About Workers’ Compensation Benefits

Schmidt, Kirifides & Rassias Attorneys

Tips For A Successful Worker’s Compensation Claim

When an employee is injured in the workplace, he or she is typically eligible for Workers’ Compensation benefits to cover lost wages and medical expenses. Depending on the nature of the injury, Workers’ Compensation claims can be very expensive for insurance companies. These companies have a variety of tactics they may use to avoid paying an employee’s claim or decrease the amount of compensation. The Delaware County Workers’ Compensation lawyers at Schmidt, Kirifides & Rassias want all injured employees to get the compensation they deserve and encourage them to follow the below tips.

 

Report The Injury Immediately

A workplace injury should be reported as soon as it occurs, particularly if it may affect an employee’s ability to work. Workers’ Compensation laws often require injuries to be reported within 21 days, but insurance companies may have their own policies that could affect employee eligibility. Reporting the injury to a superior immediately ensures legal compliance and maximizes the chances of the claim being paid in full. Injured employees must provide all of the relevant details regarding how the injury occurred. Not all injuries are caused by a workplace accident; repetitive movements can stress a particular area and lead to an injury over time.

 

Seek Medical Attention

After a workplace injury, it is important to get medical treatment. Go to an emergency room or walk-in clinic for severe injuries, or make an appointment with a doctor as soon as possible if the injury does not require immediate attention. Waiting to get medical treatment may indicate to the insurance company that the injury is minor and does not require compensation. All injuries should be thoroughly documented, including an accurate description of how the workplace injury occurred.

In order to receive their full Workers’ Compensation benefits, employees must follow all treatment plans as they have been prescribed. Employees must attend every scheduled medical appointment, not only to aid their recovery, but to ensure that they keep receiving the benefits to which they are entitled. Insurance companies may assume that if an employee misses an appointment, their injury is healed or was not that severe to begin with, which may result in termination of benefits.

 

Provide Consistent, Thorough Documentation

Injured employees may need to fill out an accident report detailing the circumstances around an injury. It is vital that these forms be filled out correctly in order for a claim to be processed and paid in full. If an employee is ill or cannot concentrate due to their injury, he or she should wait to fill out the report until they are fully capable of doing so. All reports and statements must describe the details of the accident consistently in order to be accepted by an insurance company. The accident report must be consistent with other reports. If anyone in the area witnessed the accident, their statements may also be needed to establish the circumstances surrounding the incident.

An insurance company may ask injured employees to take additional steps to legitimize their Workers’ Compensation claim. They are entitled to view medical records and bills relating to a workplace injury and may ask an employee to sign an authorization. They are not entitled to any other medical records, however, and employees should be careful not to sign an authorization for any records outside of the workplace injury before consulting with an experienced Workers’ Compensation lawyer. Insurance companies may also request a tape recorded statement describing the accident and injury, which should not be done without a lawyer.

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Death Benefit Claims

Perhaps your loved one died because of a disease contracted from toxic substances exposure at work. Or maybe a family member was tragically killed as the result of a horrific work-related accident. It is an incomprehensible tragedy any time a person dies before having the chance to live a full life. For surviving family members and loved ones, this tragedy is amplified when the cause of death was preventable. Unfortunately, many people are killed at work, leaving behind many real concerns to be dealt with by the survivors.

DEATH AND DEPENDENCY CLAIMS FOLLOWING WORKPLACE DEATHS

In fact, more Pennsylvania workers were fatally injured on the job in 2010 than in any other state except for Texas and California, according to U.S. Department of Labor statistics. These fatalities included transportation incidents, falls, contact with objects and equipment, homicides, highway incidents, fires and explosions, and exposure to harmful substances or environments. Whether your loved one was fatally injured in Delaware County, Montgomery County, Bucks County, Berks County, Chester County, Philadelphia County or in any other county in Pennsylvania, survivors will want to make certain that they have received all the Workers’ Compensation benefits to which they are entitled.

At times like these, you might want to consider obtaining legal advice on issues such as the proper calculation of death and dependency benefits, the representation of survivors in appeals or disputed claim hearings, or the negotiation of a lump sum settlement. Two major obstacles to receiving dependency and death benefits are 1) proving, in cases where the employee died some time after the incident, that the death was causally related to the accident or occupational disease, and 2) proving that the employee died of this causally related job injury or disease within 300 weeks of the accident or last exposure to a harmful substance at the workplace.

In addition, errors can be made in the calculations of funeral costs or total disability payments to compensate your family. These are the types of matters that an experienced Kennett Square Workers’ Compensation attorney at the Media, PA firm of Schmidt, Kirifides & Rassias is skilled at handling. We will bring in qualified experts from the medical profession or reconstructionist experts to prove the scenario of a particularly complex accident that resulted in your loved one’s death.

OUR PHILADELPHIA & DELCO WORKPLACE DEATH ATTORNEYS CAN HELP

Individual situations that call for careful attention are sometimes missed when a family is grieving the loss of their loved one from a tragic work-related accident or illness. Legal counsel experienced in the workplace injury area can provide crucial guidance to injured parties and to families. Call Schmidt, Kirifides & Rassias at (610) 892-9300 or contact us online for a free consultation with one of our qualified Kennett Square Workers’ Compensation lawyers about your situation following the loss of your loved one and your rights to death and dependency benefits through Pennsylvania Workers’ Compensation.

Denial Of Benefits

If you were injured at your place of employment, learning that your workers’ compensation claim was denied can be devastating. Workers’ compensation is supposed to be a safety net for workers who suffered a serious injury that requires taking time away from work. Unfortunately, some employers may look for ways to avoid paying your workers’ comp benefits, which can leave you in a precarious position with your medical bills and other expenses. If you or a family member was denied workers’ comp after being injured, you should consult with an experienced Philadelphia workers’ compensation attorney today.

At Schmidt, Kirifides & Rassias, our worker’s comp attorneys possess over 60 years of combined legal experience that they will utilize to help you appeal your denial of benefits. Our legal team will learn the intricacies of your case and assist you in developing a legal strategy to help you pursue the benefits that you deserve. To schedule a free legal consultation to discuss your benefits denial, call Schmidt, Kirifides & Rassias, at (610) 892-9300, or contact us online.

4 COMMON REASONS FOR WORKERS’ COMP DENIAL

There are multiple reasons why an employer may deny a claim for workers’ compensation. It is important to take the application and appeal process for workers’ comp seriously, a simple error in your paperwork could mean that you do not have the money you need to treat your injury. If your claim for benefits was denied, it could be for one of the following reasons.

YOUR INJURY DOES NOT QUALIFY

One of the most common reasons for a workers’ comp claim being denied is because the injury is non-compensable. A non-compensable injury can be interpreted in a few ways under Pennsylvania’s Workers’ Compensation Act. One way your injury could be classified as non-compensable is if an employer believes that your injury occurred outside the scope of your employment. For example, if the bus you were riding to work was involved in an accident and you were seriously injured, your claim for workers’ comp could be denied.

Additionally, if the employer alleges that you were intoxicated while working or that you failed to follow safety protocols, this can also be used as a basis to deny your claim.

YOUR EMPLOYER WAS NOT INFORMED OF YOUR INJURY

If you are injured on the job in Pennsylvania, you must notify your employer of the injury within 21 days of the injury. If you fail to document your claim with your employer within this timeframe, it will be more difficult to prove your claim. However, Pennsylvania does allow up to 120 days to report your injury under certain circumstances.

If you reported your injury to your employer, be sure to request documentation of the injury report. If a supervisor neglects to file your report with your company’s human resources department, this may complicate matters if you need to appeal your benefits claim later.

THE SEVERITY OF YOUR INJURIES

Having your injuries evaluated by a physician is necessary before you can claim workers’ compensation benefits. Your employer may refer you to a doctor for your injuries, or you may have to schedule an appointment with a doctor that is qualified to assess your injuries. To determine whether you qualify for workers’ comp, the doctor will issue one of the following diagnoses regarding your injury:

  • Your injury is temporary
  • You suffered an injury that will permanently disable you
  • Whether your injury was the result of a pre-existing condition and whether your job requirements aggravated it
  • Whether your injury is directly correlated to your work responsibilities

Your physician’s report will affect the type of benefits you receive or whether you qualify for benefits at all

YOU ARE NOT COVERED UNDER THE WORKERS’ COMPENSATION POLICY

Under certain circumstances, your employer or your employer’s insurance carrier may attempt to deny your claim by alleging that you do not qualify for benefits under the workers’ compensation insurance plan. Independent contractors, part-time employees, and even illegal aliens (“undocumented workers”) have the right to file workers’ compensation claims, but they can face difficulty in proving their right to benefits. The following is a list of workers that may not be covered under Pennsylvania’s Workers’ Compensation Act or that may be covered under other laws:

  • Agricultural workers
  • Casual employees
  • Domestic employees
  • Federal civilian employees
  • Harbor employees and other related positions
  • Railroad workers

This is not an exhaustive list. There are other occupations that may encounter difficulties when making a workers’ comp claim.

OUR DELAWARE COUNTY WORKPLACE INJURY LAWYERS CAN HELP YOU FILE AN APPEAL FOR YOUR BENEFITS

If you or a family member was denied workman’s compensation benefits, you should contact an experienced Delaware County workplace injury lawyer. At Schmidt, Kirifides & Rassias, our workers’ comp appeal lawyers are committed to protecting your rights and pursuing the benefits you need to handle your injury. To schedule a free legal consultation, call us at (610) 892-9300 or contact us online.

Forced Resignations

When an employee suffers an injury on the job, they are often entitled to Workers’ Compensation benefits. These benefits can provide a portion of the injured employee’s salary, as well as reimbursement for their medical costs. Although an insurer may choose to challenge a request for Workers’ Compensation benefits, some employers have been caught attempting to alleviate the need for a claim through illegal manners. When an employer attempts to convince the employee to terminate employment, also known as forced resignation, to avoid paying Workers’ Compensation benefits, they are breaking the law.

COMPENSATION FOR A FORCED RESIGNATION

Workers’ Compensation requires employers to refrain from firing their employees based upon the existence of a Workers’ Compensation claim. In an effort to evade this responsibility, employers may make work conditions for an injured employee so unpleasant that they feel compelled to seek employment elsewhere. Although the employee may ultimately resign from their position, this can be considered constructive discharge or constructive termination and is treated under the law as though the employee was fired.

Employees who are unable to work or must work a modified schedule while recovering from an injury sustained in the workplace should stay closely attuned to the treatment they receive from managers and supervisors. According to our Delaware County Workers’ Compensation lawyers, any behavior which hints at retaliation for the filing of a Workers’ Compensation claim should be documented. Moreover, upon returning to work, employees must be treated fairly. Any efforts by employers to retaliate against an employee who has received benefits including the creation of a hostile work environment or a decision to unfairly increase their workload could lead to legal action.

OUR PHILADELPHIA AND DELAWARE COUNTY WORKERS’ COMPENSATION LAWYERS CAN HELP

When an employee is forced to resign their position after seeking Workers’ Compensation benefits, the injury they suffer is two-fold. Not only must they recover from a physical injury, but they also must secure new employment. If you’ve been forced to resign, contact our workers’ compensation attorneys for help. Call (610) 892-9300 or messages us online for your free consultation.

Lump Sum Settlements

Called Compromises and Releases (C&Rs) under Pennsylvania Workers’ Compensation law, agreeing to a lump sum settlement for all or part of your claim for a work-related injury is a very common practice between employees and their employers’ insurance carrier. Sometimes, a C&R is a preferable method of resolving disputed issues, or of providing an injured worker with the money needed to move on from the work injuries.

If your injuries are quite serious and debilitating, a C&R, or lump sum settlement, can provide guaranteed income for life. Still, lump-sum settlements are not always in your best interests. There may be an unseen advantage to waiting for further litigation in the matter. While a Pennsylvania Workers’ Compensation judge must approve all lump sum settlements, the judge is not assessing the fairness of the cash settlement. The judge’s task is to ascertain that the worker understands the settlement and the rights to future benefits and claims that will be given up in exchange for the cash settlement.

CONSULT WITH A PHILADELPHIA AND DELAWARE COUNTY WORKERS’ COMPENSATION LAWYER

If you are considering a lump sum settlement instead of weekly or bi-weekly benefits in your Workers’ Compensation claim, the Media PA Workers’ Compensation attorneys at the firm of Schmidt, Kirifides & Rassias can offer you a combined total of 60 years experience in negotiating settlements with the well-paid lawyers that will undoubtedly be representing your employer.

Our compassionate Reading PA Workers’ Compensation lawyers will explain the process to you, discuss your options, and represent you at your hearing before the judge. The Workers’ Compensation attorneys at Schmidt, Kirifides & Rassias only represent injured workers, and they will do everything possible to ensure that you receive the maximum compensation possible. Don’t delay in seeking representation—once the settlement is approved by a Workers’ Compensation judge, your claim (or the portion you settled) is over, and it is extremely difficult, if not impossible, to reopen a settled case.

SUBROGATION MAY BECOME AN ISSUE IN WORKERS’ COMPENSATION SETTLEMENTS

“Subrogation” refers to circumstances in which an insurance company tries to recoup expenses for a claim it paid out when another party should have been responsible for paying at least a portion of that claim. In Workers’ Compensation cases, it is sometimes required that certain insurance benefits paid to the injured worker be paid back from the worker’s lump sum settlement. For example, if an injured worker is also receiving or is eligible for other types of Disability benefits (such as Social Security, Medicare, Short- or Long-Term Disability or benefits through a Union’s Health & Welfare Fund), these “other” benefit plans may have rights of their own regarding your Workers’ Compensation settlement. They may have the right to be paid back, out your settlement, all or some of what they have paid you.

Additionally, in cases where the injured worker may have a “third-party” lawsuit against an individual or company whose negligence caused the work injury, then the Workers’ Compensation insurance company may have the right to get back some  or ALL of the money they paid to the injured worker out of the money recovered from the third-party lawsuit. The experienced, knowledgeable Reading Workers’ Compensation lawyers at Schmidt, Kirifides & Rassias are focused on maximizing your compensation and have been successful in the past in getting subrogation rights WAIVED.

Pennsylvania Workers’ Compensation lump-sum settlements should be carefully considered. Before you rush into a negotiation, schedule a free consultation with the experienced Delaware County Workers’ Compensation attorneys at the Media, PA firm of Schmidt, Kirifides & Rassias.

We may suggest an investigation of the impact a lump sum settlement may have on the coordination of benefits, or how your overall financial picture may be complicated by other considerations that must be reviewed in addition to Workers’ Compensation matters. Call today via (610) 892-9300 or contact us online to discuss your lump sum settlement option with a knowledgeable Media PA Workers’ Compensation lawyer at Schmidt, Kirifides & Rassias.

Medical Benefit Claims

Sorting through complex rules and exceptions in order to secure Workers’ Compensation benefits is the last thing you need to worry about when you have suffered an injury at work. For example, many employees injured at work believe or are told that they must treat with a company doctor for the first 90 days after they are injured. In Pennsylvania, this is only true if the employer has provided a choice of at least six doctors, and if you have signed documents regarding the “acknowledgement of rights and duties.” The Media, PA Workers’ Compensation attorneys at Schmidt, Kirifides & Rassias urge you to secure legal advice before signing any documents following a workplace accident or injury. Remember, at the point, you are being asked to sign papers about the accident, you and your employer are not necessarily still on the same team. Some documents you sign might jeopardize or even eliminate your rights under the Workers’ Compensation Law.

HOW DO I GET MEDICAL BENEFITS FOR MY WORKPLACE INJURY IN PENNSYLVANIA?

Generally, an injured worker can go to the doctor of his or her choice for medical care, and the employer must pay for the medical care based upon a fee schedule set up by the state legislature in Harrisburg. If there is a billing dispute, or if your employer or its insurance company believes that the care was not “reasonable, necessary or related to” the work injury, the employer is responsible to file documents formally objecting to the care. This is the case in Delaware County, Chester County, Bucks County, Berks County, Montgomery County, Philadelphia County, or in any county across the state.

If your injury was caused by an incident or accident at work, your employer’s Workers’ Compensation insurance carrier cannot simply refuse to pay. The insurance company must file a petition for a hearing before a Workers’ Compensation judge or a Request for Utilization Review. A Decision from the Court or Utilization Review could have a serious impact on your right to past, present, and future medical treatment. You NEED the advice and representation of a Pennsylvania Workers’ Compensation attorney with the knowledge and skill necessary to ensure the Decision is issued in your favor. Once your claim is accepted, your Pennsylvania employer must cover all related medical expenses including your hospital stays, any surgeries or procedures, home nursing care, or modifications to your home necessary to keep you mobile and self-sufficient. You will not have to pay co-pays or deductibles.

OUR PHILADELPHIA & DELAWARE COUNTY WORKERS’ COMPENSATION ATTORNEYS CAN HELP

If you’ve been injured at work, contact our attorneys at the law firm of Schmidt, Kirifides & Rassias. With over 100 years of combined experience, we can help you with your claim. Call (610) 892-9300 or go online to schedule your free consultation at our law offices conveniently located in Media and Philadelphia, Pennsylvania.

Specific Loss Claims

The Media, PA Workers’ Compensation attorneys at Schmidt, Kirifides & Rassias know that amputation or loss of use of a body part due to an accident at work is a life-altering experience. Dealing with the intricacies of the Workers’ Compensation program should not add to your hardship at such a distressing time. An experienced Workers’ Compensation attorney will ease the burden by handling your petition for the different types of benefits that apply to such an injury.

ABOUT WORKERS’ COMPENSATIONS SPECIFIC LOSS BENEFITS IN PHILADELPHIA & DELAWARE COUNTY, PENNSYLVANIA

Specific loss benefits are available under Pennsylvania law in addition to wage loss and medical benefits. You may be entitled to these benefits if your hearing or sight, arm, leg, hand, finger, foot, or toe has lost some or all of its function due to an injury or accident at work. If you have only lost part of the use of a finger, toe, or another part of your body, you may be entitled to receive additional compensation provided under the Workers’ Compensation Act. These benefits are payable for the specific loss of the injured body part and are not payments for lost time from work; specific loss benefits are calculated separately from other types of benefits. Even if you have not missed days at work, you may be entitled to specific loss benefits. The body part affected need not be amputated or rendered useless to be compensable.

Even scars may entitle you to these additional benefits, whether caused at the time of the work injury or as a result of surgery. These disfigurement claims require very specific facts to be proven by the evidence to support an award by the Court. The Pennsylvania Workers’ Compensation attorneys at Schmidt, Kirifides & Rassias are very experienced litigators, who possess the skill necessary to thoroughly present the facts required for a successful outcome in these types of cases.

The legal test for specific loss benefits is whether the body part, hearing or eyesight has been lost for all practical intents and purposes. For specific loss of body parts or eyesight, Pennsylvania Workers’ Compensation law provides for a specific number of weeks of benefits as well as a healing period during which benefits are paid. A maximum of 275 weeks of compensation is payable for scarring of the face, neck, head caused by a work accident, or by surgery necessary after a job-related accident. The Workers’ Compensation judge assigned to your claim decides the number of weeks’ compensation you will receive at his or her discretion.

An individual may have suffered a permanent injury to a particular body part that is not totally disabling but may still be entitled to receive a set sum of benefits that has been pre-determined by the Workers’ Compensation Regulations.

Certain guidelines have been established for those who can receive specific loss benefits, including an explanation of the medical evidence required to support a loss-of-use claim. When you have suffered an injury which you now believe is permanent, you may be entitled to make a claim for a specific loss benefit if you can prove that you have lost the use of 50% or 100% of that body part.

OUR WORKERS’ COMPENSATION LAWYERS WILL REPRESENT YOUR INTERESTS

The complexities of specific loss claims are often best left to an experienced lawyer with up-to-date knowledge of the laws and regulations surrounding Pennsylvania Workers’ Compensation. Based on their detailed knowledge of the Workers’ Compensation Law and their substantial experience and skill in handling and winning these types of claims, our Media, PA Workers’ Compensation lawyers will represent you and fight for the most beneficial outcome possible. Whether you are located in Chester County, Bucks County, Delaware County, Montgomery County, Berks County, Philadelphia County, or any other county in Pennsylvania, call the Media, PA firm of Schmidt, Kirifides & Rassias at (610) 892-9300 or contact us online. Our experienced Media, PA Workers’ Compensation lawyers are happy to offer you a free consultation about your claim for specific loss benefits related to your amputation, hearing or vision loss, or the loss of use of any body part due to a work injury.

Suspension Of Benefits

When you suffer a work-related injury or illness that temporarily prohibits you from performing your job, Workers’ Compensation benefits provide you with benefits while you recover. In time, your physician may agree that you can return to work, but if you are not fully healed from your injury or illness, you need to be sure that your Workers’ Compensation benefits are merely suspended and not terminated.

Seeking the advice of the Philadelphia Workers’ Compensation attorneys at Schmidt, Kirifides & Rassias is essential to ensure that your rights under the Workers’ Compensation Act are protected. When you return to work and resume your full wage, your employer has the right to suspend your Workers’ Compensation benefits. Suspending rather than terminating or modifying your benefits acknowledges the fact that you have not yet fully recovered and that your injury or illness may again prevent you from working. When benefits have been suspended, they can be resumed if your condition changes. Before you sign any agreements to suspend your benefits, however, you need knowledgeable, experienced Workers’ Compensation attorneys to review the agreement to ensure that your benefits are available should you need them again.

PETITION TO FILE FOR SUSPENSION OF WORKERS’ COMPENSATION BENEFITS

When an employer files a petition to suspend your Workers’ Compensation benefits, they agree that you are capable of returning to work and recognize that your work-related illness or injury may require further medical treatments. A suspension also acknowledges that it may be necessary for benefits to resume if your injury or illness prevents you from working again. While the suspension is in place, the employer is required to pay all medical costs relating to the work-related illness or injury. Once in place, a suspension of benefits may remain in effect for up to 500 weeks.

The process for suspending Workers’ Compensation benefits requires the employer to file a petition with the Department of Labor and then notify you in writing within seven days. If you consent to the suspension, you would then sign a Supplemental Agreement, which is a legally binding document. If you choose to challenge the suspension, then you need to notify the Department of Labor within 20 days of receiving notice of the petition. A Supersedeas hearing would then be scheduled within the next three weeks. At the hearing, the employer will provide facts to substantiate the petition to suspend. You will need to provide strong evidence to successfully dispute this petition.

Representation by a Workers’ Compensation attorney, such as the workplace injury attorneys at Schmidt, Kirifides & Rassias, is vital at the supersedeas hearing. If you fail to provide convincing evidence that the suspension should not be granted, the judge will most likely rule in favor of the suspension. Because the judge’s ruling cannot be appealed, it is imperative that our Workers’ Compensation attorneys review all documents before submission at the hearing. Having our experienced attorneys represent you throughout the process will ensure that your Workers’ Compensation benefits remain in effect for as long as you need them.

RETURNING TO WORK AFTER A SUSPENSION OF BENEFIT IN PHILADELPHIA & DELAWARE COUNTY

Once your Workers’ Compensation benefits have been suspended it is important to follow all of the stipulations agreed upon at the time of the suspension. Ongoing medical treatments, tests, and follow-up visits must be adhered to during the suspension period. Your employer may require documentation of all doctor visits, physical therapy sessions, follow-up appointments, and other medical treatments so that your progress can be monitored. This is essential to resuming benefits should you need them.

It is also important to have our attorneys review any and all documents relating to the suspension of benefits before you sign them. Some employers will present documents as a Final Receipt or a Supplemental Agreement that can put your suspended benefits in jeopardy. You could unknowingly sign an agreement that states you are fully healed and without risk of further injury or illness. A careful review of all documents by the Philadelphia Workers’ Compensation attorneys at Schmidt, Kirifides & Rassias can avoid this. If this has happened to you, our attorneys can petition the judge to dismiss the Final Receipt.

THE WORKERS’ COMPENSATION ATTORNEYS AT SCHMIDT, KIRIFIDES & RASSIAS CAN PROTECT YOUR RIGHTS

If you are planning to return to work and face a suspension of your Workers’ Compensation benefits, the Schmidt, Kirifides & Rassias Workers’ Compensation attorneys can ensure that your benefits are protected. Do not risk losing medical coverage for your work-related injury or illness or future benefits should you need them. Our attorneys know the laws regarding suspension of Workers’ Compensation benefits and we understand how important it is to protect you and your family in the event that your injury or illness prevents you from working in the future. Whether you are signing a Supplemental Agreement or facing a Workers’ Compensation judge, our lawyers will provide experienced and knowledgeable representation. Call us today for a free consultation at (610) 892-9300 or contact us online.

The Media, PA Workers’ Compensation attorneys at Schmidt, Kirifides & Rassias know that amputation or loss of use of a body part due to an accident at work is a life-altering experience. Dealing with the intricacies of the Workers’ Compensation program should not add to your hardship at such a distressing time. An experienced Workers’ Compensation attorney will ease the burden by handling your petition for the different types of benefits that apply to such an injury.

ABOUT WORKERS’ COMPENSATIONS SPECIFIC LOSS BENEFITS IN PHILADELPHIA & DELAWARE COUNTY, PENNSYLVANIA

Specific loss benefits are available under Pennsylvania law in addition to wage loss and medical benefits. You may be entitled to these benefits if your hearing or sight, arm, leg, hand, finger, foot, or toe has lost some or all of its function due to an injury or accident at work. If you have only lost part of the use of a finger, toe, or another part of your body, you may be entitled to receive additional compensation provided under the Workers’ Compensation Act. These benefits are payable for the specific loss of the injured body part and are not payments for lost time from work; specific loss benefits are calculated separately from other types of benefits. Even if you have not missed days at work, you may be entitled to specific loss benefits. The body part affected need not be amputated or rendered useless to be compensable.

Even scars may entitle you to these additional benefits, whether caused at the time of the work injury or as a result of surgery. These disfigurement claims require very specific facts to be proven by the evidence to support an award by the Court. The Pennsylvania Workers’ Compensation attorneys at Schmidt, Kirifides & Rassias are very experienced litigators, who possess the skill necessary to thoroughly present the facts required for a successful outcome in these types of cases.

The legal test for specific loss benefits is whether the body part, hearing or eyesight has been lost for all practical intents and purposes. For specific loss of body parts or eyesight, Pennsylvania Workers’ Compensation law provides for a specific number of weeks of benefits as well as a healing period during which benefits are paid. A maximum of 275 weeks of compensation is payable for scarring of the face, neck, head caused by a work accident, or by surgery necessary after a job-related accident. The Workers’ Compensation judge assigned to your claim decides the number of weeks’ compensation you will receive at his or her discretion.

An individual may have suffered a permanent injury to a particular body part that is not totally disabling, but may still be entitled to receive a set sum of benefits that has been pre-determined by the Workers’ Compensation Regulations.

Certain guidelines have been established for those who can receive specific loss benefits, including an explanation of the medical evidence required to support a loss-of-use claim. When you have suffered an injury which you now believe is permanent, you may be entitled to make a claim for a specific loss benefit if you can prove that you have lost the use of 50% or 100% of that body part.

OUR WORKERS’ COMPENSATION LAWYERS WILL REPRESENT YOUR INTERESTS

The complexities of specific loss claims are often best left to an experienced lawyer with up-to-date knowledge of the laws and regulations surrounding Pennsylvania Workers’ Compensation. Based on their detailed knowledge of the Workers’ Compensation Law and their substantial experience and skill in handling and winning these types of claims, our Media, PA Workers’ Compensation lawyers will represent you and fight for the most beneficial outcome possible. Whether you are located in Chester County, Bucks County, Delaware County, Montgomery County, Berks County, Philadelphia County, or any other county in Pennsylvania, call the Media, PA firm of Schmidt, Kirifides & Rassias at (610) 892-9300 or contact us online. Our experienced Media PA Workers’ Compensation lawyers are happy to offer you a free consultation about your claim for specific loss benefits related to your amputation, hearing or vision loss, or the loss of use of any body part due to a work injury.

Termination Of Benefits

If you suffered a job-related injury or illness, you are entitled to receive workers’ compensation benefits. Unfortunately, some employers may search for options to modify or terminate your benefits before you are fully recovered. This is why it is important to know about all your rights when it comes to workers’ comp benefits. If your benefits are threatened by premature termination or modification, you should contact an experienced Philadelphia workers’ compensation attorney today.

The termination of benefits attorneys at Schmidt, Kirifides & Rassias will help you fight to retain the workers’ comp benefits that you deserve. You should not have to wonder about how to pay your medical bills or other expenses after being injured at the workplace. To schedule a free legal consultation to discuss your case, call Schmidt, Kirifides & Rassias at (610) 892-9300 or contact us online.

HOW AN EMPLOYER MAY TRY TO MODIFY OR TERMINATE YOUR BENEFITS

Your employer may file a petition to modify or terminate your workers’ compensation benefits if they believe that you have recuperated enough to return to work. Under other circumstances, an employee may attempt to terminate your benefits to force you into looking for another position.

Depending on the severity of your injuries, your benefits could be helping you deal with a temporary or long-term injury and the expenses related to that injury. This is why you should know about the following methods that an employer may use to cut off your benefits.

INDEPENDENT MEDICAL EXAMINATION

An independent medical examination is a procedure funded by the workers’ compensation insurance company to evaluate the status of your injury. The examining physician will send their findings to the insurance company who will determine whether you can return to work in some capacity. The insurance company may also use this information to suggest cheaper forms of medical treatment or to suspend your benefits entirely.

IMPAIRMENT RATING EVALUATION

According to Pennsylvania’s Department of Labor and Industry, impairment rating evaluations are medical exams that are necessary for a workers’ comp insurer to determine the level of impairment that an injured worker is experiencing. These examinations typically occur after the worker has received 104 weeks of total disability compensation. If your level of impairment is judged below a certain rate, your benefits could be halted or modified.

Impairment rating evaluations were deemed unconstitutional by Pennsylvania’s Supreme Court in 2017. However, an altered version of the law was reinstated in 2018.

VOCATIONAL COUNSELING

Your employer’s insurance company may try to evaluate your ability to work by requesting a vocational evaluation. This will require you to have a meeting with a labor expert chosen by the insurance company. The evaluator will assess your work experience and ask you a series of questions to determine fields that you are eligible to work in.

The issue with vocational counseling is that the jobs suggested by the expert may not be positions you are guaranteed to be hired for. Additionally, the expert may advise you take a position that does not interest you, or that is not remotely related to your experience. For example, if you have experience as a nurse, you will likely avoid positions that require you to work as a security guard. The expert may even suggest that your injury would not prevent you from working certain jobs.

It is important to note that statements that are made to a vocational expert may also be used to alter or terminate your benefits.

If your employer or their insurance carrier requested you to perform any of the above activities, they are considering modifying or terminating your benefits. Before you complete any of these tests or meetings, you should speak with an experienced workers’ comp attorney. Our firm can help you prepare for a vocational meeting or medical examination and even accompany you to ensure that your rights are not violated.

It is also important to note that these are not the only methods that an employer may use to cut off your compensation benefits.

OUR WORKERS’ COMPENSATION LAWYERS CAN HELP YOU FIGHT THE TERMINATION OF YOUR BENEFITS

If your employer is attempting to terminate your workers’ comp benefits, you should consult with an experienced Delaware County termination of benefits lawyer today. At Schmidt, Kirifides & Rassias, our dedicated legal team possesses over 60 years of combined legal experience that we will use to help you reclaim your workers’ compensation benefits. Our firm provides legal services to residents of Philadelphia, Delaware County, Media, Bucks County, and various other areas throughout southeast Pennsylvania. To schedule a free legal consultation to discuss your benefits, call Schmidt, Kirifides & Rassias at (610) 892-9300 or contact us online.

Wage Loss Claims

Employees who have been injured on the job may collect Workers’ Compensation wage loss benefits while they heal and recuperate. The Pennsylvania Workers’ Compensation Laws provide very detailed mathematical formulas to calculate the injured worker’s “average” salary, and the corresponding Workers’ Compensation benefit rate. These calculations MUST include bonuses, commissions, board and lodging and even income from any second (or third) jobs the injured worker may have had at the time they were injured.

The largest “bracket” of earnings will result in a compensation rate that is two-thirds of the worker’s “average” earnings. There are exceptions, of course, to the two-thirds rule. There is a statutory maximum wage loss benefit ($888 in 2012), which is obviously disadvantageous to highly paid employees. Depending on a few other factors, disabled workers who earn less than the average statewide worker will receive a fixed rate or 90% of their prior earnings. In addition, there are calculations and rules that affect your total benefits paid for wage loss, dependent upon the number of total days you miss work due to your injury. The Media, PA Workers’ Compensation lawyers at Schmidt, Kirifides & Rassias will explain everything you need to know, and can ensure that your employer’s carrier does not miscalculate the wage loss benefits to which you are entitled.

DISTINGUISHING PARTIAL DISABILITY AND TEMPORARY TOTAL DISABILITY WAGE LOSS IN PENNSYLVANIA

Partial Disability: If you work in Chester County, Delaware County, Philadelphia County, Montgomery County, Bucks County, Berks County, or any county across Pennsylvania, a determination will be made after you suffer a work-related injury as to whether you have a partial disability (meaning that you have the ability to return to work in some jobs even though you have not fully recovered from your injury). This determination may lead to a reduction in your wage loss benefits. You should anticipate such a proceeding by your employer if you are examined by an “insurance company doctor” and then receive a form called “Ability to Return to Work.”

In other cases, employers may offer a light duty job if you are found to be partially disabled. Even though this job may pay less than you were earning before your accident, you will still receive two-thirds of the difference from the Workers’ Compensation carrier. If you don’t believe that you are capable of the light duty job because of your accident-caused disability, you can contest the employer’s efforts to force you back to work, or their threat to stop or reduce your benefits. This petition will require the testimony of a doctor on your behalf, and competent legal advice can make the experience less intimidating and more successful in the long run.

Temporary Total Disability: These wage loss benefits were discussed above and refer to the benefits you collect when you cannot work at all immediately following your accident or injury. While there is no actual expiration date for temporary total disability benefits, you may be requested to submit to a re-evaluation of your disability status after 104 weeks. If, at that point, the determination is made that you are less than 50% disabled, your benefits will be subject to a maximum cap of 500 weeks at the same rate of pay.

As you can see, there are many calculations involved in protecting your rights, and the paperwork alone can be daunting. On top of this, some employers will try to reduce or terminate your benefits, miscalculate benefits, refuse to recognize all of your injuries as work-related, or ask you to sign documents that can limit your rights to benefits.

OUR PHILADELPHIA + DELAWARE COUNTY WORKERS’ COMPENSATION LAWYERS WILL PROTECT YOUR BENEFITS

An experienced, tenacious work injury attorney like those at the Media, PA, law firm of Schmidt, Kirifides & Rassias can make all the difference when it comes to maximizing your wage loss benefits following an injury on the job. Important documents such as a “Notice of Compensation Payable,” an “Agreement for Compensation,” or a “Notice of Temporary Compensation Payable” are much more easily understood and appropriately responded to with the help of a knowledgeable Philadelphia Workers’ Compensation lawyer. Call Schmidt, Kirifides & Rassias today at (610) 892-9300 or contact us online for a free consultation with a Pennsylvania Workers’ Compensation attorney and get the answers you need for your wage loss benefits claim.

Contact Us

Mark Schmidt
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44 E Front Street, Media,PA 19063

(610) 892-9300

info@skr.legal

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