I won my workers’ compensation case. Is it finally over? The answer to that question is — NO. Let me explain.
I explain to my clients after successfully winning a claim petition, or for that matter, any petition, that the headaches and frustration of the litigation process are over, but only temporarily. First, to deal with the matter of an appeal, whenever a party loses before a Workers’ Compensation Judge (WCJ), the other party has a right to appeal that decision to the Workers’ Compensation Appeal Board. But, what if the employer and insurance carrier do not appeal the decision? Is the frustration of litigation and hearings over? Yes, but only temporarily.
Let’s assume we win a claim petition through litigation. Great! We win! Let’s assume the insurance carrier has not appealed the decision. Great! The claimant will be paid benefits due in the claim petition including ongoing wage loss benefits and medical benefits. That is exactly what we wanted and received.
However, it is important to know that the insurance carrier is not just going to keep paying benefits without pursuing new litigation to return the injured worker to work, stop benefits, or terminate benefits. More than likely within three months of the decision granting the claim petition, the insurance carrier will likely scheduled the injured worker for another independent medical examination (IME). The insurance carrier is entitled to an IME every six months. Their hope is to receive an IME opinion that the injured worker can return to work in some capacity, which will lead to a job offer, or that the doctor finds the injured worker to be fully recovered. Therefore, the insurance carrier will follow that up with filing a Modification, Suspension, or Termination Petition, putting the injured worker back in litigation and threatening the benefits they deserve and won. Insurance carriers are often relentless in pursuing all avenues to stop benefits. The Workers’ Compensation Act provides them multiple avenues to threaten benefits.
That is why it is so important to do several things after winning a claim petition.
Continuing medical treatment is so important. The overall goal here for an injured worker is to get better and recover. Continuing treatment also allows the injured worker to receive ongoing work notes and restrictions so that wage loss benefits can continue. In fact, failure to treat can lead to a suspension of benefits. It is equally critical that you continue to update your doctor as to ongoing symptoms.
Keep in touch with your attorney
It is important to keep in touch with our office regarding ongoing treatment. That way we can continue to request medical records to defend the claim in later litigation. It is also equally important to keep in touch regarding any new medical providers that are involved in treatment. Communication remains important so we are fully ready to engage new litigation.
Communicate through our office
Finally, it is critical that communication between the injured worker and the insurance carrier and employer goes through our office. That keeps us updated on your case and your benefits and eliminates unnecessary communication that can be construed differently by the insurance carrier.
Workers’ compensation can be and often is a frustrating and complex process. Working with my office can help alleviate that frustration and avoid future problems in your case. Mooney Law offers FREE consultation for injured workers. Call today at 717-200-HELP or 717-632-4656 to schedule a free consultation. You can also email us at firstname.lastname@example.org. Finally, you can schedule a consult on our firm website.