Can my employer try to terminate my workers’ compensation benefits?
Yes. Under the Pennsylvania Workers’ Compensation Act, your employer may file a petition to terminate your right to workers’ compensation benefits, if it can show that you are no longer disabled or that any remaining disability is unrelated to the injury. Your employer can win a termination of benefits if its medical expert offers testimony that you are fully recovered, that you can return to work without restrictions, and that there are no medical findings to support your complaints of pain.
Recently, Francis Ciprero defeated a Termination Petition filed by an employer against his client, who was injured in 2009 as a result of a slip and fall. A Philadelphia area Workers’ Compensation Judge presided over the hearings, and ultimately denied the Termination Petition. As a result, Mr. Ciprero’s client will continue to receive both wage loss and medical benefits.
Will a pre-existing problem, like arthritis, prevent me from getting workers’ compensation benefits?
No. Under the Pennsylvania Workers’ Compensation Act, even if you had a pre-existing problem, such as arthritis, you may receive benefits if you can show that an aggravation, re-activation or acceleration of the condition occurred as a result of your job duties or the work incident.
David Stern filed a Claim Petition on behalf of a worker who had injured his low back while lifting heavy trash. The injured worker continued to work over the next two years, performing heavy job duties while in constant pain. He eventually stopped working because of the injury, under the advice of his doctor. Although the injured worker’s employer had agreed to pay for medical expenses related to the work injury, it refused to pay for any wage loss benefits after the injured worker stopped working.
Mr. Stern presented medical evidence which proved that although the injured worker had pre-existing problems in his lumbar spine, his work duties caused an aggravation-type injury, which explained the injured worker’s complaints and problems and inability to work following the incident. The Workers’ Compensation Judge approved Mr. Stern’s Claim Petition, and awarded wage loss benefits, dating back to when the injured worker was pulled out of work by his doctor due to the injury, plus interest.
What is an IRE?
If you are receiving workers’ compensation benefits, your employer may require you to attend a medical examination with a doctor of its own choosing. One type of examination is known as an Impairment Rating Evaluation (IRE), which can be requested up to two times within a 12 month period. If you refuse to attend, you may lose your right to receive benefits until you attend.
IREs are guided by the AMA Guides to the Evaluation of Permanent Impairment, which instructs that permanent impairment may only be rated after the status of Maximum Medical Improvement (MMI) is attained. MMI is defined as the point in a the recovery process where no formal medical or surgical intervention is expected to bring about any improvement to the injured worker’s condition.
David Stern represented an injured worker against a petition filed by the employer to force the injured worker to attend an IRE. Mr. Stern submitted evidence which demonstrated that the injured worker’s treating doctors had recommended surgery, which would minimize the pain he was experiencing due to his injury. The Workers’ Compensation Judge reviewed evidence submitted by both Mr. Stern and the employer and agreed that there was no clear evidence that the injured worker was at MMI. The employer’s petition to compel the injured worker to attend the IRE was denied.