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Filing a Worker’s Compensation claim in Philadelphia and Allentown involves several steps and adhering to specific timelines, including the statute of limitations. The process is designed to ensure that injured workers receive the necessary medical treatment and compensation for lost wages due to work-related injuries or illnesses. 

While streamlined, the process can still be confusing, especially if you’re a first-time filer. Therefore, whether you’re filing for a back or neck injury, attorneys in Allentown should always be consulted for guidance to ensure timely action that will result in fair compensation.

How to File a Workers’ Compensation Claim in Pennsylvania?

The filing process in Pennsylvania involves several specific steps, as follows:

1. Report the Injury: An injured worker must report their injury or illness to their employer or supervisor as soon as possible. Pennsylvania law requires that this report be made within 120 days of the injury. However, to ensure the best chance of receiving benefits, reporting immediately is advisable.
2. Employer’s Responsibility: Upon receiving notification of the injury, the employer is required to report it to their Worker’s Compensation insurance carrier. The employer should also provide the injured worker with a form to seek medical treatment if necessary.
3. Medical Treatment: Initially, the injured worker may be required to see a doctor from a list provided by the employer or their insurance carrier for the first 90 days after the injury. After this period, the worker can choose their doctor.
4. Claim Filing by the Insurance Company: The insurance company will file a First Report of Injury with the Pennsylvania Bureau of Worker’s Compensation. The insurer will then investigate the claim to decide on approving or denying the compensation.
5. Receiving a Decision: The insurance company must issue a decision within 21 days of being notified of the injury. If the claim is approved, benefits will start to be paid. If the claim is denied, the worker has the right to appeal.

Statute of Limitations

The statute of limitations for filing a claim petition for Worker’s Compensation benefits in Pennsylvania is three years from the date of the injury. This means if the insurance company denies the claim, or if certain benefits are disputed, the injured worker has up to three years to file a formal claim petition.

Duration of Total Temporary Disability (TTD) Benefits

In Pennsylvania, there is no specific maximum time limit for collecting TTD benefits. An injured worker can continue to receive these benefits as long as they are considered totally disabled and unable to work. However, the employer or their insurance carrier can request an Impairment Rating Evaluation (IRE), as per Act 57 of 1996, after the worker has received 104 weeks of total disability benefits to assess if the worker is at least 50% impaired according to the American Medical Association (AMA) guidelines, which could potentially change the status of benefits.

Average Whole-Person Impairment & Settlements

Specific statistics on the average whole-person impairment for injured workers in Pennsylvania are not typically published as they vary widely depending on the individual case, type of injury, and severity.

Similarly, average settlement amounts for Worker’s Compensation cases in Pennsylvania can vary significantly. Settlements depend on numerous factors, including:

• The severity of the injury;
• Worker’s age;
• Wage rate;
• Medical expenses;
• Extent of disability.

As such, there is no one “average” settlement figure that accurately represents all cases. Settlements can range from a few thousand dollars for minor injuries to substantial six-figure amounts for severe or permanent disabilities.

Where to find assertive back & neck injury attorneys near me in Allentown?

Just a few blocks away from the PPL Center Arena, in the very heart of Hamilton District, you can find some of the finest work injury lawyers in all of Allentown – Liberty Bell. Our specialists have extensive experience and can provide advice tailored to your specific situation helping you navigate the intricacies of the claims process with the utmost ease. Contact us today and let us advocate for your rights to ensure you receive the maximum compensation you deserve.

The concept of a system designed to provide financial and medical care to all employees who have suffered on-the-job injuries isn’t new. In fact, it has a long and very complex history that spans several millennia.

However, it is only over the past century that it became crystalized into what it is today: a set of comprehensive Workers’ Compensation laws that every work injury lawyer in Philadelphia adheres to.

Today, we’ll explore how the work comp system evolved over the decades, comparing its modern iterations to its original, 100+ years old form to give you insight into the ever-changing legal landscape of injured workers’ rights.

Workers’ Compensation Laws Are Over 4,000 Years Old

In virtually every state, including Pennsylvania, you may collect monetary compensation for work injuries resulting in “specific losses”, such as the loss of a limb or eye, for which you may collect only the benefits outlined in a schedule. These benefits are different from the normal situation in which you suffer a work-related injury and receive wage replacement benefits during the time that you are unable to work because of the injury. 

Scheduled specific loss benefits are the earliest form of monetary compensation provided to injured workers. The earliest recorded description of a workers’ compensation law dates to the year 2050 B.C. when Ur-Nammu, the King of the city-state of Ur, passed a law that provided monetary compensation for injuries to worker’s body parts, including fractures.

Hammurabi’s code contained a similar set of provisions. Virtually every ancient culture passed laws that provided compensation schedules of this type. The specific loss provisions of the Pennsylvania Workers’ Compensation Act, therefore, have roots in laws passed 4,000 years ago.

The Birth of Workers’ Compensation: Early Years

The idea of compensating workers for work-related injuries has deep roots. Various societies throughout history have attempted to enact efforts to provide support to injured workers, most often through community-based or employer-sponsored arrangements.

Unfortunately, these early systems were inconsistent and lacked the comprehensive equitable approach that modern workers’ compensation laws offer injured workers.

The First Workers’ Compensation Laws

The United States can trace the birth of modern workers’ compensation laws to the late 19th and early 20th centuries when industrialization and the rise of factories were rapidly expanding, leading to an increase in workplace injuries. The first state to enact workers’ compensation laws to help injured workers was Wisconsin.

Wisconsin (1911)

In the year 1911, Wisconsin passed the United States of America’s first comprehensive workers’ compensation laws. Championed by progressive leaders, this legislation was groundbreaking in its approach. Key features of the Wisconsin worker’s Compensation laws included:

• No-Fault System: Workers did not need to prove their employer’s negligence to receive benefits. Instead, benefits were provided regardless of fault. It was a huge win for injured workers, having to not worry about proving third-party liability to receive benefits.
• Medical Care: State workers were entitled to receive necessary medical treatment for their injuries, based on the nature and circumstances surrounding the incident.
• Disability Benefits: Compensation was provided for temporary and permanent disabilities, as well as for vocational rehabilitation. Vocational rehabilitation was a huge positive step, considering many people who were injured on the job would be unable to go back to that job. Vocational rehabilitation allowed them to start a new career.
• Death Benefits: In the unfortunate event of an on-the-job fatality, the dependents of the deceased worker were eligible for benefits.
• State Administration: The workers’ compensation system was administered by the state and limited individual litigation between employers and employees, creating a more predictable, equitable, and continuous workers’ compensation process.

The Evolution of Workers’ Compensation Laws in The United States of America

Since Wisconsin’s enacting & pioneering workers’ compensation legislation, similar laws have been enacted throughout the United States. Even though each state has its own workers comp system, some common principles and trends have helped to shape the modern landscape of workers’ compensation.

Expanding Coverage

Over the past several years, workers’ compensation laws have expanded to cover a broader range of workers and on-the-job injuries. Initially, in the early days, these laws primarily applied to industrial and manual labor workers. Today, they now almost always include office workers, service industry employees, and more.

Benefit Adjustments

Benefit levels have been adjusted to keep pace with changes in the cost-of-living adjustment (COLA) and medical care. Many states have also reformed their methods of calculating premiums to ensure fair compensation for all injured workers, no matter what line of work the employee was engaged in.

Medical Care

The provision of medical care has remained a core component of workers’ compensation. However, the management and State regulation of medical treatment has evolved immensely with time, with some states establishing networks and/or guidelines to control costs and ensure quality care for employees injured on the job.

Dispute Resolution

Dispute resolution mechanisms, such as mediation and arbitration, have been introduced to expedite workers’ compensation claim resolution and reduce the time and resources the court system had previously been burdened with.

Occupational Diseases

As our understanding of occupational diseases has evolved over time, workers’ compensation laws have adapted to include compensation for illnesses resulting from workplace exposures including chemical exposure, viruses, and life-threatening bacterial infections.

Return-to-Work Programs

Vocational rehabilitation and return-to-work programs have become much more common, helping injured workers re-enter the workforce with proper training, allowing them to be qualified for new careers and jobs in the workforce.

Advocacy and Legal Representation

Workers have gained greater access to workers’ compensation legal representation to help them navigate the complexities and nuances of the system and advocate for their rights.

Challenges and Controversies

While workers’ compensation laws have evolved to better protect employees in all the US states, extreme controversies and monumental challenges persist. Some of the ongoing issues include:

Coverage Gaps

Certain categories of workers, such as gig economy workers and undocumented immigrants, still face challenges in accessing workers’ compensation benefits. States do a terrific job holding employers accountable for work injuries, even if they are not covered through workers’ compensation. Many states also will force employers to provide benefits if they are properly classified as a 1099 contractor.

Benefit Reductions

In many states, injured worker’s benefit reductions and restrictions have been and are still being proposed or implemented as a cost-saving measure, leading to concerns about adequate medical care and financial compensation for injured workers.

Medical Provider Networks

The use of Medical Provider Networks (MPNs) has raised concerns about the impartiality and quality of medical care, echoing similar issues to those experienced in the past. MPNs are probably one of the biggest bones of contention in the Worker’s Compensation system. Many believe the insurance companies have used them to abuse the system by “stacking the deck” with doctors who advocate on their behalf, rather than the injured workers.

Legal Battles

The workers’ compensation system remains a battleground for legal disputes throughout the United States, with both injured workers and employers sometimes facing challenges in the claims process in a workers’ compensation claims.

The state of the modern-day Workers’ Compensation system

Workers’ compensation in the United States of America has come a long way since its inception in Wisconsin in 1911. The enacted workers’ compensation laws have provided a safety net for millions of workers, ensuring that they receive quality & timely medical care and financial support when they suffer an on-the-job injury. Over time, these laws have evolved immensely, adapting to the changing nature of work and the needs of injured workers.

Despite these advancements, challenges and controversies unfortunately persist. The ongoing contention between insurance companies and applicant lawyers highlights the importance of continually assessing and improving these systems to ensure they provide fair and effective support to all injured workers throughout the United States, simultaneously protecting them from the greed and unscrupulous tactics the insurance companies have become known for.

Where to find an adept work injury lawyer near me in Philadelphia?

With the expansion of legal mills and inexperienced lawyers, finding a place that provides expertise-based counsel is now more important than ever. In the Philadelphia region, that place is Liberty Bell. With decades of experience, thousands of successful cases behind us, and more than $1 billion in benefits recovered for our clients, our attorneys are by and wide some of the most proficient in their field. Reach out to us today or visit our offices near The Franklin Institute (by appointment only) for a free consultation!

What tactics do employers use to make life miserable for injured workers? A man who suffered a severe shoulder injury reminded us of this frequent question. He described what happened when he did not immediately notify his employer of the injury, simply because he thought it would go away.

However, when his pain persisted for 7 days, he realized that something was seriously wrong. He reported the injury to his employer, who promptly fired him, claiming that his failure to report the injury immediately was a “violation of safety rules.”

Their employer’s action was, of course, completely illegal. As every good Philadelphia work injury lawyer will tell you, under Pennsylvania law, you have the right to report a work injury for up to 120 days from the date of injury. Furthermore, you have rights under the Family and Medical Leave Act.

Finally, because employers do not have the right to retaliate against an employee for exercising rights under the Workers’ Compensation Act, such an obnoxious firing would almost certainly give rise to a lawsuit against the employer for discrimination. The problem here, however, is that this isn’t an isolated case of employer harassment.

Taking money from your pocket

Under Pennsylvania Law, an employer is entitled to a credit equal to 50% of any old age benefits against workers’ compensation benefits the employee receives. If the employee was collecting old age benefits before the work injury occurred, the employer is not entitled to a credit. 

For example, if an employee receives $2,200.00 per month in workers’ compensation benefits and $1,100.00 per month in social security retirement benefits (old age benefits), the insurance company would be obligated to pay only $1,650.00 monthly. ($2,200-$1,100/2=$1,650.00)

In Caputo v. WCAB, an injured worker challenged this position, arguing that it was a violation of the Pennsylvania Constitution. The Court rejected the employee’s challenge, sending a clear message that it’s acceptable for employers to reduce payments of workers’ compensation benefits by 50% of the social security retirement benefits the injured worker receives.

U.S. Supreme Court upholds employers’ use of class action waivers to deny employee remedies for employers’ illegal conduct

In a major blow to the rights of employees under the National Labor Relations Act to join forces in “mutual aid and protection,” the Supreme Court ruled 5 to 4 that employers could bar employees from participating in class actions against employers and force them to arbitrate disputes.  

Class actions, in which groups of similarly aggrieved individuals file suit, are among the only effective ways for employees to obtain redress for grievances against employers who violate minimum wage or overtime pay rights or violate laws against discrimination. 

Employers use arbitration agreements that contain class action waivers to force employees to file for arbitration individually. Frequently the damages recoverable by an employee are insufficient to justify the filing of an individual legal action. Furthermore, where employees are the victims of discrimination, they are often reluctant to take legal action unless they are part of a group for fear of being ostracized by co-employees.  

Among the cases consolidated in the decision is one in which employees for Murphy Oil sued the company for back pay for “off the clock” work. The employees had agreed to arbitrate employment claims individually when they accepted the jobs, but the National Labor Relations Board argued that class action waivers interfered with the right of employees to join to enforce their rights.

Former President Trump took the extremely rare step of reversing the position of a previous administration and filed a new brief in support of the employers and Justice Gorsuch wrote the decision for the majority.

Is the Supreme Court against the working class?

Justice Gorsuch’s widely condemned decision in Epic Systems v. Morris may prove to be the harbinger of a new era in which the United States Supreme Court takes an extreme anti-labor stance.

As noted in a previous section, in the 5-4 decision, Justice Gorsuch ruled that an employer may prohibit employees from joining together in class actions against the employer. The decision also held that employers may require employees to take any dispute to arbitration in which “neutral” arbitrators will rule on the merits of an employee’s claim. 

Employers who force employees to accept these conditions can get away with stealing small amounts of wages from all their employees because no individual employee would be willing to pay attorney’s fees and costs that exceed their recovery. In her dissent, Justice Ginsberg noted that employees at one of the companies would likely have to spend $200,000.00 to recover only $1,867.02 in overtime pay and an equivalent amount in liquidated damages.

Justice Gorsuch’s decision is predicated upon the absurd notion that there is equal bargaining power between employers and employees. The reality is quite different. In the case of Epic Systems, employees were told via e-mail that they had to agree to arbitrate any disputes with the employer and give up the right to pursue class actions.  Anyone who continued to work at the company after receiving the e-mail was deemed to have accepted the agreement.

Approximately 23 percent of all non-unionized employees are subject to class action waivers and mandatory arbitration agreements.  That is likely to change, and not for the better.  President Trump’s most ardent supporters will suffer because of this ruling.

Has your employer terminated your employment because you filed a workers’ compensation claim?

Under Pennsylvania law, injured workers whose employment has been terminated for filing a workers’ compensation claim, may pursue a wrongful discharge suit against their employers.  [Shick v. Shirey, 552 Pa. 590, 716 A.2d 1231 (Pa. 1998)]

Union-represented employees, however, cannot pursue a wrongful discharge lawsuit if the collective bargaining agreement protects the employee from discharge without proper cause.  [Phillips v. Babcock and Wilcox, 349 Pa. Super 351, 503 A.2d 36 (1986), appeal denied, 514 Pa. 618, 521 A.2d 933 (1987); Harper v. American Red Cross Blood Services, 153 F.Supp.2d 719 (E.D. Pa. 2001)]

The commonwealth or its political subdivisions are not subject to such a wrongful discharge claim because it does not fall within the exceptions to sovereign immunity outlined in 42 Pa. C. S. § 8522 (b).  Similarly, local agencies are immune from such lawsuits under the Pennsylvania Political Sub-Division Tort Claims Act, which does not recognize a wrongful discharge lawsuit.  [42 Pa. C.S.A. § 8542.  Kuzel v. Krause, 658 A.2d 856 (Pa. Cmwlth. 1995); Haiden v. Greene County Career and Technology Center, 2009 Westlaw 2341922 (W.D. Pa. 2009)]

Which Philadelphia work injury lawyer near me is the most reliable?

If you have been wrongly discharged in the aftermath of a workplace injury and considering actions against employers that are legally available to you, turn to The Liberty Bell Workers’ Compensation for aid.

We’ve been advocating for the rights of injured workers for well over two decades, securing more than $1 billion in benefits and winning the reputation of integrity and honesty among peers and clients alike. Don’t be tempted to hire cheap legal mill lawyers who barely know where the workers’ comp system comes from. Give us a call today or visit our offices at Temple University Center City Campus, and see for yourself the difference a highly professional team can make!

Cases dismissed for lack of prosecution. Showing up for court harried, overworked, and unprepared. Redying witnesses moments before the hearing. Withdrawing cases in an effort to judge shop. Conducting medical depositions without having reviewed the file. Performing inept cross-examinations that were not prepared in advance. Writing hurried briefs that do not accurately or cogently summarize the evidence. Selling out clients.

These are among the most common complaints about workers’ compensation mills, where lawyers are more interested in generating fees than representing their clients.

A reputable work injury attorney from Philadelphia should avoid presenting testimony from any witness who has not been prepared at least one day in advance and should have all questions ready in advance, including cross-examination. Medical testimony is most effective when the lawyer arranges all records in chronological order and forwards them to the physician well in advance of the deposition. Lawyers should prepare talking points for the preparation of the doctor and discuss anticipated cross-examination.

Unfortunately, lawyers at the legal mills care about one thing only and too often “wing it”, rather than taking these basic steps necessary to ensure their clients’ well-being.

Lazy Lawyers Phoning It In

Medical evidence in Pennsylvania workers’ compensation cases usually must be done in a formal deposition at the doctor’s office with opposing lawyers and a court reporter. At a deposition, one lawyer presents the testimony of the witness and the other cross-examines. Anyone with a Pennsylvania workers’ compensation claim (or personal injury case) has the right to expect that his or her lawyer will be well-prepared when presenting testimony from expert witnesses or cross-examining experts hired by the insurance company.

The inexperienced and rushed attorneys at many of these firms “wing it” when presenting testimony from their clients’ physicians, doing little more than having the doctor repeat comments made in medical reports. Cross-examination of insurance company doctors is even worse. Lawyers in these mega-firms do not leave their desks, cross-examining doctors by phone while the lawyer representing the insurance company is physically at the deposition. 

The lawyer has no way of knowing whether the defense attorney is providing signals to the doctor.  If he wished to do so during a telephone deposition, the defense attorney could press the “mute” button while the doctor looks through medical records, coaching the doctor with advice on how to answer questions.

Another common issue with legal mill lawyers is that they do a lousy job cross-examining these doctors. Many insurance company doctors have terrible reputations. The judge, however, has to base his or her decision on the facts of the case. If the attorney does not ask the insurance company doctor about the hundreds of thousands of dollars he earns every year working for insurance companies, the judge will not have that evidence available to explain why he or she found the insurance company physician to be not credible.

In other words, you can hire a lawyer who takes your case seriously or you can hire one who literally “phones it in.”  

Rich Law Firm, Poor Representation

Another one in a long line of complaints about Pennsylvania Workers’ Compensation legal mills is that lawyers handle your case like a product on an assembly line. There have been instances when people hire one attorney, only to be handed off to someone who is young, overworked, and inexperienced. 

Too often, legal mill staff members would instruct claimants to testify at a hearing, with no explanation about what they will be testifying about or even what to expect. After a sleepless night, the nervous witness meets their lawyer for the first time.

Similarly, there’s an instance where a claimant met the attorney who was handling his case for the first time – on the morning of the hearing. Although she appeared to be smart, it quickly became apparent that she had not read the file.

There Is No Substitute For Experience

While speaking with a severely disabled client recently, we realized, once again, just how important experience is. We had asked her a few days earlier to think about the ways her disability affected her. She spent a few days thinking about it and then we interviewed her.

She had extreme difficulty explaining the ways her condition and multiple surgeries interfered with her normal activities of daily living. The “new normal” prevented her from explaining how her plight had disrupted the lives of her and her family. We knew right away the questions that needed to be asked, and in half an hour we had a concise, if harrowing, description of the way her life had changed.

Twenty-five years ago, it would have taken me days to put this together because we simply would not have known the questions to ask. After years of talking to people and finding out the ways that their lives have been affected by misfortune, we know what they’re going through.

This kind of experience can’t be taught to a young lawyer, no matter how hard you try.

Where can I find an experienced work injury attorney near me in Philadelphia?

Beware of any firm that claims to be “the best law firm in America.” If you need to put food on your family’s table, you need to hire a lawyer who will provide you with solid, continuous representation throughout your case. 

In Philadelphia, you can find that kind of lawyer at Liberty Bell. Our team comprises honest, hard-working, and experienced attorneys, with a well-developed reputation for integrity with judges and extensive knowledge of the work comp system in Pennsylvania.

Representation by our lawyers can mean all the difference for your case, giving you the best chance of securing a favorable outcome and the maximum premiums that you deserve. Reach out to us today via phone or chat platforms, or schedule an appointment at our offices near JFK Plaza for a free consultation.

It is a prevalent misconception that most employees have an obligation to be treated exclusively by a company doctor after suffering a work injury. Despite employers asserting the necessity of adhering to a “panel provider” during the critical 90-day period post-injury, the reality is that many workers encounter significant hurdles in securing medical practitioners willing to treat them within these confines.

This raises a crucial question: should employees unquestioningly trust a company doctor, or is there a need to critically evaluate the implications of such mandated medical care? Delving into this dilemma will require the help of a proficient Philadelphia work injury attorney,  but it will go a long way toward ensuring you make informed decisions that will expedite your recovery.

Why should you have to wonder if your doctor cares about you?

There are many reasons why the trustworthiness of company-endorsed healthcare providers should always prompt a closer examination. Here are several examples that will help you gain some perspective on the matter.

Example 1: Dishonesty in omission

A client with post-concussive syndrome recently reminded us of the dramatic way that employer-designated medical providers treat workers’ compensation patients differently from the way private medical providers treat patients. 

At each visit after the first one, the panel neurologist asked her to tell him what areas had improved, which he duly noted in his records. However, he didn’t ask her any other questions pertaining to her symptoms.

For example, she still had photophobia but her headaches were somewhat better. However, all the office note said is that her headaches were better. As a result of his omission, you would think that the other symptoms didn’t exist. While the office note was accurate, it was dishonest because it was incomplete.

Example 2: The 180° turn

Similarly, in employer-designated physical therapy centers, physical therapists push patients to report improvement even when they are not getting significantly better. “Come on, you must be feeling a little bit better,” is a typical declaration injured workers get at physical therapy centers they have been referred to by company doctors.

If their backs are in spasm, which is a serious sign of injury, these facilities often report “tightness” or “tenderness to palpation.” Company doctors know that injured workers only have an obligation to treat with them for 90 days and often report significant improvement during that time, even when there has been little or none. 

Furthermore, when patient treatment reaches about the 70th day, many company doctors suddenly begin to describe “pre-existing conditions” as the cause of the patient’s symptoms, knowing that the patient will not be treated by them for longer than 90 days.

Example 3: Blind coverage denial

A former medical director for Aetna Insurance Company admitted under oath that “he never looked at patients’ records when deciding whether to approve or deny care.”  The stunning admission came amidst a deposition taken in a lawsuit filed by a college student who suffers from a rare immune disorder and needed Aetna to pre-authorize an expensive infusion.

The medical director, who signed the pre-authorization denial, admitted that he knew next to nothing about the disorder and testified that he never looked at any medical records in his entire career in connection with any review of medical treatment made by Aetna. 

The silver lining

There are some very fine medical providers who treat patients at the request of insurance companies or employers. There is no reason, however, why patients should wonder whether the provider’s loyalties are to the insurance company or them.

For this reason, those who have suffered serious work injuries should almost always try to get documentation of their symptoms from a primary care physician – even during the 90-day period during which they are supposed to be treated by the company doctor.  Furthermore, when the company’s 90-day treatment period expires, it’s time to get treated by someone you are sure is honest.

Where in Philadelphia can I find an experienced work injury attorney near me?

At Liberty Bell, you can find the finest lineup of workers’ compensation attorneys on either side of Schuylkill River. Our seasoned legal team adopts a client-centric approach, tailoring our strategies to reflect the unique circumstances of your case. We possess a profound understanding of the work comp system and we’re widely recognized in Philadelphia for our integrity and commitment to justice.

Don’t fall into the trap of legal mills whose only goal is to enhance their bottom line. Contact us today and ensure you have a partner who’s willing to fight tooth and nail to ensure the best outcome for your case!

In workers’ compensation cases, the relationship between claimants and insurance companies often seems like a high-stakes game of chess. The problem is that you, as a claimant, must play the game, while the insurers play the rules.

While the system is designed to provide financial relief to those injured on the job, it’s no secret that insurance companies often employ a host of less-than-honest strategies to protect their bottom line.

Every workers’ compensation attorney in Allentown knows this and, as someone whose livelihood may depend on a successful claim, you need to be acutely aware of these strategies as well.

Today, we’ll be exploring several of these tactics, offering you an invaluable insight into how they work, in order to equip you with the knowledge essential to recognize and protect yourself in the face of the insurance industry’s schemes.

Notice of Temporary Compensation Payable: The 90-Day Trap

If the workers’ compensation insurance company is paying benefits to you pursuant to a Notice of Temporary Compensation Payable (TNCP or NTCP), you may be in for an unpleasant surprise. Benefits paid pursuant to such a document can be stopped by the insurance company at any time within 90 days of the date your disability began. By “coincidence”, the period of time during which you may be required to treat with a company doctor is 90 days.

Why does this make a difference? If the insurance company issues a Notice of Compensation Payable (NCP), or if they pay you benefits pursuant to a TNCP for more than 90 days, the company is legally responsible for your claim, which means that they have to keep paying you benefits until you agree to let them stop, you return to work at no loss of wage, or they obtain a court order, which is not easy. 

Insurance companies are well aware of these deadlines and deal with them by entering into cozy relationships with company doctors. The doctor who is so nice to you for the first 60 days may suddenly turn on you just in time for the insurance company to issue a notice denying your workers’ compensation claim and stopping your benefits.

Insurance companies pressure these doctors to release work injury patients before 90 days have expired. This is ordinarily accomplished by having the doctor say that you have recovered or that your problems are related to some pre-existing condition.

Pennsylvania Supreme Court Subrogation Cases

The Pennsylvania Supreme Court has issued several cases that have a significant impact on an insurance company’s right to recover from the proceeds of personal injury cases against third parties arising out of cases in which the plaintiff has received benefits for a work-related injury.

Pennsylvania State Police v. Workers’ Compensation Appeal Board, 184 A.3d 958 (Pa. 2018)

Watch out if an insurance company tries to assert a right of subrogation in a case under the Motor Vehicle Financial Responsibility Law where the plaintiff is receiving Heart and Lung Act benefits. 

The Heart and Lung Act provides for payment of full salary and medical expense benefits to certain municipal employees including firefighters and police officers who are temporarily disabled because of work-related injuries.

An insurance company has no right of subrogation for either salary or medical expense benefits paid under this statute. Sometimes an insurance company will claim they are entitled to recover the amounts that were otherwise payable under the Pennsylvania Workers’ Compensation Act, or approximately two‑thirds of salary benefits and all medical expense payments.

They have no such right. If the third-party claim is covered by the Motor Vehicle Financial Responsibility Law and the benefits were paid pursuant to the Heart and Lung Act, the insurance company or the employer has no right of subrogation.

Whitmoyer v. Workers’ Compensation Appeal Board, 186 A.3d 647 (Pa. 2018)

Sometimes insurance companies try to slip language into third-party settlement agreements that give them the right to reduce payment of future medical expenses. For example, an insurance company may put language in a third-party settlement agreement in which they agree to pay 40 percent of future medical bills with the plaintiff/claimant to pay the remainder.

Under Pennsylvania law, following repayment of compensation paid to the date of the third-party settlement, the employer or the insurance company may not reduce payment of future medical expense benefits. They have the right to pay reduced wage loss benefits in the future if the third-party recovery exceeds the amount of the lien, but they do not have the right to reduce future medical expense payments.

Pennsylvania Workers’ Comp Offsets

It’s bad enough that your benefits are fixed on the date of injury and never go up. Insurance companies also have the right to cut your workers’ compensation benefits based on other benefits that you receive.

• If you are receiving Social Security Retirement benefits, the insurance company is allowed to reduce your wage loss benefits by an amount equal to half of your monthly retirement benefits.  
• If you’re receiving pension benefits from a plan that was funded by the employer for whom you were working at the time of injury, the insurance company can take a dollar-for-dollar credit for those benefits.
• If you received a severance package that was funded by your time-of‑injury employer, the insurance company has a right to take credit for that.

Your benefits will also be reduced for each dollar you receive in unemployment compensation benefits during your period of work-related disability. The insurance company giveth and the insurance company taketh away. 

Where to find an experienced workers’ compensation attorney near me in Allentown?

If you need an adept legal team that factors in every detail to help you realize maximum benefits while avoiding common work comp pitfalls, you won’t find anyone better on either side of Little Lehigh Creek than Liberty Bell. 

For more than two decades, our ethical attorneys provided comprehensive guidance to injured workers throughout Allentown and the region, helping them realize maximum benefits and secure their future. Today, we’re here to do the same for you. Reach out to us for a 100% free, no-obligation consultation!

Considering how life-altering workplace injuries can be, both physically and financially, securing fair compensation through a workers’ compensation claim can be a critical step toward financial stability.

However, while settling a work comp claim can provide you with the support you need to recover and move forward with your life, this process is not without its hidden dangers that, more often than not, go unmentioned.

Fortunately, it is possible to avoid these common pitfalls, especially if you have a good Allentown workers’ compensation attorney, who will expand on the information we provided here, thereby giving you all the tools necessary to successfully realize your claim.

Understand the Compromise and Release Agreement

In Pennsylvania, workers’ compensation cases are settled by entering into a compromise and release agreement. The parties then must go to a hearing in which the workers’ compensation judge determines whether the injured worker understands the significance of the agreement.

In Hong v. WCAB, 51 A.3d 905 (Pa. Cmwlth. 2012), the injured worker entered into a lump sum settlement. The agreement did not say whether unpaid medical bills would be paid in addition to the lump sum. After the settlement, the injured worker learned that one physician had an outstanding bill in excess of $37,000.00 which the employer refused to pay.

The Commonwealth Court stated that to set aside a compromise and release agreement, the party trying to set it aside must show fraud, deception, duress, or mutual mistake. The court found that none of these factors was present. 

The court found that had the claimant wanted to ensure payment of past medical bills in addition to the lump sum, his counsel could have included appropriate language in the agreement. That the claimant had counsel was an important factor for the court.

Bottom line: Make sure you understand the Compromise and Release Agreement, including any provisions concerning the payment of medical expenses.

Protecting your right to medical coverage

If you are keeping the medical expenses open when you settle your case, look closely at the language. Sometimes injured workers will settle a workers’ compensation case while keeping the insurance companies’ responsibility to medical bills open.

In DePue v. WCAB, 61 A.3d 1062 (Pa. Cmwlth. 2012), the injured worker entered into a compromise and release agreement which described the injury as “closed head injury with seizure disorder and short-term memory loss.”

After the compromise and release agreement was approved, the injured worker filed a penalty petition alleging that the employer failed to pay for medical bills for a shoulder injury and then filed a review petition to add a left shoulder injury to the description of injury.

The Commonwealth Court ruled that the injured worker cannot do so. In connection with the resolution of the case, the injured worker is bound by the description of injury contained in the compromise and release agreement. 

The parties can, by agreement, say that the agreement is without prejudice to the right of the claimant to add additional injuries at some future point. Absent that language, the injured worker is going to be bound by the description of injury contained in the compromise and release agreement.

Bottom line: If you are keeping medical expenses open in the settlement of your workers’ compensation case, pay careful attention to the description of the injury contained in the agreement, to avoid falling into this common insurance company’s trap.

What was the biggest workers’ comp settlement in Pennsylvania?

This is one of the most common questions work comp lawyers hear anywhere from Lehigh Valley to Pitsburg, expecting to hear about astronomical sums. The truth, however, is – it doesn’t really matter.

There are limits on the benefits an injured person may receive under the Pennsylvania Workers’ Compensation Act.  For the profoundly injured or disabled worker who may need expensive medical care, it may make no sense to settle a workers’ compensation case.  Merely because an attorney settled a workers’ compensation case for a large sum of money may mean nothing if the client gives up medical coverage.  If the settlement is used to pay for medical treatment and the money runs out, the client may have nothing but Medicare to pay for additional medical treatment, and Medicare has very significant coverage limitations.

Workers’ compensation is not like a personal injury law, in which an individual can recover for loss of future earning power, pain and suffering, and economic damages.  Most workers’ compensation recoveries in Pennsylvania are limited primarily to medical expense coverage. When the parties settle a workers’ compensation case, it is a true settlement in which all parties agree to the settlement amount. In a personal injury case, an attorney can always let a jury decide the value of the case. That cannot be done in workers’ compensation court.

If a firm brags about a multi-million-dollar workers’ compensation settlement, they represented somebody who suffered a catastrophic injury and settled the case for a lump sum the insurance company was willing to pay because it thought it would be cheaper than paying for future medical expenses. 

If the insurance company thinks it is cheaper to pay millions in a lump-sum settlement of medical expenses, do you think the worker may have been better off with open life-long medical coverage? Don’t be fooled by people bragging about settling such cases.  We routinely reject requests to settle their claims for medical benefits because it sometimes is not in the interests of the profoundly sick or injured to give up medical coverage.

Where in Allentown can I find a dedicated workers’ compensation attorney?

At Liberty Bell, we have extensive experience helping individuals navigate the convoluted alleyways of Pennsylvania’s work comp system. Our team of highly knowledgeable lawyers from Allentown knows the ins and outs of the process and can help you avoid common dangers and pitfalls with the utmost confidence. Reach out to us today for a free consultation and ensure you have a team who will fervently advocate for your rights!

It is a well-known fact that workers’ compensation cases can become extremely complex, either from the very beginning or at some point during the process, primarily because of a massive number of factors that must be taken into consideration.

While having complete medical documentation and adept legal guidance from a reputable work injury attorney in Allentown are key, there are two lesser-known factors that can impact the favorable resolution of your claim: the witness’s memory and the judge’s mindset.

How can the witness’s memory impact the claim resolution?

While we generally think our memories are excellent, we tend to reconstruct the past in a way that is consistent with our interests and emotional needs. However, this also makes our minds easily tricked into remembering things that did not occur.

Attorneys throughout Lehigh County often deal with witnesses who are far too confident in their recollections. Some people simply cannot be convinced that their memories may be wrong no matter how strong the evidence.

A real-life example

Years ago, a young associate I supervised was concerned that a particular witness in a workers’ compensation case did not wish to acknowledge that her memory of the events that led to her injury was incorrect. The theory in the case was simple.

She was a woman in her 50s who, for many years, hoisted reams and boxes of paper onto her right shoulder to carry them from one location in the store to the other. Over the course of time, her right rotator cuff deteriorated and finally tore. 

Because virtually all the burden of doing this was on her right shoulder and arm, her left rotator cuff was fine. The woman, however, was convinced she suffered a specific incident in which she hurt her shoulder. 

While it is probable that, at some point, she started feeling some pain in her shoulder when she lifted boxes, the problem was that she wrote two separate statements about how she injured her shoulder and made no mention of any specific incident.

In both statements, she said that she developed the symptoms over time. This was a perfectly reasonable explanation for her condition which, if accepted by the judge, would have resulted in a determination in her favor.

To make matters worse, the medical records of five separate medical providers, including a physical therapist, made no mention of a specific incident resulting in an injury. She insisted, however, that she told “all of them” about the time she lifted a box of paper on her shoulder and hurt herself. 

I explained to my associate that she needed to discuss with the woman the problems associated with contradicting her own medical records and statements and talk to her about the fallibility of memory and the tendency for people to remember things that occurred in the past in a way that is consistent with their emotional makeup, needs, and interests. 

I joined the associate in a conference room while she spoke with the claimant. She began by discussing the issue of memory, and the client acknowledged that she understood that memory is fallible. She discussed the problems associated with contradicting your own statements when testifying before a judge.

She explained the problem of trying to say that six separate medical providers had somehow recorded her history incorrectly. In the end, the woman agreed her memory of the incident was wrong, and that there could not have been a specific injury that resulted in her rotator cuff tear.

The U-turn

When she appeared before a judge, she testified consistently with her statements and the history that she provided to her medical providers, stating that the symptoms had occurred over the course of time and seemed to worsen during work hours. Her testimony was perfectly fine.

However, on cross-examination, the attorney asked the claimant if there was a specific incident that resulted in her injury. So strong was her memory of a specific incident, that she fell into the trap.

She claimed there was a specific incident, and then was subjected to 25 minutes of cross-examination during which she was confronted with both of her witness statements and the medical records from six different medical providers in which no history of a specific incident was recorded.

The Outcome

I genuinely believe this woman was testifying truthfully, in the sense that she honestly believed that her shoulder injury had resulted from a single incident in which she had lifted a box of paper onto her shoulders. I also believe, however, that this memory was completely false and that her shoulder problem resulted from repetitively lifting such boxes onto her shoulder over the course of time.

When the pressure was on, however, she could not resist insisting on the accuracy of her memory, which had predictable consequences: While my associate was able to get the case settled, the value of the settlement had gone down considerably. 

The Takeaway

When a witness testifies to a story that is contradicted by multiple documents containing descriptions of statements made by the witness, it is nearly impossible to convince a finder of fact that the witness is testifying truthfully. 

Therefore, if you’re due to testify in a workers’ compensation case, it is highly advisable to acknowledge the fact that your recollection of past events may not be perfect and to rely on the guidance of your legal counsel instead.

Will the mindset of the judge affect the outcome of my case?

Does the mindset of the judge have an impact on the likelihood that you will win or lose your workers’ compensation case? This is one of the most common questions we hear in our law firm and the answer is, unsurprisingly, “yes”. Like everyone, workers’ compensation judges in Pennsylvania have their own viewpoints, biases, and life experiences. 

Some are highly skeptical about certain medical providers. Others are skeptical about particular attorneys or law firms. Some judges are pro-employer, others pro-claimant. As such, it is only natural to conclude that the mindset of the judge can have a serious impact on whether you win or lose your workers’ compensation case.

Who’s the preferred work injury attorney near me in Allentown?

Whether you wish to discuss your options regarding long-term disability benefits or need a reliable team to help you avoid insurance companies’ traps after filing a claim, Liberty Bell should be your first choice. With a proven, 20-year-long track record of success, our dedicated team from Allentown has extensive experience of the region’s legal landscape and can help you navigate every facet of Pennsylvania Workers’ Compensation law with utmost confidence. Reach out today!

Many working Americans have long-term disability coverage through their employers. What they don’t realize is how the deck is stacked against purchasers of employer-supplied disability insurance.

Imagine you were injured in an automobile accident and filed suit against the man who drove his car into the back of yours because he was busy texting his bookie. You showed up in court and amazingly enough, the judge is the person who smashed into the back of your car! 

Over in the jury box are his wife and family. The defense attorney is his brother. You, of course, are all alone, because you didn’t know that you needed a work injury lawyer in Allentown. What do you think the outcome will be?

License To Steal: How Long-Term Disability Insurance Companies Cheat You Blind

The above hypothetical scenario, disconcerting as it may be, paints an almost perfect picture of how long-term disability claims are handled. Though the law that governs these types of policies says that the insurance companies are supposed to administer these claims in a fair and impartial manner, most of the insurers pay lip service to this requirement.

The insurance company has an array of professional claims people who gather your medical records, and have them reviewed by physicians who make their money certifying that you’re not disabled. Claims personnel make intrusive phone calls to your doctors and then place misleading descriptions of the conversations in the claim record.

To top it all off, you probably won’t know that you’re entitled to take a look at all the records that the insurance company is using to determine whether you’re entitled to benefits. If the record in the case is closed by the insurance company, you won’t have the right to submit more evidence into the record if you’re required to take an appeal of the decision to a federal judge.

Considering all the complexities of the process already imposed by the system, as well as the immense potential for further complications, it’s safe to say that trying to pursue a long-term disability claim on your own would be a grave mistake. Instead, hire an experienced lawyer at the earliest possible moment and let their expertise guide you toward financial security.

Supplementing Your Lost Income: How Your Long-Term Disability Insurance Should Bridge The Gap

After a life-changing injury or medical condition leaves you disabled, it can be difficult to know what your future has in store for you. Other than your own recovery, one of your first priorities is to secure your finances.

Facing what could amount to years without an income is certainly frightening, but fortunately, long-term disability insurance may be able to help you stay afloat during your absence from the workplace.

However, while long-term disability insurance can be a wonderful asset, it can also be very tricky for some individuals to obtain. With complicated application and appeal procedures, many people have a challenging time collecting the benefits that they have paid for much of their tenure with a particular employer.

When these individuals do finally succeed in obtaining long-term disability benefits, many are surprised to learn that it is not an immediate and complete income replacement: it acts primarily as a supplement and is not available immediately. Here are some important things to know about your long-term disability policy benefits:

• You will not receive your long-term disability benefits immediately after you apply. There is a window in which you will not receive long-term disability benefits. This is known as the elimination period and typically lasts three to six months. During this time, your short-term disability will still be paying out, so you will still have some supplemental income.
• You may have to apply for Social Security Disability Insurance, as well. Insurance companies are concerned with their bottom line, and if there is another way for you to collect money, they will insist that you do so. If your Social Security Disability Insurance application is successful, the amount you receive monthly will be taken out of your long-term disability benefits, and you will receive the excess.
• Long-term disability benefits are not meant to replace your income, they are meant to supplement it. This means that you will be receiving a percentage of your income, which will be outlined in your long-term disability insurance policy. Typically, those on long-term disability receive about 60% of their former income.
• Employer-sponsored plans are covered by the Employee Retirement Income Security Act (ERISA), a law drafted to benefit employers, not employees. If your claim is denied, you may have to pursue internal appeal rights. If you do not have an attorney assisting you in your internal appeal, the decision may be nearly impossible to get reversed.

Now That Taxes On The Wealthy Have Been Cut, It’s Time To Cut Benefits For The Disabled

One of the saddest myths perpetuated by the right is that most people collecting Social Security disability benefits are lazy, as Senator Rand Paul once implied. “Who doesn’t get up a little anxious for work every day and their back hurts?” – Senator Paul asked, demonstrating that he has no idea what the program is about.

President Trump’s 2018 budget called for $72.5 billion in cuts in SSDI and supplemental security income (SSI), another program for disabled people, over 10 years. His position on this is ironic, given that nine out of the ten counties with the highest share of working-age adults collecting SSDI benefits voted for him. 

Social Security Disability Insurance (SSDI) is not a welfare program

We pay into the program to insure against the risk that someday our bodies may give out on us and we will be unable to work. The benefits paid are meager and difficult to get. Sixty percent of the claims are turned down anyhow and, if you appeal a denial, it can take as long as 2 years to get a hearing before a Social Security judge. 

SSDI is a program for people who are desperately ill and suffering from cancer, severe heart disease, uncontrollable diabetes, or other terrible ailments. Beneficiaries of SSDI benefits have a mortality rate that is three times that of people their age. About one-fifth of men and one-sixth of women in the program die within 5 years of getting their first Social Security disability check. 

Do You Qualify For Social Security Disability Insurance Benefits?

The process for applying for Social Security Disability Insurance (SSDI) benefits can be daunting. Many people are unsure of where to start and are intimidated by the large number of applicants who are denied benefits each year.

One of the first questions we are often asked as Social Security disability attorneys is if the individual even qualifies for SSDI benefits. While it can be challenging to determine each individual’s eligibility, especially since many people suffer from several ailments simultaneously, we have included some of the basic requirements for disability benefits below.

Are You Eligible to Receive Social Security Disability Benefits?

SSDI benefits are benefits that you work hard to earn, and have paid for over your working life through FICA taxes. Depending on the length and recency of your work history (it varies based on your age), you may have already met the work requirements to be eligible for SSDI, so let’s look at some of the other qualifiers:

• You are unable to work because of a disability;
• You have medical records that support your disability;
• You have been, or are expected to be, disabled and unable to work for at least 12 months;
• You are under the age of 65.

The Social Security Administration provides a comprehensive list of qualifying disabilities, and here is an example of just a few:

• Blindness;
• Amputation;
• Cancer;
• Traumatic brain injury;
• Spine injuries;
• Multiple sclerosis;
• High blood pressure or cholesterol;
• Heart conditions;
• Diabetes;
• HIV-positive diagnosis;
• Mental impairments such as depression, bipolar disorder, schizophrenia, or PTSD.

Each condition has its own set of guidelines and standards for being considered a disability, and solid medical evidence of your conditions and treatments provided by your physician can greatly help your case. Remember, be sure to list all of your conditions when applying for SSDI and not just the ones you consider disabling, as their effects will be considered as a combined whole.

Star Trek, Social Security Disability, and the Nature of Human Rationality – Thinking Like Mr. Spock Is Not Logical

In Antonio Damasio’s book, Descartes’ Error, he relates the story of a patient he calls Elliot, who appeared to be “intelligent, skilled and able-bodied,” but who nonetheless was incapable of working and whose application for disability benefits had been denied.

When Dr. Damasio met Elliot, he was coherent and capable of talking about all that was occurring in the world, including political affairs, history, and business. His memory of his life story was flawless.

Elliot had an excellent job and was rising up the ladder in a good firm. Eventually, however, he began to develop headaches that interfered with his ability to concentrate. His condition worsened, and his work had to be completed or corrected by others. His family physician suspected a brain tumor, which turned out to be correct. 

Just above his naval cavities, he had a tumor about the size of an orange that compressed both frontal lobes. Though benign, the tumor was growing rapidly and he had to undergo surgery if he were to survive.  His medical team successfully removed the tumor. Unfortunately, however, he was left with a radical change in personality.

Though he continued to be intelligent, he could not get up for work without prompting. He proved to be unable to manage time and devoted inordinate effort to activities that were only loosely related to his main tasks or were relatively trivial compared to other pressing matters.  

He read and understood the materials provided to him, but he would devote his time to activities he found most interesting rather than those that were most important. For example, he occasionally began sorting client documents, which he ordinarily did well. Suddenly fascinated by a particular document, he would waste an entire day reading and analyzing it, ignoring more important tasks.

Soon he lost his job, fell prey to con artists, and lost all his money and his family. Elliott suffered no anxiety from his poor decisions. He accepted catastrophic reversals with complete aplomb, never losing any sleep. He could have starved to death, calmly accepting his terrible fate.

Star Trek fans think of emotions as interfering with, rather than supporting rationality. When the Enterprise faced annihilation at the hands of the evil Klingons, Captain Kirk nearly always turned to Mr. Spock, whose emotionless logical advice often saved the day. Had Elliott been advising Captain Kirk, he might have been too busy making a paper clip chain to consider how to maneuver the ship away from the Klingon death rays.

Decision-making can be rational only if we suffer the emotional consequences of error. Though anxiety can be disabling if it is excessive, it is an adaptation crucial for survival. If he were not a fictional character, it is likely that Mr. Spock would need Dr. Damasio to testify in his social security disability hearing.

Who’s the leading work injury lawyer near me in Allentown?

While long-term disability benefits do have certain limitations, they are an important financial lifeline for many individuals and families throughout the United States. If you have been injured and are applying for long-term disability benefits, or have already been denied, reach out to Liberty Bell Workers’ Compensation today, located near Allentown Public Library.

With decades of experience in the field and thousands of successful cases behind us, we’re the premier team to guide you through the complexities of Pennsylvania’s legal system. Don’t wait to realize your rights – call our office or begin a live chat now to schedule a free consultation with our firm!