Answers to Common Questions about Pennsylvania Workers’ Compensation

questionsQ. If I am already getting benefits, why should I hire Lowenthal & Abrams?

A. It is very common for benefits to start without a problem, only to be cut off later. If you hire us right from the beginning, we will be available to help should there be an issue. We will already be up on your case and will be able to move quickly. You never have to pay if you don’t actually need our help.

Q. I was hurt at work and need a lawyer. How will I pay?

A. Workers’ compensation cases are handled on a contingency basis. This means the payment comes from your benefits as opposed to you having to pay in advance. We only get our fee if we are successful.

Q. What kind of benefits are available?

A. Lost wages and medical bills are the most common kinds of benefits. If you will be out of work for a very long time, you might be eligible for a lump sum payment. If you have an amputation, you will be entitled to specific benefits for your loss. If you are the spouse or child of someone who died at work, you might be able to get death benefits.

Q. How much will my wage benefits be?

A. Your wage benefits are calculated based on a formula. When you hire us, we will help you with this calculation. It is important that you know how much your benefits are supposed to be, because sometimes the insurance company will make a mistake.

Q. How long can I get benefits?

A. You can receive benefits for as long as you are unable to work. This issue is one of the biggest in workers’ compensation cases. Often insurance companies will argue that you can return to work when you cannot. The insurance company will generally seek to limit how long it is responsible for paying you benefits.

Q. Can I see my own doctor?

A. Your employer is allowed to give you a list of doctors that you must choose from and treat with for the first 90 days. If the employer fails to give you the list or the 90 days have past, you may treat with a doctor of your choice.

Q. What is an IME?

A. An IME is an “independent medical examination.” The problem is the medical examiner is often not very independent and will be looking for reasons to terminate your benefits. You are required to attend an IME but it is best that you speak with your lawyer about what to expect before hand.

Q. What is a nurse case worker? Must I allow her into my doctor appointments?

A. Nurse case workers are individuals hired by the insurance company to look for ways to deny or minimize your claim. While the nurse case worker will pretend to be your friend, she is not. You are not required to speak with her. Nor are you required to allow her to be with you at your appointments.

Q. I was not at work when I got hurt, can I still get benefits?

A. If you were injured because you were doing work for your employer, you might still be able to get workers’ compensation benefits. The legal phrase is “course or scope of employment.” So, for example, if you were in a car accident because you were on an errand for your employer, you might still be eligible. If you are a mover and are on a job moving furniture, then you should be entitled to benefits.

Q. My employer says it is my fault I am injured, so I can’t get my benefits.

A. With very few exceptions, fault is not an issue in workers’ compensation cases. The fact that you caused your injury through some kind of mistake doesn’t matter. You are still entitled to benefits.

Q. My employer says I had a pre-existing condition, so I can’t get benefits.

A. If your pre-existing condition was made worse by your employment, you should be able to get benefits.

Q. Can I sue my employer?

A. The workers’ compensation system takes the place of a traditional lawsuit. You cannot sue your employer if you are injured at work.

Q. Can I ever sue?

Sometimes there is a third party that can be sued. For example, if you were in a car accident that was caused by someone else, you would seek both workers’ compensation and financial compensation from the person who caused the car accident.

Claim Denied?

Q. What can I do if my workers’ compensation claim is denied?

A. If your claim is denied, you can appeal the denial. You should retain the services of an expert* in Pennsylvania workers’ compensation law to help you.

Pain and Suffering?

Q. Can I receive an award for pain and suffering as part of my benefits?

A. No, workers’ compensation does not include pain and suffering.

LOWENTHAL AND ABRAMS, P.C.

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