• Claim Petition

We file this petition on your behalf when the insurance company refuses to recognize the fact that you have been injured at work. You will know this if you have received a Bureau of Workers’ Compensation document titled “Notice of Denial”. If you have received this document, then we need to file a Claim Petition on your behalf. It is simply a document that alleges you were injured at work and we want the insurance company to recognize the injury.

Once the petition is filed with the Bureau of Workers’ Compensation, it is assigned to a workers’ compensation judge, who will then schedule a hearing. Usually, at the first hearing you will have to testify about how you injured yourself at work. We will also have to inform the judge of the name of a treating physician who will be supporting our case. Therefore, it is extremely important that you seek medical attention if you have injured yourself at work. We cannot win your case if you do not have a treating doctor who will testify that you injured yourself at work.

Usually, after the Claim Petition is filed, the insurance company will send you for an Independent Medical Exam. This exam is done by a doctor hired by the insurance company to give them the opinion they want, which is usually not in our favor. This doctor will also, eventually, testify that you either did not suffer an injury at work or that while you may have suffered an injury at work, your current complaints are not related to the work incident.

After all of the evidence has been presented, the judge will have to make a decision. You can expect a petition like this to take at least 6-9 months before we receive a decision.

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• Petition to Reinstate Compensation Benefits

This petition is filed with the Bureau of Workers’ Compensation when you have been back to work with restrictions, but are no longer able to continue working either because the Employer took away your job (laid off) or you physically can no longer do the work. This type of petition will require your testimony to establish why you are no longer working and the testimony of a treating physician to establish that you were still working under restrictions.

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• Termination Petition

Most people think of being fired when they hear “Termination Petition”. However, under the workers’ compensation act, the insurance company files a Termination Petition when it believes that you have fully recovered from the work injury. It will usually file this type of petition after you have been examined by an independent medical examiner, who is hired by the insurance company to provide them with an opinion of full recovery. This doctor will usually indicate that whatever was wrong with you is no longer present or that any ongoing symptoms you have are not work-related. A typical example of this that we see is with low back or neck injuries. Let say you hurt your low back and now you have pain going down your legs. You have had MRIs that indicate you have a herniated disc and degenerative changes in your spine. Degenerative changes means that you have arthritis. Prior to this injury, you never had any pain going down your legs. However, an IME doctor will do a cursory exam of you and go over the medical records. Despite what you tell him, he will indicate that your complaints of pain stem from the degenerative changes, which were not caused by the work injury. That way, the insurance company can file the Termination Petition to try to stop your wage loss and medical benefits.

We fight this type of petition by presenting your testimony of how the injury happened and what type of ongoing pain you still have. We also fight the petition with testimony from a treating physician who must testify that you have not fully recovered from the work injury. It is possible to defend against a Termination Petition without the testimony of a treating physician, but such cases are rarely successful. That is why it is extremely important to have a treating physician.

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• Suspension Petition/Modification Petition

With a suspension petition, the insurance company is arguing that while you may not be fully recovered from the work injury, you can go back to work and earn as much money as you were prior to the work injury. A modification petition is based upon the fact that you can do some type of work but not earn as much as you were prior to the work injury. With either of these petitions, it does not matter that you may be going back to work with restrictions. What matters is that the insurance company may be able to prove to a judge that you are capable of earning some type of money. If the insurance company is successful with this, then your wage loss benefits will either be suspended or reduced, but the insurance company will still be responsible for your work-related medical treatment.

In order to be successful in a Suspension/Modification Petition, the insurance company must offer you a position back with your employer, find you new work or establish that you have an earning capacity. If the insurance company offers you work with your old employer or attempts to find you work with a new employer, there are certain rules that they must follow. If the insurance company is trying either of these items, you need to contact us immediately to make sure your rights are protected.

If the insurance company is going to try to determine if you have an earning capacity, they will start with requiring you to sit down with a vocational expert. You should understand that this person is not hired to find you a job or give you advise on getting retrained in a new vocation. This person is hired by the insurance company to give them information so that it can attempt to suspend your benefits. When you are contacted to set up a vocational meeting, you should immediately contact us to make sure that the insurance company is abiding by the workers’ compensation act.

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• Petition to Review a Notice of Compensation Payable

A Notice of Compensation Payable (NCP) is the document that is on file with the Bureau of Workers’ Compensation that officially recognizes your work injury. It is important that this document accurately reflect your actual injury. Too often, the insurance company file the NCP and indicates that the injury is only a strain or sprain when in fact you may have torn a ligament, herniated a disc or broken a bone. Insurance companies will often refuse to pay for medical treatment when it is for something that they have no recognized. For example, the NCP may state that you suffered a low back strain. However, your doctor diagnoses you with a disc herniation and wants to operate to relieve your pain. The insurance company may refused to pay for the treatment because the accepted injury is a low back strain and an operation is not necessary to treat a low back strain. That is why we will review the NCP and compare it with what your doctor has diagnosed you with to make sure the insurance company is playing by the rules. If they refuse to voluntarily amend the NCP, then we will file a Petition to Review the NCP to force them to do so.

We will also file a Petition to Review the NCP if the insurance company has incorrectly calculated your wage loss benefits. Again, we will provide all of the data to the insurance company to establish that the wage loss benefits are incorrectly calculated and ask them to voluntarily amend the NCP. However, if they refuse, then we will file the Petition to force them to do so.

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• Penalty Petition

A Penalty Petition can be filed any time the insurance company does not follow a judge’s order or the terms of the workers’ compensation Act. The judge could award a penalty of up to 50% of the amount of benefits at issue.

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• Petition for Approval of a Compromise and Release

If you have agreed to settle your case, then we must file a Petition for Approval of a Compromise and Release. The Bureau of Workers’ Compensation then assigns the petition to a judge, who will schedule a hearing. This hearing is designed for you to testify that you understand you are settling your case. The judge does not play a role in determining whether this is a fair settlement for you or the insurance company. His role is to simply make sure that you understand that you are waiving your rights under the workers’ compensation act to any further benefits related to the work injury.

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