Important Tips for Every Injured Worker
- Treat the employer as your enemy, unless proved otherwise.Many employers, even good ones, turn into your enemy after you are involved in a work injury. Even if you have been working at the same company for ten or twenty years without ever having an accident, your employer may not believe you when you and your doctor say you cannot return to your pre-injury job after a work injury. This comes as a great shock and disappointment to many workers, but it is a fact that needs to be faced.
- Learn your rights regarding medical treatment. Many employers give their workers inaccurate information about their rights and obligations. For example, the law requires that employers provide their workers with a list of five doctors that they can see for the first ninety days after a work accident. If they don’t give the worker a list of five doctors, the worker is free to choose any doctor the worker wants. However, many employers simply tell the worker where to go and do not advise them of their rights. The only way to avoid acting on false information is to consult with an attorney who specializes in handling workers’ compensation matters. As the laws change and as new cases are decided, you need a lawyer who handles many workers’ comp cases and who keeps up with new developments in Pennsylvania workers’ comp law.
- Make sure that you have notified the proper personnel about your injuries. Under the law, you have an obligation to notify your employer about your injury within 120 days of the injury. The law has interpreted that to mean that you must make sure your supervisor knows about the injury – and not just any co-employee. Don’t assume that because you have been out of work for some period of time after an injury that you have satisfied this requirement. Make sure you tell your supervisor, and that your supervisor fills out a form called an Employer’s Report of Occupational Injury and Disease. Ask for a copy of that form, and keep it for your records.
- Do not let your employer harass you with phone calls. After an injury, your employer may call you on the phone to find out how you’re doing. While the first phone call may seem to be out of concern for your well being, at some point it will become clear to you that the employer has other motives. You may feel that you have to respond. This is another place where a workers’ compensation lawyer from Fenner & Boles can help. Our attorney can contact the employer and demand that the employer direct all further communications with you through the attorney’s office. This will give you great peace of mind, and allow you to focus on getting medical care and getting better.
- If the panel physician gives you advice that you do not agree with, seek treatment with your own doctor. Sometimes, your employer will refer you to a medical provider who gives you advice that simply seems wrong to you. For example, you go to the doctor and tell him that your lower back is killing you, and the doctor recommends that you take the rest of the day off, but go back to work full duty tomorrow without recommending any diagnostic or medical testing. The doctor may not even have asked you any questions about your job duties. Based upon your experience with other doctors outside a workers’ compensation context, you believe this to be false. Or based upon how you are feeling and your knowledge of your job duties, you know you will not be able to walk back onto the job the next day and perform a day’s work. Make an appointment to see another doctor. If the employer gave you a list of five doctors, you can go to one of the other doctors on his list or to a doctor of your own choice. If you have a list and don’t go to a doctor on that list, the doctor you see will not be able to bill the workers’ compensation insurance carrier for the office visit. Still, you may have other insurance to cover the visit, and if you don’t, in the long run, it will have been worthwhile for you to pay for the office visit yourself rather than risk having no accurate medical documentation of the extent of your injuries for the first 90 days. And if you do not have a list, the doctor you see will be able to bill the workers’ compensation insurance carrier for your office visit, even if it is not the doctor to whom your employer referred you. If you have questions about what to do, contact a worker’s comp lawyer at Fenner & Boles.
- If the employer accepts your claim with a notice of compensation payable, review the document carefully for mistakes. If your employer and its insurer accept your claim by issuing a document titled Notice of Compensation Payable, and you start receiving benefits, you may be tempted to ignore the language in the Notice of Compensation Payable. That may be a big mistake. Before you can safely conclude that the Notice of Compensation Payable is accurate, you must review it very carefully for the following information:
- Did the employer accurately calculate your wages for purposes of establishing your compensation rate?
- Did the employer accurately state the areas of your body that were injured, and list all of the diagnoses related to your work injury?
- Did the employer correctly state the date of injury?
If any of this information is incorrect on the Notice of Compensation Payable, a workers’ compensation attorney can get them corrected. Often, the attorney can write to the insurer and get the information corrected without drawn-out legal proceedings. Other times, legal proceedings will be necessary. However, you will do yourself a great disservice in the long run if you ignore the mistakes because you do not feel that they are causing you any harm. The most common mistake is when an employer issues a Notice of Compensation Payable, but doesn’t list all of the areas of injury. Under such circumstances, the employee may be getting his work loss benefits and his doctors may be getting paid for office visits and physical therapy. However, as soon as the doctor recommends surgery, the insurer may refuse to pay for the treatment, claiming it is not related to the workers’ compensation injury that they agreed to compensate. The only way to avoid being in either of those circumstances is to seek legal representation as soon as you notice that the Notice of Compensation Payable does not list all of your injuries.
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- If the employer issues a notice of compensation denial and you are injured, seek legal representation even if the employer has permitted you to return to a light duty job. Sometimes, an employer will issue a Notice of Compensation Denial, while allowing the worker to work in a light-duty capacity and paying for medical treatment. Under such circumstances, it may be tempting to not want to “rock the boat.” If you are injured and hurting and cannot perform your pre-injury job, this is a mistake. Why? Because if your employer decides down the line to terminate your employment without cause (which the law permits under most circumstances since most Pennsylvania employees can be hired and fired “at will”), you will not be able to collect workers’ compensation benefits. Also, if your employer decides not to pay for your medical treatment, you will have no legal recourse. Often, employers will pay for medical treatment that is not costly, even though they have issued a Notice of Compensation Denial, but as soon as the doctor recommends surgery, they refuse to pay for the treatment. The only way to avoid being in either of those circumstances is to talk to a workers’ compensation lawyer as soon as the Notice of Compensation Denial is issued.
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Be prepared for the medical examination requested by the insurance company. If you are out on workers’ compensation for any extended period of time, your employer or its insurer will at some point ask for you to be examined by a doctor of their choice. Often, they will refer to this examination as an “Independent Medical Examination,” which may mislead you into assuming that the doctor who examines you is truly independent and unbiased. That would be a false assumption. These are commonly referred to by lawyers who represent injured workers as “defense medical examinations.” In many instances, the doctor performing the examination receives a sizable percentage of his income from examining injured workers on behalf of insurance companies. It stands to reason that if the insurance company chooses that particular doctor to perform the “independent” examination, it is because they have reason to believe that they will get an opinion favorable to them. This is not always the case; however, there is no way for you to know going into the examination whether that particular doctor is one who would allow his biases or loyalties to the insurance company to overshadow his obligations as a doctor. If a doctor wants to support the insurance company’s position at the expense of the worker, he may misrepresent the information you provide in your history or in his report of your physical examination. Sometimes, this is done by asking misleading or incomplete questions.
One way to protect yourself is to be sure that you have a witness to the examination. It will be your word against the doctor’s word if you claim later on that you did not tell him something, or that he did not do a certain test that he claims to have done. A witness can go a long way to preventing such an occurrence. Another way to protect yourself is to review all of the facts of your case with an attorney before you attend the examination so that you are prepared for the questions you will be asked. The practice in our workers’ compensation law firm is to make sure our clients are well prepared before they go into the medical examination. We send them a specially-prepared pamphlet dealing with medical examinations, and review with them all of the facts relating to their particular case. Where necessary, we also send a witness with specialized knowledge, such as a nurse or investigator, to the medical examination to make sure that no unanticipated problems cause long-term harm to their right to benefits or compensation.
- Do not settle your claim without first seeking the advice of a workers’ compensation attorney. Sometimes, an insurance company may offer you some amount of money in settlement of your claim, even if you do not have a lawyer. In our opinion, it is never a good idea to settle a case without a lawyer – primarily because you will not know what it is you are giving up unless a lawyer has carefully reviewed your medical records, your pre-injury job, your prior job experience, the sequence of events from the time you were injured up to the present, and evaluated them in light of current law. So do yourself a favor: Don’t get seduced by the fact that someone has offered you what seems to be a sizable amount of money. Review all of the facts with a lawyer with extensive experience representing injured workers before you take the next step. If the offer was a fair one, the insurer should have no problem holding the offer open until you have had an opportunity to consult with an attorney. And if they tell you they won’t hold the offer open, you can draw your own conclusions.
For more information, see our Workers’ Compensation Information Center and our Workers’ Compensation e-newsletter.
