As a leading workers’ compensation firm in Pennsylvania, Brilliant & Neiman LLC has worked with the PA Bureau of Workers’ Compensation on issues, such as the mediation process, in the past. The Bureau is now getting ready to institute the final part of its overhaul, transitioning into the online Workers’ Compensation Automation and Integration System (WCAIS). Initially, last September, the Bureau started the transition to WCAIS, by putting the Workers’ Compensation Appeal Board (WCAB) onto the system. This next, and final, step will be to bring the rest of the Bureau, and the entire adjudication process, into WCAIS.

It was no surprise, then, that the attorneys at Brilliant & Neiman LLC were again invited by the Bureau to be among a select group of attorneys and legal professionals from across the State of Pennsylvania to assist the Bureau with the final stages of this development. This partnership is beneficial to the Bureau, by having the attorneys work on the new system under the watch of the Bureau – to further tweak the process and refine its efficiency, as well as to the attorneys involved, by having an early exposure to the new system and gaining valuable experience.

The WCAIS system will streamline the workers’ compensation process in PA, centralizing the filing of petitions, the scheduling of hearings and the entire litigation of cases. Currently, the system is scheduled to go live on September 9, 2013. This new process should greatly increase the efficiency of both the Bureau, and the parties involved in litigation. We at Brilliant & Neiman LLC were excited and honored to share our time and experience with the Bureau, to help make the system better for all involved.

The term “collateral estoppel” essentially means that once an issue is fully litigated, it cannot be litigated again. The primary example of this concept, as it applies to PA workers’ compensation, is the Weney case. Whenever we have seen the use of “collateral estoppel” in Pennsylvania workers’ comp, however, we have seen it used to the detriment of the injured worker. For once, however, the Commonwealth Court of Pennsylvania used this concept to benefit the injured worker.

In Channellock, Inc. v. Workers’ Compensation Appeal Board (WCAB), the Claimant suffered an annular tear and a herniated disk at the L5-S1 level at work in 2001. The injured worker was offered a “no work” job at the employer, which he accepted (a “no work” job is literally a job where the injured worker reports to the employer to do nothing; this is a frequent tool used by devious employers, as was attempted here, to subvert the workers’ comp process). Due to his pain medications, and the inactivity inherent in a “no work” job, Claimant fell asleep and was promptly terminated.

Litigation ensued before a Workers’ Compensation Judge (WCJ). A decision was rendered by the WCJ, denying a Petition for Termination (since the injured worker was not found to be fully recovered) and granting a Petition for Reinstatement (finding that “the no duty position was not within Claimant’s capabilities because Claimant had difficulty staying awake due to his prescribed medication”).

As a general rule, an injured worker is entitled to benefits under the Pennsylvania Workers’ Compensation Act when he or she is disabled as the result of a work injury. A spouse or dependent of an injured worker is usually entitled to death benefits (which vary, depending on the relationships of the dependents who exist) when the injured worker dies as a result of the work injury. There are, of course, exceptions to this rule. One of those exceptions is the time involved between the work injury and the injured worker’s death. In this situation, we can see a terribly unfair result.

Recently, there was an example of this situation, and its inequitable results. In Whitesell v. Workers’ Compensation Appeal Board (WCAB), the injured worker suffered a back injury at work in 2003. Initially, the injury was accepted by the workers’ compensation insurance carrier by Notice of Compensation Payable (NCP), which described the injury as a lumbar strain and sprain. In 2006, there was litigation in which the description of injury was amended to include “lumbar disc disruption L4-L5, resulting in total disc arthroplasty at L4-L5 level.” Tragically, the injured worker died in 2011, as a result of “mixed drug toxicity,” from the medications she was taking for the work injury.

Since the death was related to the work injury, one would presume that death, or fatal claim, benefits would be available to the surviving spouse/dependents. One would be wrong. The Pennsylvania Workers’ Compensation Act, states, in Section 301(c)(1), ” . . . wherever death is mentioned as a cause for compensation under this act, it shall mean only death resulting from such injury and its resultant effects, and occurring within three hundred weeks after the injury.” Since the death here did not take place within 300 weeks of the original injury, death benefits were denied by the Workers’ Compensation Judge (WCJ). This was affirmed by the WCAB.

It is with a heavy heart, and great sadness, that we relate that the Pennsylvania Workers’ Compensation community has lost a valued member. Workers’ Compensation Judge Mark Peleak passed away while bicycling on July 7, 2013. Judge Peleak presided in the Wilkes-Barre Workers’ Compensation Office, which is in the Central District. Our thoughts and prayers go out to his family and his many friends and admirers. He will be missed.

We were appalled when the Commonwealth Court of Pennsylvania recently found armed robbery to be a “normal” part of the job as a clerk working for the Pennsylvania Liquor Control Board. Accordingly, we are seeking to take our battle to the top.

When a party loses a workers’ compensation case in Pennsylvania, the decision of the Workers’ Compensation Judge (WCJ) can be appealed to the Workers’ Compensation Appeal Board (WCAB). A party then has the right to file an appeal with the Commonwealth Court of Pennsylvania. That is the end for a party having the automatic right to appeal a workers’ compensation case in PA. Beyond that is at the discretion of the Pennsylvania Supreme Court, the highest Court in the State.

Once a party loses at the level of the Commonwealth Court of Pennsylvania, and wants to take the case to the PA Supreme Court, the party must request “allocatur” by filing a Petition for Allowance of Appeal. The High Court then has the discretion whether to accept the appeal (grant allocatur) or not. Very few appeals are accepted by the Supreme Court.

We have expressed our displeasure for how the Pennsylvania Workers’ Compensation Act treats mental/emotional injuries. As long as the cause of the injury is purely mental/emotional, any resulting disability is only compensable if the cause represents an “abnormal working condition.” The standard for this test varies according to the job in question; a police office, firefighter or other first responder would have a greater burden of proof than an accountant, chef or automobile mechanic, simply because their job tends to expose them to more shocking events.

This issue is dear in our hearts, since we have a case we have discussed on our blog previously, highlighting this ridiculous standard. For those who do not recall, we represent a liquor store clerk who was the victim of an armed robbery. Understandably, the clerk was then disabled by post-traumatic stress disorder. The Pennsylvania Liquor Control Board had the gall to deny the claim, saying that armed robbery at one of their stores was not “abnormal.” (It offends us as taxpayers, and citizens, that the agency openly embraces such incompetence by knowingly exposing their employees to danger, rather than make any effort at a solution).

The case was litigated, with both medical experts agreeing that the clerk had post-traumatic stress disorder, and that he was unable to return to that employment. In defense, the Pennsylvania Liquor Control Board (LCB) showed their training process, which included how to handle an armed robbery, the location and function of panic buttons, and the “open safe” key. All of the training materials, however, stated that the occurrence of armed robbery in a liquor store was “rare,” and that this was an “unlikely event.” Neither the clerk, nor any of the four witnesses presented by the LCB, was ever the victim of an armed robbery. Indeed, the manager of the store at which the clerk worked was not even aware of the procedure following a robbery. The store had panic buttons installed, but did not have any guards.

Regular readers to our blog know that, in addition to noting recent court decisions involving workers’ compensation matters in Pennsylvania, we also try to keep injured workers informed about any developments in diagnosing or treating work injuries. Along these lines, one of the frequent topics we blog on is pain, and how it can be relieved. We’ve looked at what methods may be coming in the future, and at other possible contributions to pain.

We have also discussed acupuncture in the past. This treatment method has always been controversial, perhaps even more so in the workers’ compensation setting. Like chiropractic treatment, acupuncture is frequently met by the workers’ compensation insurance carrier with Utilization Review (to challenge whether the treatment is “reasonable and necessary”). According to a recent article published on the website of the International Anesthesia Research Society, there is proof that acupuncture actually can help with certain physical ailments, including post-operative pain, and chronic pain.

This article cited various studies, where acupuncture was tested against a placebo (sort of faked acupuncture). In at least one of these controlled studies, it was definitively shown that “acupuncture is more effective than placebo.” This result led the authors of that study to conclude that, “acupuncture is effective for the treatment of chronic pain and is therefore a reasonable treatment option.” In fact, at least one study showed that the difference between acupuncture and placebo is similar to the difference between medication and placebo, in relieving pain with arthritic knee conditions.

As we discussed previously, premiums for workers’ compensation insurance in Pennsylvania have been reduced for the second consecutive period. Apparently, all is not well for the insurance carriers in PA however. It appears a change in the law has made several insurance carriers refuse to cover fire departments in Pennsylvania.

In 2011, the PA legislature passed Act 146. As we discussed on our blog, this law created a presumption that cancer in a firefighter was related to his or her employment for the purposes of workers’ compensation benefits (meaning the burden of proof would fall to the employer to prove the cancer was not related to work activities). The period within which a claim can be reported was also significantly extended.

According to a recent article on Firehouse.com, these changes to the Pennsylvania Workers’ Compensation Act made several insurance carriers drop the workers ‘ compensation coverage for fire departments in PA. Of course, communities or townships can self-insure for workers’ comp, or they, like any employer, can turn to the State Workers’ Insurance Fund (SWIF), a quasi-government insurance carrier which will offer coverage to any employer in PA.

In the Pennsylvania workers’ compensation system, we frequently see cases involving carpal tunnel syndrome (CTS). As many of you know, this condition occurs when the median nerve is entrapped in the wrist. There are many potential causes of CTS, including familial history, certain medical conditions, trauma and certain physical activities. CTS can also occur “idiopathically” (without a known cause). Frequently, we see litigation regarding whether CTS in any given case is related to the work activities.

Are we all at the same risk to develop CTS? According to a recent study published in the Archives of Physical Medicine and Rehabilitation, and referenced in The Wall Street Journal recently, the size and shape of a person’s hand and wrist can show whether that person is predisposed to the development of CTS. Specifically, if a person has a “short and wide hand with square wrist matching to narrow and deep tunnel entrance,” that person has an increased likelihood for developing CTS. Of course, that leads us into an examination of what causes CTS, and whether CTS in any given case can be accepted as a work-related injury.

According to the University of Maryland Medical Center, “Work that involves high force or vibration is particularly hazardous (to developing CTS), as is repetitive hand and wrist work in cold temperatures.” They also note that repetitive use of the hands and wrists can cause repetitive stress disorder, overuse syndrome and chronic upper limb pain syndrome. Similarly, the National Health Service in the United Kingdom relates that CTS can be triggered by activities with “strenuous grip, repetitive wrist flexion and exposure to vibration,” including motions associated with manual labor. This is consistent with the view of the National Safety Council, who noted that “(r)epetitive manual work tasks requiring a forceful grip and use of vibrating tools can damage the median nerve in the arm, contributing to CTS.”

One of the most difficult decisions faced by an injured worker in PA is how to decide who to hire as their worker’s compensation attorney. Many sites, or publications, have a list of attorneys they tout. Maybe they are called “Super” attorneys or “Awesome” lawyers, or some other cleaver marketing name. What standards do they use? Are they objective? Is there really merit in being named? Who knows. Now, however, there is an objective, regulated selection process authorized by the Pennsylvania Supreme Court.

As we mentioned before, Pennsylvania has created a Workers’ Compensation Law Certification process. First, an attorney is screened to be certain he or she possesses the requisite experience to sit for the examination (a minimum of five years practicing in workers’ comp is required). Specific cases must be provided, including briefs and written arguments. The attorney must certify that at least half of his or her practice is devoted to PA workers’ comp matters. Only then is the attorney even allowed to sit for the examination test.

This test was given for the first time in March, 2013. The grueling four hour assessment covered every aspect of PA workers’ compensation law, thoroughly testing each applicant’s knowledge of the workers’ comp system. Both multiple choice and essay questions were involved.

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