PA Workers' Compensation Matters...                      

A work injury can be devastating to you. It affects not only your income but can affect your health coverage and other benefits. The law in PA is very intricate and you need an attorney to guide you. Representing injured workers has been a major part of my law practice over the years.  When you are injured on the job, the combination of physical, financial and psychological stress can be overwhelming. You need someone who knows the law and can fight for your rights. Call me for a free consultation. Some important tips when injured: Give notice of your injury immediately-you can lose your right to benefits if you do not give notice.   Get immediate medical attention-you must document your injury.  If your employer maintains a provider list, then you must go to their designated physicians for the statutory time period if they direct you to do so.   Contact an attorney.  Even when you do not need to retain me yet, I can guide you so that you comply with the requirements of the Workers' Compensation Act with regard to notice, return to work, treatment, and resolving your case.                      Read below for some FAQ and answers. Call my office for help. 215-752-3732 Or email me at jjsesq@comcast.net

 

Q. I was injured at work and I have been out for awhile. Now I am going to lose my company group health insurance. What can I do? A. When an employee is injured on the job, employers often terminate the worker after a certain time period of absence (usually one year). This often includes termination of health insurance coverage which was part of the employment benefit. Injured workers can find that they have great difficulty obtaining new health coverage which does not exclude a pre-existing condition (the work injury). If you worked for a business with 20 or more employees, you can often obtain continuation of your coverage at 102% of the group rate under COBRA for about 18 months after your other coverage is ended. Once that has been exhausted, you may be able to take advantage of the Federal Health Insurance Portability & Accountability Act of 1996. This prohibits insurance carriers from excluding pre-existing conditions in certain circumstances. In order to qualify, the employer must have 25 employees or more and the plan must be a group plan.

 

Q.  My employer scheduled me for some exam called an IRE...can they modify my workers' compensation benefits?  I have heard that they can cut me off automatically.  Is this true? A.  Under Section 306 (a.2)(1) of the Act, an employer is entitled to obtain an exam called an IRE after the employee has received 104 weeks of total disability benefits.  Under this section, an employer is allowed to automatically modify payment of the employee's benefits to partial benefits which will continue for 500 weeks and then stop, if their doctor finds that the employee is less than 50% disabled.  This is determined by a complex group of standards based on percentages.  This section of the Act has far reaching effects on all injured employees. Due to recent litigation on behalf of injured employees, the Pennsylvania Supreme Court held that the employer MUST make this request within the 60 day period after the employee has received 104 weeks of benefits in order to take advantage of the automatic modification provision.  This does not mean than an employer can not request an IRE, but it MUST go to the judge to get a modification if the exam is requested outside the 60 day period.  This allows the employee to obtain counsel and provide medical evidence to contest the partial disability status, which is an important right for any worker injured after June 24, 1996.

 

 

             
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LANGHORNE , PA   215.752.3732    

Contact Joyce   jjsesq@comcast.net