Tag: Workers’ Compensation

On Saturday June 7, 2014 I spoke at a quarterly meeting of the Teamsters, Graphic Communications Unions in Philadelphia, PA. Members present were from DC-9/Graphics Communications Union 14-M President, Kurt Freeman and Graphics Communications Union 16-N, President, Joe Inemer. I spoke about difference between third party cases and Workers Compensation claims. I spent time educating the union leaders regarding how to protect their members when injured in a work related accident and the recoveries that could be obtained both under their workers’ compensation claim and the third party claims. It is important for unions to understand the difference between third party claims because each allows a worker to recover differently for their losses. Third party claims are when someone other than the employer causes your accident, even though the accident may occur at work. Workers’ compensation claims are when you are injured at work but the injury is not the fault of anyone else (third party). Joe Inemer commented, “Your presentation was very informative. When it concluded, we continued to discuss what a great presentation it was.”

Employees who are injured in the course and scope of their employment are entitled to weekly wage loss benefits and medical benefits. To determine the correct amount of weekly wage loss benefits payable to given individuals, their average weekly wage must be calculated. When an injured worker does not have a fixed income or salary, the Pennsylvania Workers’ Compensation Act focuses on the amount of time the employee actually worked for the employer immediately preceding the work incident and the amount of wages earned during that period of time. Under these circumstances, where varied wages are involved, the act has delineated three different methods for calculating an individual’s average weekly wage.

The Compassionate Allowance program expedites disability decisions for persons with the most serious, and often fatal, conditions to ensure that these persons receive their disability decisions quickly, rather than the months or years it takes for most disability claims to be decided upon. The Compassionate Allowance program identifies claims where the applicant’s disease or condition clearly meets Social Security’s standard for disability.

In my previous posts, I discussed the sometime difficult issue of whether you are “in the course and scope of your employment” at the time an injury occurs. A recent case highlights the difficulty.

Under Workers’ Compensation, the employer is responsible for medical care and treatment that is reasonable and necessary as a result of the work injury. What happens when new symptoms arise sometime after the actual work incident? Are the new symptoms considered part of your work injury?

If you are injured while commuting to or from work, you generally cannot make a Workers’ Compensation claim. Commuting to and from work is not considered in the course of employment (“coming and going rule”). The following are exceptions to this general rule:

The Workers’ Compensation Act provides that an employee’s workers’ compensation claim may be resolved, in whole or in part, through a Compromise and Release of your workers’ compensation benefits. “Compromise and Release” is the name given to the settlement documents when you settle your claim. The settlement is referred to as a “C&R”.

The issue of whether a travelling employee’s activity is in furtherance of the employer’s business and affairs, and therefore in the scope of employment, is difficult to determine. If a travelling employee is injured after setting out on the business of the employer, it is presumed that the employee is in the course and scope of employment when the injury occurs. However, this is not without limits. The courts have to look at the employee’s activity and the circumstances surrounding the injury event. They must look to see if the employee is engaged in an activity that was reasonable and incidental to the employment duties at the time. If the court cannot find that the activity is reasonable and incidental to his/her job, then any claim will be denied.

Under Pennsylvania Workers’ Compensation Law, employers and insurers can be subject to monetary penalties. The Law provides that the Court has the power to impose penalties for a violation of any provision of the Workers’ Compensation Act, Rules and Regulations. Employers and insurers may be penalized up to ten percent (10%) of an amount awarded, plus interest. This penalty may be increased to fifty percent (50%) in cases of unreasonable or excessive delays.

The Pennsylvania Workers’ Compensation Act provides that certain injuries are eligible for specific loss awards. A specific loss in Workers’ Compensation is when you lose use of a specific body part. In that case, the Workers’ Compensation Act has predetermined a set amount of weeks that you are permitted to receive payment, based on the body part you lost.