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…
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…
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…
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…
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,…
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…
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…
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…
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…
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…