• Do I have to go to an independent medical examination (IME)?

An independent medical examination is allowed under the Workers' Compensation Act where an insurance company or your Employer wants an "independent" opinion from a physician who is not treating you. Often the physicians employed by the insurance companies are not independent at all. However, you are required to attend at least one independent medical examination at the request of the Employer. They are required to provide you with transportation or reimburse your mileage expense.

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• How often can my Employer or insurance company send me for an independent medical examination (IME)?

The Workers' Compensation Act allows for one (1) independent medical examination. After that, the Employer must establish some need to have any subsequent examinations. However, in practice, the Employers or Workers' Compensation Insurance Companies commonly are allowed to require up to two (2) independent medical examinations per year. If your medical condition has stabilized, they may be only allowed one (1) per year.

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• How long must I treat with the company's physician?

The Workers' Compensation Act states that work-related expenses will only be paid of you treat with a physician that is designated by your Employer for the first ninety (90) days following the first date of medical treatment. However, this requirement is only effective if your Employer has properly notified you of the list of designated physicians. If you were not properly notified, or if you did not sign a document confirming this requirement, you should give us a call because you may not be required to treat with the company physician at all.

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• Am I required to communicate with a rehabilitation nurse that is hired by the insurance company?

No. The Workers' Compensation Act does not require you to discuss your confidential medical information with anyone other than your physician. If a rehabilitation nurse calls you, or comes to your office visits with your doctor, you are allowed to instruct your physician to not communicate with the rehabilitation nurse. Likewise, you are not required to speak to the rehabilitation nurse. Your physician will send copies of your medical records to the Workers' Compensation Insurance Company. This i show they get their information on your condition.

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• Do I need to hire a lawyer to have my questions answered?

Absolutely not. Folks call our offices every day for general information without any charge or obligation. We take phone calls on a daily basis from injured workers that have no need to hire us. We gladly answer questions or will send you written information to review. We believe that information is power. We conduct educational seminars all over Central Pennsylvania for free. Please feel free to call us with any questions or for a schedule of our next educational seminar.

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• My employer caused my accident. Can I sue for pain and suffering?

Unfortunately, your employer is immune from suit, meaning you can not sue it at all, except for Workers' Compensation benefits. This is a "trade off" under the Workers' Compensation Act. Workers' Comp benefits are due automatically, regardless of fault, but they are limited in scope. You cannot sue a co-employee for his or her negligence either.

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• What about the situation where someone else injures me while I am working?

While you cannot sue your employer or a co-employee, there are circumstances under which you can sue another person or business. This is commonly called a "third party action".

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• How do "third party actions" work?

The two most typical cases are ordinary negligence cases and products liability cases. An example of an ordinary negligence case is when you are driving a vehicle for your employer (it might even be your own vehicle) and you are injured by the negligence of another driver. An example of a products liability action is when you are injured by a defective machine that was not designed or built by your company.

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• What kind of damages can I collect in a "third party action"?

In third party actions, you can make a claim for all types of damages such as pain and suffering, medical bills, full wage loss and loss of earning capacity, loss of life's pleasures, loss of consortium, scarring and disfigurement, etc. Be aware, however, that Pennsylvania has a Motor Vehicle Law that strictly governs lawsuits arising out of motor vehicle accidents. We can advise you concerning the interplay between these actions and a Workers' Compensation claim.

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• Does this mean I can sue for Workers' Comp benefits AND sue a third party for other damages?

Yes, but you may NOT obtain what is known as "double recovery". As a general rule, if you sue a third party for all of your damages, you must immediately repay your employer or its Workers' Compensation carrier for any payments they have made on your behalf. Worse than that, your employer might receive a credit against future benefits. We can advise you on how the two processes work together and how to settle your claims to maximize your recoveries in both actions.

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• What happens if I am fired?

If your employer decides to fire you after a work injury, there should not be any change in your Workers' Compensation benefits. if you are off of work when you are fired, and receiving Workers' Compensation benefits, your benefits should continue without any change. If you are working when you are fired, you may be entitled to have your Workers' Compensation benefits reinstated. You should call our attorneys to discuss the details.

If you are fired solely because you reported a work injury, you may be entitled to Workers' Compensation benefits and additional damages. Again, you should call one of our attorneys to discuss your rights and the circumstances.

Employers commonly "trump up charges" against injured workers as an attempt to fire them and avoid any liability. If you feel that your employer is setting you up to be fired, you should call our attorneys immediately to assess the situation. If your employer is looking for reasons to fire you, or has fired you under false pretenses, your employer may try to use that situation to avoid liability for your work related injury.

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• Can the insurance company stop my benefits for no reason?

Unfortunately, we get many calls from injured workers who have been threatened by insurance adjusters who ell the injured worker that benefits may be stopped unless they comply with specific requests by the insurance company or employer. If an insurance adjuster, or your employer, ever threatens to stop your Workers' Compensation benefits for any reason, this is a clear sign that you need to discuss your case with an experience Workers' Compensation attorney.

Neither your employer nor their insurance company can stop your Workers' Compensation benefits unless they have either your agreement or an Order of Court from a Judge after a hearing. There are two exceptions to this rule. First, an employer can suspend your benefits if you are receiving certain other disability benefits or pension income. Second, they can lower or stop your benefits if you have returned to work and you are earning money. However, even under these exceptions, you must be given written notice of any modification or suspension of your benefits.

Again, if someone is threatening to lower or stop your compensation benefits, it is important that you speak to our attorneys.

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• Where are Workers' Compensation hearing locations?

The Workers' Compensation Bureau has many hearing locations all over the state of Pennsylvania. Most major cities have a hearing location somewhere within the city. The location of a hearing is based upon your zip code. If your case requires litigation, the hearing location will be at a city that is closest to your zip code. The location has nothing to do with the location of your employer, or the attorneys in the case.

When we represent injured workers in Pennsylvania, we travel to their homes and their city to represent them. For a listing of the geographic areas where our attorneys routinely practice, click here.

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• What do I do about trouble getting my medications?

If you are having trouble getting your medications, you are not alone. One of the most common complaints that we hear from callers is difficulty with getting prescription medication.

Workers' Compensation carriers must pay for any medication that is reasonable, necessary and related to your work injury. If they choose not to pay for a medication, they must have a medical basis to refuse that payment. Your insurance company may seek a review from an independent physician regarding whether or not your medications are appropriate. You must be given notice if that occurs. If you receive notice that your employer is seeking a "Utilization REview" you should contact our attorneys immediately to discuss your rights and obligations. If a utilization review occurs, and your physician refuses to cooperate, you may have important medical treatment permanently terminated.

Helping our clients obtain their necessary medications is a daily event for our attorneys and our excellent staff. We work with our clients and their physicians to make sure that their necessary medications are promptly available to them. We also work with a company called Injured Workers' Pharmacy that provides medications even where there are legal disputes over the medications. WE are not in any way associated with Injured Workers' Pharmacy. Rather, we simply find that this company does provide an important service to our clients. If you would like to learn more about Injured Workers' Pharmacy, click here.

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