Worker Comp Generally

July 12, 2011

Bulging Disc in Lumbar Spine Can Cause Nerve Problem

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.

July 8, 2011

PA Workers’ Comp Memorial Video a Moving Tribute and Reminder

by Glenn Neiman

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.

July 5, 2011

PA Workers’ Compensation Reform Bill Signed into Law

by Glenn Neiman

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.

May 27, 2011

PA Workers’ Comp and Social Security Disability Benefits Can Cause Tax Consequences When Received Together

by Glenn Neiman

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.

May 23, 2011

Utilization Review in PA Workers’ Comp Can Cause Medication Dangers

by Glenn Neiman

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.

May 20, 2011

Injured Workers in PA Can Sometimes Get Compensation for Pain and Suffering

by Glenn Neiman

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.

May 9, 2011

Supreme Court of Pennsylvania Accepts Appeal in Phoenixville Hospital v. Workers’ Compensation Appeal Board (Shoap)

by Glenn Neiman

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.

April 27, 2011

PA Supreme Court Accepts Appeal in Robinson

by Glenn Neiman

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:

April 22, 2011

PA Bureau of Workers’ Compensation Issues New Notice of Compensation Denial; Employers No Longer Able to Accept Claims by Using Denial

by Glenn Neiman

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.

January 11, 2011

PA Workers’ Comp Law Expands Definition of “Employee”

by Glenn Neiman

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.