Suffering a workplace injury can be a devastating loss for both individuals and their families. Navigating the often-complex legal process necessary to recover both physically and financially from such an event adds further difficulties to an already stressful situation.
At Pond Lehocky, we specialize in fighting for the rights of workers who have been negatively impacted by a work-related illness or injury, and it is our honor to help them recover to the greatest extent possible.
Workers’ Rights and Obligations
The Pennsylvania Workers’ Compensation Act is a law that was created specifically to protect employees who cannot work due to an injury or illness that occurred as a result of their employment activities. Under the law, affected employees may be entitled to wage-loss compensation and paid medical expenses.
All Pennsylvania employers are required to maintain insurance policies that will pay for workers’ compensation claims or to self-insure and pay those benefits directly. Employees have obligations under the Commonwealth’s workers’ compensation law as well, one of the most important of which is a strict deadline to report work-related medical issues.
Failure to promptly notify a supervisor or manager at the workplace where an injury occurred may result in a claim being barred. For issues that developed over a long period of time, such as repetitive and cumulative injuries, a manager or supervisor must be notified as soon as a qualified medical professional has diagnosed the condition. The same is true of job-related illnesses, such as mesothelioma, which can take years to manifest at a level sufficient for a definitive diagnosis.
Advocates for workers
All employees are entitled to represent themselves when making a worker’s compensation claim but doing so can put them at a significant disadvantage. The law firms representing workers’ compensation insurance companies vigorously defend their clients and attempt to minimize the benefits paid. Workers need an experienced and well-resourced legal team capable of fighting just as zealously on their behalf.
Even if an employee is already receiving workers’ compensation benefits, a consultation with an experienced attorney can reveal if the current benefit arrangement is appropriate and assist the worker in defending any challenges to their benefits or medical treatment being made by the insurance company.
Pond Lehocky Giordano offers all workers’ compensation consultations completely free of charge and accepts no fee unless the claim is successful. Under Pennsylvania law, successful workers’ compensation claimants only pay up to 20-percent of their benefits, and all attorneys fees must be approved by a judge.
Medical Examinations and Treatment
After a worker files a claim, employers are entitled to a DME (Defense Medical Examination) so that their medical expert can offer their opinion as to the extent of the injury or illness. The employer or their insurance company can make a DME request once every six months for every injury.
It should be noted that under Pennsylvania law, there is a 90-Day Rule that requires injured workers to utilize specific physicians within the first 90 days after the onset or diagnosis of their medical issue. Employers must notify employees of this rule and other requirements at the time of hiring, as well as whenever any changes are made, such as a change in the list of approved physicians. That list must include:
- At least six healthcare providers (three of which must be physicians)
- Providers that are geographically accessible
- Providers that are specialized in the conditions related to anticipated work-related medical issues
Pond Lehocky Giordano keeps its own on-staff medical team that has one goal: ensuring workers have access to the best doctors and medical care available. Our team ensures workers receive objective, accurate, and compassionate evaluations of their condition so that they have the best opportunity possible to recover from their illness or injury.
Third Party Lawsuits
Under the Pennsylvania Workers’ Compensation Act, an employee making a successful claim as the result of a workplace illness or injury is precluded from suing their employer. However, if a third party (i.e. someone other than the employer) was responsible in any way for the harm that occurred, that party can potentially be sued in addition to the workers’ compensation claim.
Injured workers making a successful claim for compensation are entitled to indemnity (wage-loss) benefits that are typically equal to two-thirds of their pre-tax weekly earnings before the injury occurred. There are minimum and maximum adjustments to that figure, however, required under Pennsylvania law. The maximum is based on the Department of Labor and Industry’s calculation of the statewide average weekly wage.
There are several types of workers’ compensation benefits:
- Wage Loss Benefits: payments to compensate for loss of wages due to total or partial disability
- Death Benefits: payments to the surviving dependents of a worker who died as the result of a workplace illness or injury
- Specific Loss Benefits: payments to compensate for the loss of a body part, the permanent loss of the use of a body part, or for permanent scarring or disfigurement to the neck, face, or head
- Medical Care: payments for reasonable surgical and medical care required to treat the workplace-related injury or illness
In cases of partial disability (situations where the worker can or does return to work in a lower paying role with work-related restrictions, or is found to be not totally disabled), benefits can be paid for a maximum of 500 weeks.
In cases of total disability, employers or their insurer are entitled to request a medical examination to determine if the employee has improved to at least 35-percent impairment (which is the threshold for a determination of partial, not total disability) every 104 weeks.
Let’s talk about your story.Always a FREE consultation. NO FEES unless you win.
If you have suffered a work-related injury or illness and need a lawyer for workers’ compensation, contact Pond Lehocky Giordano today at 1-800-568-7500.
YOUR WORKERS’ COMPENSATION CASE:
A VIDEO GUIDE
Learn about the entire claims process by watching this short video: