Montgomery & Bucks County Workers' Compensation Law Blog

Monday, February 16, 2015

Maximum Medical Improvement and Your Rights

How Are Injury Levels and Benefit Amounts Determined Following Workplace Injury, Treatment and Recovery?

Workers’ compensation claims may seem simple at first glance. A worker is injured at work, he or she cannot work for a while and compensation is received until a return to work is possible. Simple, right?

Actually, workers’ compensation claims are often highly complex and may revolve around difficult questions such as:
• How is the accuracy and validity of Impairment Rating Evaluations (IREs) determined?
• What percentage of full-body impairment did the worker experience?
• Once time has passed, healing has occurred and treatment has been administered, when is Maximum Medical Improvement(MMI) reached?

And, perhaps most importantly, “Who answers these questions and subsequently determines the amount and duration of financial compensation?” 

A recent Pennsylvania case shed light on how the accuracy and validity of IREs may be weighed in some disputes. IREs are crucial to workers’ compensation claims, because they are used by judges to measure the extent and effect of injuries and, subsequently, the level of ongoing benefits. 

In 2004, Nicole Neff was injured at work and claimed serious and long-term impairment. Yet her IRE showed that, despite the fact that future surgery may improve her recovery, she had already achieved Maximum Medical Improvement. The IRE also showed that she had a full-body impairment of just one percent. The Workers’ Compensation judge accepted the IRE findings, and the Workers' Compensation Appeal Board affirmed the decision. Neff responded by filing suit in civil court. 

In Neff’s 2014 case, Neff v. WCAB, she and her attorneys claimed that she could not have achieved Maximum Medical Improvement since the IRE showed that future surgery could improve her condition. This claim seems logical and valid. Yet the court upheld the previous rulings, basing its decision on the fact that relevant guidelines instruct that an individual is at Maximum Medical Improvement when the condition is “static or stable” and when “one would not expect a change in condition at any time in the immediate future" and the clarity and credibility of the IRE doctor.

If you were injured at work, do not navigate the complexities of IREs and Maximum Medical Improvement without the help of an experienced workers’ compensation attorney. If you live in Montgomery or Bucks County, Pennsylvania, contact Louis P. Lombardi II & Associates, PC at (610)239-7600.

Wednesday, January 28, 2015

Bankruptcy Judge Shielded Workers Compensation Settlement

Can workers compensation settlement and Medicare set-aside account funds be used for expenses other than medical treatment?

A worker broke his hip and settled the workers compensation claim related to the injury for $225,000 in workers compensation benefits and $72,742 placed into a Medicare set-aside account for future medical treatment. The worker used those funds to purchase real estate in York, Pennsylvania, and a new truck

About two years after the purchases, when filing for Chapter 7 bankruptcy protection in U.S. Bankruptcy Court in Wilkes-Barre, the worker asked for the properties, truck and remaining funds from the workers compensation settlement to be exempted from the proceedings. Despite objections by the trustee in the bankruptcy case, the judge exempted everything as requested by the worker.

The judge found that the settlement funds were reasonably necessary to support the worker’s family. The worker was unemployed, his wife had a low-earning job, and two of their three children were under 18. While the worker was receiving some income from his brother, the judge found it to be modest.

One of the worker’s real estate purchases was a parcel of property that the worker sold to his brother under an installment payment agreement. The worker did not disclose that agreement to the bankruptcy court. Still, the judge determined that the income had only a negligible impact on the worker’s bankruptcy case and did not have to be included as an asset.

The Medicare set-aside fund was not included in the bankruptcy proceedings because it was intended for medical expenses, although the worker did not use it for that purpose.

The attorneys at Louis P. Lombardi II & Associates are experienced in handling all types of workers’ compensation claims. We service the areas of Philadelphia and Montgomery and Bucks County, Pennsylvania. Contact us at (610)239-7600 for a consultation today.

Monday, January 12, 2015

Pennsylvania State Liquor Store Manager Awarded Workers Compensation Benefits the Second Time Around

What can you do if your workers’ compensation claim is denied?

Many Americans are injured on the job everyday.  That is why most employers are required to carry some form of workers’ compensation insurance.  Sometimes, a worker is injured in an unusual way and when he or she makes a claim for benefits it may be denied due to the uncommon circumstance.  When this happens, the worker often has the right to appeal.  This is exactly the situation in a recent Pennsylvania workers’ compensation case. 

In 2008, Gregory Kochanowicz was working as a manager at a Pennsylvania state liquor store in Morrisville.  During his shift, a robber entered the store wielding a gun and demanded that Kochanowicz hand over the money in the store safe.  The robber held a gun to Kochanowicz’s head throughout most of the ordeal and also duct taped him and a co-worker to chairs.

While, Kochanowicz remained physically unharmed, he claims to have been seriously disturbed by the incident. Kochanowicz claims that he was unable to go back to work after the ordeal and to have suffered severe emotional distress.  As such, Kochanowicz filed a workers compensation claim with his employer the Pennsylvania Liquor Control.  The agency disputed the claim and the Commonwealth Court denied Kochanowicz’s plea for benefits. Kochanowicz appealed the denial to the Pennsylvania Supreme Court and this court sent the case back down to the Commonwealth Court for further review.  At this point, the Commonwealth Court decided that benefits were warranted and found in favor of Kochanowicz.  The court noted in its opinion that because the circumstances leading to Kochanowicz’s injuries were not considered normal working conditions that he should be entitled to benefits.  

If you were injured at work, even in an unusual way, do not be discouraged from pursuing a workers’ compensation claim.  The attorneys at Louis P. Lombardi II & Associates are experienced in representing clients in a variety of circumstances and may be able to help you.  The firm represents clients in and around the areas of Montgomery and Bucks County, Pennsylvania and can be reached at (610)239-7600 or (888)818-4343.  Contact us for a consultation today.

Monday, December 29, 2014

Dog Bite on Break Leads to Workers’ Compensation Benefits

Can you receive workers’ compensation benefits if you were injured while on a break?

In Pennsylvania, an employee may be entitled to workers’ compensation benefits if he or she was injured during the course and scope of his or her employment.  While during the course and scope of employment is a phrase that implies that the person must be injured while working, this is not the case.  This phrase has come to encompass a variety of situations as evidenced by a recent Pennsylvania case.

Sean Sovens worked full time for a manufacturing company and part time as a cook at the 1912 Hoover House Restaurant.  In the spring of 2010, while working his one night a week at the restaurant, he went out for a smoke break.  At the same time, his co-worker’s father stopped by, bringing with him the co-worker’s dog.  Sovens pet the dog and the dog attacked him, biting him on the face and causing lacerations.  This incident resulted in Sovens missing 6 days of work.  

Sovens filed a workers’ compensation claim in April of the same year and the restaurant argued that he should be denied benefits because the dog bite did not occur within the course and scope of his employment.  The judge did not agree with the restaurant and instead awarded Sovens’ benefits, assessing his salary to be over $900 a week, which included the wages from his full time job.  

The restaurant appealed the award of benefits and the salary assessment.  While the Pennsylvania Workers’ Compensation Appeals Board found that the salary was calculated incorrectly, they also found that Sovens was entitled to benefits nonetheless.  The decision was appealed further and subsequently upheld by the Pennsylvania Commonwealth Court. This high court found that breaks for leisure that do not interfere with work are considered to be within the course and scope of employment.  They also found that the petting of the dog in Sovens case did not cause him to fall outside of the course or scope.  In addition, the court held that the fact that he was injured while smoking in an area provided by the restaurant was further evidence that the incident occurred while he was on the job.

The attorneys at Louis P. Lombardi II & Associates are experienced in handling all types of workers’ compensation claims.  We service the areas of Philadelphia, Montgomery and Bucks County, Pennsylvania and can be reached at (610)239-7600. Contact us for a consultation today.

Friday, July 18, 2014

PA Man Wins Settlement After Being Fired by Retaliating Employer

Companies, for obvious reasons, don't always appreciate employees trying to get them up to speed, though, particularly when federal safety officials are notified about the problems. In some cases, employers lash out at such employees either by firing them, demoting them, or some other form of ill or unfair treatment.

Read more . . .

Thursday, July 10, 2014

Sugar plant accident highlights risks for temp workers

Factory work presents many risks for workers, depending on the setting and the type of work being done. Employers, of course, have the duty of ensuring their employees and temporary workers are adequately protected. As we frequently point out on this blog, though, employers don't always do this.

A recent accident at a sugar plant in Fairless Hills, Pennsylvania, is an example of the serious consequences of safety failures on the part of an employer. An employee at the plant, according to investigators, had been buried alive in sugar after attempting to unclog a large hopper. Investigators pointed out that a manager at the plant had removed a safety device 13 days before the accident, which device would have prevented the employee's death had it been left on.

Read more . . .

Friday, June 27, 2014

Worker misclassification results in denial of benefits

Workplace injuries can often be prevented, but sometimes injuries occur because of the carelessness of a fellow employee. An example of this type of accident is a permanent hand injury suffered by a Pennsylvania truck driver when employees of other companies failed to properly cap his pressurized tank and later failed to safely correct the problem. As a result of these mistakes, the trucker suffered an injury for which he is seeking over $75,000 of damages.

Sources did not mention whether the trucker received workers' compensation benefits for his injuries. Truckers who are classified as employees, of course, have the ability to seek workers' compensation as a matter of course. There are situations, though, where truckers may not have this compensation available. This can happen when a worker is classified as an independent contractors when he is actually an employee.

Read more . . .

Friday, June 6, 2014

PA court rules in favor of deceased worker's claim

Employers are not always cooperative with workers' compensation claims and sometimes try to create barriers for an injured employee seeking recovery. One way of doing this is to claim that the employee's injury is not work-related. In cases where the injury clearly took place while the employee was on the job, the argument may be that the employee was not technically acting as an employee at the time of the injury.

This was the argument made by a Pittsburgh gas station when a workers' compensation claim was filed on behalf of a manager who was injured back in 2009 by a robber. According to sources, the manager tried to stop a robber who attempted to steal money from the cash register. In the process of doing so, he ended up with a traumatic brain injury which left him in a coma for a number of months before he died in April of 2010.

Read more . . .

Friday, May 30, 2014

Injured employees and the right to workers' compensation

In a recent post, we commented that employers are well aware of the costs of workers' compensation claims and, because of the financial impact of such claims, aren't always supportive of the rights of injured employers. A recent article in Small Business Trends highlights this issue, and notes that companies may be able to save money on workers' compensation claims by providing their employees voluntary accident and disability insurance as part of their benefits packages.

A certain number of employers have reported that offering such benefits can indeed decrease workers' compensation claims, and thereby the costs of workplace injury. In some cases, such insurance can be added by employers at no additional cost to the company. This is certainly a positive thing from an employer's perspective, but advocates for injured workers should view such recommendations with a healthy dose of skepticism, since they may not ultimately be for the benefit of workers.

Read more . . .

Thursday, May 22, 2014

Report shows workplace injuries to be costly

A recent report looking at workplace fatality statistics is a stark reminder of the risks some workers face every day on the job. The report, published by the American Federation of Labor and Congress of Industrial Organizations, found that an average of 4,628 workers died on the job in 2012, and that an estimated additional 50,000 workers died from work-related diseases.

Based on these numbers, it is believed that an average of 150 workers die each day because of their work environment. In terms of the total number of work-related injuries and illnesses in 2012, the reported number was 3.8 million. This number, though, is mostly likely low due to underreporting.

Read more . . .

Friday, May 16, 2014

Report looks at prevalence, preventability of ladder accidents at work

Ladders in the workplace can be dangerous, for obvious reasons. When ladders are routinely used at work, the risk of workplace injuries increases, and employers need to ensure workers are properly trained and that they are observing appropriate safety practices.

According to a recent report by the Centers for Disease Control, one of the leading causes of workplace injuries and deaths is falls from ladders. The study says that roughly 20 percent of workplace fall injuries involve ladders, while about 43 percent of fatal falls over the last decade have involved ladders. In 2011, a total of 113 workers died from ladders falls, while there were about 15,500 ladder-related injuries requiring at least a day off work and 34,000 ladder-related injuries requiring a hospital visit.

Read more . . .

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