One of the more important, and often overlooked, aspects of a workers compensation claim in Pennsylvania is the description of injury. More times than not, if you get hurt at work and your employer accepts your work injury, the description of your injury provided is nothing more than a ‘strain/sprain’ or ‘contusion’, whether it be to your neck, back, shoulder, etc. . . Often times, it is simply not accurate.
So why is that the description provided on the PA Department of Labor & Industry forms that you get? Could be a few reasons. First, many insurance carries only accept sprain/strains and contusions. Second, your actual injury may have just happened and the actual medical diagnosis is unclear. Third, it may actually be accurate.
More than likely, the first two reasons are applicable. Many insurance carriers do not accept anything outside those generalized descriptions. There is a reason for that. By accepting only generalized descriptions of injury like a strain/sprain, it provides the insurance carrier leeway in denying future medical treatment. For example, if you have an accepted left shoulder strain, but you recently had a left shoulder MRI that indicated a rotator cuff tear, the insurance carrier may deny surgery. They will deny surgery based on the fact that they only ever accepted a left shoulder strain/sprain, not a rotator cuff tear. Another frequent example is a head injury. Often times, the accepted injury for a head injury is a ‘head contusion’. That provides leeway for the insurance carrier to deny treatment for concussion and post concussion syndrome. They often do as well. Continue reading
An Amazon Warehouse employee was killed in a work accident recently.
The is the second death at the Middletown/Carlisle facility since 2014. If you recall, an employee was killed in 2014 in a pallet jack accident.
The Occupational Safety and Health Administration is investigating a death at an area Amazon facility.
Devan Michael Shoemaker, 28, of Millerstown, died Tuesday of multiple traumatic injuries at the Amazon warehouse on Allen Road in South Middleton Township.
Cumberland County Coroner Charles Hall confirmed Shoemaker died after the 5:15 p.m. accident in which he was run over while helping the driver of a truck tractor hook up a trailer.
Amazon had already been warned and fined by OSHA in 2016 at it’s New Jersey facility for failure to address workplace safety concerns. I’ve written in this issue time and time again. Big conglomerates like Amazon consistently skirt safety issues for lower operating costs, while the employees are the ones to suffer, often from devastating work injuries, and in this case, even death.
I have represented many injured workers at Amazon in Carlisle. With Central Pennsylvania’s warehouse growth in full swing, more and more warehouse type injuries are occurring. Check out my previous article on common warehouse injuries.
If you work at one of the many warehouse or distribution center in Central Pennsylvania and have sustained a work injury, don’t hesitate to call Mooney & Associates to protect your right and benefits you may be entitled to under the Workers Compensation Act. Places of employment like this often try and intimidate injured employees, downplay injuries, deny injuries, terminate employment when injured, or have injured workers sign forms quickly. Get represented! Call Mooney & Associates for a FREE CONSULTATION AT 717-200-HELP or 1-877-632-4656.
Under Pennsylvania law, do I have to return to light duty when I am hurt on the job. Why would an injured worker ask that? Well, it isn’t that these clients are lazy, not at all. Many times, an injured worker simply wants appropriate time to recover and heal from the work injury.
Legal ramifications for turning down light duty
Turning down available light duty is not a wise decision and can put workers compensation benefits at risk. In Pennsylvania, your employer has the right to offer you modified duty employment. Many employers in Central Pennsylvania do offer light-duty work assignments or alternate work programs. The critical thing to remember is that both the employer and the injured employee must act in good faith in offering and responding to an offer of light-duty work. Failure to do so can result in a suspension or reduction in you wage loss benefits. Continue reading
Either way you look at it, a work injury can be financially disturbing for many. Many injured workers have their injury denied, meaning they are receiving no income while they litigate their claim. Others have an accepted claim, but for medical benefits only, which again means, no wage loss benefits while the claim is being litigated. Others may be receiving benefits, but at a reduced rate from their regular, average weekly wages. Often, it causes financial hardship.
Regardless, work injuries often times require significant medical treatment. That means trips back and forth to the doctors, to pain management, to physical therapy, and to the pharmacy. Unfortunately, there is a misperception out there that an injured worker is entitled to reimbursement of travel expenses back and forth for their treatment. The injury isn’t my fault, why should I have to pay for my own gas to and from treatment. Great argument. And I agree wholeheartedly. However, in Pennsylvania, it is not a reality. Continue reading
An obvious question asked by many clients is just how long does Workers Compensation litigation take in Pennsylvania. It is a concerning issue for many injured workers because they are either off work with a denied injury or off work and the insurance carrier has accepted the injury, but only for medical purposes, not wage loss. That means that the injured worker is out of work, often times with no alternative sources of income.
In Pennsylvania, a typical time line for workers compensation litigation extend from 8 months to 12 months. Let’s walk through the time line to illustrate why the lengthy time line exists.
First, from the time you file a claim, it may be 15-45 days before a hearing is scheduled. Depending upon what Judge is assigned to your case, you may or may not testify at the first hearing. I advise my clients on that issue immediately (So there is at minimum 1 month) Continue reading
Attorneys across the Commonwealth of Pennsylvania have been waiting for the Pennsylvania Supreme Court to clarify the status of the Impairment Rating Evaluation section of the Act, since the Commonwealth Court struck down provisions and remanded the case back to a Workers Compensation Judge. The PA Supreme Court issued it’s decision as I sat in a workers compensation hearing around 11:30 AM this morning. In Protz v. WCAB (Derry Area School District), No. 6 WAP 2016, the Court struck down the IRE provisions of the Act as unconstitutional in it’s entirety.
To help you understand, let me first explain the IRE process. First, and foremost, it is a process used to limit injured worker wage loss benefits. The injured worker is examined by a doctor chosen by the Commonwealth for what is called an impairment rating evaluation. The IRE exam is solely used to establish a whole body impairment. If the IRE examination finds an injured worker to have 50% or less whole body impairment from the work-related diagnoses, then wage loss benefits are capped to 500 weeks (about 9 1/2 years). A request for an IRE examination by the insurance carrier cannot occur until an injured worker has received at least 104 weeks (2 years) of total disability compensation. Don’t confuse this examination with an IME (defense) examination. They are entirely different. IRE examinations are nothing more than a tool for an insurance carrier to limit wage loss benefits of the injured worker. Additionally, the provision is also unfair because it is nearly impossible to get a 50% or more whole impairment rating evaluation, outside completely catastrophic injuries. Continue reading
You may have heard about Medicare Set Aside agreements when it comes to Workers Compensation lump sum settlements. They are complex and confusing too many. Let me try and help explain a little about this complex area of law.
First, when is a Medicare Set Aside agreement required as part of a structured workers compensation settlement? Generally, with a worker’s compensation settlement, federal law prohibits Medicare from paying for injury-related medical expenses or medications that an employer is responsible to pay. In essence, other insurance coverage exists for those medical expenses. To achieve that purpose, Federal government regulations require that a portion of settlement funds be “set-aside” in an account to pay for future medical expenses related to the work injury. So what specifically triggers this process? Here are the general criteria when a settlement should be submitted for CMS review.
CMS will only review new WCMSA proposals that meet the following criteria:
The claimant is a Medicare beneficiary and the total settlement amount is greater than $25,000.00; or
The claimant has a reasonable expectation of Medicare enrollment within 30 months of the settlement date and the anticipated total settlement amount for future medical expenses and disability/lost wages over the life or duration of the settlement agreement is expected to be greater than $250,000.00
So, what is the important words in here — “is” and reasonable Continue reading
The US Department of Labor’s Division of Federal Employee Compensation has issued new guidelines for the use of opioids to treat injured federal employees. There has been significant nationwide concern over the growing opioid addiction epidemic across America and we should expect more changes to come, at the state levels as well.
Here is the gist of the new opioid guidelines.
- Implementation is set for August 2017
- Opioids can be prescribed for an initial 60 days. However, the prescription must be broken down to two 30 prescriptions each.
- After the initial 60 day prescription, then to extend opioids, the treating physician must complete a Letter of Medical Neccessity (LMN). A LMN must be completed for any subsequent prescriptions.
- Compound medications containing opioids must alway be prescribed with a LMN. This guidelines goes into effect as of June 26, 2017.
The use of narcotic painkillers has been steadily increasing, and with that rise in use has come addiction, abuse and resulting deaths. Many estimates put opioid use three times higher this decade than previous decades. Unfortunately, patients with long-term injuries are readily prescribed narcotic pain medications and that use has created significant dependency issues for many users, especially those suffering from arthritis and back injury. In many instances, insurance companies simply find it much cheaper to pay for opioid prescriptions than other treatments, including surgical procedures, that could provide much more effective long-term relief.
I suspect we will start to see similar measures rolled out in state Workers’ Compensation programs.
If you are an injured Federal Government employee, or you have suffered any work injury in the private sector and live in Pennsylvania or Maryland, contact Mooney & Associates today for a FREE consultation. Don’t risk it going alone. You have too much to lose. You can call us at 717-200-HURT.
We have seen the various reports from time to time on the overall impact of understaffing at Pennsylvania Nursing Homes. In this report of 18 of Pennsylvania’s most understaffed nursing care facilities, ten of the eighteen are owned and operated by Manor Care, and three of the 18 are right here in the mid-state, in Chambersburg, Carlisle, and New Bloomfield in Perry County. These reports generally focus around the sub-standard care is causes to the patients who reside or are being cared for in the facilities. Rightfully so.
The untold stories of understaffing in these care facilities is the risk it puts on nursing home employees. I get my fair share of injured nursing home employees. Many times, understaffing is the culprit of these injuries. Most common are lifting injuries. These injuries usually occur when lifting patients. They can occur due to lack of lifting equipment and understaffing. Frequently we see back, neck, and shoulder injuries when it comes to lifting residents. These injuries also occur due to lack of or sped up training due to understaffing. It isn’t just sped up training though, many time it can be faulted to poor training programs.
We also see CNAs and LPNs injured by violent acts of residents. Again, many times it is due to understaffing for patients with medical conditions that cause either violent tendencies or inability to understand or control reaction. Fortunately, health care employees are speaking up regarding violence in health care facilities and demanding protections. OSHA is considering new workplace violence standards.
We also see injuries occur due to lack of staffing because of employee fatigue. Patient care is not easy. It can be quite taxing.
Health care can be a quite rewarding career field. Unfortunately, it is also a dangerous field, as health related work injuries now rank as high as construction work injuries. The focus of understaffing at nursing homes should turn to patient care and employee safety. For more information on workers safety in nursing homes, visit the OSHA website here.
Meanwhile, if you work in a nursing home in Pennsylvania and you have been hurt at work, protect your rights and potential entitlement to benefits. Too many injured CNAs stay silent out of fear of their employer. You don’t need to do that. Contact Mooney & Associates today for a FREE CONSULTATION. Let us help protect you! Call today at 717-200-HURT.
Thousands of people get hurt in slip and falls every year. Often times these occur in places of business, such as grocery stores, retails stores, health care facilities and more. The aftermath of these type of non-work related accidents can be overwhelming, worrisome, and costly. Here, we provide you seven steps to take if you are a victim in a slip and fall accident.
- Get pictures. I know, the last thing any person is concerned about when injured is taking pictures at the scene of the injury. However, photos can be an important piece of evidence, as well as, an important tool for your attorney in evaluating the viability of your case. If your slip and fall was the result of a defect, and you did not get pictures that day, return to the property and take pictures.
- Report the injury. Many times, when a person slips and falls in a store, they are embarrassed. They just get up, in pain, and go there way to try and get out of the store quickly. Don’t do that. Report the injury to the manager or property owner. Property owners or managers must be made aware of the injury. Report it. Ask for an incident report after you report the injury. Get the name of the manager or employee you spoke with to report the injury. Get the name of any witnesses.
- Call Mooney & Associates. Call us right away. Call us at 717-200-HURT. It is important that you contact us right away so we can guide you through the process and advise on what documents and forms to sign, and what not to. Personal injury consultations with Mooney & Associates are FREE. We will look at the circumstances and evaluate your case to determine if you have a viable case. If so, you will be given a contingency fee agreement, which means, we do not get paid unless you get paid!
- Do not talk to Insurance Company. Tall to Mooney & Associates first. We can provide advice and guidance. Recorded statements are meant to restrict and box you in. Talk to us first. Protect yourself.
- Treat. Seems simple. It is important when you are hurt in a slip and fall to seek medical treatment. Follow your doctors treatment protocol. Proper diagnosis is critical to getting your feeling better and recovered. Keep notes and track your pain and treatment, it is critical for settlement evaluation. Keep treatment information, like medical records, bills, insurance explanation of benefits forms, receipts, and more.
- Account for losses. Keep an accounting of losses you incurred, such as deductibles paid, medical bills paid, prescriptions paid, and any other expenses you had to incur because of your accident. Provide them to your attorney.
- Document changes. Document changes you had to undergo, such as, things you have been restricted form doing, like hobbies, due to the injuries you suffered. Document any wage loss you may have incurred due to the injuries. Write it down, whatever you feel. Keep a good injury and recovery journal.
Slip and falls are unfortunately too common. Make your life and your case easier. Follow these seven steps and protect yourself.
Mooney & Associates had 14 offices through South Central Pennsylvania. That is for your convenience. We bring our law firm close to you. Simply call us at 717-200-HURT to schedule a FREE CONSULTATION.