DeMarco & DeMarco, P.C.

Frequently Asked Questions about Pennsylvania Workers' Compensation:

Q. What should a worker do if he or she suspects that an illness or injury is work related?

A. Often, a worker develops a lingering illness which is difficult for the family physician to diagnose and he is treated with medications that alleviate the symptoms but general malaise and weakness continue.

If the family physician did not inquire into the details of the patient's occupational duties and environment, the worker may continue to be exposed to harmful substances when the best treatment should have been removal from the exposure. Under the above circumstances, pulmonologists or occupational medical specialists should be consulted and workers compensation benefits would be available if it can be determined that the illness or injury resulted from the exposure.

More...

Frequently Asked Questions about Pennsylvania Automobile Accidents:

Q. Having read the difference between "no-fault" and "at-fault," what kind of State is Pennsylvania?

A. Pennsylvania is a confusing combination of both "no fault" and "at fault." The law is so complicated that even attorneys don't understand the complexities of Motor Vehicle Financial Responsibility Act, so it is strongly recommended that you consult an attorney who concentrates on automobile accidents in the event of an injury from an automobile accident. Regarding medical expenses and wage loss benefits, insurance is "no fault," and each insured looks to his/her own automobile policy for benefits, regardless as to the cause of the accident or whether the insured was personally responsible for his injuries.

Regarding pain, suffering, and other non-economic loss, benefits are "fault" based, and the person who acted negligently and caused another's injuries is responsible for compensating the injured for his/her damages.

More...

An on-the-job injury usually occurs in the presence of the other workers and the necessity for medical treatment and disability is apparent. As a result, the insurance carrier will issue a Notice of Compensation Payable within twenty-one days. A Temporary Notice of Compensation Payable permits the insurance company to issue the notice prior to completing its investigation retaining the option of revoking its acceptance of liability. The insurance carrier can also issue a Notice of Compensation Denial, which form requires an explanation for its reason for the denial. In that event, the worker must file a petition before the Pennsylvania Bureau of Workers' Compensation and the petition is assigned to an Administrative Law Judge for determination. Hearings are held at various locations in Philadelphia and the surrounding counties. The hearings are recorded and a final determination is made based on the Judge's finding of facts and conclusions of law. The Pennsylvania Rules of Evidence are applied with regard to the admissibility of evidence.

More...

An injured worker is not only required to utilize physicians named by his employers for the first ninety days of treatment, he must also submit to periodical independent medical examinations. Although the insurance company labels the examination "independent," the physician is chosen and paid by the employer, and is more accurately a "defense" medical witness. The fee paid is considerably more than that paid by medicare, HMO's, or the regular patients of the physician. If the physician is required to testify in workers' compensation litigation, he is usually paid $3000.00 or more for a deposition which rarely takes longer than one hour. The total time spent by the physician is rarely more than two hours.

It is not surprising that insurance companies frequently choose physicians whose opinions are most likely to be favorable to the employer and provide evidence for terminating a worker's ongoing wage loss benefits. One insurance company physician admitted that ninety percent of his "independent" medical evaluations resulted in an opinion of full recovery from the injury.

More...

Workers' compensation law comes into play any time an injury occurs on the job. Even employers are careful to instruct workers to report all injuries so that an employee who fails to do so raises a serious doubt when he attempts to submit a wage loss claim with an old injury that was never reported. Even if a worker does not seek medical treatment or loses any time form work, the accident should be reported to the worker's immediate supervisor.

Often, a worker injures his back, arm, or shoulder and continues to work causing further aggravation of the original injury. This may occur over a period of days, weeks, months, or years. When the worker finally reports the injury, the claim is seriously questioned because suspicion arises that the injury occurred off the job.

More...

Workers' compensation reform has gradually reduced Pennsylvania workers' right to benefits and increased the need for the worker to be informed about his rights under the Workers' Compensation Act. With the original passage of workers' compensation laws in 1915, workers were required to give up their right to sue their employer for pain and suffering from injuries caused by the employer. In return, employers were required to pay medical bills and two thirds of lost wages irrespective of whether the employer or the employee caused the injury.

More...