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.
As a VA attorney, I speak to many potential clients who wish to pursue claims for post-traumatic stress disorder (PTSD). For VA purposes, PTSD occurs when a veteran experiences a traumatic event while in the military. According to the VA, the symptoms of PTSD include “reliving the event, avoiding places or things that remind you of the event, a shift to more negative thoughts and feelings, feeling numb, and feeling keyed up (also called hyperarousal)”. Often times these symptoms can arise many years after the traumatic event.
A lot of people believe that only veterans who experienced a traumatic event during combat can get VA benefits for PTSD. This is false. Banks Law has been successful in litigating PTSD claims involving events such as a physical altercation while in the military, sexual harassment by superiors, and near death experiences while in training.
It is important to remember that if you believe you are experiencing symptoms of PTSD and you feel it is related to the military, you must get treatment for it so that there is enough medical evidence to support your case.
If you feel you may have a VA claim for PTSD, please call Banks Law. Our attorneys would be happy to discuss your case with you.
The article below is a great example of how a paratrooper was awarded PTSD from a non-combat event. After 43 years, he was finally awarded PTSD as a result of a botched parachute jump:
Medical evidence is a key factor for any disability claim, whether it is workers’ compensation, social security, etc.
The consistency of one’s medical treatment is very important. The length of time and frequency can be helpful to a Judge deciding your case. If there are gaps in your medical care, it’s less likely a Judge will rule in your favor. It’s harder to convince a Judge that you are disabled if you don’t take the time to address your injury with your doctor. The more you treat, the more medical documentation there is to support your claim.
Be open and honest with your treating physicians. Be sure to tell your doctor any and all symptoms you are experiencing. It’s also very important to advise your doctor of any injuries you sustained. Many Claimants leave out factors because it’s not their primary reason for their visit or think it’s not relevant.
Apart from this affecting your legal case, this may affect your condition for the rest of your life.
April is National Social Security Month! The Social Security website has provided five steps to assist in your financial security.
Step One: Allows you to get to know your Social Security and explains how Social Security is more than just retirement benefits.
Step Two: Allows you to review and verify your earnings by logging into or creating an account through my Social Security. Please note that in order to be eligible for disability, retirement, and Medicare benefits you need to have earned 40 work credits. $1300.00 = 1 credit and an individual can earn up to 4 credits a year.
Step Three: Shows how to calculate and estimate your social security benefits. Planning for retirement can be tedious, however, social security has devised a system to assist in determining how long someone will have to work in order to live comfortably in their retirement.
Step Four: Shows how to apply for benefits. The Social Security Administrations does accommodate all individuals and allows those who cannot leave their home to apply by phone as well.
Step Five: Allows you to manage your benefits and control your benefits when you need to via your my Social Security account.
Click the link below to review additional information regarding the above five steps.
1) I tell you negative things about your case because it is important.TRUE. At some point in time after your workers’compensation case has gone to court, you are going to be given the opportunity to settle your case. Part of settling your case is evaluating all the pros and cons to our arguments. We determine the value of your case (for settlement purposes) based on many things, but in part how strong we believe our arguments are. Because litigation is uncertain, it is important to know your chances of having a Judge decide your case in your favor versus the certainty of settlement.
2) I can help you with more than just your case. TRUE!
I am a counselor at law so I can give you advice on where you should go for medical treatment, whether you have the right to sue anyone else other than your employer, and whether you can protect your job while you are out of work.
3) I hate it when you call. FALSE, FALSE, FALSE!
I love to talk about your case with you. I really do. Your case is why I have a job. I put time, energy and brain power into your case. If you have questions, I want to answer them. My goal is that you are comfortable and informed of the process every step of the way in your workers’compensation case.
4) Your past is important. TRUE
I ask about past injuries because I need to know if your injury is an aggravation of a condition you had before your work related injury, or if you were completely asymptomatic before you were hurt making your injury acute/new or, traumatic. By the way, both types of injuries, aggravations and new/acute injuries, are compensable under the PA Workers’Compensation Act though how the claim is litigated depends on the type of injury involved.
5) I filed for Workers’Compensation benefits and have a hearing scheduled. I’ll get my benefits awarded at that first hearing. FALSE.
Unfortunately this is false. If your Employer denies your workers’compensation claim, you will have to file a Claim Petition and go to court to obtain wage loss and medical benefits. Your petition will be heard by a Judge who will ultimately decide whether he/she believes you were injured and, whether the injury disabled you from work. Both the injured worker and the employer have the opportunity to present evidence to the Judge. Litigation takes time. It can take a year or more before the Judge issues a decision. This is one of the many reasons it is so important to have an experienced workers’compensation attorney represent you. Your attorney can make sure this process goes as quickly as possible and, that the best case is presented to get you the workers’compensation benefits.
As one may expect, a work-injury and the missed income following that injury can have a devastating effect on the injured worker and his or her family. This is especially true if your employer’s workers’ compensation insurance carrier decides not to pick up your claim and instead decides to deny you benefits. The good news is, the attorneys and staff at Banks Law will work hard to ensure that you get the best representation which will give you the best opportunity to recover your lost wages and secure your compensation and medical benefits going forward. However, it is important to know that even if you are successful in having the insurance carrier recognize your claim and accept your work injury, you will not receive a weekly check that is equal to what you made while you were working. The amount of weekly compensation benefits an injured worker may be eligible to receive is based on his or her average weekly wage. Depending on what the average weekly wage is, that figure is then used to determine what the injured worker’s weekly compensation benefits rate is. The Workers’ Compensation Rate Schedule is determined by the Pennsylvania Legislature and is updated yearly. The rate schedule for 2017, and the years prior, can be found at http://www.dli.pa.gov/Businesses/Compensation/WC/claims/Pages/Statewide-Average-Weekly-Wage-(SAWW).aspx.
If you have any questions about Workers’ Compensation, Social Security Disability, Long-Term Disability or Veterans Disability, please call and put the hardworking attorneys of Banks Law to work for you.
Just because you have a pre-existing condition does NOT mean your work injury should be denied. A core concept in the law is the “eggshell plaintiff rule.” It says that even someone whose bones break as easily as an eggshell can still fully recover for all injuries resulting from a tort, even if the act that caused those injuries would not have hurt the average person nearly as badly. In workers’ compensation, that means that even if you have a severe pre-existing condition, if it was made worse by a work-related injury, then you are entitled to workers’ compensation benefits.
A colorful case from Indiana provides a good example of this concept. In it, a morbidly obese employee suffered from diabetes and used a cane because of her bad knees. At an employee appreciation dinner she got stuck in a booth and ended up cracking her femur (thigh bone) trying to get out of the booth. The fact that her pre-existing condition (obesity and leg problems) contributed to her injury was irrelevant thanks to the eggshell plaintiff rule. Waters v. Indiana State Univ., 953 N.E.2d. 1108 (Ind. Ct. App. 2011).
For you, this rule means that even if you had a very bad back before your work injury, for example, you should still get workers’ compensation benefits if your bad back was made worse by a work injury. Oftentimes insurance companies will ignore the eggshell plaintiff rule and deny liability for work injuries because of a pre-existing condition. They are wrong when they do this. You need an attorney to help make the insurance company do the right thing and accept liability for your work injury, even if you have a pre-existing condition. Don’t hesitate. Call Banks Law today.
ABSOLUTELY NOT! As long as you’re receiving wage loss benefits, you’re also entitled to full medical coverage for your work injury. Your employer or, its workers’ compensation insurance carrier are legally obligated to pay for your work-related medical bills, including prescriptions; doctors’ visits; diagnostic studies such as x-rays, MRI’s, CAT Scans; surgery; hospital visits; physical therapy, chiropractic treatment; etc.Do NOT pay for any medical treatment yourself because it’s a lot harder for us to get you or your private health insurance carrier reimbursed than it is for us to force the insurance company to pay your medical provider directly. Plus, you shouldn’t have to pay a co-pay to your doctor or pharmacist when your work-related medical bills and prescriptions are the sole responsibility of the workers’ compensation insurance carrier.
The problem is that many of your doctors and pharmacies who aren’t accustomed to dealing with workers’ compensation claims either don’t want to wait for payment from the insurance company or, they don’t know what’s needed to properly submit their bill for payment. Another problem is if your workers’ compensation claim is denied and you need to hire a lawyer to file a petition to get it recognized. Many doctors and pharmacies that aren’t familiar with the workers’ compensation system won’t treat you or fill your prescriptions without a guarantee that they’ll be paid. The workers’ compensation insurance carrier isn’t responsible for paying your medical and pharmacy bills when your claim is denied until a Judge orders them to pay the bills. But, your attorney can refer you to doctors, diagnostic facilities, therapist and pharmacies that will treat you and fill your prescriptions until a Judge issues a decision in your case. At Banks Law, we have partnered with WIRX Pharmacy, a local Philadelphia-based mail order and hand delivery pharmacy, who will fill and deliver your work related prescriptions to your home, whether your claim is accepted or not, usually in less than 24 hours. Their customer service and response time are excellent. More importantly, they’re located right here in Philadelphia unlike many of the other mail order pharmacies that you might be used to, so if a mail order delivery problem arises, it can be fixed through a hand delivery. Because Banks Law is an investor in WIRX, we have an incentive to make sure the delivery of your work-related prescription medication is seamless. You’ll direct any pharmacy questions to Banks Law just like you do with any legal issues involved in your case. This eliminates the need to deal with anyone other than Banks Law to resolve issues in your case. WIRX pharmacy is another example of our full service pledge to you. Call us and find out more about the benefits of having your work related prescriptions filled and delivered to your home by WIRX.
12. Issue easy-to-read badges to all workers indicating their level of training.
13. Authorize all workers to issue “stop work” cards to address safety risks.
Brian Turmail, a spokesperson for the AGC, adds, “What distinguishes one firm from another is their people. So you better make sure that you’re protecting your people because that’s the secret sauce for your success.”
Banks Law is proud to represent the hardworking people in Philadelphia.
Call us 24/7 at 215-561-1000 to discuss your case. We are sincerely grateful to the thousands of workers who have trusted us to help them. Be safe.
Returning to work after a work injury can be a little scary, but here are a few tips to make the process go a little smoother. When your physician releases you to return to work, please make sure you have a conversation with your doctor. You should discuss whether your physician is releasing you to full duty or modified duty. If your physician is releasing you to return to work modified duty, then be sure to discuss withyour employer the specific restrictions outlined in your release
Key questions are as follows:
1. How many hours can I work a day;
2. How long can I sit or stand;
3. How much can I lift;
4. How much can I push or pull;
5. Can I drive on my medication;
6. Will my medication effect my cognitive skills; and
7. How frequently should I stand or move around?
Make sure you discuss whether or not you feel you can perform the duties outlined by your physician. Your goal is to have a successful return to work whether it be full duty or modified duty.
If you are returning to work modified or light duty, please give your restrictions to your employer before you return to make sure they accommodate your restrictions. If your employer does make accommodations based on your restrictions, please make sure you adhere to your restrictions. You do not want to reinjure yourself. Again, your goal is to have a successful recovery.