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If you have a question about Workers Compensation or Social Security, you’ve come to the right place.

We have answered hundreds of questions our clients have asked us over the years right on this site.

Just look to the right and you’ll see a section that says “Have A Question?”. Just type your question in the box and click Search.

If we have an answer and other information related to your question on this site, it will show on the screen for you.

If we do not have your answer, it’s okay. Just pick up the phone and call us at 877-291-9675.

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AVVO Five Star Review for Matt Kaminsky – posted December 10, 2017

I hired Esquire Kaminsky to assist with my Worker’s Compensation case in January of 2017. I was impressed with his quick response to my inquiry for guidance in helping me to determine whether I had a case to pursue. After our first telephone contact, Attorney Kaminsky was understanding and patient when I requested to meet him face-to-face to clarify some of the information before I retained him as my counsel. After that initial meeting, it was evident that Matt was dedicated to advocating for me and my rights as a worker injured on the job. He was open and honest from the beginning and this immediately put me and my husband at ease. Throughout my case, Matt was prompt to return calls and kept me abreast of any filings or procedures that needed to be completed. My case was settled in less than 10 months with a settlement that reflected his hard work and dedication to my individual situation. Thanks Matt and your team for working for my rights.

by anonymous

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$152,500 – Settlement for Ankle Fracture

A Union employee from Halifax, PA, working as a steel worker, sustained a work injury in September 2016 where he crushed his right ankle between two pieces of steel.  The insurance carrier, ESIS, accepted as a left ankle contusion.  They day the injury occurred, the employee immediately had to have surgery to repair his ankle with plates and screws by the Company Doctor.  The injured worker has ongoing pain in his ankle and couldn’t use walk properly.  The Company Doctor sent him for a Functional Capacity Exam at his office which reported he could return to medium duty work in April 2017.  The injured worker immediately got a second opinion at Hershey Medical Center.  The doctor at Hershey Medical Center didn’t allow him to return to work because the injured worker was still suffering from a broken ankle that hasn’t healed properly and required an additional surgery to fix.  The employer advised the employee that he was to return to work in May 2017 based on the FCE working in a different position within his restrictions.  The injured worker did not return to work because his doctor at Hershey Medical Center advised that he disapproved the job.  Because the employee did not return to work, the insurance carrier filed Modification and Suspension Petitions.  We then filed a Review Petition seeking to have the description injury amended to left ankle displaced and comminuted distal fibular shaft fracture, displaced medial malleolus fracture requiring surgery and a plate to correct and posterior tibial tendon dysfunction.  The insurance carrier had the employee attend an independent medical examination in July 2017.  The IME physician, Dr. Pollack,  reported that the injured worker’s ongoing symptoms were related to his work injury and that he was not fully recovered.  While the case was being litigated, the parties attended a Mediation and an amicable resolution was reached and it was resolved for $152,568 via a Compromise and Release Agreement.  At the time of the settlement, the injured worker was awaiting further surgery.  The insurance carrier agreed to pay for the surgery.  During the pendency of the claim, the injured worker received $215,299.62 in wage loss benefits and $28,786.40 in medical benefits for his work injury.

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Harold Crisp (name changed for this summary) was injured in the course of his employment in Carlisle, PA. Gallagher Bassett, the workers’ compensation insurance carrier for the employer,
issued a Notice of Temporary Compensation Payable (NTCP) on June 22, 2016 for Mr. Crisp’s June 8, 2016 work injury described as a right knee sprain. The insurance carried then issued a Notice of Workers’ Compensation Denial on August 9, 2016.

We filed a Claim Petition for the injury which was actually an injury to his right knee, blood clots in the right leg and right-sided foot drop. We sought payment of TTD wage loss benefits from the date of injury and ongoing until his condition should change in accordance with the Act, along with the payment of related medical bills, interest, litigation costs and attorney’s fees.

Mr. Crisp testified he was working the maintenance department when while emptying the tank of a driveable floor scrubber into a manhole, he slipped and his left leg fell into the manhole with his right leg behind and underneath him. Claimant reported his injury and noted that he pain in his low back and right leg while he finished his shift the day the injury occurred. The next morning he woke with right leg pain and his knee down to his foot was numb and he had difficulty moving his foot. He called his supervisor who advised him to go to the emergency room. He was then referred to Dr. Dahl at OIP. Physical therapy was attempted but was stopped because his leg was swelling, red and warm. He was sent to the ER where he was placed on medication for blood blots. He has to use a compression stocking, a foot brace and a knee brace. He testified he had not worked since the injury occurred and that none of his doctors had released him to return to work.

Defendant had 4 fact witnesses testify in this case. The HR witnessed testified she spoke with Mr. Crisp and completed a First Incident Report regarding the incident. His supervisor testified he completed a written statement regarding the incident. Two co-workers also testified that they did not Mr. Crisp injured himself. One of the co-workers testified he completed a written statement but then wrote a second one at the direction of his supervisor. The two co-workers gave different answers as to that Mr. Crisp was wearing the day of the injury and what the weather was that day.

Dr. Dahl testified that Mr. Crisp had decreased range of motion in his right leg, that he had foot drop and blood clots. He testified Mr. Crisp suffered an exacerbation of preexisting osteoarthritis of the right knee, multiple DVTs involving the right lower leg and acute severe peroneal nerve palsy resulting in foot drop and a medial collateral ligament strain/sprain of the knee and that he later developed cellulitis because of having to wear a brace. He indicated any surgery would have to wait until Mr. Crisp completed his Coumadin therapy for his blood clots.

The Judge found Mr. Crisp to be more credible than the testimony of the Defense’s four fact witnesses and specifically wrote in his Decision that he found the two co-workers’ recollection of the evening to be untrustworthy. The Judge granted our Claim Petition and the description of injury was found to be exacerbation of preexisting osteoarthritis of the right knee, medial collateral ligament strain/sprain of the right knee, multiple DVTs involving the right lower extremity, acute severe peroneal nerve palsy resulting in foot drop and right leg cellulitis. The Judge awarded payment of TTD wage loss benefits from June 9, 2016 and ongoing until otherwise agreed or adjudicated. The insurance carrier was also ordered to pay for all of Mr. Crisp’s related medical bills.

The law firm of Calhoon & Kaminsky represents injured workers throughout Pennsylvania, including but not limited to, Altoona, Harrisburg, Pottsville, Allentown, Reading, Bloomsburg, Easton, Bethlehem, Norristown, Bristol, Williamsport, State College, Wilkes-Barre, Scranton, Lancaster, Waynesboro, York and all cities in Bucks County, Chester County, Columbia County, Dauphin County, Delaware County, Lackawanna County, Lancaster County, Lebanon County, Lehigh County, Luzerne County, Lycoming County, Montgomery County, Monroe County, Montour County, Northampton County, Northumberland County, Philadelphia County, Pike County, Schuylkill County, Wyoming County and York County, PA.

Our offices are located at 2411 North Front Street, Harrisburg, PA and we can arrange for meeting locations at law offices throughout the State.

Order our Free Consumer Guide about Pennsylvania Workers’ Compensation.

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October 8, 2017 AVVO Review:

Amazing. I was completely lost with the whole process until Matt walked me through it. He explained everything to me in a way that I could easily understand. He didn’t rush me through anything or make me feel unintelligent when I needed extra explanation or guidance. Matt made the process easier and took the stress out of it.

by Tammy

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Attorney Matt Kaminsky of Calhoon and Kaminsky P.C. is the recipient of AVVO’s 2017 Client Choice Award.

AVVO has recently awarded to Matt Kaminsky, it’s 2017 Client Choice Award.  This award is given to attorney’s who receive 5 for more 4+ Star Reviews in a calendar year.

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Regular Session 2017-2018, House Bill 18 is attempting to amend the Workers’ Compensation Act.   The Sponsor of this Bill is Ryan Mackenzie from District 134 serving Berks and Lehigh Counties.  If this Bill is passed and the Workers’ Compensation Act is amended, it will have devastating effects on Pa’s Injured Workers’ rights to the medical care they need.  This Bill will limit the injured worker’s treating doctor from prescribing the medications that he believes is needed for the injured worker and subject those prescriptions to even greater scrutiny by putting in place a evidence-based drug formulary.

This Bill is being pushed as trying to reduce the “opioid abuse and addiction” stemming from the Pennsylvania’s Workers’ Compensation program.  It appears to be yet another way the Insurance Company Lobbyists are trying to take treatment away from an injured worker and reduce what the Insurance Companies and Employers have to pay.  To further support this you only need to look to the proposed Bill Section VIII, in which it requires after 18 months from this Bill being put into law, the amount of money being saved is to be calculated then reported and subsequently “the amount of savings shall be used to provide an immediate reduction in rate, equal to the savings, applicable to Employers’ Worker’s Compensation Policies”.

By introducing an evidence-based drug formulary, it will put all Injured Workers in a set box with only certain allowable prescriptions.  Simply put, if your work injury case is at all outside the box then there is good chance you won’t be able to get the prescriptions you need.  This doesn’t benefit Injured Workers but rather further limits their treatment options.

If your treating doctor still prescribes the medications which he feels are required then it subjects your treatment provided by him to a Utilization Review.  These Utilization Review Organizations will have no choice but to abide by these “amended rules” of evidence-based drug prescription making it more difficult for the doctor to give you the treatment you need and deserve for your work injury.

All Injured Workers have everyone you know call your State Representative to vote “No” for House Bill 18.

For those Claimant’s Attorneys reading our blog, The Memorandum from the Bill wants there to be continual updates to the drug formularies from new research as new evidence indicates a particular drug is appropriate for the injured workers diagnosis.  I can see similar issues developing here as it did with IREs and Protz.  We will have to remain vigilant to protect our client’s rights.

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Test your knowledge with our Newsletter Trivia

Don’t miss your chance to win a Visa gift card.  Send us your trivia response by June 30, 2017.

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A machine operator from Mechanicsburg, PA, sustained a work injury while working for a local warehouse, in June 2012. The insurance carrier, New Hampshire Insurance Company, issued a Notice of Compensation Payable accepting the injury as a lumbar sprain/strain.  The injured worker had to undergo surgical intervention performed by Dr. Grandrimo.  The insurance carrier had the injured worker attend an IME in 2014.  Dr. Kline, the IME physician, reported that the actual work injury was a left L3-4 disc herniation, status post operative decompression and resolved chest sprain/strain.  He reported that the injured worked had not obtained full recovery and that he had reached maximum medical improvement and that his prognosis for full recovery was poor. The insurance carrier then had the injured worker attend another IME in 2015 with Dr. Kline.  He again reported that the injured worked had not obtained a full recovery.  The case ultimately settled via a full Compromise and Release for $175,000 for the injured workers’ wage loss benefits.  The injured worker was a Medicare beneficiary and therefore the insurance carrier agreed to fund a Medicare Set Aside approved by Medicare in the amount of $528,881 to pay for the injured workers’ future medical treatment related to his work injury.

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Summary to date:

 

Barbara Woods injured her back, eye and arm at work.  The workers’ compensation insurance company agreed to pay medical bills for some of her injuries and temporarily paid weekly workers’ compensation.  The payment by a Notice of Temporary Compensation Payable was revoked (stopped). She hired Attorney Matt Kaminsky who filed a Claim Petition.  Todd, her boyfriend, then calls Matt to find out what happens next.  Matt first checks with Ms. Woods to make sure that she authorizes him to speak with Todd.  Matt then explains the next step in the case to Todd.

 

Definition of terms:

 

Defense Attorney – The opposing lawyer who represents the employer and the WC insurance company.

Claim Petition – a special form which contains all the important aspects of Barbara’s claim.

Appearance – an attorney registers with the Judge in a particular case,

Service – mailing copies of all official documents filed to everyone listed within the claim. (The claimant, employer, defense attorney, insurance carrier)

Answer – A response filed by the attorney for the insurance company (defense attorney)

Bureau – the Bureau of Workers’ Compensation in Harrisburg, PA.

 

The Claim Petition is filed electronically through the Workers’ Compensation Automation and Integration System (WCAIS).

Here are the requirements for logging on to WCAIS and filing a Petition.

 

  1. An attorney or a Claimant can enter their appearance by listing the date of injury and social security number, or the WCAIS number and date of injury.
  2. An attorney can enter their appearance for Claimants.  This was done in Ms. Woods’ case.
  3. Once an appearance has been entered, the attorney is able to access the official documents which the adjuster has filed with the Bureau.  From this location, Attorney Kaminsky is able to file Petitions in the case. There are other petitions other than a Claim Petition which can be filed, such as a Petition for Reinstatement, Petition for Review, Petition for Penalties and Petition for Review of a UR Determination.  We will be discussing these Petitions in future chapters.
  4. It is very important that the attorney notify all of parties listed in the case.  A copy of the Petition and the Certificate of Service is available within WCAIS for serving all of the parties.

 

Once the Claim Petition is filed, the Petition section of the Bureau of Workers’ Compensation assigned the Petition to a Workers’ Compensation Judge.  Petitions are signed to Judges based on the Claimant’s county of residence in Pennsylvania.

Barbara will receive different forms from the Bureau of Workers’ Compensation including an Assignment to Judge and a Hearing Notice.  Once the Petition is circulated to the insurance company, the attorney for the insurance company has 20 days to file an Answer.  These are usually boilerplate meaning that the defense attorney denies everything in the Claim Petition.

Barbara’s case has now been assigned to WC Judge Smith.  He is a civil service employee hired by the Commonwealth of Pennsylvania.  Neither Barbara nor ACME can request a change of Judge unless there is a very good reason.  A Pre-trial hearing has been scheduled to occur in Harrisburg, PA.  Barbara, Attorney Kaminsky and the defense attorney attend.  Sometimes, the employer shows up.

There are usually at least three hearings in the average workers’ compensation case.  1)  A pre-trial hearing for the Judge to set up the schedule / time table of the case.  2) A second hearing four to eight weeks later for Barbara to testify.  Both Attorney Kaminsky at Attorney Gunstadt (attorney for ACME) will be asking questions.  3)A third hearing is usually a final hearing for testimony from any employer witnesses.

In the meantime, Barbara has 90 days from the first hearing to submit evidence from her doctor.  The attorney for ACME has 90 days thereafter to submit medical evidence from their doctor.

There are rules and deadlines involved which are contained in the Special Rules of Practice and Procedure before WC Judges.  Although WC is supposed to be a prompt and non technical source of payments for workers’ injured on the job; in reality, the average WC case takes a year to litigate and be decided measured from the date the Claim Petition was first filed.

In addition, Judge Smith will have special rules of his own on how he wants cases handled in front of him.  Thus, WC litigation involves complicated law, rules, regulations and directions.  It is like football.  You don’t just kick the ball and run down the field.  There are rules to it.

 

NEXT:  Getting ready for the pre-trial hearing!

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Should I have recorded the IME or brought a witness?

This is a common question – how to approach IMEs.

A couple of basics:

There is no such thing as an IME. The term “IME” does not appear in the Workers Compensation Law. The proper term is “ physician legally authorized to practice…who shall be selected and paid for by the employer”

People who use the term IME are wrong.

Maybe “PLATPWSBSAPFBTE” is too hard to say, although “employer’s medical exam ( EME) would be just as easy to say and more accurate.

More likely, insurance companies want you to think that the exam is somehow independent and objective,

Which it usually isn’t.

But sometimes is.

Tape recording of an EME is a mistake because:

  1. The EME doctor will do a better job of examining you and it will be harder for your lawyer to cross examine him/her,
  2. There are complicated laws on the topic, and
  3. The WC Judge probably won’t be impressed.

You can bring a witness only if they are a licensed medical professional such as a nurse or doctor.

 

Some background.

There are generally three types of  EME doctors:

  1. The hired guns who will say anything for a price
  2. A working physician who needs extra income because he or she has a child in college or is paying a lot of alimony.
  3. A retired or disabled doctor who can’t practice. ( These can be the hardest category of EME doctor for your lawyer to deal with).

 

We here at Calhoon and Kaminsky know the  players in the  Work Comp system and can tell whether a  EME doctor is #1, #2 or #3. It is important to know this  because it changes your approach.

If you have an EME coming up with a #1 doctor; you will want to minimize pain and symptoms because a #1 doctor will give you a Waddell Test/Blankenship Inventory which will be used to say you  are faking. You will, as in all EMEs, will want to  give full and consistent effort. And, you will want to promptly have the same tests performed by your doctor to see if there are different results.

The worst doctor  knows more medicine than the best lawyer. And #1 EME doctors are professional and convincing actors- they can testify really well. A #1 EME doctor can be tripped up on the history ( which they frequently don’t know well ) or when they have a nurse perform the tests and then testify that they did it.

Your approach to a #2 or #3 doctor should be very different depending  on who it is. These are real doctors ( especially category #2) and they sometimes will side with the injured worker rather than the insurance company. It happens. Not too often, but it does happen. It never happens with a #1 doctor who, at most, will occasionally say that a claimant is only partially disabled.

 

Remember that the EME itself is not important. It is the WC Judge’s reaction to the EME which counts. And, WC Judges have different opinions on this.

One WC Judge has an excellent memory and keeps track of what a #2 doctor said in every case before him. That doctor would always say that a spinal disc was ruptured when testifying for a patient and would testify that the same type of disc was only bulging when testifying for the insurance company. Result? That WC Judge never believed what that doctor testified to in any case.

The WC Judges vary widely in terms of their background, approach, opinions and temperment.

It is very important to know which Judge you will or may get BEFORE you undergo an EME

 

If you find any of this confusing, give us a call and we will advise you at no cost. The law firm of Calhoon & Kaminsky represents injured workers Disability throughout Pennsylvania, including but not limited to, Altoona, Harrisburg, Pottsville, Allentown, Reading, Bloomsburg, Easton, Bethlehem, Norristown, Bristol, Williamsport, State College, Wilkes-Barre, Scranton, Lancaster, Waynesboro, York and all cities in Bucks County, Chester County, Columbia County, Dauphin County, Delaware County, Lackawanna County, Lancaster County, Lebanon County, Lehigh County, Luzerne County, Lycoming County, Montgomery County, Monroe County, Montour County, Northampton County, Northumberland County, Philadelphia County, Pike County, Schuylkill County, Wyoming County and York County, PA. Our offices are located at 2411 North Front Street, Harrisburg, PA and we can arrange for meeting locations at law offices throughout the State.

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