Workers' Compensation Q&A

While hiring legal representation to support you for your Workers’ Compensation claim is not necessary we do recommend it. However, whether you retain us as your attorney or not, we do answer questions and provide advice to injured workers daily at no cost to you. Further, if you do decide to retain us as your attorney you pay no fee until we win your case, and even then we will only be paying you the money you deserve. We also offer free seminars that provide valuable information about the Workers’ Compensation Act and what happens when you file a claim. If you are interested in more information on these seminars or have a specific question not listed on our website click here and let us know what we can do for you.

An IME is an independent medical examination. The Workers’ Compensation Act allows that the insurance company and/or your employer can send you to at least one independent medical examination so they can get an independent opinion on your condition from a medical professional who is not treating you already. Typically the physician chosen by your employer or the insurance company is employed by your employer or the insurance company, which raises the question of unbiased independent opinion. Regardless of this issue, you are still required to go to at least one appointment if your employer requests it. Sometimes your employer can require more than one IME if they establish a legitimate need for follow up exams. An attorney can help verify if any additional IME’s are needed, which is why it’s very important to contact an attorney when dealing with any type of Workers’ Compensation claim. Transportation must either be provided or the cost of transportation must be reimbursed for any IME’s that you attend at the request of your employer or insurance company.

The Workers’ Compensation Act does not require that you discuss your medical information or condition with anyone other than your medical care provider. If a nurse case manager shows up at your appointments you can tell your physician not to share your information with them. You can also decline to speak to them if they contact you directly. The only information that has to be shared with your Workers’ Comp insurance company or employer are the medical records that your physician is required to send directly to them.

Coworkers and employers are individually protected from suits against them under the Workers’ Compensation Act. When injured at work the only thing you can file a claim for are Workers’ Comp Benefits. These are automatically given regardless of who caused the accident or injury. There is an option to file a claim against third parties for negligence, more commonly called third party actions.

Suits can be brought against third parties if they are not related to your company in any way. This means if you are driving a vehicle for your employer and are involved in an accident it is possible to file a claim against the negligent driver who caused the accident or if you are injured because of defective machinery, not built by your company, you can file a claim against the manufacturer.

Third party actions don’t have many limitations on the types of damages you can make claims for. Just as with any other claim for defective machinery or car accidents it’s possible you can seek compensation for pain and suffering, medical expenses, loss of earning capacity, and loss of quality of life. These claims are different than Workers’ Compensation claims, and have very different laws and intricacies involved with them. At The Pisanchyn Law Firm all of our attorneys are experienced in cases involving Workers’ Compensation, Automobile Accidents, and all other types of personal injury claims so we can easily guide you through any and all necessary steps that need to be taken for any of these claims.

It is possible to file a claim for Workers’ Comp benefits and file a claim against a third party for other damages but you cannot get what is called “double recovery.” This means if you seek full compensation from a third party (pain and suffering, full wage loss, loss of earning capacity, medical expenses, etc.) you cannot receive Workers’ Compensation Benefits on top of it. If you file a claim against a third party for all damages you are required to repay your employer or its insurance carrier for any Workers’ Comp payments they have made on your behalf. It’s very important to hire an attorney to advise you and walk you through the process of filing double claims in order to maximize your recoveries and not lose any of your compensation.

An employer can decide to fire you if your injury prevents you from fulfilling the job you held prior, however, no changes should be made to the benefits you receive from Workers’ Compensation. If you went back to work after your injury, then were fired due to an inability to fulfill your job requirements because of the lasting effects of your injury, you could be eligible to have your Workers’ Comp Benefits reinstated. Also, if you were after reporting a work injury, you could be entitled for Workers’ Comp Benefits and additional damages. Regardless of when you were fired, during or after your injury occurred, you should contact us for advice on what to do next.

Unfortunately, it’s not uncommon for employers to make up accusations or come down hard on employees who are injured in hopes of terminating their employment for a legitimate reason to avoid providing Workers’ Compensation Benefits. If you feel that your employer is doing this you should contact our Workers’ Compensation attorneys immediately to ensure that you and your benefits are protected.

There are two instances in which your employer or the insurance company can suspend, stop, or lower your benefits without your agreement or a court order. If you are receiving other disability benefits or pension income or if you have returned to work and are earning money your benefits can be stopped, suspended, or lowered. Even with these instances you must be notified in writing that these changes are being made.

If your employer or the insurance company is threatening to stop your benefits and it’s not because of the above reasons you need to contact us immediately. Neither can stop your benefits without your agreement or without a court order from a Judge.

Medication that is necessary, related to your work injury, and reasonable is to be paid by your Workers’ Comp carrier. Notice must be given to you if your medications will not be paid for. The insurance company must have a medical reason to decline payment. A review from an independent physician can be sought to verify if the medication is necessary and appropriate, if this is done you must be notified prior. If you find out that a “utilization review” is being sought you should contact us to discuss whether or not you are required to submit to this and whether or not your rights have been violated. There are times when the independent physician does not support the medication and your treatment could be jeopardized or terminated.

If you have any questions please do not hesitate to call or email us. Also, visit the Pennsylvania Department of Labor and Industry for the most up to date information in regards to the Workers' Compensation Act.

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Our services are free until we win your case and even then you will never pay out of pocket; we will only be paying you the money you deserve.