should contact a workers’ compensation lawyer right away to file a Claim Petition. A Claim Petition will be litigated before a Workers’ Compensation Judge. Read More

What is an IME (Independent Medical Evaluation)?

Workers' Compensation

What is an IME?

An Independent Medical Evaluation, also known as an IME, is scheduled by the Workers’ Compensation Carrier to evaluate the injured workers’ current medical status.  This medical exam is performed by a doctor, relevant to your injury, selected by the insurance carrier – which is ‘independent’ from the doctor currently treating you. So, for example, if you have a back injury and are treating with an orthopedic surgeon, you would be sent to an orthopedic surgeon. Read More

What is an Notice of Compensation Payable (NCP)?

Workers' Compensation

Once an employer sends the Workers’ Compensation Carrier notice of your work injury they have 21 days to respond in the form of a Denial or Notice of Compensation Payable. The notice will come in the form of a letter via the postal mail. Whether denied or accepted, I always advise to consult a Workers’ Compensation attorney to review your case and be prepared to respond when necessary. Read More

What is an URO?

Workers' Compensation

What is a URO? Also known as a Utilization Review

In Pennsylvania workers’ compensation law, a Utilization Review, also referred to as a URO is a process used by the workers’ compensation carriers to challenge the reasonableness and necessity of medical care and treatment provided to the injured worker.  In Pennsylvania, when medical treatment is rendered to an injured worker, the medical bill, along with the medical notes and other required documentation is sent to the workers’ compensation carrier for expected payment. If the treatment is related to the work injury, but the carrier believes that the treatment is excessive, not reasonable or necessary, then they will send the relevant medical documentation from the medical provider under review to a Utilization Review Organization to make a determination as to the reasonableness and necessity of the treatment that the treating physician or provider gives to the injured worker. Read More

What is “Donate Life”?

donatelife

Did you know in the United States of America April is designated as National Donate Life Month!

To celebrate, let us explore more about the non-profit organization Donate Life America and what it could mean for the residents of the Commonwealth of Pennsylvania.

“Donate Life Pennsylvania is a collaborative initiative between Gift of Life Donor Program (GOL), the Center for Organ Recovery & Education (CORE), and the Pennsylvania Departments of Health and Transportation. It is funded by residents of Pennsylvania through voluntary contributions included with driver’s license renewals, vehicle registrations and state income tax filings. All contributions are used by the Governor Robert P. Casey Memorial Organ and Tissue Donation Awareness Trust Fund to educate Pennsylvanians, build awareness about the importance of organ and tissue donation, and increase the number of people who sign up to become donors on their driver’s license, learner’s permit or state identification card.” Donate Life

How can you get involved or support Donate Life PA?

It’s pretty easy. Simply sign up to be an organ donor or make a monetary donation!  

Good news for Pennsylvania residents, you do not have to wait for your driver’s license renewal to change your Organ Donor status. You can sign up anytime online with the following information:

  • PA Driver’s License Number
  • Date of Birth
  • Last four digits of your Social Security Number.

Here are a few staggering statistics from the Donate Life website regarding the need for organ donations. Read More

PA Workers’ Compensation Employee Rights Scenarios

workers rights

Employee Legal Awareness Day was established by an Australian lawyer, Paul Brennan. His aim was to emphasize the importance of legal education for employees and small businesses and reduce their risk of legal problems. The day isn’t only about laws though, Brennan also suggests that employees should increase their awareness of their company’s policies. According to him, it is important for employees to have a copy of the employer’s handbook, where you can find information about bereavement policy, attendance and punctuality, conflict of interest statements and non-disclosure agreements.   We thought it would be the perfect opportunity to focus on the employees’ rights in the event of a work injury. Here are a few “what if” scenarios: Read More

Re-entering the Workforce After a Work Injury

work injury

Life After a Work Injury

A work injury can oftentimes alter a person’s career path. Recovering from a work injury is not always easy. January is commonly known as a month of new beginnings, a fresh start or clean slate. If you or a loved one has suffered a work injury, these phrases may have a new meaning as it maybe be an unfamiliar beginning. Work injuries affect more than just the injured worker, it affects the family and the life they have known.  

Redirection or a career course correction is often needed, although at the time it can be difficult. Like many of life’s hurdles there is often a silver lining when we look for it. What is your silver lining? In the spirit of starting the New Year off on the right foot, despite a work injury, here are a few tips to evaluating your new quality of life and making the most of your future despite the potential limitations of a work injury. Read More

Added Benefits to Serving as a Volunteer

Workers' Compensation

The Pennsylvania Workers’ Compensation Act is geared to be, for the most part, charitable and caring to the injured worker.  A perfect example of this is the section of the Act dealing with volunteer workers.  In Pennsylvania, volunteer emergency workers, including volunteer fire departments, volunteer ambulance workers, and even volunteer forest firefighters are included as employees under the Act.  Because they unselfishly give of their time and services, they have the presumption that their wages are at least equal to the statewide average weekly wage for the purpose of calculating their weekly compensation rate. Read More

Chiropractic Connections

chiropractic connections

Without our health, it is difficult to enjoy all life has to offer. So, when a serious work injury happens and you’re unable to work, earn an income, or do simple tasks it can take a toll on us both physically and emotionally.

October was National Chiropractic Health Month and it got me thinking about all of the wonderful Chiropractors who I have come into contact with in the workers’ comp field in Pennsylvania. Read More

Post-Hurricane Season – Lessons Learned for Future Preparedness

hurricane preparedness

This year North America had a very active hurricane season leaving us to look back and ask the questions, what can we take away or do differently to prevent loss of life, excessive property damage and to ensure a quick recovery post-natural disaster. Having a plan prepared for the unlikely event of a disaster, with or without warning, can be a huge help when disaster strikes.  After seeing the devastation brought on this year by Hurricane Harvey, Irma, Jose, and Maria it is clear that weather can be fierce and unpredictable.

Although we cannot control the weather, we can control our actions. Here are a few things we can be mindful of prior to the next massive weather event. Read More