Today’s post is from Glenn Neiman who is a workers’ compensation lawyer in Pennsylvania. His state has already gone through many of the “reforms” that we are now seeing in Michigan. I think he offers a great perspective that can help with the challenges we are now facing. Specially, dealing with the issue of wage loss and disability. Read his comments below.
As I am sure many of you know, workers compensation laws vary widely from State to State. Unless your injury involved more than one State (called concurrent jurisdiction), giving you a choice, you, like most injured workers, are stuck with the workers comp laws in your State. Since we only handle Pennsylvania workers compensation cases, we can only speak in detail about that system.
The workers compensation system in Pennsylvania is foreign in many ways to the system you find in Michigan. While there are certainly similarities, there are also vast differences. As a global statement, both the PA system and that in MI, are called wage loss States, meaning the primary inquiry for eligibility for benefits is whether the injured worker is losing wages as a result of their injury (thus, the Courts are not overly interested in what the injured worker is losing in lifes activities, outside work).
Once an injured worker has a claim accepted in Pennsylvania, generally, the workers comp insurance carrier needs the permission of a Workers Compensation Judge (WCJ) to reduce or stop the payment of total disability benefits. The situations when the insurance company can legally stop payments without the approval of a WCJ are very few (when the injured worker returns to work at greater than pre-injury wages, or when the injured worker is incarcerated after a conviction are two such exceptions to the rule).
After an injured worker in PA receives total disability benefits for two years, the insurance carrier can send him or her for an Impairment Rating Evaluation (IRE). This is a process where a physician selected by the Pennsylvania Bureau of Workers Compensation examines the injured worker and calculates the whole body impairment rating caused by the work injury. If the whole body impairment rating is less than 50% (as we find in over 99% of work injuries in PA), the disability status changes from total to partial. There is no change in the amount of benefits received by the injured worker, but the change of this status puts a limit to how long the injured worker can receive the wage loss benefits in PA.
Aside from getting an IRE, the workers comp insurance carrier in PA can reduce or stop ongoing benefits by demonstrating work is available to the injured worker through the use of a Labor Market Survey, or by actual job referrals (though that is rarely done since major changes to the Pennsylvania Workers Compensation Act in 1996). Proving that the injured worker has fully recovered from a work injury also can lead to a stoppage of benefits (and that, unlike the other situations, would also put a stop to medical benefits). One other area, in which there has recently been a great deal of appellate litigation in Pennsylvania, is the stoppage of benefits due to the retirement (or voluntary withdrawal from the labor market) of the injured worker.
As you can imagine, whether your case involves Michigan law, or Pennsylvania law, the area of workers compensation is very complex. There are many rights and responsibilities of the injured worker. Trying to handle a case on your own is often a dangerous plan. It is always wise to at least consult with an attorney experienced in workers compensation law in the State where your claim is based.
(Glenn C. Neiman, Esquire, is a Partner at Brilliant & Neiman LLC, a firm serving the needs of injured workers in Southeastern and Central Pennsylvania. The firm limits its practice to representing injured workers in PA workers compensation cases. Since 1992, Mr. Neiman has been practicing primarily in the field of PA workers compensation. A member of the esteemed faculty of Lawline.com, Mr. Neiman has also lectured at the request of the Bucks County Bar Association and the National Business Institute. Mr. Neiman is a past Chair of the Workers Compensation Section of the Bucks County Bar Association. You can find Brilliant & Neiman LLC on the web at www.bnlegal.com, and can see their blog at www.pennsylvaniaworkerscompensationlawyerblog.com/)