Worker Comp Generally

November 13, 2024

PA Workers’ Compensation Available to First Responders Suffering Post-Traumatic Stress Disorder

Pennsylvania workers’ comp unfairly treats mental or psychological injuries differently than physical ones. Our system is a “no-fault” structure. What does that mean? Put simply, if an employee is doing his or her job, and suffers a disabling physical injury, he or she is generally entitled to PA workers’ compensation benefits.

It usually does not matter why the injured worker was hurt, though the injured worker had to be engaged in an activity less foolish than swinging a sledgehammer at a bowling ball, or recreationally leaping down a flight of stairs. Mental or psychological injuries, however, are treated by a different standard. As a general rule, mental or psychological injuries have to be suffered as a result of “abnormal working conditions.”

There is an entire string of cases, as you might imagine, addressing what constitutes “abnormal working conditions.” This varies by the job one is doing, so first responders, such as police officers, fire fighters and EMTs, had a very high burden to prove something they encounter on the job is “abnormal.” Establishing Post-Traumatic Stress Disorder (PTSD) for a first responder was a difficult battle.

October 18, 2024

PA Workers Compensation Judge Must Consider All Conditions “Due To” A Work Injury In IRE

by Glenn Neiman

One of the bigger “victories” by the PA workers’ compensation insurance industry against the injured workers in Pennsylvania is the Impairment Rating Evaluation (IRE) process. Under this process, after an injured worker has received 104 weeks of temporary total disability benefits, the insurance company can initiate an IRE, which can limit the period of time an injured worker can receive workers’ compensation benefits. The IRE process is covered in great detail on our website.

If the examining physician finds that the injured worker has less than a 35% “whole body impairment” due to the work injury, the benefits can shift from “total” in character to “partial.” This does not change the amount of the benefits the injured worker receives, but it limits the duration for which the injured worker can receive those benefits.

One of the questions in the IRE process is which conditions or diagnoses need to be considered by the IRE physician in calculating the “whole body impairment.” There was a school of thought, championed by the insurance industry, that the IRE could only consider those conditions or diagnoses actually accepted as work-related. Thankfully, the Commonwealth Court of Pennsylvania has provided some clarification, establishing that the IRE physician must consider all conditions or diagnoses “due to” the work injury, whether accepted or not.

October 11, 2024

Direct Deposit for PA Workers’ Compensation Benefits Moves a Step Closer

by Glenn Neiman

As attorneys who represent injured workers across the great State of Pennsylvania, we are all too aware that our clients who rely on the US Postal Service for the delivery of their workers’ compensation checks can occasionally find their checks lost or delayed in transit. Since mortgage companies, landlords, car financers, grocery stores and other lenders do not want to hear about delays in the mail, injured workers too often have to deal with the stress of a late check on top of the stress they already feel from the work injury.

Fortunately, those times may be changing! We just learned that Senate Bill 1232 passed the PA House unanimously, and will now move to the Senate for consideration. Should this Bill become law, injured workers all across Pennsylvania would be able to have their workers’ compensation benefits delivered by direct deposit.

This will not stop the occasional “computer issue” which for some reason causes an injured worker to “fall off the system,” but at least it can stop the annoyance of not knowing whether the check was actually mailed or not. We will also be aware of the issue sooner and can move to have it quickly resolved.

August 22, 2024

Torn Meniscus Is Significant Injury in PA Workers’ Comp

by Glenn Neiman

Knee injuries are common in Pennsylvania workers’ compensation. Over the years, we have had many clients with a torn meniscus in his or her knee. This is generally regarded as a minor injury by the insurance industry, a perception we have never understood.

Recently, Minnesota Vikings Quarterback J.J. McCarthy injured his knee. Further testing revealed a torn meniscus. Note that the referenced article describes the meniscus as a “tendon,” though it is not. The meniscus is a piece of cartilage in the knee. Essentially, the meniscus functions as a cushion between the “tibia” (shin bone) and the “femur” (thigh bone).

Surgery is often required to address a meniscus tear, though it is not usually the first avenue to try (that said, Mr. McCarthy had the surgery immediately and will miss the entire 2024 season while recovering). Typically, in our experience, an injured worker will receive conservative treatment initially, in an effort to avoid surgery. If surgery is eventually required, this obviously extends the total period the injured worker may be out of work.

June 3, 2024

Notice of a Work Injury in PA Workers’ Compensation

by Glenn Neiman

No matter what kind of company one works for, as long as one is an “employee,” as defined in the Pennsylvania Workers’ Compensation Act (and not otherwise excluded by other laws, such as federal employees, military personnel, maritime workers and railroad workers), one is entitled to workers’ compensation benefits if an injury is suffered while at work. This is true whether one works for a sole proprietor, small corporation or a major international conglomerate.

When a work injury takes place in PA, notice is required to be given to the “employer” within 120 days of the injury. Failure to do so can result in the injured worker being barred from receiving any workers’ compensation benefits for the injury. This can get more complicated when we are dealing with a sole proprietorship or a small corporation, where the owner is the injured worker. To whom must this notice be provided?

The Commonwealth Court of Pennsylvania recently addressed this issue in Erie Insurance Property & Casualty Company v. Heater (Workers’ Compensation Appeal Board). In this case, the injured worker was the owner of a sole proprietorship. By definition, the “employer” had notice of the work injury as soon as the injured worker had the injury, since they are the same entity.

May 29, 2024

PA Bureau of Workers’ Compensation Seminar Will Cause Brilliant & Neiman to be Closed May 30, 2024 and May 31, 2024

by Glenn Neiman

On May 30, 2024 and May 31, 2024, the annual Pennsylvania Bureau of Workers’ Compensation “Workers’ Compensation Conference” will take place in Hershey, PA. Here, attorneys, Workers’ Compensation Judges (WCJs), employer representatives, adjusters, risk management/safety employees and others who work in the world of workers’ comp across the entire State of PA, gather to discuss and learn changes and trends of which they should be aware.

As we do each year, our attorneys will attend the conference this year. The majority of the attorney attendees at this seminar work for the insurance carriers. This places us in the minority, but out attendance at this seminar is critical to our ability to properly represent our clients.

By listening while the insurance industry representatives are told about the state of the workers’ compensation laws, and impact of recent cases, we are getting insight into how the insurers will treat different situations. This helps us understand and anticipate steps and strategies the workers’ compensation insurance carriers may take. We are also able to have informal conversations with WCJs and defense attorneys, building relationships that may improve communication in future dealings. We are also learning about any new developments or trends that may have escaped our notice.

January 4, 2024

PA Workers’ Compensation Maximum Rate for 2024 Announced

by Glenn Neiman

The Pennsylvania Bureau of Workers’ Compensation has released the maximum workers’ compensation rate for injuries suffered in 2024. This is based upon the statewide average weekly wage. For injuries suffered in 2024, the maximum workers’ comp rate will be $1,325.00 per week. This is up from the 2023 maximum rate of $1,273.00.

As with have noted in previous blogs, the rate in effect at the time of the injury is the rate which will remain for that case permanently. Unlike other benefit programs, like Social Security, there is no annual increase for existing injuries, such as cost of living adjustments.

The grid to see the calculation of the workers’ compensation rate from the Average Weekly Wage (AWW) can be found on the website of the Bureau of Workers’ Compensation. While the calculation of the rate from the AWW is purely mathematical, the calculation of the AWW itself is complicated and should always be checked by an attorney experienced in PA workers’ compensation.

November 7, 2023

Three Year Statute of Limitations Applies in PA Workers’ Comp With Medical-Only Notice of Compensation Payable

by Glenn Neiman

We are often asked why an injured worker in Pennsylvania needs an attorney. “They know I got hurt on the job,” the injured worker might say, “Why would I need a lawyer?” Well, the Commonwealth Court of Pennsylvania recently issued a decision that demonstrates why every injured worker in PA should have an attorney protecting his or her rights.

In Keffer v. Colfax Corporation and Phoenix Insurance Company (Workers’ Compensation Appeal Board) it appears the injured worker did everything his employer and the insurance carrier asked. And, he lost all of his rights in the process. This case is a very important lesson for every injured worker in Pennsylvania.

The injured worker in this case hurt his low back lifting a box of metal rods on December 18, 2014. The insurance carrier issued a Notice of Temporary Compensation Payable (NTCP), accepting the injury as a “low back strain,” and the payment of workers’ compensation benefits began. These benefits continued until the injured worker returned to full-duty work on March 9, 2015. The insurance carrier then issued a Notice Stopping Temporary Compensation (NSTC) and a medical-only Notice of Compensation Payable (NCP) on March 12, 2015.

October 3, 2023

Types of Diagnostic Testing Used for PA Workers’ Compensation Spinal Injuries

by Glenn Neiman

When an injured worker in Pennsylvania hurts his or her spine, there are many diagnostic tests that a doctor may prescribe. Sometimes, the doctors do not fully explain what a test is, or what it may show. We believe that an injured worker should be fully informed, whether as to the legal aspects of his or her case, or the medical aspects. While we are certainly not doctors, and would never suggest or recommend treatment, if the doctor will not educate his or her patient, that responsibility can fall to us. We believe our clients are best served by being fully informed about what is happening in their case, both medically and legally.

From our experience, the first thing a doctor does when seeing a patient for a work injury to the neck or back is get x-rays. An x-ray will show bone, such as a fracture (including, potentially, a stress fracture), but will not visualize soft tissue, like discs, muscles, tendons or ligaments. This would be to rule out the presence of a fracture (though, if a fracture is still suspected, a bone scan can be done to better analyze the presence or absence of a fracture).

If the injured worker has pain, numbness or tingling into one or both arms, or one or both legs, a doctor may suspect the presence of “radiculopathy” or “radiculitis”, meaning that a nerve is possibly being pinched or touched by another structure, either a bulging or herniated disc, or due to “stenosis,” a narrowing of the spine which can be degenerative (though stenosis can be “aggravated” by an injury at work). To assess the discs, and degree of stenosis, doctors often prescribe an MRI, with or without contrast. The results of the MRI may help the doctor determine whether surgery can help reduce the pressure on the nerve, to potentially relieve the radiating symptoms to the arm or leg.

September 28, 2023

Injured at Work in Pennsylvania?

by Glenn Neiman

You are hurt at work. What do you do now? Keep in mind that not every injury is a sudden event, like injuring your low back picking up a box or falling down steps at work. Some injuries are harder to determine and understand, even for the person who is hurt. Things like repetitive stress injuries, such as carpal tunnel syndrome, tendinitis or bursitis, or chemical/smoke exposure, or even an illness, for example, COVID, can appear over a period of days or weeks.

Regardless of the type of injury, or how it happened, the first thing to do is report the injury. I cannot tell you how many times a client has told us that he or she did not report an injury immediately because “I didn’t think it was anything serious.” The fact is, all injuries should be reported immediately. It is far better to report something and then learn it is nothing serious than to fail to do so, and then discover it is worse than you initially suspected. A delayed reporting of an injury is often used by a workers’ compensation insurance insurer as a basis to deny the workers’ comp claim. Don’t make this mistake!

Once you have reported the injury, attention turns toward getting medical treatment. Many people think the employer, or the workers’ compensation insurer, controls what doctor the injured worker can see for a work injury. The truth is the employer, or the workers’ comp insurer, can limit the treatment options for a maximum of 90 days (and even then, certain steps have to have been met).