One aspect of the Pennsylvania Workers’ Compensation system we (thankfully) do not often address is what is known as a “fatal claim,” where the employee is killed in the work accident. This can, of course, occur in the injury itself, or it can occur as a consequence of the original…
Articles Posted in Case Law Update
Surveillance Evidence Alone May Stop PA Workers’ Comp Benefits
We have previously tackled the issue of reinstating benefits under the PA Workers’ Compensation Act. Then, though, we were focusing on how an injured worker can get his or her benefits reinstated. A recent case from the Commonwealth Court of Pennsylvania addresses an even stickier issue – whether the injured…
PA Workers’ Comp Claim Denied for Violation of Positive Work Order
Generally speaking, the PA workers’ compensation system is a “no fault” system. It usually doesn’t matter why an employee gets hurt, as long as he or she was doing his or her job at the time. As with most rules, of course, there are exceptions. One exception to this rule…
Workers’ Comp Insurer in PA Cannot Prove Immigration Status by Injured Worker’s Refusal to Answer
How the Pennsylvania workers’ compensation system handles undocumented workers is a frequently misunderstood topic, which we have previous addressed. We mentioned that undocumented workers are entitled to workers’ compensation benefits as a general rule, thanks to the Pennsylvania Supreme Court’s decision in Reinforced Earth Co. v. Workers’ Compensation Appeal Board…
Workers’ Comp Judge in PA Can Award Penalties When Outstanding Medical Bills are Primary Evidence
When a workers’ compensation insurance carrier in Pennsylvania does not agree with the medical treatment being received by an injured worker, there are steps the carrier can take. The most common is “Utilization Review,” which challenges the reasonableness and necessity of medical treatment. The carrier can also file a Petition…
Taking Pension, Not Looking for Work, Leads to “Retirement” in PA Workers’ Comp
Once again, we are reporting on the Pennsylvania Court System addressing the issue of retirement, and voluntary withdrawal from the labor market, in the context of a PA workers’ compensation case. In Department of Public Welfare/Norristown State Hospital v.Workers’ Compensation Appeal Board (Roberts), the Commonwealth Court of Pennsylvania reversed the…
Unemployment Compensation Benefits Not Includable in Average Weekly Wage for PA Workers’ Compensation
The calculation of the Average Weekly Wage (AWW) under the Pennsylvania Workers’ Compensation Act has been explained previously on this blog. Generally, assuming the injured worker had been working for his or her employer for more than a year before the work injury, the AWW is calculated by taking the…
Petition to Terminate in PA Workers’ Comp Requires Unequivocal Testimony That Injured Worker Fully Recovered
The most damaging petition a workers’ compensation insurance carrier can file against an injured worker in Pennsylvania is a Petition to Terminate. If granted, a Petition to Terminate ends the injured worker’s rights to all PA workers’ compensation benefits for his or her injury, whether wage loss replacement (known as…
IRE Valid in PA Workers’ Comp Even if Condition is Later Objectively Worse
Impairment Rating Evaluations (IREs), under the Pennsylvania Workers’ Compensation Act, have been discussed in this blog before. Basically, the IRE process enables the workers’ comp insurance carrier to switch an injured workers’ disability status to partial if there is a whole body impairment of less than 50% (a ridiculously high…
PA Workers’ Comp Insurer Only Responsible for Part of Medical Expenses
Under the Pennsylvania Workers’ Compensation Act, the workers’ comp insurance carrier is responsible for all reasonable and necessary medical treatment which is related to the work injury. In very rare circumstances, the cost of wage loss (“indemnity”) benefits and medical expenses can be allocated between more than one insurance carrier.…