Author Archives: Karl Voigt IV, Esq.

“What does a Notice of Ability to Return to Work Mean For Me?”

by Karl Voigt

Karl just answered this Pennsylvania workers’ compensation question on Avvo.com:

What does an Ability to Return to Work Mean for me? I was back to FT work light duty but MMI. Now laid off.

We would generally need more facts from you in order to better answer your question. However, I see two issues in your question.

First, apparently you were back to work at modified duties, but were laid off. In these situations, your workers’ compensation wage loss benefits should indeed be reinstated. The rationale behind this rule is that, if your earnings loss recurs through essentially no fault of your own, you should be paid by the workers’ compensation insurance company. Any rule to the contrary would be patently unfair to injured workers, because an employer could hypothetically take somebody back to work at modified duties, then lay them off and not expect to have to pay workers’ compensation benefits. Hence this rule.

Second, you have since your layoff received a Notice of Ability to Return to Work. This is usually issued by the insurance company after an IME doctor – or even your own treating doctor – releases you to return to work at modified duties. The latter has seemingly already occurred because you were actually working light duty. It’s issuance is required before the workers’ compensation carrier attempts to do vocational development in your case. Namely, the insurer may now assign a vocational counselor to identify hypothetical job opportunities for you.

As far as what you have to do now that you have received the Notice, it may be time to talk to a lawyer, who may put you in several different directions knowing more facts about your case. She might advise you to begin to seek employment within your physical limitations. She could give you advice during the vocational counseling process. She might also discuss with you the possibility of a lump sum settlement. Good luck!

 

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“Do Nurse Case Managers Have the Right to Talk To My Doctors?

by Karl Voigt

Karl just answered this Pennsylvania workers’ compensation question on Avvo.com:

“Gentlemen I know has been going to MHR 10 months now. He has an ICM case worker who wants him to sign papers that its ok for her to talk to his doctors. He’s very smart at somethings. Should he sign these papers when she is not even a family member or wife, girlfriend just a case worker?”

Not unless you give them permission, either express or implied. Which is why you should never sign anything for the benefit of a nurse case manager.

My almost wholesale experience — with only a few exceptions — with nurses hired by the insurance company is that they interfere and try to regulate injured workers’ medical care. It’s not unusual to hear stories of nurse case managers attempting to bully a treating physician into releasing a claimant back to work when it’s far too early. Or, even worse, trying to interfere with their medication formula.

While a nurse case manager may attempt to appear to be your friend, this is simply not the case. The nurse’s paycheck comes from the insurance company and the insurance company sets the agenda. Further, the nurse has no ethical duty to act in an injured worker’s best interest.

When a client comes to my office and the nurse case manager is involved, often one of my first steps is to write a letter to the nurse, with carbon copies to my client’s treating physicians, that revokes and rescinds any express or implied release of medical information. I encourage the same in this case. Good luck!

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“What does it mean when the final WC order grants benefits and grants termination?”

by Karl Voigt

Karl just answered this Pennsylvania workers’ compensation question on Avvo.com:

“What does it mean when the final WC order grants benefits and grants termination?

My workers compensation order says I’ve been granted reinstatement and benefits through the circulation of the order. The order then states the termination petition has been granted for a date prior to the circulation date. What does this mean?”

I have to agree that, assuming you were represented, this is a question best posed to your attorney. However, I would be most curious to know upon what facts the judge relied in terminating your benefits as of the date prior to the circulation of the order.

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Can I receive a lump sum settlement from workers’ comp and can I sue anyone else?

by Karl Voigt

Karl just answered this Pennsylvania workers’ compensation question on Avvo.com:

“I was hurt at work 2 weeks ago, the company doctor put me on light duty and i lost a week of work now im on full duty and my employer says they gave away my position. i have a surgeon and my private doctor telling me that i need surgery asap and they told me not to go back to work until i have the surgery and im healed. i was told i am not getting workers comp and i have not returned to work.
I work for a hiring agency and was contracted to work at a water treatment plant through them. my paychecks come from the agency. Also i went to the comp doctor 3 times they told me that i didnt have a hernia at all and that i pulled a muscle, 4th time i went they tell me i do have a hernia and that i dont need surgery”

The other answers are correct – we don’t know enough of the facts in your case. However, some general answers can point you in the right direction.

First and foremost, nearly any case can settle. The big questions are “when?” and “for how much?”. As a general rule I think that settlement should only come after two prerequisites are met. Namely, an injured worker’s medical condition must be plateaued; it may be unwise to settle the case when one is facing imminent surgery. Second, an injured worker should have a plan as to what happens after the settlement. Reeducation? Move on to a different job? Collect Social Security disability? Once these conditions are met, that is the time to seriously contemplate settling your case for a lump sum.

As far as being able to sue anyone else, certainly your employer enjoys immunity from civil lawsuit. Which means immunity from any assessment of damages for pain and suffering. Sometimes, however, other parties are more responsible for your injury. As an example, a worker could be injured in a motor vehicle accident. If it happened while working, clearly it should be covered by Workers’ Compensation. However, that individual may also have the right to sue the person who hit him. However, any recovery could be reduced because of the concept of subrogation. If the Workers’ Compensation insurance company paid any benefits, they may be entitled to reimbursement from the proceeds of the personal injury award.

If all of this seems complex, you’re right. I will echo the other answers here and strongly suggest that you meet with a certified Workers’ Compensation specialist. Good luck!

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Should I Get a Lawyer for My Workers’ Compensation Claim?

Karl answered this Pennsylvania workers’ compensation question on Avvo.com:

“Should I get a lawyer for my workers compensation claim? I separated my ac joint in my right shoulder in may of 2013. As a result I have a brachial plexus injury to the nerves in my shoulder. I have been out on workers comp for a year now and my symptoms have not changed they have tried medication and many different nerve blocks and still have the pain and numbness. My WC has not discussed settlement or anything and I dont know if I should get a lawyer or just wait to see what happens. Any advice would be greatly appreciated. Thank you.”

 

It’s not very likely that any lawyer will tell you that you don’t need a lawyer. On the upside, while you should most definitely be consulting with one, you may not have to pay one immediately. There are plenty of attorneys here on Avvo who can help you. Look for one who is a specialist in workers’ compensation.

As far as the specifics of your case, brachial plexitis is a pretty serious injury and often requires years of treatment. It is at the very least prudent to have a lawyer on hand just in case you ever have to hire one. Namely, it will be most helpful for you if you have a lawyer who becomes familiar with the specifics of your case, including your medical treatment. That lawyer will be able to provide direction in your case, and prepare a defense well in advance if the insurance company ever tries to attack your benefits.

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Travel Expenses for WC medical treatment

by Karl Voigt

Karl answered this Pennsylvania workers’ compensation question on Avvo.com:

“I had surgery performed by an out of state provider. Can my travel and OOP costs be reimbursed by WC carrier?”

There is a compelling argument that the carrier should reimburse your costs. Until about 1992, workers’ compensation carriers would regularly have to reimburse Pennsylvania claimants for all travel expenses incurred treating their work injury. Unfortunately, following the issuance of an appellate case, Helen Mining Co. V. WCAB, 616 A.2d 759, the law changed. The courts can now only award travel expenses in cases where the requisite medical treatment is not available in your locale. If you can indeed prove that it was absolutely necessary to travel out-of-state for treatment, there is a good chance that your expenses should be reimbursed.

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Governor Approves Minor Changes to PA Workers’ Compensation Act for Maritime Workers

by Karl Voigt

Governor Corbett today has signed a new bill, promoted by legislators in Pennsylvania maritime regions, that makes some minor changes to the Workers’ Compensation Act.

House Bill 2081 changes workers’ compensation coverage for any person engaged in maritime employment, such as longshoremen, ship repairmen, shipbuilders, ship-breakers, pleasure boat captains, stevedores, vessel repairers, harbor pilots, bridge builders and harbor workers. Prior to this legislation, maritime employers were required to maintain insurance on their employees both under state and federal policies. These policies were often redundant, as benefits were almost always paid under the federal program. However, now, only the federal coverage must be maintained by employers.

Legislators from districts surrounding the Delaware River and Lake Erie supported the legislation  so as to save employers money and therefore encourage new hiring. It is hoped that the changes will save maritime employers money by not have to “double insure” their employees.

The text of the law can be found at:

http://www.legis.state.pa.us/cfdocs/billinfo/billinfo.cfm?syear=2013&sind=0&body=H&type=B&bn=2081

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