Pennsylvania Workers' Compensation Lawyer Blog

As attorneys who limit their practice to representing the injured worker in PA workers’ comp cases, we are thrilled by the recent announcement that the Supreme Court of Pennsylvania has approved the process of creating a “certified workers’ compensation attorney” in Pennsylvania (or, in other words, a workers’ compensation specialist).

We have seen the damage done to cases when an injured worker trusts a general practitioner to handle a Pennsylvania workers’ comp case. The Pennsylvania Workers’ Compensation Act is a complicated piece of legislation. As loyal readers of our blog know, this is a frequent topic of cases decided by the appellate courts in PA. Trusting a workers’ compensation case to an attorney not experienced in that area of law is akin to having an orthopedist handle your coronary artery bypass surgery. Just not a good idea.

A work-related injury can cause tremendous disruption, and loss, to both the injured worker and his and her family; we are thrilled that in the near future, that injured worker can have the confidence that he or she is selecting a “certified workers’ compensation attorney.” We, of course, look forward to becoming “certified workers’ compensation attorneys” as soon as the process for the testing and certification is completed.

Once again, we are honored and excited to report that our blog has been selected by LexisNexis as one of the Top 25 Blogs for Workers' Compensation and Workplace Issues for 2011. We recognize all of the wonderful blogs out there covering not only Pennsylvania workers’ comp issues, but also blogs covering workers’ comp across the entire Country. It is for this reason that we are so humbled at again being recognized. We are especially proud, since this is our third such recognition in the past four years.

We again thank LexisNexis, and our loyal readers, for this providing us the opportunity to serve. We will make every effort over the ensuing months, and years, to show that we are worthy of this recognition.

Over the years, we have had blog entries on many different topics of interest to the injured worker in PA. One theme we have never dealt with, however, is the emotionally-charged area of politics. While we generally try to avoid politics, we would be remiss if we did not comment about one of the candidates for Judge on the Commonwealth Court of Pennsylvania.

As loyal readers of our blog know, the Commonwealth Court of Pennsylvania is the next appellate level, above the Workers’ Compensation Appeal Board (WCAB). This Court must address many issues directly impacting the lives of injured workers in PA. Judges on this Court are elected in the general election. We believe it is important for voters to be informed, allowing them to make the best decisions possible.

One of the candidates for Commonwealth Court Judge in the election coming up on November 8 is Kathryn Boockvar. Back in June of this year, we attended the 10th Annual Workers' Compensation Conference in Hershey, PA, which is presented by The Pennsylvania Bureau of Workers' Compensation. In addition to the many attorneys who practice in the area of PA workers’ comp, we noticed Ms. Boockvar in attendance. We were both impressed and encouraged that Ms. Boockvar was interested enough in the PA workers’ compensation system to attend such an event. In addition to her obvious interest in workers’ compensation, her resume shows that she spent much of her career representing disabled individuals.

Again we do not normally get involved in politics or in telling people for whom to vote. However, we do believe that everyone should be informed so that when they vote they know who potentially may have their interests in mind. We suggest that you take the time to research Ms. Boockvar’s qualifications. By reviewing her website, informed voters can make their own decisions as to who to vote for on November, 8, 2011.

Guiding PA workers’ compensation attorneys in how and why to expand the description of injury in a Pennsylvania workers’ comp case was the topic of the most recent seminar given by one of our partners, Glenn C. Neiman, for Lawline.com on July 22, 2011. Unlike the previous work Mr. Neiman has done for Lawline.com, this recent seminar was streamed live to attorneys across Pennsylvania (and the rest of the Country as well). In addition to discussing the nuts and bolts of changing a description of injury, Mr. Neiman also gave a brief update regarding some recent decisions from PA Courts of interest to the Pennsylvania workers’ comp lawyer community.

“The description of injury is really what drives a workers’ comp claim in Pennsylvania,” Mr. Neiman explained, when asked why this topic is important, “When we look at whether a work injury is fully recovered, or whether an injured worker can go back to work, or whether medical treatment is related to the work injury, we are always looking at the accepted work injury.”

While the seminar was performed live, it will also be added to the Lawline.com catalogue, so other attorneys across PA can learn about this important topic. “Not every firm limits its practice to Pennsylvania workers’ compensation cases like we do,” said Mr. Neiman, “so this seminar is of special benefit to those attorneys who do not handle PA workers’ comp matters on a regular basis.”

On July 7, 2011, Governor Tom Corbett signed House Bill 797 into law, as Act 46 of 2011, amending the Pennsylvania Workers’ Compensation Act by giving firefighters protection against the risk of cancer. The legislation adds a presumption that cancer suffered by veteran firefighters is related to their work duties. More information can be found in the related press release.

This new law, of course, has been well received by groups associated with firefighters in Pennsylvania, such as Delaware County Firemen’s Association, Pennsylvania Professional Fire Fighters Association, International Association of Firefighters Local 2781 and Firehouse.com.

As attorneys representing injured workers in PA, we applaud the Pennsylvania legislature for passing this measure, and providing support to the brave men and women who put their lives on the line for us every day of the week.

Often, physicians who perform Independent Medical Examinations (IMEs), hired by the PA workers’ compensation insurance carrier, seem less than truly independent (I know, shocking, huh?). I have heard IME doctors over the years testify that a bulging disc is a natural finding, one that cannot cause symptoms, and cannot lead to nerve impingement. This, of course, is not the only view, as an article on Laser Spine Institute’s website demonstrates.

I also know another person who would disagree with the view shared by these doctors in the IME community. While Phillies pitcher Roy Oswalt does not have to worry about the Pennsylvania workers’ comp system (unlike most of us, he gets paid whether he works or not), he does have to live with the symptoms of a bulging disc.

As Mr. Oswalt described in this article on Philly.com, the bulging disc is sending pain down his leg. Interestingly, I have also heard IME doctors testify that a nerve being impinged or irritated by a disc (called “radiculopathy” or “radiculitis”) will cause pain along the entire course of the nerve, down to the foot. In this case, Mr. Oswalt noted that his pain has gradually gone all the way down the leg. Since he has no reason to magnify his symptoms (considering IME doctors would say injured workers always have a financial motivation to lie), this information from Mr. Oswalt is both reliable and persuasive.

This should be a reminder to Workers’ Compensation Judges throughout the State of Pennsylvania, that a bulging disc (even, as Mr. Oswalt has, a “mild” bulging disc) can cause debilitating symptoms that not only can sideline a pitcher, but can put a construction worker, warehouse helper, chef, secretary, nurse and any other job, out of work.

As PA workers’ compensation attorneys, we appreciate the efforts of the Philadelphia Area Project on Occupational Safety and Health (PhilaPOSH), a group who is devoted to the safety and protection of workers across Southeastern Pennsylvania, as well as into New Jersey and Delaware.

PhilaPOSH conducted an event this past Memorial Day, to remember those workers who had been killed while performing their jobs. In addition to remembering those who had fallen, the organization also strove to increase the focus on making worksites across PA safer, so the list of fatal work injuries can be decreased, if not eliminated. A moving video, with clips from this event, is available on Youtube.

On June 30, 2011, Governor Tom Corbett signed House Bill 440, bringing the measure into law. While the Pennsylvania Bureau of Workers' Compensation labelled this a "reform bill," it appears it will have no real impact on injured workers in PA. Rather, the aim of the new law is to expand the availability of workers' compensation insurance coverage to small businesses.

We have already mentioned on a past blog entry that injured workers in Pennsylvania can collect PA workers’ compensation benefits and Social Security Disability benefits at the same time. However, a recent opinion from the United States Tax Court, reported on LawyersUSAOnline.com, reminds us that the receipt of the two benefit programs together can have unintended tax consequences.

Our firm only handles Pennsylvania workers’ compensation cases; we do not handle tax matters of any kind. Having said that, depending on the spouse’s earnings, if Social Security Disability benefits are being received, workers’ compensation benefits received by an injured worker in PA can be taxable, when ordinarily they would not be taxable. This issue was also addressed recently by the Social Security Administration in a POMS (essentially, a memo). Obviously, this situation changes depending on the circumstances in each case, and the advice of a tax professional should be obtained.

On many occasions over the years, we have addressed the Utilization Review (UR) process in Pennsylvania workers’ compensation cases. This is the process either party, usually the workers’ comp insurance carrier, uses to obtain a determination as to whether a treatment at issue is “reasonable and necessary” such that the insurance company must pay for the treatment.

What is sometimes lost in this abstract analysis is the impact a UR has on real live people. When a Request for Utilization Review is filed by a workers’ compensation insurer, the insurance carrier is immediately relieved of payment of bills for the treatment at issue, unless and until the treatment at issue is found to be “reasonable and necessary.”

Being in business for profit, or at least to make a living, not all providers are able, or willing, to continue to provide treatment once a UR is filed. One of the most dangerous areas this problem hits home is with medications.

Many medications cannot be suddenly stopped without risk of very severe consequences. Yet, when a UR is filed, frequently retail pharmacies will refuse to fill prescriptions, leaving the injured worker without the medication he or she desperately needs.

This is one of those flaws in the Pennsylvania Workers’ Compensation Act that seems so clear, and so basic, that the PA Legislature would have to fix it, right? That is what we keep thinking, but we have thus far been unsuccessful in having this issue resolved. Sadly, it may take widespread media coverage of a tragic event before things are made right.

While the Pennsylvania Workers’ Compensation Act generally precludes an injured worker in PA from suing his or her employer, the injured worker does have the ability to sue a third party, if that party is responsible for the injury. Since workers’ compensation in PA does not provide any payment for pain and suffering, the ability to file a civil action against a third party is a valuable option. Answers to this, and other questions regarding the PA workers’ comp system, can be found on the Brilliant & Neiman LLC website.

As can be seen from a recent article in the Legal Intelligencer, verdicts in cases involving work injuries can be significant. This again demonstrates the importance of having an experienced PA workers’ comp attorney, who knows what to be looking for in such a case.

Previously, we posted a blog entry on the Commonwealth Court of Pennsylvania decision in Phoenixville Hospital v. Workers’ Compensation Appeal Board (Shoap). This was the decision where the Commonwealth Court was unmoved when the injured worker applied for every job in a Labor Market Survey and found none available to him. The Court said the workers’ compensation insurance carrier can still obtain a Modification or Suspension of workers’ comp benefits in this situation.

Thankfully, the Supreme Court of Pennsylvania accepted appeal in this matter on April 27, 2011. We will certainly keep our readers informed when the Supreme Court of PA reaches a decision.

Back in October, we blogged about the decision of the Commonwealth Court of Pennsylvania in City of Pittsburgh v. Workers’ Compensation Appeal Board (Robinson), which addressed what caused a presumption that an injured worker “retired,” entitling the workers’ comp insurance carrier to a suspension of workers’ compensation benefits.

The decision of the Commonwealth Court arguably made a murky area of the law even more confusing, but it also attempted to inject some compassion and logic into an aspect of law short on both.

For better or worse, the Supreme Court of Pennsylvania has accepted an appeal in this matter. Specifically, the issue for the Court to determine is:

“Did the Commonwealth Court err by holding that, in a petition to suspend
compensation benefits based upon an alleged voluntary withdrawal from the
workforce, the employer bears the burden of showing by the totality of the
circumstances that the claimant has chosen not to return to the workforce?”

We will, of course, let you folks know the final result as soon as we are advised.

Readers of this blog, from previous blog entries, know our frustration with the developing practice of workers’ comp insurance carriers “accepting” medical-only claims by issuing a Notice of Denial (NCD).

Aside from the logical problem, there are procedural issues this creates for attorneys representing injured workers in PA. For example, this practice lets the workers’ comp insurance carrier deny the wage aspect of a claim and avoid unreasonable contest fees, and would often wreak havoc with an injured worker’s attempt to obtain medical treatment for the work injury. There is also concern that the NCD would not stop the statute of limitations, meaning a claim could be barred if the injured worker did not know to file a Claim Petition within three years of the injury.

The PA Bureau of Workers’ Compensation recognized the problem years ago, and created a medical-only Notice of Compensation Payable (NCP). This document would properly preserve the statute of limitations, and let everybody know the true status of the claim. The Courts in Pennsylvania, however, as noted in our previous blog entries above, continued to allow workers’ comp insurance carriers to “accept” claims by using an NCD, making the medical-only NCP useless.

We are pleased to report that the Pennsylvania Bureau of Workers’ Compensation has now revised the NCD, which appears will stop this abuse by the workers’ comp insurance carriers. As you can see by clicking here, the new NCD does not permit the acceptance of the claim by use of this document.

We applaud the Bureau for closing this loophole, which the Courts had created. This change will benefit injured workers across the State of Pennsylvania.

Under the Pennsylvania Workers’ Compensation Act, to be eligible for PA workers’ comp benefits, the disabled person must be an “employee.” Often, this is obvious and not even in question. There are times, however, when a case turns on whether, in fact, the injured person was truly an “employee.” We most often see this situation when the issue is whether the injured worker was an “employee” or an “independent contractor.”

The analysis, to determine whether someone was an “employee” or an “independent contractor,” depends on the facts in each case. It frequently becomes a very complicated issue, requiring multiple depositions and extensive litigation.

At least some of this situation will be easier to determine, now that the Pennsylvania Legislature passed Act 72 of 2010, on October 13, 2010 (This is listed as House Bill 400). The law will take effect 2/11/11. While this law applies only to the construction industry, we expect that to be read broadly, to include roofing, plumbing and other related areas.

Under Act 72, an injured worker (in the construction industry) will be considered an “independent contractor” only if all of the following conditions are met:

(1) the individual has a written contract to perform such services;
(2) the individual is free from control or direction over performance of
such services both under the contract of service and in fact; and
(3) as to such services, the individual is customarily engaged in an independently established trade, occupation, profession or business.

This law should significantly limit an employer’s ability to try and escape liability under the PA Workers’ Compensation Act, and make it easier for injured workers in the construction industry to get the workers’ comp benefits they need.

In Pennsylvania workers’ comp, as in workers’ compensation systems throughout the U.S., the American Medical Association’s Guides to the Evaluation of Permanent Impairment is being used to assess disability. In other words, an injured worker’s condition and ability to work is being determined by referencing a book, distancing any subjectivity at all. The Guides are now in the Sixth Edition (some States use a specific edition of the Guides, while others, like PA, use the most recent edition).

As discussed in a previous blog entry, PA has a ridiculously high standard to maintain total disability. In Pennsylvania, an injured worker can be deemed only “partially disabled” if they do not reach 50% “whole body impairment.” For point of comparison, as an example, a “very severe,” “approaching total functional loss,” of the cervical spine can reach a maximum whole body impairment of 30%. For the lumbar spine, the whole body impairment can be as high as 33%. Obviously, a devastating injury to the neck or low back, by these figures, will fall short of 50%. It is completely unrealistic, and just plain mean spirited, however, to suggest that an injured worker with this degree of impairment is capable of employment.

Fortunately, the debate is living on, at least on the Federal level. On November 17, 2010, testimony was given by Emily A. Spieler, J.D., Dean and Edwin W. Hadley Professor of Law at Northeastern University School of Law in Boston, Massachusetts, before the Subcommittee on Workforce Protections Committee on Education and Labor in the
U.S. House of Representatives. In her presentation, Ms. Spieler, who had a role in the drafting of previous edition of the Guides, touched on the limitations in using the Guides for determining “disability” (which, of course, is completely different from “impairment”).

While the 50% “whole body impairment” threshold still exists in Pennsylvania workers’ comp, the Sixth Edition of the AMA Guides makes meeting this absurd standard even more difficult for an injured worker in PA. Just looking at musculoskeletal injuries, which comprise the majority of PA workers’ compensation cases, Ms. Spieler observed:

“Probably the most significant changes are the elimination of the Range of Motion assessment and the pain addon. In addition, cases involving surgical intervention are all substantially reduced in terms of WPI. These include spinal fusion (reduced from 24% to 15% WPI), ankle replacement with poor result (30% to 24% WPI), total knee replacement (from 20% to 15% WPI) and hip fracture (from 25% to 12% WPI).”

Her testimony addresses many of the issues and reasons why the Guide, at least as it stands now, should not be used to determine disability. As always, we, the injured workers, and potential injured workers in PA, must rely on the Pennsylvania Legislature to do the right thing, to make the Pennsylvania Workers’ Compensation Act the law protecting injured workers, as it was designed to serve.

Though, generally speaking, Pennsylvania’s workers’ compensation system is based purely on wage loss, there are exceptions to the rule. With most work-related injuries in PA, workers’ comp is paid only if the injured worker is disabled from his or her job by the work injury.

One large exception is the category of injuries called “specific loss.” This encompasses when an injured worker permanently loses the use of certain body parts or senses. In this event, benefits are paid under the Pennsylvania Workers’ Compensation Act, whether or not there is any disability resulting from the injury. This covers fingers, toes, hands, feet, arms and legs, in addition to the senses of sight and hearing.

Loss of hearing has had many changes in PA workers’ compensation law over the years. In fact, the entire way hearing loss is compensated under PA workers’ comp was changed with Act 1, passed in 1995. For all hearing loss since then, the amount of workers’ compensation benefits paid varies according to the percentage of binaural (both ears) hearing impairment. To receive any workers’ comp benefits, there must be at least a 10% hearing impairment; while, on the other hand, an impairment over 75% is deemed to be a complete loss of hearing.

One issue that arises in hearing loss cases is the contribution of “presbycusis,” the name for the loss of hearing which happens naturally as we age. When addressing the impact of harmful noise-exposure at work in a hearing loss, we also look at the type of hearing loss, as there are different characteristics for different causes. Of course, we also look at other kinds of noise to which the injured worker may have been exposed (military, hunting, power tools, just for a few examples).

Often, a loss of hearing is an insidious, gradual, process, which is not discovered for several years. Indeed, in many of our clients over the years, the injured worker is the last to notice (the family, and friends, who deal with the injured worker, are typically the first to notice).

When the loss of hearing is not raised until after retirement, there can be additional issues arising. One of these issues was faced recently by the Commonwealth Court of Pennsylvania in City of Philadelphia v. Workers’ Compensation Appeal Board (Seaman).

In this case, the injured worker was a fireman in the City of Philadelphia for many years. Several months after he retired, a hearing loss test (known as an “audiogram”) revealed a significant loss of hearing. The injured worker filed a Claim Petition, which was granted by a Workers’ Compensation Judge (WCJ).

The PA workers’ compensation insurance carrier appealed to the Commonwealth Court of Pennsylvania, saying that the injured worker could not win, because he could not prove the extent of hearing loss on the date he retired. The Court, however, rejected this defense and affirmed the granting of the Claim Petition. Unless there was a previous hearing loss test done close in time to the retirement, showing a significantly lesser hearing impairment, there is no such burden on the injured worker, the Court found.

Even more recently, in a decision rendered November 19, 2010, the Commonwealth Court of Pennsylvania again addressed hearing loss in the matter of Joy Mining Machinery Company v. Workers’ Compensation Appeal Board (Zerres). Here, as in the Seaman case above, the WCJ granted the Claim Petition finding a work-related loss of hearing (13.125% hearing loss in this case).

The issues in the Zerres case were whether the injured worker could prove he was exposed to the harmful noise within the three years before a Claim Petition was filed, and whether the WCJ could properly give greater weight to the injured worker’s testimony about noise level than noise-level studies (called “dosimetry readings”) offered by the employer.

The Court affirmed the decision of the WCJ, finding that the testimony of the injured worker, without more, if believed by the WCJ, was sufficient both for the timing of the noise exposure, as well as the level of exposure. The Court noted that the dosimetry readings offered by the employer were not done on the person of the injured worker, nor were they done every day in every area, thus, the dosimetry readings did not prove to what extent the injured worker was actually exposed.

We were humbled and appreciative to learn that our blog has been selected by LexisNexis as one of the Top 25 Blogs for Workers' Compensation and Workplace Issues. Considering all of the excellent blogs covering just Pennsylvania workers’ comp issues, it was incredibly rewarding for us to be selected to such an elite group, not only for PA, but for blogs covering the issue across the entire Country. We are especially proud, since this is our second such recognition in the past three years.

The entire list of the Top 25 Blogs for Workers' Compensation and Workplace Issues can he found here.

We again thank LexisNexis, and our loyal readers, for this tremendous honor. Over the ensuing months, and years, we will strive to be worthy of this recognition.

Last week, we attended a PA Workers’ Compensation seminar in Hershey, Pennsylvania. This is the “Fall Section Meeting of the Pennsylvania Bar Association’s Workers’ Compensation Section.” For years, workers’ comp attorneys from across the entire State of PA have gathered at this seminar to learn and discuss new cases and trends in PA workers’ compensation.

As you know, from reading our blog, we stay very current on workers’ comp cases coming out of the Commonwealth Court of PA and the Pennsylvania Supreme Court. But, we recognize the importance of attending seminars like this one, so that we can interact with other workers’ compensation attorneys across PA, as well as the Workers’ Compensation Judges, and stay on top of trends and developments.

We believe it is this desire to stay current in all aspects of PA workers’ compensation law which makes Brilliant & Neiman LLC able to help injured workers as well as possible. Sometimes, general practice attorneys, who do not limit their entire practice to PA workers’ comp cases, as we do, are not able to stay as current on all aspects of cases they handle. We believe this is the primary benefit to us limiting our practice to just representing injured workers in their PA workers’ compensation cases.

In the Summer 2010 issue of News & Notes, published by the PA Bureau of Workers’ Compensation, Workers’ Compensation Judge (WCJ) Joseph Hagan was named to be Judge Manager for the Southeastern District of Pennsylvania. Judge Hagan has been a WCJ in this district, working from the Philadelphia Workers’ Compensation Hearing Office, since 1988. The Southeastern District covers the Northeast Philadelphia, Center City Philadelphia and Upper Darby Workers’ Compensation Hearing Offices.

WCJ Karen Wertheimer remains Judge Manager for the Eastern District of PA. This includes the Allentown, Bristol, Lancaster, Malvern, Northampton and Reading Workers’ Comp Hearing Offices. Interestingly, this District also has two “informal” or “unlisted” locations – an injured worker who resides in Quakertown, Doylestown or other parts of the Central/Upper Bucks County will have hearings held in the Doylestown Courthouse, while an injured worker who lives in the eastern portion of Montgomery County will have hearings held in Dresher.

The Central District of PA, encompassing Harrisburg, Hazleton, Pottsville, Scranton, Wilkes-Barre and Williamsport, is headed by Judge Manager Susan Caravaggio, and the Western District is led by Judge Manager David Cicola.

Though workers’ compensation laws vary from State to State, there are some elements which remain fairly constant. Workers’ compensation laws are generally “no fault” statutes (no need for an injured worker to demonstrate negligence), and they generally exclude the recovery of “pain and suffering.” Workers’ compensation systems also are usually streamlined (as compared to general civil litigation) and procedures are often more relaxed than in ordinary State Court systems.

Therefore, trends, developments and concerns in workers’ compensation systems can frequently be addressed at a level relevant to every State in the Country. Recently, we were contacted by Gregory M. Duhl, Associate Professor of Law at William Mitchell College of Law in Minnesota, regarding an article he co-authored with Jaclyn Milner, an attorney in Minnesota. Since the article deals with the impact of social networking sites on workers’ compensation cases in general, it certainly appears to be of interest to injured workers in Pennsylvania, as well as every other State in the Country.

The full article can be found at http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1675026 . I encourage all injured workers, and workers’ compensation attorneys, to read the article carefully. Our society is becoming more and more technologically advanced, and many injured workers, and perhaps even their attorneys, do not realize how social networking sites, such as Facebook, Twitter and Myspace, can impact a workers’ compensation case. As the article notes, both the information within social networking sites themselves, as well as the “guidance” for when and where future surveillance may be productive, these sites can be an enormous liability to a workers’ compensation case.

Some time ago, we made a brief deviation from our normal course of not blogging about own active cases, to discuss a liquor store clerk who was robbed at gunpoint. The PA Liquor Control Board (LCB) denied the claim, stating that being robbed at gunpoint was not an “abnormal working condition” for a PA LCB clerk (remember that the next time you think of stepping into a State Store in Pennsylvania – armed robbery is simply accepted as a normal course of a day by management). We filed a Claim Petition on the clerk’s behalf and litigated the case.

We are pleased to report that the Workers’ Compensation Judge (WCJ) did not buy Defendant’s argument, and did not believe that society has degraded far enough such that a clerk can expect armed robbery on his or her normal day at work. In granting our Claim Petition, the WCJ rejected the Defendant’s attempt to expand the Commonwealth Court of Pennsylvania’s disastrous decision in of McLaurin v. Workers’ Compensation Appeal Board (SEPTA), wherein the Court, in its infinite wisdom, found that a SEPTA driver’s normal workday includes being assaulted by a gun-wielding teen (sending the message, as we understand it, that anyone foolish enough to step on a SEPTA vehicle can expect to face such consequences).

Undaunted, however, the PA LCB has filed an appeal with the Pennsylvania Workers’ Compensation Appeal Board (WCAB). It appears the PA LCB’s argument is that the WCJ was incorrect and Pennsylvania liquor stores are just as deadly as SEPTA vehicles (how very proud they must feel while making these arguments). We find it amazing, not to mention disheartening, that our own governmental agencies would be stooping to such disgraceful antics to deny a case. Rather than address what they clearly view as a “normal working condition,” perhaps by improving security methods, the PA LCB instead is trying to use its stubborn ignorance and incompetence as a basis to deny an injury to one of its own employees. How can one put any word other than “disgraceful” on that?

As discussed in a previous blog entry, PA workers’ compensation proceedings are usually held in the County in which the injured worker resides. Counties are then grouped by “Districts.” In the State of PA, there are four Districts: Eastern, Southeastern, Central and Western.

Hearings for the Eastern District are located in Allentown, Bristol, Lancaster, Malvern and Reading (also, though not officially listed on the Bureau of Workers’ Compensation official website, some hearings take place in Doylestown and Dresher). The Southeastern District sees hearings in Northeast Philadelphia and Center City Philadelphia, in addition to Upper Darby. Harrisburg, Hazleton, Pottsville, Scranton, Wilkes-Barre and Williamsport comprise the Central District. Throughout the State of Pennsylvania, there are now a total of 95 Workers’ Compensation Judges (WCJ).

This number includes four new WCJs who have just been introduced by the Bureau of Workers’ Compensation. In the Philadelphia Workers’ Compensation Hearing Office (Southeastern District), Timothy Bulman and Sandra Craig have been added. Robert O’Donnell has joined the Lancaster Workers’ Compensation Hearing Office (Eastern District). The Western District, Johnstown Workers’ Compensation Hearing Office, has added Steven Minnich.

More information on the division of workers’ compensation hearing offices across Pennsylvania, and on the Workers’ Compensation Judges in PA, is available on the PA Bureau of Workers’ Compensation office website.

As we mentioned in a previous blog entry, we are excited to sponsor a seminar on Pennsylvania Workers’ Compensation, which is free to injured workers. More information can be seen in our ads in many area newspapers, or you can view the ad on www.phillyburbs.com by clicking here. We think this opportunity to learn about work injuries, from two experienced PA workers’ compensation attorneys, an occupational medicine physician and two representatives of a physical therapy facility, is a valuable experience which should be taken by every injured worker. We look forward to seeing all of you in our offices for the seminar on May 10, 2010 at 6:00. Just call us at (215) 244-8101 to reserve your spot.

Representing injured workers in Pennsylvania workers’ compensation cases, we realize how scary and unfamiliar the PA workers’ comp system can be, especially to an injured worker who does not have an attorney representing them. As we try to do from time to time, we are sponsoring a free PA workers’ compensation seminar on Monday, May 10, 2010, at 6:00 p.m. at our Trevose office (Three Neshaminy Interplex, Suite 301)[Just North of Northeast Philadelphia, just off the Roosevelt Boulevard/Route One, I-95 and the Pennsylvania Turnpike].

We are excited to have Dr. Joel Kravitz, who is Board Certified in Occupational Medicine and Family Medicine, as well as Dr. Gene Nelson, Clinical Care Coordinator at Progress Physical Therapy Centers, and Bill Leitzel, MS Physical Therapist at Progress Physical Therapy Centers joining us for this seminar. In addition to speaking, all of the panelists will be available to answer the many questions you may have.

We encourage all injured workers to take advantage of this unique opportunity to have both your medical and legal questions answered. This is a rare opportunity, and seating is limited, so we ask that you call our offices at (215) 244-8101 to reserve your spot. If you are unable to attend this free seminar, but would like to schedule a personal appointment with us, also feel free to call us to schedule.

When an aggrieved party wants to appeal a decision of a Workers’ Compensation Judge in PA, the first step is to the Pennsylvania Workers’ Compensation Appeal Board (WCAB). Until recently, the WCAB was comprised of a total of 15 commissioners, who would travel throughout the State of Pennsylvania, holding oral arguments in Philadelphia, Pittsburgh, Harrisburg, Scranton, Johnstown and Erie.

Unfortunately, due to budget difficulties faced by PA, the total of 15 commissioners on the WCAB has been drastically reduced. Right now, only five commissioners remain. Apparently, there will be another three commissioners named, when they are approved by the PA Senate.

This reduction in staffing is almost certain to have a negative effect on the speed with which WCAB decisions are issued. While we would love to provide a link for more information, there has been no official word on this development from the PA Bureau of Workers’ Compensation (other than to change the listed commissioners to the current total of five).

In the PA Workers’ Compensation system, we often see the workers’ comp insurance company doctors employ a fanatical reliance on “objective” diagnostic studies, at least when the results are negative. These doctors who perform Independent Medical Examinations (IMEs)[More accurately known as Defense Medical Examinations (DMEs)] use a negative study to say the injured worker must be fully recovered.

This view, of course, is far too simplistic and quite flawed. One could ask Kevin Curtis for confirmation. As many of you know, Kevin Curtis is a wide receiver for the Philadelphia Eagles. He has not been able to play football this year due to persistent pain in his knee. Repeated MRI studies of the knee were negative for any structural damage at all. Had Mr. Curtis been an injured worker, the IME/DME doctors would have said there is nothing wrong with him, and he can return to unrestricted work.

Yet, with millions of dollars hanging in the balance, Mr. Curtis remains unable to return to the field. In fact, the symptoms were so troubling to Curtis that he underwent arthroscopic surgery on his knee. This type of case should serve as a reminder to Workers’ Compensation Judges (WCJs), as well as to those doctors performing IMEs and DMEs, that no diagnostic test, whether x-ray, MRI or CT scan, is infallible. And, sometimes, when an injured worker says his or her knee (or shoulder, or back, or whatever) really hurts, even in the face of a negative study, maybe it really does still hurt.

Since we limit our practice to representing injured workers' in PA workers' compensation cases, we see frequent situations when an injured worker is treated poorly by the workers' comp insurance carrier. Sometimes, though, the situation seems way beyond common sense and logic. I am currently litigating one of those cases, against the Commonwealth of Pennsylvania/Liquor Control Board.

When a work injury in PA is emotional or psychological in nature, the condition must have been caused by an “abnormal working condition” to be eligible for Pennsylvania workers’ comp benefits. In other words, the emotional or psychological condition must be cause by something other than a subjective response to normal working conditions. What determines “normal working conditions” depends on the occupation in question.

Firefighters, police, emergency medical technicians and other first responders are normally expected to face much more stressful conditions than a secretary, accountant, factory worker or construction worker, for example. An event happening to a policeman may be a normal working condition, but if the same event happened to an automobile mechanic, that would be an abnormal working condition. These cases often depend greatly on the facts involved in each case.

I currently represent a clerk who works for Commonwealth of Pennsylvania/Liquor Control Board. The clerk was the victim of an armed robbery, and suffered emotional or psychological injuries as a result of this incident. To my surprise, and disgust, the LCB denied the claim, stating on the Notice of Denial, “Incident is not considered an abnormal working condition for this employer.”

Has society deteriorated to the point that we consider the armed robbery of a retail store to be the normal part of a clerk’s workday? I certainly hope the Workers’ Compensation Judge tells the LCB that society expects more from its members. Armed robbery should never be considered a “normal” part of a reasonable society.

An article in the New York Times, talking about how insurance company’s “Independent Medical Examiners” (IME) may not be acting truthfully, hit home to me. Though the article deals specifically with New York workers’ comp, their system is close enough to Pennsylvania’s that comparisons are valid.

While I urge folks to read the entire article, the part that was my absolute favorite was the insurance company doctor who said, “If you did a truly pure report, you’d be out on your ears and the insurers wouldn’t pay for it. You have to give them what they want, or you’re in Florida. That’s the game, baby.”

It still amazes me when I see an injured worker represented by a general practice attorney. As you folks can see from the frequent postings on our blog, the law in Pennsylvania workers’ comp frequently changes. Lawyers who do not handle PA workers’ compensation cases on a regular basis can be at a severe disadvantage.

When you break your leg, you do not seek the medical opinion of a heart doctor. Instead, you want to be treated by a doctor who sees conditions like yours everyday. A doctor who remains informed about changes in areas of medicine as it concerns your condition. Do not treat your legal needs any less. Make sure when selecting a PA workers’ compensation attorney, the lawyer you pick has extensive Pennsylvania workers’ comp experience and practices frequently in this area.

A recent post on Workers’ Comp Insider, a blog devoted to workers’ compensation cost control, explores the problems being faced by FedEx and its workers. FedEx has managed to avoid having its workers join a union, by classifying them instead as “independent contractors” rather than “employees.” The blog entry points out that this arrangement may be on the way out, given the potential impact of a Democrat-controlled congress. Note was also made that State Courts have frequently found the FedEx drivers, who wear FedEx uniforms and drive FedEx trucks, to be “employees,” regardless of how they are described by FedEx.

This points out an important fact, one that may not be known by every injured worker – just because an employer terms its workers “independent contractors” does not make it so. In fact, for Pennsylvania workers’ compensation purposes, a Workers’ Compensation Judge (WCJ) will examine many elements of the relationship between the injured worker and the employer. How that relationship is described, and whether they are called “employee” or not, is only a minor factor.

The most important factor in determining whether an injured worker is truly an “employee” in PA is the degree of direction and control held by the employer. For example, is the employee told what to do and how to do it, or does the employee make these decisions on his or her own. Even if this control is not actually exercised by the employer, Pennsylvania Courts have found its mere existence proof enough.

Other factors include terms of agreement between the parties, the nature of the work or occupation, skill required for the performance of the work, whether one is engaged in the regular business of the employer, whether payment is by the time or by the job and also whether employer has the right to terminate the employment at any time.

Though this issue may be most common in the setting of a delivery driver, it is hardly limited to that situation. We have seen this issue arise in the construction industry, in nursing and healthcare, in auto-service positions and in teaching and coaching. These complicated elements in a Pennsylvania workers’ compensation case once again highlight the importance of having a lawyer who is experienced in PA workers’ comp matters.

Under the Pennsylvania Workers’ Compensation Act, physical injuries, like carpal tunnel syndrome, low back strain or a fractured arm, are treated differently than emotional/psychological injuries, like post-traumatic stress disorder (PTSD), depression or anxiety. To obtain workers’ comp benefits in PA for emotional/psychological injuries, the injury must result from an “abnormal working condition,” rather than a person’s subjective response to a normal working condition. What constitutes an “abnormal working condition” under Pennsylvania workers’ comp law varies depending on the job at issue and is the subject of many court decisions.

Recently, the courts in PA have been very demanding in what constitutes an “abnormal working condition.” For some professions, such as firemen, policemen and other emergency first responders, the courts have set the threshold extremely high, finding very little in those jobs could possibly be “abnormal.” Essentially, some jobs should expect the unexpected, the courts seem to say.

Typically, harassment or bad behavior by a boss will not reach the level of an “abnormal working condition.” In fact, one of my favorite quotes on this subject comes from a 1996 decision of the Supreme Court of Pennsylvania, “In assessing whether work conditions are abnormal, we must recognize that the work environment is a microcosm of society. It is not a shelter from rude behavior, obscene language, incivility, or stress.”

With this in mind, a recent decision by the Commonwealth Court of Pennsylvania, Community Empowerment Association v. Workers’ Compensation Appeal Board (Porch), decided November 25, 2008, was a pleasant surprise. In this case, the Claimant was a victim of both sexual and religious harassment, and suffered emotional and psychological injury as a result. A Claim Petition was filed, and was subsequently granted by a Workers’ Compensation Judge (WCJ). On appeal, the Court found these facts sufficient to rise to the level of an “abnormal working condition.”

While emotional and psychological injuries sometimes have a more difficult burden of proof than a typical physical injury under PA workers’ compensation law, an injured worker should be aware that such claims can still sometimes be successful. As with any work injury, it is critical to consult immediately with an attorney experienced in Pennsylvania workers’ compensation.

Though the case of Armstrong v. Workers’ Compensation Appeal Board was decided by the Commonwealth Court of Pennsylvania over a year ago, on August 27, 2007, this decision continues to both amaze and irritate those of us who limit our practice to representing the injured worker in PA workers’ comp cases.

Under Section 406.1 of the Pennsylvania Workers’ Compensation Act, the workers’ comp insurance carrier has 21 days to accept or deny a claim. Typically, and logically, acceptance of a claim is done by issuing a Notice of Compensation Payable (NCP) [or an Agreement for Compensation], and denial of a claim is done by issuing a Notice of Denial (NCD). Since this seems to make perfect sense, naturally, this is not necessarily how things work.

On a Notice of Denial, there are six boxes, or “bases of denial.” Essentially, the workers’ comp insurance company checks one or more of those boxes, indicating the reason or reasons for the denial. Box number four on an NCD states, “Although an injury took place, the employee is not disabled as a result of this injury within the meaning of the Pennsylvania Workers’ Compensation Act.” This is rather unnecessary, since there is also a “medical only” NCP, to be issued when the workers’ comp insurance carrier feels there is no disability from the work injury.

In Armstrong, an NCD was issued, and box number four was checked. One of the issues the Court faced was whether the Notice of Denial was actually a document accepting the case. In a decision that seems contrary to common sense, the Court held that a Notice of Denial, with box four checked, does indeed mean that the workers’ compensation insurance carrier accepted the claim. Logic only an appellate court could love.

Under the Pennsylvania Workers’ Compensation Act, a workers’ comp insurance carrier has 21 days to accept or deny a claim. During that period, the workers’ comp insurance carrier is to investigate the claim. This both fair and clear.

The award of attorney fees under the PA Workers’ Compensation Act is supposed to be the rule. Only when the workers’ comp insurance carrier demonstrates that the they had a reasonable basis to deny the claim is an award of fees to be denied. This is how the law sets forth the process. Again, this seems both fair and clear.

Unfortunately, the reality is that unreasonable contest attorney fees are rarely ordered against the workers’ compensation insurance carrier. Even though the PA Workers’ Compensation Act, and the cases from PA Courts, show the workers’ comp insurance carrier must have a basis to deny a claim at the time the decision is made to deny the claim, Workers’ Compensation Judges (WCJs) rarely apply the law this way.

On September 26, 2008, the Commonwealth Court of Pennsylvania decided Hansen v. Workers’ Compensation Appeal Board, in which unreasonable contest attorney fees were denied. In this case, at the time the decision was made to deny the claim, the workers’ comp insurance carrier had five progress notes from the injured worker’s doctor. One of these notes made mention of the injured worker’s occupation, in discussing her carpal tunnel syndrome. None of the notes specifically stated the carpal tunnel was work-related. The workers’ comp insurance carrier denied the claim. The WCJ granted the claim, but denied unreasonable contest attorney fees. The injured worker appealed the denial of attorney fees.

On appeal to the Commonwealth Court, the decision of the WCJ, denying the unreasonable contest attorney fees was affirmed. The Court reasoned that the workers’ comp insurance carrier had a factual basis to deny the claim since the progress notes were vague, and the injured worker had performed similar work for other employers in the past. The Court apparently had no problem with the fact that the workers’ comp insurance carrier did not request the injured worker attend an Independent Medical Examination (IME) until after a lawyer was retained and litigation was begun.

To us, as lawyers who regularly practice in the area of PA workers’ comp, the Court has now switched the burden to the injured worker to show clear evidence of a work injury to the workers’ comp insurance carrier. Previously, based on the actual language of the Pennsylvania Workers’ Compensation Act, we believed the workers’ comp insurance carrier had a duty to investigate an injury once report of the injury had been received (since this is what the Act specifically states in Section 406.1). It now appears the workers’ compensation insurance carrier has much less of a duty to investigate report of a work injury than is written in the Act.

Claimants receiving, or attempting to receive, workers' compensation benefits in PA are required to report receipt of various income. There are three what we call "verification forms," which workers' compensation insurance companies can send to these claimants. If these forms, which were approved by the Pennsylvania Bureau of Workers' Compensation, are not completed by the claimants, and returned to the workers' comp insurance carrier within 30 days, workers' compensation benefits can be stopped.

On the other hand, I recently received a copy of a "Claim Status Report," which was sent by the workers' comp insurance carrier to my client. Some of the questions were similar to those on the forms approved by the Pennsylvania Bureau of Workers' Compensation, but there were other questions which a claimant would have no obligation to answer.

This is just another instance of why every Claimant should have access to an experienced PA workers' comp attorney. Any time something is received by a workers' compensation claimant, there should be a discussion with the attorney. There are so many rights and responsibilities the injured worker should know, that it just makes sense to have someone to watch their back.

Under the PA Workers’ Comp Act, generally speaking, a worker is not eligible for Pennsylvania workers’ compensation benefits when he or she is commuting to work. Under the law, the worker is not “in the scope of employment” at that time. One exception to this rule is for “traveling employees,” who are usually in the scope and course of their employment while moving from place to place. Obviously, it is advantageous for an injured worker who is hurt commuting to work to be found to be a “traveling employee.”

In a recent case, Jamison v. WCAB (Gallagher Home Health), the Commonwealth Court of Pennsylvania held that a home health nurse, who was hurt commuting to her assignment, was a traveling employee, despite the fact she worked for three different employers (sometimes all on the same day). The Workers’ Compensation Judge (WCJ) had found that Claimant was not a traveling employee, because she could be working for any of her three employers on any given day. As such, the WCJ denied the Claim Petition.

In reversing the WCJ, the Court found that claimant was a traveling employee with regard to her home health nurse job (the issue of multiple employers was essentially irrelevant). Once found to be a traveling employee, claimant was entitled to a presumption that she was working for her employer at the time she was driving from her home to the patient’s house. To prevail and defeat the claim, the workers’ compensation insurance company would have to prove the claimant abandoned her duties for the employer (for instance, by proving that claimant was actually on her way to work at one of her other jobs). Since the workers’ comp insurance carrier failed to prove this, the WCJ erred in denying workers’ compensation benefits to claimant.

In a previous blog entry, I mentioned the April 28, 2008 decision by the Commonwealth Court of Pennsylvania in Diehl v. WCAB, which greatly limited what a workers’ compensation insurance carrier in Pennsylvania can do with an Impairment Rating Evaluation (IRE). This decision was very favorable to the injured worker. Unfortunately, on June 24, 2008, the Commonwealth Court of Pennsylvania issued an order, and granted the workers’ compensation insurance company’s application for reargument, and vacated the prior decision. This means that, for now, the law returns as it had been before the Diehl decision was issued (meaning the workers’ comp insurance company does NOT have to show job availability when trying to have benefits changed to partial based on an IRE).

Though there will be reargument on this case, and a new decision will be issued, many of us Pennsylvania workers’ compensation attorneys doubt that the new decision will be as favorable as the one which has been vacated. We will, of course, post about the new decision when it is made.

Last month, I wrote a blog entry explaining how every State, including Pennsylvania, had very different laws governing workers’ compensation systems within that State. One point I should clear up is that not every injured worker in Pennsylvania automatically qualifies for the PA workers’ compensation system. Whole occupations, or groups of workers, are subject to workers’ comp systems which vary from the Pennsylvania Workers’ Compensation Act.

For example, employees of the Federal Government must go under the Federal Employees’ Compensation Act (FECA), which is administered by the Office of Workers’ Compensation (OWCP). Railroad workers are usually subject to the Federal Employers’ Liability Act (FELA), which uses the Federal Court system for its procedure. The Longshore and Harbor Workers’ Compensation Act (“Longshore Act”) governs employees engaged in maritime activities (though these cases sometimes have “dual jurisdiction” in PA and can proceed either through the Longshore Act or the regular Pennsylvania workers’ comp system, often depending whether the injury took place on the water or on dry land). So, not every worker who is injured in PA will be proceeding through the Pennsylvania Workers’ Compensation Act.

On the other hand, there are times when a worker who is injured in another State can still proceed under the Pennsylvania workers’ compensation system (Like the example above with the Longshore Act, this is known as “dual jurisdiction,” since there would also likely be jurisdiction in the State in which the injury took place). In this situation, we look at where the injured worker was hired, where the injured worker usually worked (and where the injured worker expected to work), and other factors, to see what options the injured worker has for which workers’ comp system to use.

As with so many areas of the law, the work injury can be a complicated process right from the start. Before a lawyer can even get into the details of the injury, and see if there is a valid workers’ comp case, the lawyer must figure out the best law to use (when there is even a choice).

Many injured workers in Pennsylvania are not aware that they can apply for Social Security Disability (SSD), while still receiving workers’ comp benefits in PA. Though the two programs have different standards for what “disabled” means, and the injured worker may not be able to receive full benefits from both programs, there is no need to choose one or the other.

An injured worker qualifies for workers’ compensation benefits in Pennsylvania when he or she is disabled from work by an injury which took place in the scope and course of his or her employment. One qualifies for Social Security Disability benefits when one is disabled from all gainful employment, regardless of the cause of the disability. Many times, the workers’ comp claimant in PA qualifies for both, but is not aware they can receive both.

Between the two programs, a workers’ compensation claimant in Pennsylvania can only receive a certain percentage of their pre-injury earnings. Usually this amount will be more than the workers’ comp benefits alone. Plus, getting approved for SSD will lead to getting Medicare benefits, which can be a valuable resource. The Social Security Administration will withhold any SSD benefits a workers’ compensation claimant in Pennsylvania would otherwise be entitled to (the amount of SSD over that percentage of pre-injury earnings). There is no deduction from workers’ comp benefits in PA for SSD (contrary to Social Security Retirement benefits, for which the workers’ compensation insurance carrier gets a credit in Pennsylvania).

As with any potential benefit, a workers’ comp claimant in Pennsylvania should fully investigate whether applying for SSD benefits would be a good choice in their particular situation (in some cases, the injured worker may be better off not applying for SSD). This, as with any decision a workers’ comp claimant makes, should be discussed with an experienced Pennsylvania workers’ compensation lawyer.

Many injured workers in Pennsylvania know not to sign a document they receive from the workers’ compensation insurance company without checking first with an experienced workers’ compensation attorney. Unfortunately, few injured workers are aware that some documents exist in the Pennsylvania Workers’ Compensation Act which can cause workers’ comp benefits to be reduced, or stopped, even if the documents are NOT signed by the injured worker.

When an injured worker returns to work in PA, he or she is still entitled to workers’ compensation benefits if there is still a loss in earnings (maybe the modified job pays less per hour, or offers fewer hours). The workers’ compensation insurance company must take some action if it wishes to reduce, or stop, weekly compensation benefits. In the old days, the workers’ compensation insurance company would have to file a Petition for Modification or Suspension, and litigate the issue. This is no longer the case.

These days, the workers’ compensation insurance company can simply file a Notification of Modification or Suspension, which contains an affidavit that the injured worker has returned to work, whether at pre-injury or reduced wages. If the Notification of Modification or Suspension is not “challenged” (appealed) by the injured worker, the Notification of Modification or Suspension has the same legal effect as if the injured worker signed a Supplemental Agreement, agreeing that the injured worker did return to work at those wages.

The challenge of the Notification of Modification or Suspension must be filed by the injured worker within 20 days of when the injured worker received the Notification of Modification or Suspension. According to a recent case in the Commonwealth Court of PA, Wawa v. W.C.A.B. (Seltzer), the date the injured worker received the Notification of Modification or Suspension is a finding of fact to be made by the Workers’ Compensation Judge (and will not be disturbed on appeal, if supported by “substantial evidence”).

This is yet another danger to the injured worker, who may be unaware that valuable rights can be lost simply by not taking action. It is very important that the injured worker be fully informed of the potential pitfalls contained within the Pennsylvania Workers’ Compensation Act.

A common fear with an injured worker is the impact of his or her employer, or the workers’ compensation insurance carrier, filing for bankruptcy. In Pennsylvania, an injured worker need not be concerned with such a development. Whether it is the bankruptcy of the employer, or the workers’ compensation insurance carrier, in PA, workers’ compensation benefits should not be disturbed.

When a party files for bankruptcy, which is governed by Federal law, the main purpose (or at least the immediate purpose) is the protection of the “automatic stay,” provided by Section 362(a)(1) of the Federal Bankruptcy Code, 11 U.S.C. §362(a)(1). The “automatic stay” causes any collections efforts (including any litigation) to be stopped. A creditor usually must apply for permission with the bankruptcy court, in order to have the stay lifted. Only if the request is granted, and the stay is lifted, can the creditor take any action on the debt (including litigation). The automatic stay allows payments from the bankrupt party to stop. This would, of course, be catastrophic for an injured worker who relies on Pennsylvania workers’ comp benefits.

Workers’ compensation laws are State laws, as opposed to Federal law, such as bankruptcy. One of the exceptions to the “automatic stay” is an exercise of a State’s “police powers,” under 11 U.S.C. §362(b)(4). The Commonwealth Court of Pennsylvania has recently confirmed that “the administration of worker’s compensation claims by the State … is a valid exercise of a governmental unit’s regulatory power, and is exempt from the automatic stay.” Pope & Talbot v. W.C.A.B. (Pawlowski), decided on May 21, 2008. Therefore, workers’ compensation benefits in PA are usually to be paid regardless of the filing of bankruptcy. Similarly, litigation in workers’ compensation cases in Pennsylvania may continue, despite the bankruptcy filing.

In years past, if an employer in PA failed to carry Pennsylvania workers’ compensation insurance (which is a crime in Pennsylvania), and that employer filed for bankruptcy, the injured worker may have been left out in the cold. Fortunately, as part of Act 147, passed by the Pennsylvania Legislature in 2006, the Uninsured Employers’ Guaranty Fund (UEGF) was created. The UEGF, funded by payments from all workers’ comp insurance companies in PA, steps in when there is a claim against an uninsured employer (regardless of whether that employer is bankrupt). This fund provides a measure of security for the injured worker who, unknown to the worker, is employed by a company who fails to carry the required workers’ comp insurance.

As you may recall, last month I brought up the case of Mason v. WCAB (Joy Mining Machinery), in which the Commonwealth Court of PA punished an injured worker merely for taking his pension. In that case, the Court had said workers’ compensation benefits will be suspended, unless the injured worker shows either that he or she is disabled from all work, or that he or she is actively seeking work.

The Commonwealth Court of Pennsylvania has struck again, in Penn State v. WCAB (Hensal), decided on May 19, 2008. In this case, the injured worker argued that his workers’ comp benefits should not be stopped, even though he took his pension, because he was actively seeking work. As proof, the injured worker testified that he signed up for Career Link (a program run by the State of Pennsylvania) and periodically checked websites and newspaper ads, but found no work. Though the Workers’ Compensation Judge (WCJ), and the Workers’ Compensation Appeal Board (WCAB), agreed and found the injured worker’s efforts showed that he is truly looking for work and has not “voluntarily removed himself from the labor market,” the Commonwealth Court of Pennsylvania disagreed, and ordered the workers’ compensation benefits stopped.

Specifically, The Court said:

“Searching the Internet and newspaper ads for jobs, without more, does not constitute a job search; it constitutes “surfing” the web and reading the newspaper – it is window shopping. To show that he was engaged in a good-faith effort, a claimant has to show that he applied or sent applications for employment or other indicia that he was actively applying for employment.”

This case proves instructive on how to limit the damaging effects of taking a pension. Remember, too, that aside from this issue (of whether the PA workers’ compensation benefits are suspended due to the change in status), there is also the issue of the workers’ compensation insurance carrier taking a credit against the pension that is being taken. This process is littered with pitfalls which can permanently harm an injured worker’s rights under the Pennsylvania Workers’ Compensation Act. Before making a decision, like whether to take a pension, which could impact your workers’ compensation benefits, it is always a good idea to consult with a lawyer experienced in PA workers’ compensation matters.

On November 9, 2006, the most recent amendment to the Pennsylvania Workers’ Compensation Act, known as Act 147 of 2006, was signed into law. Several of the provisions of Act 147 were designed to quicken the litigation process in PA workers’ comp. One of those provisions created what is known as “Mandatory Mediation.”

Mediation, generally speaking, is a process where an independent person meets with the parties to a dispute and helps the parties reach a resolution to their quarrel. This is a process used in all types of litigation, and even in disputes outside of litigation. Usually, this is a very informal process. The mediator will meet with the parties separate and together, working to try and bring them together on common ground. There is no court reporter present, and things said in mediation are not admissible in the litigation (encouraging the parties to be honest about the strengths and weaknesses of their position).

Mediation has been used in Pennsylvania workers’ compensation matters as long as I can recall. In the past, mediation only happened in PA workers’ comp when the parties so requested. The process was entirely voluntary, and did not occur that often.

Act 147 made mediation mandatory, in every case, unless the Workers’ Compensation Judge felt that mediation would be futile. As a result, we are seeing much more mediation in Pennsylvania workers’ comp than in years past. In turn, the increased mediation seems to have led to workers’ compensation settlements becoming more frequent in PA.

Mandatory mediation is not binding. That means that if a settlement cannot be agreed upon by all parties, then there is no settlement. Usually, there is little to lose by engaging in mediation. If a settlement cannot be reached, nothing is lost other than the time spent by the parties (and even then, some issues in the litigation may get resolved, narrowing the disputes which remain).

As with Act 147 generally, mandatory mediation appears to be a beneficial change to the PA Workers’ Compensation Act for the injured worker. I am proud to have participated in meetings working on this litigation, with the Pennsylvania Trial Lawyers Association (now known as Pennsylvania Association for Justice). As a PA workers’ comp attorney, I salute the hard work of the Pennsylvania Association for Justice in having such fair legislation passed.

An injured worker in Pennsylvania is generally entitled to be compensated for his or her lost wages (called “indemnity” benefits), and have medical expenses related to the work injury paid. When an injured worker loses the use of certain parts of the body, payment can also be obtained (this is called “specific loss” benefits). Included in “specific loss” benefits is compensation for scarring, or “disfigurement,” on the head, face or neck.

Under the Pennsylvania Workers’ Compensation Act, in Section 306(c), there is a list of body parts, and how many weeks of workers’ compensation benefits an injured worker would receive for the loss of each. For example, the loss of a hand leads to a payment of 335 weeks of workers’ compensation benefits. A foot is 250 weeks. Other amounts are listed for forearm, leg, lower leg, eye and more. Payment for fingers depends upon which finger is involved (from 100 weeks for a thumb to 28 weeks for the little finger). The Act also includes some period of additional compensation, called a “healing period.” For example, the lost hand adds a healing period of 20 weeks and the lost foot leads to an additional 25 weeks. Compensation for scarring on the head, face or neck is completely within the discretion of the Workers’ Compensation Judge, who can award from zero to 275 weeks, depending on how disfiguring the scarring is felt to be.

To obtain specific loss benefits in PA workers’ compensation, an injured worker must show that the part of the body at issue has been “permanently” lost “for all practical intents and purposes.” The quoted portions above are usually where disputes exist, often requiring the decision of a Workers’ Compensation Judge.

While the testimony of the injured worker is important in determining whether there is a loss of use “for all practical intents and purposes,” according to a recent case decided by the Commonwealth Court of Pennsylvania, medical evidence must also be presented in support of the injured worker. In Jacobi v. W.C.A.B., decided by the Court on February 12, 2008, the claimant testified about how he is limited in using his right middle finger (which had been caught in a freight door and subject to three surgeries, the last of which involved the placement of a screw), but the claimant did not present any medical evidence which stated that the use of the finger has been lost “for all practical intents and purposes.” The Court reversed the decision of the Workers’ Compensation Judge, who had awarded benefits to the claimant.

Even when an injured worker receives a decision from the Workers’ Compensation Judge (WCJ) in Pennsylvania, the case is not over. Either side may appeal the decision to the next level, the Workers’ Compensation Appeal Board (WCAB). Such an appeal must be filed within 20 days of the decision of the WCJ.

An appeal must allege that the Workers’ Compensation Judge committed an “error of law” or that the decision issued by the Judge is not a “reasoned decision.” Simply disagreeing with the decision is not a proper basis of appeal. An appeal cannot challenge who the Judge believed (called “determination of credibility”), since this is solely at the discretion of the Judge.

The WCAB schedules oral argument at various locations throughout the year. At the time oral argument is made, the WCAB also expects a brief to be filed by the appealing party (though a party can request additional time to submit a brief).

Once the decision of the WCAB is made, the losing party can then appeal to the Commonwealth Court of Pennsylvania. This appeal must be filed within 30 days of the WCAB decision. Oral argument is rarely done at this level and the matter is usually decided just on the written arguments filed by the parties.

The decision of the Commonwealth Court of Pennsylvania can be appealed to the Supreme Court of PA, though the Supreme Court only hears cases it chooses. The appealing party files a petition for “Allocatur” with the Supreme Court of PA, which the Court then grants or denies. If the Court grants allocatur, it accepts the appeal and will decide the issue. If the Court denies allocatur, the decision of the Commonwealth Court of Pennsylvania becomes final.

Recently, Hazleton, Pennsylvania, was in the news for its efforts to crack down on undocumented, illegal aliens. We also are hearing the Presidential candidates speak about their views on how to handle these people. It might make one wonder how an undocumented, illegal worker is treated under the Pennsylvania Workers’ Compensation Act.
The short answer is that an undocumented, illegal worker is entitled to workers’ compensation benefits in PA. The Supreme Court of Pennsylvania decided The Reinforced Earth Company v. W.C.A.B. (Astudillo) in 2002, answering this question with certainty.

Since that time, however, the Courts in PA have not been so kind to undocumented workers. While access to medical treatment for the work injury has continued undisturbed, the illegal worker’s right to wage loss (also known as “indemnity”) benefits has been reduced. As long as the undocumented worker is totally disabled, he or she is entitled to both medical and indemnity benefits. On the other hand, once the illegal alien worker is capable of ANY type of employment, the workers’ compensation insurance carrier can file a petition before a Workers’ Compensation Judge to have the indemnity benefits stopped (again, the medical benefits for the work injury would still continue).

In a typical workers’ comp case in Pennsylvania, if the workers’ compensation insurance carrier wants to reduce or stop (“modify” or “suspend”) indemnity benefits, the workers’ compensation insurance carrier must prove there is work available within the physical restrictions of the injured worker. When the injured worker is an undocumented alien, however, the workers’ compensation insurance carrier does not have to show that any work is available. This was made clear by the Commonwealth Court of Pennsylvania in Morris Painting, Inc. v. WCAB (Piotrowski), decided in 2003.

Indeed, even an illegal alien who has returned to work, at a loss in earnings, is not entitled to any indemnity benefits. The Commonwealth Court of PA decided Jose Mora v. WCAB (DDP Contracting Co., Inc) in 2004. In that decision, the Court held that even actual earnings of an illegal alien cannot be the basis for partial disability benefits because the injured worker in that case is not legally able to work in the United States.

As with the likely result on the mounting illegal alien issue at the National level, a compromise has developed with regard to PA workers’ comp benefits available to an injured undocumented illegal worker.

Pennsylvania workers’ compensation law is like no other State. I mean no disrespect by that statement; truly, PA workers comp is unique, like in every other State. Unlike Federal laws which may be of concern to an injured worker, such as Social Security Disability (SSD) or the Americans with Disabilities Act (ADA), which apply to any injured worker in the United States, each State has its own set of workers’ compensation laws.

The difference between workers’ comp laws from State to State is tremendous. For instance, in Pennsylvania, once an injured worker is receiving workers’ compensation benefits, the workers’ compensation insurance carrier usually must get the permission of a Workers’ Compensation Judge to stop the benefits. In some other States, the workers’ compensation insurance company can simply stop paying benefits on its own. Also, in PA, the Employer, or workers’ compensation insurance company, can only control treatment, at most, for the first 90 days. After that time, if not before, an injured worker in Pennsylvania can select his or her own doctor.

On the down side, in PA, once an injured worker returns to work with no loss in wages, there is usually no more money due the injured worker. There is no compensation for the injured worker who can no longer take part in pleasurable activities (as long as the injured worker can do his or her job, according to PA law, no compensation is payable). In some other States, an injured worker who returns to work can still get money for his “percentage of impairment.”

So, while you are looking at the information out there, including on this Blog and on the Brilliant & Neiman LLC website, please keep in mind that every State has different workers’ comp laws. If your case is not a Pennsylvania workers’ compensation case, the information here may or may not apply to you. We would strongly recommend you talk to an attorney licensed in the State in which you were injured. Follow this link for helpful information regarding workers' compensation laws in other States.

There are many things in life that are not fair. At least one of those things rears its ugly head in Pennsylvania workers’ comp. Unless an employee has a contract, or is a member of a union, there is very little protection for the employee from being fired from his or her job while out of work on workers’ compensation in PA. While an employee cannot legally be fired in Pennsylvania for pursuing a workers’ compensation claim [Shick v. Shirey, 716 A.2d 1231 (Pa. 1998)], it is often difficult to prove the reason for the termination is the pursuit of a workers’ comp case (as opposed to just the absenteeism of the injured worker). Please note, also, that workers’ compensation benefits in PA continue regardless of whether a totally disabled injured worker has been terminated from his or her job or not.

Federal laws do offer some protections for the injured worker caught in this position. The Family and Medical Leave Act (FMLA) can provide some job protection for a period of time. If an injured worker is terminated from his or her job, COBRA may allow the private health insurance coverage to continue, with the injured worker able to assume the payments at the group rate used by his or her employer.

Unfortunately, though, there is often very little that we, as Pennsylvania workers’ compensation attorneys, can do to protect our clients from being terminated from their jobs while they are disabled from work and receiving workers’ compensation benefits.