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5 Myths about your Pennsylvania Workers' Compensation Claim

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There are many myths and misconceptions in the world of workers' compensation law.  Here are 5 myths regarding Pennsylvania Workers' Compensation claims:

1) You can treat with whatever doctor you want, whenever you want ...

Unfortunately, you are obligated to treat with a panel doctor for the first 90 days following the work injury.  Very often the list is made up of urgent care facilities such as Worknet, Concentra, or WorkFirst, but you may see that your doctor is also on the panel list.  After the 90 days has elapsed, you may seek treatment from the medical provider of your choice, and the employer will have to pay for all reasonable, necessary and related treatment, regardless of the provider.  

2) You are entitled to recover pain and suffering for a work injury...

The exclusivity provision of the Pennsylvania Workers' Compensation Act essentially prevents an injured worker from suing their employer for tort actions related to the work-related injury.  Therefore, an injured worker is prevented from suing their employer, or co-worker(s) for pain and suffering damages.  If you are injured in a motor vehicle accident, however, a suit against another driver, or a third party, is a claim that you can pursue in addition to the workers' compensation claim you have from being hurt at work.

3) You must return to work if the Independent Medical Examiner says you can...

Very often the Independent Medical Examiner will release you to return to work in a modified capacity, or even that you have fully recovered from the work injury and thus are able to return to work.  Just because the IME doctor is concluding that, it is more important to follow your doctor's restrictions.  It is advised that if you receive a "Notice of Ability to Return to Work" and a job offer from your employer of the insurance company, that you discuss these immediately with your attorney because a failure to appropriately respond to a job offer may jeopardize your benefits.  If you do not return to work because of the restrictions placed on you by your doctor, and you notify the employer of this, they would have to petition the court to try and modify, terminate or suspend your benefits.

4) You must allow the Nurse Case Worker to all of your medical appointments...

The Nurse case worker and the adjuster will both try and make it seem that you do not have a choice in allowing the nurse case worker into your appointments, but you absolutely can bar them from attending your appointments.  If you do not want the nurse case worker present, let your lawyer know and they most certainly can write a letter to make this happen on your case.  You may still see the nurse case worker after your appointments (waiting to talk to the doctor) but they will not be in your appointments.  Many doctors will honor your request to not discuss your claim if you ask, so if you are concerned about this also discuss this issue with your medical providers.

5) You should handle your case without an experienced attorney...

The insurance company will certainly have an attorney who specializes in workers' compensation, while this is probably your first workers compensation case. You will have many question, such as "what are your rights?"  "How do you know if they are paying you the right amount of money?"  "Am I entitled to additional benefits?" These are questions that you need to have answered. There are most likely additional issues that you would never even consider, because you are not an attorney.  Most workers' compensation lawyers will not charge you for a consultation, and a fee is not collected until the insurance company files something to alter your benefits, or a settlement is negotiated. Hiring an attorney early on in your claim process allows you to have the peace of mind that your rights wont be affected without your knowledge and also for you to have all of your questions answered by someone who is familiar with your case.

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