Workers Comp Back Injury in Pennsylvania

back injury

Almost everything we do during the day requires us to use our back. Standing, sitting, walking, even watching TV — we use our spines, and the muscles and ligaments that protect our spines, to move our bodies. We especially use our backs when we work. Think of all the times during the day that you lift, move, pull, push, pick up, put down or reach up as part of your job. Whether you are a nursing assistant required to lift patients in and out of bed every day, a trucker who spends long hours sitting in one position or a library assistant who stacks books on a shelf repeatedly, none of these tasks would be possible without our backs.

The sad truth is that, as we get older, our backs age as well. That’s why suffering a back injury at work can be so debilitating. As you age, a back injury can aggravate the natural decline of your back’s muscles or ligaments or the discs that cushion your vertebrae. For younger workers who aren’t worried yet about the effects of aging, suffering a back injury can be the start of a lifelong struggle with pain, because once you hurt your back, it’s a lot easier to hurt it again.

Depending on what kind of back injury is sustained, you may only be sidelined for a few weeks. A more serious back injury, the kind that requires surgery, can leave you laid up for several months or even prevent you from ever working again.

If you suffer any kind of back injury on your job in Pennsylvania, you could be eligible for workers’ compensation benefits. This even includes older workers who may have some natural degeneration in their back, if they can show that this natural aging process was aggravated by an injury at work.

Overview of the Back

A healthy, strong back allows you to stretch and bend without pain. Your back has three natural curves — the Cervical curve, the Thoracic curve and the Lumbar curve — that keep your body balanced. Your spinal column is protected by muscles and ligaments. Discs separate your vertebrae and allow your spine to move and bend.

Your back is composed of the following parts:

  • Spine: The spine is made up of 24 vertebrae that can bend and move, and nine vertebrae that are fixed in place. Each of the vertebrae has a hole in its center, known as the spinal canal, through which runs the bundle of nerves that form the spinal cord.
  • Discs: Discs can be found in between each of the moving vertebrae. It’s a small, fluid-filled pouch. It has a tougher outer shell filled with a jellylike substance. Each disc is basically a shock absorber for your vertebrae.
  • Ligaments: Ligaments are composed of dense tissue that band around the spine to keep the spinal column stable and in place. Ligaments also play an important role in allowing the spinal cord to bend and twist.
  • Muscles: The back has many muscles which extend vertically on both sides of the spinal column. Other muscles that play an important part in helping to protect your back include your stomach muscle, your gluteus maximus (your posterior) and your thigh muscles.

Different Types of Back Injuries

If you injure your back at work, the pain may be acute or chronic:

  • Acute pain: This pain comes on very fast but normally disappears within three weeks to a month and a half. The pain can be quite intense at times, but it will eventually stop.
  • Chronic pain: This is pain that lasts a long time. It may not be as intense as acute pain, but it seldom disappears quickly. It can last months or even years and can often be permanently disabling.

Not all back injuries are the same, but they generally fall within these categories:

1. Sprains and Strains of the Lumbar Muscles

If you try to lift or carry an item that is too heavy, you may very easily suffer a muscle or ligament strain in your lumbar region (the lower back). There are three grades of back strain, ranging from grade 1 muscle strains (causing the least damage to muscles and your ability to move) to grade 3 strains, which are the most severe. A grade 3 strain signifies that your muscle has been completely torn or that you are experiencing an inability to function properly.

Lumbar sprains can result in a lot of pain but are more acute than chronic because they are musculoskeletal injuries. Normally, a doctor will prescribe muscle relaxers, physical therapy or pain medication for a lumbar sprain.

2. A Herniated or Ruptured Disc

A vertebrae’s disc is very pliable, with a tough covering and a soft interior — that’s why they work so well. If a vertebra suddenly squeezes a disc, which may happen when you experience a fall, are involved in a car accident or you pick up something that’s too heavy, that tough covering may tear. This is a ruptured disc. If the disc’s interior bulges out through the tear, this is known as a herniated disc.

A ruptured or herniated disc can cause a great deal of pain and it is not something that necessarily disappears quickly. For instance, if the disc’s interior bulges out, it can irritate or damage the spinal cord, which can lead to even more pain. This is a serious injury that often requires months of recuperation, and it could result in work restrictions when an injured worker returns to the job.

3. Osteoarthritis or Aggravating an Aging Disc

For most people, your back starts to degenerate when you hit your 30s. In the worst cases, when you experience degenerative disc disease, it may manifest in the form of spinal stenosis (the spinal canal narrows), spondylolisthesis (the vertebrae in your lower back is displaced) or osteoarthritis (when the cartilage protecting your vertebrae degenerates or when the space between your vertebrae starts to narrow).

If you suffer an accident at work, and it aggravates or exacerbates any pre-existing condition like osteoarthritis, you may be eligible for workers’ compensation. In this case, it’s important to prove that it was your work injury that led directly to your degenerative disc disease worsening.

Doctors may first try to treat the symptoms with injections, physical therapy and pain medication. An injured worker may require surgery, however — including a discectomy (where a portion of the herniated disc is removed), a total disc replacement, kyphoplasty (a doctor injects bone cement into an injured disc in an effort to fix a deformity) or a lumbar fusion (a surgeon grafts bone onto the injured vertebra in an effort to stop the motion causing pain).

Common Ways to Injure Your Back at Work

According to the statistics on work-related injuries for 2016 from the Bureau of Labor Statistics (BLS), back injuries cause 38.5% of all work-related musculoskeletal injuries. Back cases accounted for 134,550 out of 349,050 total cases.

The jobs with the highest number of back injuries include:

  • Nursing Assistants (52.8% of all injuries reported by nursing assistants were back injuries)
  • Store Clerks and Order Fillers (45.7%)
  • Laborers, Freight and Stock Movers (43%)
  • Maintenance and Repair Workers (42.5%)
  • Heavy and Trailer Truck Drivers (32.4 %)

Even if you are not employed in one of these jobs, you are still at risk of suffering a work-related back injury. If your job involves any of the following tasks, a back injury is possible:

  • Carrying or lifting materials, especially heavy items
  • Shelving or stocking goods
  • Pulling or pushing carts or machinery
  • Picking things off the floor
  • Crawling or kneeling
  • Digging
  • Sweeping or cleaning
  • Twisting
  • Operating machinery that vibrates a great deal, such as a jackhammer
  • Driving

You could do one of these activities once and hurt your back. A back problem can also develop over time as a result of repetitive activity or motion.

Other causes of work-related back injuries include:

  • Lack of (or insufficient amount of) training on correct lifting procedures
  • Being in a rush to finish a task and not getting help with manipulating an object too heavy for one person
  • Bad posture
  • Being out of shape
  • Repeatedly lifting heavy objects like patients or equipment
  • Lifting and twisting at the same time
  • Losing your footing on wet or slippery floors
  • Fatigue, especially when caused by working too many hours
  • Doing a task while being bent over for a lengthy period
  • Being involved in a car accident while working

What Should I Do If I’m Injured at Work?

what to do if you injure your back at work

If you sustain a sudden back injury at work, the first thing you should do is notify your employer and seek medical treatment. Don’t try to tough it out. There are good reasons for this approach. If you are hurt, you want medical treatment right away. If you don’t report it and seek medical treatment after you suffer a back injury, this makes it easier for the insurance company to argue you were hurt somewhere other than work because it wasn’t reported or treated timely.

If the company nurse or your supervisor believes you need an ambulance to go to an emergency room, listen to them. If you suffered a serious back injury, any continued activity will only make it worse.

If your injury is not debilitating, notify the appropriate supervisor or your employer that you’ve been injured. Then seek medical treatment. Otherwise, you have 120 days to let your employer know about a work-related injury or that you became aware of a work-related injury.

Inform any medical professional treating you that you suffered an injury on the job. Take time to explain to each caretaker the circumstances of your injury. This is important because it helps establish a timeline in terms of applying for workers’ compensation benefits and helps provide evidence if you need to appeal a denial of those benefits by your employer.

In Pennsylvania, an injured employee will receive a list of physicians from their employer who they must visit during the initial 90 days of their injury. Oftentimes, this list of available physicians will be posted in a break area. After 90 days you can switch to your own doctor, but you must notify your employer’s insurance company of the shift within five days.

Once you have reported your injury to your supervisor or employer, they must notify your insurance company as soon as possible. They will also notify the Bureau of Workers’ Compensation in Pennsylvania within seven days. You don’t receive any compensation from the Bureau, but this starts the timeline if you are forced to file a workers’ compensation appeal. After you report the injury, your employer and your employer’s insurance company have no more than 21 days to determine if you are eligible for workers’ compensation benefits or to choose to deny your claim.

Pennsylvania Workers’ Compensation

businesses required to have workers' comp insurance

The state of Pennsylvania created workers’ compensation in 1915. The goal was to protect injured workers and their employers. Up until 1915, workers were able to sue their employers. If they won their cases, they could receive generous compensation. If they lost, they would receive nothing. Meanwhile, employers faced the same roll of the dice. If they won, they would not owe anything to an injured worker. But if they lost, compensation could be expensive and threaten their business.

Under Pennsylvania law, any business, company or individual who employs at least one person is required to carry workers’ compensation insurance. This is true whether the employees are full-time, part-time or seasonal. The law contains some exemptions. For instance, independent contractors are not covered by workers’ compensation and people who work for the federal government, the military, the railroad or as longshoremen have their own systems.

The Pennsylvania workers’ compensation system is known as a no-fault system. This means if you are injured on the job, it doesn’t matter if you are responsible for your own injury or if your employer is responsible. Any worker is still eligible to receive workers’ compensation benefits. Because of this, employees give up the ability to sue employers.

If your work-related back injury makes you eligible for workers’ compensation, you can receive benefits for any medical expenses (including the cost of going back and forth to treatments and all prescriptions) as well as compensation for lost wages. Lost wages compensation is calculated using two-thirds of your average weekly pay during the past year. It is not unlimited. In 2019, the most injured workers can receive in lost wages compensation is $1,049 per week. Workers’ compensation also does not provide any benefits for pain and suffering. If you are receiving workers’ compensation lost wages benefits, however, they are tax-free.

Since back injuries are potentially very expensive for your employer’s insurance company — back injuries often result in a worker being off the job for a lengthy period — many initial workers’ compensation claims involving a back injury are denied by your employer and their insurance company. If this happens, you should immediately contact an experienced workers’ compensation attorney.

If your claim is accepted, the lost wages compensation you receive could fall into one of these categories:

1. Total Disability

If a physician decides your work-related back injury has resulted in total disability, it is possible you could continue to get benefits throughout the entire time you are disabled. While it’s possible you could receive benefits for the remainder of your life, this does not happen often and is highly unlikely. After 104 weeks, your employer can request that you take what is known as an Impairment Rating Exam (IRE). This is a controversial procedure (the Pennsylvania Supreme Court ruled it unconstitutional in 2017 but the legislature reinstated it in 2018 with some changes) where a physician selected by your employer’s insurance company determines the extent of your impairment.

If you are found to be less than 35% impaired, you’ll be switched to benefits for partial disability and it will limit the time period that you can receive wage loss benefits.

2. Partial Disability

definition of partial disability

Benefit payments for a partial disability can last about nine and a half years or 500 weeks. Having a partial disability often means that you will be able to go back to your job at some point. This often happens when your doctor believes you have reached Maximum Medical Improvement (MMI). This is the point at which the doctor believes you will not recover any more than you have recovered up to that point.

In many cases, a person can return to their job with medical restrictions that may involve a light-duty schedule. If your new position does not pay as much as your previous position, workers’ compensation will provide two-thirds of the difference between your previous job earnings and your new job earnings.

What If My Employer or Their Insurance Company Denies My Claim?

what to do if your employer or their insurance company denies your workers' comp claim

If your employer and your employer’s insurance provider deny your claim after 21 days, you will receive a Notice of Workers’ Compensation Denial:

  • Once your claim is denied, you can then file a claim petition. Any injured worker can file this petition three years after the date of their injury.
  • The Bureau of Workers’ Compensation will assign a judge to your case and they will contact you, and your employer’s insurance company, about the hearing date.
  • If the workers’ compensation judge dismisses or denies your claim, you can file an appeal with the Workers’ Compensation Appeal Board. But you must do so within 20 days.
  • If the Appeal Board denies your claim, you have 30 days to file an appeal with the Pennsylvania Commonwealth Court.
  • If the Commonwealth Court denies your claim, you have 30 days to file an appeal with the Pennsylvania Supreme Court. This is the final court of appeal.

The entire process can last anywhere from several months to several years. It depends on the number of appeals and how far apart the hearings are held. At any time during this process, a worker can settle their claim with the employer’s insurance company.

Settling Your Back Injury Case

Injured workers may decide to pursue a settlement with their employer and the insurance company for a variety of reasons:

  • They are frustrated and tired with the entire workers’ compensation process.
  • They have outstanding medical bills that need to be paid.
  • They have found another job.
  • They have waited a long time for compensation but the disputed issues between the worker and the insurance company have prevented those benefits from being awarded.

Injured workers will usually wait until they’ve reached MMI before they seek a settlement. Once they reach MMI, an injured worker will know what their long-term medical costs will be and how much money they will need to provide for their family’s future.

There are also reasons for not accepting an offer of settlement from your employer’s insurance company:

  • Their offer is inadequate for your financial needs.
  • You go back to your previous employer and you are given a new job with medical restrictions. You enjoy this job, but the insurance company says they will not settle with you unless you quit.
  • You’re uncertain about medical costs in the future and you lack another form of health insurance.

Advantages of Partnering With a Workers’ Compensation Lawyer

benefits of working with a workers' compensation lawyer for your back injury case

If you are open to negotiating a settlement for your work-related back injury, before you accept any offer from your employer’s insurance company, you should first speak to an experienced workers’ compensation attorney.

Insurance companies are notorious for pulling every trick imaginable to delay, reduce or deny the workers’ compensation benefits to which you are entitled. Insurance companies are not in business to do favors for you — they are in business to make money. Battling with an insurance company on your own is difficult even at the best of times.

Imagine how difficult it could be if you are also dealing with a serious work-related back injury — filing the paperwork on time, gathering all the documentation and medical evidence and speaking to any witnesses who may have seen your injury. An experienced workers’ compensation attorney understands how insurance companies will try to pull the wool over your eyes.

Experienced workers’ compensation lawyers also do this full-time. When you work with one, they will help you prepare your case to be presented to a workers’ compensation judge. Or, if you have decided to seek a settlement with your employer’s insurance company, they will make sure you receive a reasonable and fair settlement.

If You Have Suffered a Work-Related Back Injury, Contact Calhoon and Kaminsky P.C.

contact Calhoon & Kaminsky if you have suffered a work-related back injury

We want to help each of our clients receive the workers’ compensation benefits they deserve. That’s our goal. That’s why we only do workers’ compensation cases. We care about ensuring that injured workers in Pennsylvania receive fair treatment. We understand how difficult it can be when you suffer a back injury and how it affects your job, your life and your family’s financial future.

We offer a free evaluation — and if you’re not able to travel to our offices, we will come to you in order to discuss your claim. You can call us any time at (717) 695-4722 or contact us to tell us about your situation. One of our team members will be in touch with you as soon as possible.