5 Simple Rules to
Help You with Your
PA Workers’
Compensation
Case
COPYRIGHT 2013 by PaWorkersCompHelpNow
Harrisburg, PA
Telephone: 877-COMP-HELP (877-266-7435)
Web address:
www.paworkerscomphelpnow.com
No part of this book may be copied or reproduced in any manner whatsoever
without the express written consent of PaWorkersCompHelpNow.
Comments in this book are not intended to provide legal advice. This book is a
guide. For specific legal advice on your case, you should call a reputable and
experienced workers’ compensation lawyer.
WHY I WROTE THIS BOOK?
For over 25 years, I represented employers both large and small
in the area of PA Workers’ Compensation. I originated strategies
to defend employers and their workers’ compensation insurance
carriers when they were faced with claims by injured workers
and their families for PA Workers’ Compensation. I represented
these employers from the very beginning of their claims’
strategies and all the way through the legal system right up to
the highest court in PA, The Pennsylvania Supreme Court.
I have seen first-hand the strategies, tactics and operations of the
workers’ compensation insurance companies. I know why they
operate, how they operate and, most importantly, WEAKNESSES
in their strategies handling PA Workers’ Compensation claims.
NOW, I offer this unique perspective representing injured workers and their families with PA
Workers’ Compensation claims. I have seen the physical and financial devastation that a work
injury can bring upon injured workers and their families. I know how the insurance companies
use delay tactics to starve out some injured workers who can no longer make car payments,
mortgage payments or even adequately provide for their family’s basic needs like food and
clothing.
I welcome you to contact me for a
FREE
, no obligation consultation so I can demonstrate to
you my unique ability to handle
your
PA Workers’ Compensation case.
A.J. Palutis, Esq.
The Do’s and Don’ts of PA
Workers’ Compensation
RULE # 1: IMMEDIATELY AFTER YOUR INJURY
Do report your injury immediately to a person in supervisory authority at your place of employment. You have 120 days to properly report your work injury, but just telling a co-worker is not good enough to meet the reporting requirements.
Don’t assume your injury will get better and tough it out.
Do treat with a panel physician if presented for your signature with a panel list of providers in conjunction with a written “Acknowledgment of Rights and Duties.” Make certain to accurately describe the nature of ALL of your injuries and a complete history as to how your work injury or activities caused or aggravated your conditions.
Don’t treat with a panel provider if not given a list of approved healthcare providers after your injury and if you have not been presented for signature with a written “Acknowledgment of Rights and Duties.” In this circumstance, you may treat with any doctor of your choosing.
Do, if treating with a doctor of your choosing, including a family doctor, make certain to accurately describe the nature of ALL of your injuries and a complete history as to how your work injury or activities caused or aggravated your conditions.
Don’t think that because you have a pre-existing problem with your back, neck, arm, legs, elbows, ankles, knees or any other body part that you are NOT covered by PA Workers’ Compensation.
Do be aware that any work activity or incident that aggravates (makes worse) your pre-existing condition can be a new work injury in PA.
DO
DO
DO
DO
DON’T
DON’T
DON’T
RULE # 2: AFTER REPORTING YOUR WORK-RELATED
INJURY AND SEEKING MEDICAL ATTENTION
Don’t assume that your claim for medical and wage loss benefits has been accepted by the employer and their workers’ compensation insurance carrier.
Do be aware that the employer and the workers’ compensation carrier have 21 days to accept or deny your workers’
compensation claim from the date of your reported injury.
Don’t assume that because your medical bills are being paid by workers’
compensation insurance that your claim has been accepted.
Do be aware that you will be contacted by a claims representative of the workers’
compensation insurance company.
Don’t assume that the claims representative is on your side or your friend.
Do be cooperative in answering the basic questions about your work injury and your contact information.
Don’t provide a recorded statement to the claims representative.
DO
DO
DO
DON’T
DON’T
DON’T
DON’T
RULE # 3: IF YOUR WORKERS’ COMPENSATION IS
DENIED
DO contact an experienced workers’ compensation lawyer.
Don’t assume you can handle the case on your own. There are strict time limits that must be followed to protect your rights under the PA Workers’ Compensation Act.
Do be aware that when the employer denies responsibility for your workers'
compensation claim that the employer must forward a workers' compensation DENIAL form to the employee along with a copy to the Pa. Bureau of Workers' Compensation. The DENIAL form must contain the date and an accurate description of the work injury.
Don’t assume that the DENIAL form is the end of your claim.
Do be aware that the DENIAL form contains specific instructions to the injured employee detailing how the injured worker may file a CLAIM PETITION in order to appeal this initial denial.
Don’t contact your employer or the workers' compensation insurance carrier concerning your receipt of the DENIAL form.
Do contact an experienced workers' compensation attorney to file the CLAIM
PETITION. The DENIAL form must be received by the employee within 21 days after the employer has notice or knowledge of your injury. You need not loose any time from work before the 21 day rule starts running. If the employer fails to send the DENIAL form to the employee within the 21 day time period, your attorney may also file a PENALTY PETITION seeking penalties of up to 50% of benefits owed for a late submission of the DENIAL form. This means you may receive more money if your CLAIM PETITION is granted in conjunction with the employer submitting a late DENAIL form.
Don’t delay contacting an experienced Pa. Workers' Compensation attorney to review the DENIAL form in order to protect your rights under the Pa. Workers' Compensation Act.
DO
DON’T
DO
DON’T
DO
DON’T
DO
DON’T
RULE # 4: IF YOUR WORKERS’ COMPENSATION CASE IS
ACCEPTED BY A NOTICE OF TEMPORARY
COMPENSATION PAYABLE (TNCP)
DO be aware that this is a TEMPORARY acceptance of your claim. It may be retracted (taken away) at anytime within 90 days from the date it was issued.
Don’t assume that because you received a TNCP that your wage loss benefits will be paid.
Do be aware that the TNCP may limit your benefits to payment of medical bills only.
Don’t assume that the TNCP correctly describes your injuries that occurred at work.
Do contact an experienced PA Workers’ Compensation attorney to file a claim petition to establish your claim properly even if you receive a TNCP. Your claim is not accepted until you receive a regular Notice of Compensation Payable with
DO
DO
DO
DON’T
DON’T
RULE # 5: IF YOUR CLAIM IS ACCEPTED BY A NOTICE
OF COMPENSATION PAYABLE or
AGREEMENT FOR COMPENSATION
Don’t assume that your claim will last a lifetime. Your wage loss claim will be limited to 500 weeks.
Do make yourself aware of your rights and responsibilities under the PA Workers’ Compensation Act by immediately contacting an experienced PA Workers’
Compensation Attorney
Don’t assume that each and every medical bill will be paid without a fight by the workers’ compensation insurance carrier.
Do beware that the workers’ compensation insurance carrier and the employer may attempt to force you back to work even if you are not physically ready.
Don’t agree to attend an independent medical or vocational examination without first speaking to an experienced PA Worker’s Compensation Lawyer.
Do be aware that while receiving PA Workers’ Compensation benefits, the insurance carrier is actively involved in your claim to make certain that they can limit the time you can receive benefits or determine a way to cut off your benefits. They are not in the business of paying claims. They are in the business of collecting premiums.
Don’t assume that if a Nurse Case Manager is assigned to your case that he or she is there to advocate your case and seek the best medical treatment available to help you.
DO
DO
DON’T
DON’T
DO
DON’T
DON’T
Do assume that the Nurse Case Manager works for the insurance company and will speak with your doctors about returning you to work even if you feel you are not ready.
Don’t participate in social media sites where your personal
information and activities are accessible to the employer and the workers’ compensation insurance carrier. They hire investigators to comb the World Wide Web to locate and catch you doing or saying things that might compromise your claim.
Do be aware that the insurance company might hire private investigators to monitor your activities in public. While they may not intrude upon your personal property or record any unauthorized audio statements, they may position themselves on public property to film or take pictures of your activities.
