Unfortunately, a work-related injury can be financially disturbing for many workers and their families. You will not receive workers’ compensation benefits if your claim is denied. Even if your work-related injury is accepted, many injured workers struggle, because, depending on your pre-injury wages, normally your worker’s compensation benefits are 2/3 of your gross income. For some people who live paycheck to paycheck, reduced wages can be a financial hardship.
Worker’s compensation injuries involve a lot of medical treatment. People often ask if travel expenses are reimbursed by the Carrier. There is a persuasive argument that the carrier should reimburse your travel costs. Unfortunately, following the issuance of an appellate case, Helen Mining Co. V. WCAB, 616 A.2d 759, the law changed. If necessary medical treatment is not available in your area, and you can prove that it’s absolutely necessary to travel out of the state for treatment, there’s a good chance that your expenses should be reimbursed.
“The other rare exceptions were carved out in Helen Mining Co. v. WCAB (Tantlinger), 616 A.2d 759 (Pa.Cmwlth. 1992), in which the court said:
- If treatment is available locally, the claimant is not entitled to reimbursement for travel expenses except in exceptional circumstances;
- If treatment is available locally and the claimant chooses a physician outside the local area, the claimant is not entitled to reimbursement for travel expenses;
3. If treatment is not available locally, the claimant is entitled to reimbursement for travel expenses as long as the claimant travels to a facility where others are or would be referred.”
Social Security benefits are not just for disabled adult workers. Children under the age of 18 years old may qualify for Supplemental Security Income (SSI) benefits. The requirements to receive SSI benefits are very different for children. In order to be awarded SSI benefits, it must be shown that the child has at least two “marked” limitations or one “extreme” limitation in six areas of functioning. These six areas are:
- Acquiring and Using information
- Interacting and Relating to Others
- Attending and Completing Tasks
- Moving About and Manipulating Objects
- Caring for Self
- Health and Physical Well-Being
A “marked” limitation seriously interferes with the child’s ability to initiate, sustain, or complete independent tasks. An “extreme” limitation is a limitation that very seriously interferes with the child’s ability to initiate, sustain, or complete independent tasks. Most SSI cases involve children who suffer from ADHD, Oppositional Defiant Disorder, and other diagnoses that cause behavioral issues. However, physical issues such as uncontrolled seizures, severe asthma, and serious orthopedic issues may interfere with one or more of the six areas of functioning.
As with any disability matter, it is crucial that the child maintain regular medical treatment with his or her physicians and mental health providers. It is also extremely important that all medications prescribed by a medical doctor are taken as prescribed and on a regular basis. Official school records, report cards, Individualized Evaluation Plans (IEPs), and school attendance/lateness logs can be very helpful.
Because the Social Security Administration denies many child SSI claims each year, it is crucial that you do not go at it alone. The attorneys at Banks Law will be happy to speak with you regarding your child’s SSI case and answer any questions you may have.
There are approximately four hundred homeless veterans within the City of Philadelphia. Many of these veterans have served our country overseas and have returned with a number of physically and mentally disabling conditions. In that, the veterans are unable to continue to maintain gainful employment leaving them no choice but to take to the streets. Unfortunately, these individuals are unaware of the amount of resources they have access to. Below are two links that offer help to our homeless veterans.
This information is provided directly from the Veterans Affairs and offers health care, housing assistance, employment assistance, foreclosure assistance and advises on how to apply for same.
This link is for the VMC (Veterans Multi-Service Center), which is the only non-profit agency in Philadelphia and the surrounding areas that offers services to all veterans, including the homeless. The VMC also offers job opportunities, assistance with GI Bills, information on presumptive disabilities and supportive services for veterans and their families.
Did You Know…? In some cases injured workers’ are entitled to have modifications of their home or vehicle paid for by the workers’ compensation insurance company?
Generally, Section 306(f) of the PA Workers’ Compensation Act, provides for payment of reasonable medical expenses that are related a person’s work injury. These services include, among other things, surgery, medicines, supplies prosthesis, chiropractic care and even massages and acupuncture. Until the employer can establish that any or all of this care is not reasonable or necessary, bills for related medical treatment must be paid no later than 30 days after the insurance company receives the bill from the doctor. The Workers’ Compensation insurance company is only responsible for paying for treatment related to the claimed work injury. If you break your ankle at work, do not expect the workers’ compensation insurance company to pay for treatment for an unrelated heart condition.
In some cases, a person’s injury is so severe, that she might need more assistance than traditional medical care. What happens if a person is so severely injured that she can no longer drive? What happens if a person is so severely injured that she can no longer climb stairs to her own bedroom? In special circumstances, the Workers’ Compensation insurance carrier may be liable to pay for modifications to an injured workers’ home or vehicle, when necessary, because of a work related injury.
The Courts in Pennsylvania have found that the remodeling of a home and modification of an automobile should be treated as necessary orthopedic appliances, that are eligible for payment. Enterprise Rent-A-Car v. WCAB (Clabaugh), 934 A.2d 124 (Pa.Cmwlth.2007). In one situation, PA Courts found that modifications to a vehicle weren’t enough to help an injured worker, and ordered the insurance co. to pay for the purchase price of a special van that could be outfitted with wheelchair lift. Griffiths v. WCAB (Seven Stars Farm, Inc.), 943 A.2d 242 (Pa.2008). The costs required to retrofit a van with hand controls and other modifications are the employer’s obligation under the Act. Petrilla v. WCAB (People’s Natural Gas), 692 A.2d 242 (Pa. 2008). Other medical supplies the insurance carrier is normally responsible for paying for include, wheelchairs, walkers, chair lifts, special beds ect.
Whether you can force the Workers’ Compensation insurance company to pay for modifications to your home or vehicle depends on the unique circumstances surrounding your work injury. Insurance Companies normally do not pay for these expensive items without a fight. That is why it is always important to have an experienced attorney protect your rights, and to fight for your best interests.