Termination of Worker’s Comp Benefits
The first sign that your workers’ compensation wage loss benefits may be in jeopardy is when you receive in the mail a notice for you to attend an Independent Medical Examination (IME). This is a quick one-time examination by a physician of the workers’ compensation carrier’s choice. Keep in mind that the physician is paid directly by the carrier, and in most instances will find a way to side with the workers’ compensation carrier’s position that there is nothing wrong with you regarding your work injury and that you are fully recovered from your work injury.
After a Workers’ Compensation Carrier receives the Independent Medical Examination (IME) report and if it states a full recovery of your work injury, the Workers’ Compensation Carrier will hire an attorney to file a Termination Petition against you, the injured worker, in an attempt to stop all of your wage loss and medical workers’ compensation benefits that you are receiving.
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.
What is a notice of compensation payable?
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 should 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.
To mark the approaching Labor Day, it would be befitting to focus on how the Workers’ Compensation Act in Pennsylvania has evolved over time.
The Enactment of Pennsylvania’s Law on Workers’ Compensation: A Brief History
The Pennsylvania Workers’ Comp Act came into force in 1915. Prior to this Act, injured workers in the state were required to show “negligence” on part of the employer in order to obtain any form of compensation.
Negligence meant that the worker would have established through evidence what was the reasonable “standard of care” for their particular job, and that the employer’s failure to exercise that level of care led to the workplace injury.
In the early 1900s, workers in Pennsylvania were engaged in primary occupations, such as farming, coal mining, and factory jobs.
The kind of safety systems and technology that are available to today’s workers were virtually non-existent at that time. As a result, the workers experienced a high incidence of catastrophic injuries – with little to no legal recourse.
An unsafe workplace environment occurs when a worker is exposed to physical conditions that pose a risk of injury while performing normal daily work duties.
For example, defective or broken machinery, exposed electrical wiring, direct exposure to hazardous chemicals, uneven or slippery floors, or lack of personal protective equipment (PPE) could create an unsafe working conditions for workers.
OSHA Guidelines on Dealing with Unsafe Working Conditions
Under both federal and Pennsylvania laws, an employer is required to provide a safe workplace. In the case of unsafe working conditions, a worker in PA can report the violation to their employer as well as to the office of OSHA (Occupational Safety and Health Administration) at the state or federal level.Read More
In Pennsylvania, you are eligible for workers’ compensation benefits from day one! As long as you are working your job, as defined by your job description and you are injured, making you unable to work your job, you can file a claim for workers’ compensation benefits.
You must meet the following requirements, however, to be eligible for workers’ compensation benefits.
- You must be an employee, receiving a W-2, not an independent contractor.
- You must give timely proper “notice” of your work injury to your boss, supervisor, or foreman within 120 days from the date of the injury. It is best, however, to give notice as soon as possible so that steps can be taken for the employer to submit the claim to their workers’ compensation carrier.
- Treat for the work injury and have a physician write a note and/or report that you are “disabled” as a result of the work injury and that you are unable to work your regular job or any type of job (setting, desk, light, medium work).
If an emergency such as a fire, toxic gas leak or chemical spill occurs at your workplace, causing you an injury, removing you to a safe place (away from the hazard) should be the first task of the employer. Do you know what to do if you are injured during an emergency at work?
The employer should have an emergency evacuation, rescue, and safety plan in place along with safety equipment and trained personnel.
Seek Medical Attention
You must seek medical attention as soon as possible following the workplace emergency and accident.
Visiting the emergency room is warranted in most cases. If further medical treatment is advised, your employer should give you a list of panel providers for you to choose from for treatment. Typically, if you want your medical bills paid by the workers’ compensation carrier, you are required to treat with the panel providers for the first 90 days after your injury.Read More
Not all employers are alike! If you or someone you know suffers a work injury, the first step is to give “Notice” in some fashion to your boss, supervisor, or foreman. Your PA employer is then to turn the claim over to their workers’ compensation insurance carrier to be processed. Once this is done, the assigned workers’ compensation adjuster has twenty-one (21) days to either accept or deny the claim. Even if the claim is accepted, it could be accepted temporarily or as a medical only, which can be explained by an experienced PA workers’ compensation attorney in further detail.
PA workers’ compensation benefits are in two (2) parts; there is the wage loss paid to you by the workers’ compensation carrier while you are out of work because of the injury, and there are medical benefits paid for the treatment for the work injury.
If the workers’ compensation adjuster denies your claim, your only next step is to file a Workers’ Compensation Claim Petition. In order to have the best chance of winning on the Claim Petition, you really need to have a PA Workers’ Compensation Lawyer with years of experience represent you. The burden of proof is always on you, the injured worker, to prove that you suffered a work injury while in the course and scope of your employment.Read More
Many areas in Pennsylvania experience high temperatures in the summer months. Although doctors advise people to minimize heat exposure in these months, many PA workers don’t have that option. Staying hydrated at work isn’t always as easy as it seems.
Making sure that workers are sufficiently hydrated is one of the most effective ways to protect them during the season of heat waves.
Heat Illness – Risk Factors
Workers should be aware of the various risk factors that could reduce their heat tolerance levels.
Risk factors that may contribute to heat illness include hot air and humidity, limited air circulation, indoor radiant heat (from hot manufacturing equipment and processes), heavy protective clothing, and dehydration (not drinking an adequate amount of fluid).Read More
Injuries at the workplace can range from minor to severe, and the risks can vary depending on the nature of the job.
Workplace injuries can be serious, affecting the victim’s quality of life as well as reducing their ability to earn wages for a period of time, or even permanently in some cases.
Here is a description of five high risk injury jobs in Pennsylvania:
Numerous potential hazards are present at various construction sites across Pennsylvania. Even after observing all the safety precautions, construction workers continue to be at a high risk of jobsite accidents and serious injuries.
Figures published by the Bureau of Labor Statistics (BLS) show that 4 out of 100 construction workers suffer every year from workplace injuries. This high injury rate reflects the high-risk job environment in the construction industry in PA.