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As we mentioned in a previous blog entry, workers’ compensation claimants in Pennsylvania are often eligible for Social Security Disability (SSD) benefits as well as workers’ comp benefits. Any increase in income to an injured worker can be the difference between financial survival and ruin.

The Social Security Disability application process can be very difficult and intimidating. Approximately two-thirds of all SSD applications will be denied at the initial level. A recent article on the internet described seven helpful tips. We thought this article may be of benefit to our readers.

While we at Brilliant & Neiman LLC limit our entire practice to Pennsylvania workers’ compensation cases, and do not handle SSD matters, we have relationships with other attorneys throughout PA, providing our clients access to quality legal representation for any legal matter, including SSD.

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Many of those who are injured at work and receiving Pennsylvania workers’ compensation benefits are using, or have used, the Fentanyl Transdermal Patch (FTP). As with any medication, the injured worker often has questions regarding the usage of the Fentanyl patch. This set of Frequently Asked Questions about FTP may be of interest to those workers’ comp claimants who use this medication.

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Ordinarily, an injured worker in Pennsylvania cannot receive both workers’ compensation total disability benefits and also wages. Generally speaking, if an injured worker in PA has returned to work, he or she is no longer, by definition, “totally disabled.” The injured worker may be entitled to partial workers’ compensation benefits (if a loss in earnings continues), but would not be entitled to total disability benefits.

A rare exception to this rule was recently addressed by the Commonwealth Court of Pennsylvania on July 22, 2008, when the Allegheny Power Service Corp. v. WCAB (Cockroft) decision was rendered.

Total disability benefits under the Pennsylvania Workers’ Compensation Act are paid under Section 301(a). “Specific loss” benefits (benefits to compensate for the loss of use of a body part) are paid under Section 301(c). These specific loss benefits are paid regardless of whether there is any wage loss or not.

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Not that long ago, a Pennsylvania workers’ compensation insurance company could terminate the benefits of an injured worker anytime they found a doctor to say the injured worker had fully recovered from his or her work injury. This encouraged the workers’ compensation insurance carriers to file Termination Petition after Termination Petition, until they found a doctor the Workers’ Compensation Judge believed. Fortunately, this is no longer the case in PA. The case that allowed such a luxury by the workers’ compensation insurance carrier, King v. WCAB, was overruled by the Pennsylvania Supreme Court in Lewis v. WCAB.

The law now, confirmed by the Commonwealth Court of Pennsylvania in Prebish v. WCAB, decided on July 14, 2008, is that the workers’ comp insurance company must have an opinion that the condition of the injured worker has changed since the last termination was adjudicated. This keeps the workers’ compensation insurance carriers from harassing the injured worker by filing an endless stream of Termination Petitions. To learn how to avoid being the victim of continued litigation by the workers’ compensation insurance carriers, contact an experienced Pennsylvania workers’ comp attorney.

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Thoracic outlet syndrome is a debilitating injury we see in Pennsylvania workers’ compensation cases. In this condition, the blood vessels and/or nerves in the arms may be compressed, causing various symptoms, including pain, numbness, tingling and a “cool” feeling in the arms.

There is no easy cure for thoracic outlet syndrome. No medication, surgery, or other treatment method seems universally able to help the injured worker with this condition.

Hope may be on the horizon, however. A study is currently underway, investigating whether an injection of BOTOX may be an efficient reliever of symptoms from thoracic outlet syndrome. While it will be some time before this treatment is approved by the FDA (if ever), this development is worth watching for those who suffer from this diagnosis.

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The Federal Government has created a temporary program known as Emergency Unemployment Compensation (EUC), which may be of benefit to injured workers in PA. EUC benefits can provide up to 13 weeks of additional unemployment compensation benefits to those unemployed folks who are not eligible for unemployment compensation benefits from Pennsylvania (or any other State).

While an injured worker in Pennsylvania cannot collect both workers’ compensation benefits and unemployment benefits in PA, this source of funds may be of use to those injured workers who are not currently receiving Pennsylvania workers’ compensation benefits (such as those individuals who have had their workers’ comp cases denied).

More information regarding UEC benefits, including how to apply and who is eligible for the program, can be obtained by visiting the PA Department of Labor & Industry website.

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Since the site of the current Philadelphia Workers’ Compensation Hearing Office, The State Office Building at Broad and Spring Garden Streets, has been sold, we previously mentioned that the Philadelphia Workers’ Compensation Hearing Office would be moving.

We have now been advised by the Judge Manager for the Philadelphia Workers’ Compensation Hearing Office, The Honorable Karen Wertheimer, that the new location will be 110 North 8th Street, Philadelphia, PA 19107.

Though the time of the relocation remains unknown, we do expect it to take place in the near future. We will, of course, advise you when the change actually takes place.

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While, in Pennsylvania, an injured worker generally cannot sue his or her employer for causing the injury, the injured worker is free to sue a third party. For example, the injured worker could file an action against a manufacturer of a product which caused the injury, or another driver who caused an accident. When an injured worker receives a settlement or a verdict leading to the recovery of money from a third party, Section 319 of the Pennsylvania Workers’ Compensation Act says the workers’ compensation insurance carrier is entitled to be repaid all or part of the benefits the carrier paid to the injured worker.

Though the goals of Section 319 are somewhat logical – to keep a party from receiving a double benefit, the result of this law is often troublesome. In effect, between the repayment made from the recovery, and the credit the workers’ compensation insurance carrier enjoys against future wage and medical benefits, the injured worker often winds up netting absolutely nothing from the third party case. Considering that the Pennsylvania Workers’ Compensation Act does not provide for any compensation for pain and suffering, it seems terribly unjust that the injured worker can recover money in a third party case, intended to compensate for pain and suffering, and yet end up netting nothing.

Recently, the Commonwealth Court of Pennsylvania decided the case of Gorman v. WCAB. Here, the claimant settled his workers’ comp case. At that time, he was not pursuing a third party suit. In the Compromise & Release Agreement (the document used when a workers’ compensation case is settled in PA), the parties stated that there was no lien for any third party case. After the workers’ compensation settlement was done, the claimant successfully pursued a third party case and recovered money.

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As a general rule, the Pennsylvania Workers’ Compensation Act requires medical providers to submit their bills to the workers’ compensation insurance carrier on the correct forms. Again, the usual rule is that the workers’ comp insurance carrier is not required to pay bills until they are submitted on the proper forms (and until supporting documentation is provided).

A recent decision by the Commonwealth Court of Pennsylvania, however, confirms the beliefs of us Pennsylvania workers’ compensation attorneys, who feel this technical step is not always necessary. In Shelton v. WCAB, decided by the Court on June 26, 2008, the workers’ compensation insurance carrier was ordered to pay medical bills even though the bills were not submitted on the proper forms.

In this case, the Court drew a distinction between the situations when the claim has already been accepted as opposed to one where there has never been liability of the workers’ compensation insurance carrier established. When the liability of the workers’ compensation insurance carrier has not yet been established, then bills must be on the proper forms. When we are dealing with an accepted claim, then this technicality may not be necessary.

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In a previous blog entry, I mentioned the April 28, 2008 decision by the Commonwealth Court of Pennsylvania in Diehl v. WCAB, which greatly limited what a workers’ compensation insurance carrier in Pennsylvania can do with an Impairment Rating Evaluation (IRE). This decision was very favorable to the injured worker. Unfortunately, on June 24, 2008, the Commonwealth Court of Pennsylvania issued an order, and granted the workers’ compensation insurance company’s application for reargument, and vacated the prior decision. This means that, for now, the law returns as it had been before the Diehl decision was issued (meaning the workers’ comp insurance company does NOT have to show job availability when trying to have benefits changed to partial based on an IRE).

Though there will be reargument on this case, and a new decision will be issued, many of us Pennsylvania workers’ compensation attorneys doubt that the new decision will be as favorable as the one which has been vacated. We will, of course, post about the new decision when it is made.

Contact Information
Philadelphia & Surrounding Areas
260 W Street Rd
Warminster, PA 18974
Phone: (215) 638-7500
Fax: (267) 803-6298
Trevose
5 Neshaminy Interplex Dr, #205
Trevose, PA 19053
Phone: (215) 638-7500
[Formerly (215) 244-8101]
Fax: (267) 803-6298
Lehigh Valley
609 Hamilton Mall
Allentown, PA 18101
Phone: (610) 740-1002
Fax: (267) 803-6298

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