The Blog

Worker’s Compensation: Fact vs. Fiction

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.

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How much may I be eligible to collect in weekly workers’ compensation benefits if I am injured and how do they come up with that figure?

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.

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Pre-existing conditions and workers’ compensation

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.

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Must I pay out-of-pocket for my work-related prescriptions?

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.

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Construction Injuries

The construction industry is booming in Philadelphia and there is increased focus on keeping workers safe while on the job.

“According to the Arlington, VA-based Associated Contractors of America,

71% of construction firms are expected to add to their headcount in 2016.”

Construction fatalities have been steadily increasing as the numbers of workers grow.

There is a new comprehensive action plan published by the AGC to help companies protect their workers The plan is titled-

“13 Proven Steps to Improve Construction Worker Safety”

For new employees:

1. Establish a buddy system for all new hires.

2. Hold safety orientation sessions for all new hires, including temporary workers.

Ongoing training:

3. Ensure managers and supervisors have the appropriate leadership and effective communication skills to instill safety culture and concepts into the workforce.

4. Institute two separate Pre-Task Hazard Analysis training programs.

5. Hold monthly “lunch and learn” safety training programs.

6. Require all foreman and superintendents to attend “Leadership in Safety Excellence” certification courses.

7. Hold targeted safety training to address all safety incidents.

8. Make sure all training and materials are available in languages that can be read by all members of your workforce.

9. Train your trainers.

Operating procedures:

10. Create worker task-specific “pocket safety guides” for every assigned task.

11. Establish craft-specific safety mentoring programs.

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.

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Returning to work after injury?

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 with your 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.

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How to Gain Trust Between Clients & Support Staff

  1. Always be available for client’s needs. Give clients your personal email/contact number to answer their questions or any concerns they may have to the best of your ability. Encourage your door is always open. Let clients know feedback and questions are always welcome.
  2. Pay attention and truly listen to what clients are saying and trying to tell you.  It’s easy to get distracted, but don’t let your attention drift or spend the time thinking about what you will say in response. Provide reflective feedback.  Rephrase to your client their questions/ concerns to let them know you heard and understood their points.
  3. Don’t rely on surface statements. If you don’t know the answer, that’s ok.  Spend time to research and get to the critical issues that are most meaningful to our client. Understand what the client really wants and try to meet those expectations to build respect.
  4. Keep your promises. If you make a commitment to a client, stick to it. Try to “under-promise” and “over-deliver.” In other words, don’t commit to something you cannot complete. Instead, give yourself more time than needed and be consistent. This generates good will among your clients and support staff.
  5. 5. Be aware of cultural differences when communicating. It’s not enough just to be polite; make sure your behavior is not inadvertently perceived as disrespectful according to other cultural norms.
  6. 6. Stay in contact. Touch base regularly with clients, and hold meetings with employees frequently enough to ensure everyone feels informed and are on the same page.  Remind clients that you care about them and you are interested in what they have to say.

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Why when I ask to speak with my attorney am I transferred to a team member instead?

Banks Law would like for our clients to understand that after you meet with your attorney, there is a whole team ready and waiting to assist you (and your attorney) with the handling of your file.  Your attorney will be in court 80% of the time or handling various appointments, depositions, meetings, etc. so that’s why Banks Law expands valuable time and resources into making sure that all of our staff members are fully trained to assist you.  Please have full confidence that your file is being monitored by at least 3 different staff members (including your attorney) at all times.  Each staff member is in charge of different aspects of your file. 

From our medical coordinators setting up your treatment to our pharmacy coordinator setting up your medications with WIRX pharmacy.  The second you leave our office we’re filing any necessary petitions and requesting your medical records pertaining to your work injury from your providers.  In addition to our hands on approach, we also have running checklists and reminders set via case management systems so that no aspect of your file goes unattended.  So that’s why you may get a call from different members of our staff.  Each one has their own assignments in your file.  We’re all here to help and we truly appreciate your confidence in our team and look forward continuing to serve you. 

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Can I Receive Workers’ Compensation Benefits if I am Injured in a Different State?

The answer is maybe. Finding the answer can be complicated. Every set of facts are different, so it is important to speak with an experienced attorney who can analyze the specific facts of your case.

Generally, Under Section 305.2 of the Act, if certain facts are true, you can still be eligible for benefits through the Pennsylvania Workers’ Compensation Act. If you are hired in Pennsylvania, you are more likely to get benefits through the Pennsylvania Workers’ Compensation Act. Even if you weren’t hired for work in Pennsylvania, you could get Pennsylvania benefits if your work is “principally localized” in Pennsylvania. That means if you perform most of your work on behalf of your employer in Pennsylvania, and if your Employer has a business location in Pennsylvania, you could be hired in a different state, and even live in a different state, but be eligible for Pennsylvania Workers’ Compensation benefits.

Even though you could potentially be eligible for Workers’ Compensation benefits in multiple states, you are only entitled to benefits from one place. Sorry, you cannot collect benefits from many states at once. If you already received benefits from one state, the insurance company for the state where your benefits will be paid would receive a credit for benefits paid by any other jurisdiction.

All jurisdictions are not created equal. If you think you may be entitled to benefits under the Pennsylvania Workers’ Compensation Act, talk to an attorney.

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What to Expect When Injured on the Job?

If you are injured at work it is important that you know what to expect.  It can be an overwhelming experience, especially if it is the first time you have ever had a work injury.  First and foremost, report your injury to your supervisor or Human Resources Department immediately.  Your employer should have posters in a common area at your place of employment outlining the steps to take should you suffer a work injury.  Be sure to complete an Injury Report.  If you suffer a serious injury and do not have time to complete these steps, your health and well-being is most important so get to a medical facility for treatment first.  Make sure you explain to the medical provider that you were injured at work.  Please obtain documentation from the medical provider and, if you did not have a chance to report your injury to your employer, make sure you do so as soon as possible.  You may think you do not need an attorney, but it is important to know your rights.  Please feel free to reach out to Banks Law to discuss your case.  We are here to answer your questions, put you at ease and guide you through this difficult time.

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