Recovering from a work injury can be an uphill battle. You may face long-term care needs, potentially including physical therapy and rehabilitation. All of this care can be incredibly expensive, and it may keep you from returning to work, meaning you cannot afford other daily costs either.
That is where Workers’ Compensation is a lifesaver. Benefits can pay for medical care and around 2/3 of lost wages. They can even pay you specific payments for certain serious injuries and losses. However, you should have a lawyer help you get these benefits.
For your free case review, call Cardamone Law’s Certified Pennsylvania Workers’ Compensation Lawyers at (267) 651-7945 today.
Why Do I Need a Workers’ Comp Lawyer?
There are three major reasons you need a Workers’ Comp lawyer to help with your case:
Your Disability
If you are disabled right now, then it might be impossible to actually handle your case on your own. The evidence collection, the documents the court needs filed, and the rigors of negotiating a claim just might not be in the cards now, but you need the benefits now. Our lawyers can do this for you so you can focus on getting better.
Costs
There are upfront costs that can be prohibitively expensive when filing a claim. Your employer has their insurance carrier funding things like medical exams that they can demand you undergo, but there is no fund to help you get your own exams. You may also need to pay other costs for evidence collection, such as deposition costs.
Our attorneys can cover these up front and get reimbursed by the defendant when we win your case.
Procedures
Workers’ Compensation is quite a different system from traditional lawsuits and even traditional insurance claims. The system is difficult, even for lawyers who might have moderate experience with these claims. Our lawyers are certified specialists, meaning we have passed additional tests and proven our experience and skills in Workers’ Compensation law.
Qualifying Injuries
An injury can qualify for Workers’ Compensation if it happened within the scope of your employment. Employees get injured in all kinds of ways, and there is no requirement that there was a mistake or violation that led to the injury; all work-related accidents should be covered.
However, there is no coverage for these causes:
- Victims intentionally injuring themselves
- Injuries caused by drug use or alcohol use
- Injuries caused by illegal activity (usually misdemeanors or felonies; traffic violations should not be enough).
This may include all kinds of accidental injuries:
- Broken bones
- Head and brain injuries
- Neck, back, and spinal cord injuries
- Soft tissue injuries
- Amputation and crush injuries
- Serious facial scarring
- Lost senses or bodily functions.
There are even “specific loss” benefits that can be paid to cover…
- Amputation
- Permanent lost function
- Lost hearing
- Lost vision
- Serious facial scars.
Qualifying Workers
Most employees in the state will qualify for Workers’ Comp coverage from their employer. There are a few workers – such as realtors – who are excluded, and federal workers use a different system. Otherwise, employers are required to cover nearly anyone who fits the definition of “employee.”
This does leave out independent contractors and other self-employed workers. The distinction between an independent contractor and an employee is not usually W-2 vs. 1099, but rather how much control the worker has over their own daily operations. If you work for yourself and control your own work, you might be an independent contractor.
Contractors are also usually paid under a company name and perform a trade or task that is different from their employer. This can get muddied in some industries like construction and transportation, so always check with a lawyer what your status should be.
What Doctors Can I See for a Work Injury?
Workers’ Compensation should cover all medical care needed to treat your injuries, but there are of course additional complications.
Listed Providers
First, in the initial 90 days, you usually need to treat with a provider from an approved list your employer or their insurance carrier provides. This should be available at your workplace or upon demand.
That list must include a few doctors, and the variety is often enough to get you the care you need. However, if you need to see a specialist or get a second opinion on surgery, you can see unlisted providers. You may still need to use a listed surgeon to carry out the procedure, but the second opinion can help you decide if surgery is necessary or not.
Approved Providers
Second, usually only care from a licensed provider is covered, and only if the care was prescribed. This may allow you to see some traditional medicine providers, chiropractors, acupuncturists, and other atypical providers.
Payments
Payment for medical marijuana is also potentially allowed, but it is often reimbursed instead of being paid directly to the provider. Otherwise, payments usually go straight to the doctor rather than to the worker unless they are part of a settlement.
Do I Need to See a Doctor for Workers’ Comp?
You will typically need to see multiple doctors in the course of getting your treatment and your benefits. You certainly need to see at least one doctor to get the treatment you need, though you might see other providers for treatment as well (e.g., physical therapists, psychiatrists, etc.) On top of that, you will also potentially undergo exams to determine the extent of your disabilities.
Your employer can request medical exams – at their expense – to confirm your disability and determine what restrictions are placed on your work. In some cases, you may be able to return to work with certain restrictions determined by these doctors.
After 104 weeks on benefits, they can also send you to Impairment Rating Evaluations to check your disability status. A disability rating under 35% whole body impairment often means changing you to partial disability status, which leaves you with only 500 more weeks of benefits.
Call Our Workers’ Compensation Specialists in Plymouth Meeting
To get a free case review, call Cardamone Law’s Workers’ Comp lawyers at (267) 651-7945.
