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There are two different sets of rules here:
1. The panel doctor rule: If the employer has a posted Panel of Providers ( doctors) and made you aware of your obligation to go treat in writing; you are required to treat with one or more doctors on this list if you want to pursue a WC claim. This Rule controls payment, not treatment. You are free to treat with your own choice of doctor within the first 90 days but Workers Compensation won’t pay for it unless it is an emergency. Many family doctors are unfamiliar with how this WC Rule works and will incorrectly tell you that they can’t treat you during the first 90 days. They are wrong about this but it is hard to tell them they are wrong.
Once the 90 days is up; you are free to treat with any doctor you want as long as: 1) You have a Notice of Compensation Payable, 2) The treatment is reasonable and necessary, 3) The doctor is licensed in Pennsylvania, 4) You give 5 days notice to the WC insurance company and 5) The doctor fills out the proper paperwork.
2. The IME Rule: First, please note that the term “independent medical examination” does not appear in the PA WC Law. The official name is : “physical examination or expert interview by an appropriate health care provider or other expert, who shall be selected and paid for by the employer (PEOEIAHCPOOE)”, Section 314 (a). Insurance Companies lie about this because they want you to think the exam is independent. This is worth noting; WC insurance companies are permitted to lie to injured workers.
The WC insurance company can request an PEOEIAHCPOOE ( see our IME Blog) every six months and/or once the case is in litigation in front of a WC Judge
The short answer is no. The long answer is yes.
The Notice of Ability to Return to Work is a “warning shot” by the WC Insurance Company that they are planning to take legal action to cut off or reduce your weekly or bi-weekly WC check. In 4 out of 5 cases; the PA injured worker receiving Workers Compensation will be in WC Court within 6 months. While the law does not provide for or require a response from the injured worker; it is foolish to ignore it. It may be too late to defend the claim well if you wait for the WC insurance company to file a Petition for Modification or Suspension against you. In most cases where a Notice of Ability to Return to Work is issued, the injured worker has been required to attend an IME ( misnamed; the actual name is Employers Medical Exam) or has been required to meet with a so-called Vocational Expert. ( The 1996 changes to the law require the injured worker to participate in these phony vocational meetings). These are warning signs that the WC Insurance Company plans to take the injured worker to WC Court; WC carriers don’t spend thousands of dollars on medical exams without expecting something in return.
Thus, the injured worker receiving a Notice of Ability To Return to Work needs to promptly develop a defensive strategy to win a contested WC case if the WC carrier files a Petition asking a WC Judge to reduce WC payments
The next logical question injured workers ask is “Do I have to return to work when I received a Notice of Ability to Return to Work LIBC-757 form?” Click on the link to see our blog about this.
Welcome to the first episode of Barbara Smith’s Pennsylvania Workers Compensation case. We, the attorneys and paralegals at Calhoon and Kaminsky, will be presenting a multi-part story of one woman’s Pa Workers Compensation journey. We will be discussing her injury, medical treatment, employer defenses, drug testing, Unemployment Compensation, Family Medical Leave, Average Weekly Wage, litigation, settlement and many other topics. Please feel free to send us questions and concerns as we move through all aspects of her case!
Barbara Smith is a 32 year old machinist. For the past 5 years she has operated a lath at the ACME Corporation. This is a skilled and difficult job. It is mentally stressful because of the pace of production and the tolerances required to manufacture titanium parts for the robot surgery industry. It is also physically demanding because of the requirement that the operator load the metal blanks from skids.
On January 16, 2015 Barbara was hurt at work. She had been up late the night before watching “Breaking Bad” with her boyfriend Todd and hadn’t had as much sleep as she should have. While daydreaming a bit; her machine started to jam. Barbara did not react as quickly as she should have. Instinctively, she reached with her right hand to save the valuable titanium blanks which were spilling on the floor. With her left hand; she pulled the safety switch which should have shut off the machine. It didn’t work and Barbara’s right hand and forearm became entangled in the cutting blades of the lath. Desperate to free herself; Barbara pulled backwards, freeing her injured hand but striking the base of her spine against her metal Operators Chair. Barbara had had problems with her low back for years after her years as she was catcher for semi-pro softball teams. On January 16, Barbara felt a sharp pain at her belt line in her back and a sharp pain radiating down her leg. To make matters worse, one of the titanium blanks shattered , sending a metal shard into her right eye. Barbara, in violation of industry standards, had pushed her safety goggles to the top of her head in order to focus on the computer screen on her lath. Barbara’s Supervisor had previously issued a memo to all machinists at ACME noting that it was strongly advised that safety glasses must be worn at all times on the production floor.
Question: What WC injuries did Barbara sustain on January 16, 2015? Answers:
- The hand /arm injury; This will be considered a work injury because it was caused by the work she was doing.
- The back injury: This is a separate and distinct injury from the hand arm injury. It certainly could be considered a WC injury since it was probably caused or materially aggravated by the January 16 incident despite her preexisting back problems
- The eye injury although the employer may argue that this injury should not be covered because she wasn’t wearing her safety glasses.
Extra Credit Questions to Consider : ( We will be discussing these in future episodes)
- What is the significance of Barbara being fatigued because she stayed up late the night before watching NetFlix with Todd? Can she be denied WC because of this?
- What is the significance of the injury occurring because Barbara was day dreaming when she should have been paying attention?
- What about the failure of the emergency shut off switch to work?
- What about the fact that Barbara had pre-existing back problems?
- Is Barbara responsible for her eye injury because she wasn’t wearing safety glasses?
- Can Barbara sue her employer for failing to make sure that the emergency cut off switch was operational? The maintenance of the machines was pushed back by the Plant Superintendent, who was bucking for a promotion.
- What is the relationship between the three injuries? Does Barbara collect three WC payments?
Injured workers often fear filing a claim for PA Workers’ Compensation because they are afraid that they will lose their job. An injured worker cannot be fired simply because they filed a Workers’ Compensation claim. If you are fired for only filing a Workers’ Compensation claim, it is unlawful. See our blog “Can my employer fire me in Retaliation For Reporting a Work Injury?“.
The Employer can on the other hand terminate an employee for other reasons while they have an open workers’ compensation claim. Some common examples are that the employee is working light or modified duty or even full duty and the employee violates a company policy such as: attendance/tardiness; production or sales exceptions; even arguing with a supervisor; or the company may be laying-off employee’s including the injured worker due to lack of work. These situations all affect the injured employee’s Pa Worker’s Compensation benefits differently. The details about the injured worker’s termination are very important and in some cases may still allow for them to reinstate or re-start collecting Workers’ Compensation wage loss benefits. However, these situations are dependent on very specific facts surrounding the termination and the injured worker’s medical restrictions which are different for each injured worker. The situation should be discussed with an attorney to evaluate the circumstances around the termination and the Workers’ Compensation claim status in order for the injured worker to understand their rights.
If you were fired while on Pennsylvania Workers’ Compensation and you have questions, contact the legal team at Calhoon and Kaminsky. We will provide you a free case evaluation and answer all your questions to give you peace of mind.
I highly recommend Mr. Cook. He has represented more than once and consistently remained calm, professional, supportive and provided great guidance. With his assurance I was able to represent myself appropriately when called to do so. In addition, he made sure to address all my concerns and kept me focused on achieving my goals.
Anonymous Review on AVVO – Sept 8, 2016
Serious head trauma from a Pennsylvania work injury can be extremely difficult on the injured worker and on their family. Often the injured worker’s life changes in ways that are hard to imagine from not being able to care for themselves any longer to drastic changes in their behavior and personality. Caring for these injured workers is not only difficult on their families but it can be challenging to find the proper medical facilities and assistance programs that will be needed as part of a life-long care plan. These are all concerns that their PA Workers’ Compensation Attorney needs to keep in mind when adjudicating or settling their Workers’ Compensation claim for a serious head injury.
Injured workers may need specialized rehabilitation and lifelong nursing care depending on the severity head-injury. Specialists should be brought to perform neuropsychological evaluations to see what medical treatments and programs the injured worker may need in the future. A quick settlement may not be in the best interest of the injured worker. Giving the injured worker time to use the benefits of the Pennsylvania Worker’s Compensation Insurance Carrier to develop a baseline of care maybe advisable to better understand how the injured worker is recovering and if future inpatient or outpatient care will be required.
If you suffered a head injury while working in Pennsylvania, call the team at Calhoon and Associates for a free case evaluation. We are here to provide you and your family with trusted answers and peace of mind.
The short answer is yes. The laws around the use and restrictions of use for drones in Pennsylvania are still emerging. The popularity and use of drones in surveillance have dramatically increased in the last couple years and lawmakers are scrambling to keep up. Several Pennsylvania law makers have proposed tighter regulations around the use of drones in Pennsylvania to address Fourth Amendment privacy concerns. A recent Federal ruling has allowed the use of drones for commercial use and the FAA has setup new registration requirements. Some of the FAA operating restrictions are that a drone cannot fly higher than 400 feet due to airplane traffic and the drone must be in the visual site of the operator. What does all this mean for my Pa Workers Comp Case?
Simply put the use of drones to get surveillance video is allowed. However, I doubt it will be utilized as a primary way to get video surveillance on an injured worker. There are problems with the use of drones; they are loud, the battery life for flight time is short and the angle of the video is not good. This is all contrary to what private investigators want. They don’t want to let the injured worker know they are watching and they often sit for hours to get minutes of video. Most likely the use of drones will be for pre-surveillance activities; to see over fences or in rural areas where homes are far off the road to determine in the injured worker is at home; or if their vehicle is on the property. Then setup their surveillance cameras based on the information obtained from the drone video. Surveillance is a part of the Employer’s arsenal in a Pennsylvania Workers’ Compensation case and drones may become a regular part of it. As with all surveillance techniques, as long as the injured worker is staying within their treating physician’s work restrictions they shouldn’t worry.
If you are on Pennsylvania Workers’ Compensation and you think you are being watched by the insurance company. Call the team at Calhoon and Associates for a free case evaluation, 717-695-4722.
Even before Pennsylvania passed its first Workers’ Compensation Laws in 1915, Pennsylvania recognized its labor force in the late 1880s with a Labor day. The first Labor day was in New York City on September 5, 1982. It was organized by the Central Labor Union and they encouraged other Unions to follow its lead. By 1985 the idea of Labor Day had spread like wild fire through other states and continued to grow in popularity over the next few years. On June 28, 1894, Congress enacted a law that stated the first Monday of September each year would be a national holiday.
Labor day was the creation of labor movement of the 1880’s and is a day dedicated to the social and economic achievements of the great American worker. The day is an annual tribute to the all American workers who’s accomplishments have made our country one of great strength and prosperity. Brick by brick, America was built by the blood, sweat and dreams of its workers. The American worker’s drive and dedication continues to make our Country great, prosperous and the envy of other nations.
For this the team at Calhoon and Associates pays tribute to the hard working American’s and we are thankful that we have opportunity to serve them in their time of need by giving to them trusted answers and the peace of mind that they deserve.
I was injured at work and really needed help navigating through the worker’s comp process. Mr. Calhoun and his team were excellent and will guide you every step of the way. Communication with him and his staff is outstanding. You never have to wait days for an answer; he responds very promptly. His office is fully automated so I kept everything on my computer minimizing the amount of paperwork. He deserves 5 stars and I would highly recommend him and his team to any injured worker.
I’m sure you were told by someone that you need or should have your treating doctor testify or their deposition be taken in your PA Workers’ Comp case and you are not sure why this is needed.
First, a review of the law. The Pennsylvania Workers’ Compensation Act says that the deposition of a doctor must be taken where the case involves a year or more off work. This comes up in two situations:
1. Where the injured worker files a Claim Petition and disability ( time off work) will be more than a year, or
2. Where the WC Insurance Company/Employer files a Petition for Termination.
What is a deposition? Its an actual Worker’ Compensation court hearing held in the doctor’s office. The Doctor is sworn in by the Court Reporter, just like in a courtroom. The lawyer for the Injured Worker and the lawyer for the Employer/Insurance Company each ask questions. The whole conversation of questions and answers are written up in a transcript by the court reporter and given to the WC Judge as an official exhibit.
How much do depositions cost? That is up to the doctor; there is no law or regulation which tells a doctor what they can charge for a deposition in Workers’ Compensation cases. In Central PA, depositions are in the $1,500 to $3,000 range; plus the cost of the court reporter.
Why is it a good idea to take a deposition of your doctor? Because a deposition allows the doctor to explain in detail the history, the examination, the results of tests, consultations with other doctors and then give their opinions on the nature and extent of disability. The doctor can also discuss the opinions of opposing IME doctor hired by the WC insurance company and explain why they are wrong. Also, Doctors are busy people. Sometimes, their reports and letters are written by an assistant or nurse and that won’t happen in a Work Comp deposition. There the doctor in person explains the whole medical picture.
Will an Injured Worker get their money back that they spent on a deposition? Yes, if their case is won in front of the Workers’ Compensation Judge or the case settles and the cost is negotiated into the settlement.
Do you have additional questions about your Workers’ Compensation case; or you have recently been injured on the job and are having difficulties with your worker’s compensation benefits? If so, contact the team at Calhoon & Kaminsky at 1-877-291-9675 for answers to your questions and a Free Case Evaluation.