The meniscus is an important piece of cartilage between your shin and your thigh that pads the impact between these bones. Every step, flex, and bend can lead to terrible pain if you tear your meniscus, something that is all too common during work tasks.
If your meniscus tear was work-related, you can get medical treatment and lost wages covered through Workers’ Compensation. Filing your claim on time and following through with all medical appointments is vital to keeping your claim. Our lawyers can advise you on whether you qualify for benefits and fight to get full damages paid for your injury.
For your free case evaluation with the Certified Pennsylvania Workers’ Compensation Lawyers at Cardamone Law, call (267) 651-7945 today.
How to File a Claim
Most claims will involve at least one of these claims, though all three might be needed in some cases.
Initial Claim with Employer
Your Workers’ Comp claim is initiated by reporting your injury to your employer within 21 days (though you may still file within 120 days). They then report the injury to their Workers’ Comp carrier and start the insurance claim.
They should accept or deny the claim within 21 days, with some potential extensions allowed. If they deny you or fail to respond, you can file a formal claim.
Formal Claim Petition
Claim Petitions can be filed after a denial. These go to the Workers’ Comp Office of Adjudication in the Department of Labor and Industry. A Claim Petition puts the claim before a Workers’ Comp Judge to decide, instead of giving the employer/insurance carrier the final say.
Lawsuits
You cannot sue your employer or coworkers for injuries, but you may sue outside third parties who caused your injuries. Lawsuits can be filed alongside Workers’ Comp claims.
Lawsuits pay additional damages you cannot get in a Work Comp claim, such as pain and suffering – something that might be very important to a painful injury like a meniscus tear.
What Happens After Filing?
After filing, expect these steps:
Continue Getting Medical Care
You must continue to treat your injuries, keep all doctor’s appointments, and attend recommended physical therapy. In the first 90 days, you must use providers approved by your employer and their carrier, or else coverage can be denied.
Evidence Collection
Our lawyers will collect evidence like records and security footage. We can also depose witnesses and seek medical records and doctors’ reports to prove your injury claim.
Workers’ Comp Hearings
The WCJ holds a formal hearing where evidence is received, and victims may be asked to testify. There may be multiple hearings, but the final “hearing” is the Workers’ Comp version of a trial.
Trial for Lawsuits
If you can file a lawsuit, that may go to trial before a judge and jury. In this trial, we need to prove the defendant was at fault and how much your damages are worth.
Decisions and Settlements
In a Workers’ Comp claim, the WCJ decides the claim and orders benefits granted if you win. In a trial, the jury determines fault and damages.
At any point, claims can settle if the other side is willing to agree to pay benefits/damages. Some Workers’ Comp claims also settle after you are already on benefits, cashing out any remaining benefits in one lump sum instead of continuing to administer the claim.
What Benefits Can You Get Through Workers’ Compensation for a Meniscus Tear?
Three areas of benefits may be available:
Medical Benefits
All medical care should be covered to treat your meniscus tear. This can involve anything from emergency care to MRIs and other imaging to potential surgery, along with physical therapy. Even a total knee replacement may be needed if the damage is severe enough and impacts your knee function enough.
Wage-Loss or Indemnity Benefits
If you cannot work at all, you get 2/3 of your pre-injury wage while you cannot work. These wage-loss/indemnity benefits are capped at the statewide average wage and have a floor at half that or 90% of your pre-injury wage, whichever is lower.
If you work to some extent despite your injury, you get 2/3 of the difference in pre- and post-injury wages instead.
Specific Loss Benefits
Specific loss benefits are only paid for permanent injuries listed in the Workers’ Comp Act. The only one that might apply to a meniscus tear is permanent lost function, though that is often a far more serious injury than just a meniscus tear alone.
If these benefits are available, they are paid at 2/3 of your pre-injury wage with a cap at the statewide average wage and a floor at half that for a number of weeks listed in the statute, based on the specific injury.
What Damages Can a Lawsuit Add?
By filing an injury lawsuit, you can potentially recover these damages that would be unavailable in a Workers’ Comp claim.
Keep in mind that lawsuits may also recover damages you already got paid through Workers’ Comp. When this happens, you pay them back to the Workers’ Comp insurance carrier through a process called subrogation.
Remaining Lost Wages
Workers’ Compensation only pays around 2/3 of your lost wages. Lawsuits can recover full lost wages, covering what Workers’ Comp does not. The trade-off is that you need to prove fault first to win a lawsuit.
Economic Damages
Other damages, such as damaged clothing or home accommodation costs and childcare during hospital visits, may also be covered.
Pain and Suffering
Pain and suffering is an important area of damages you cannot get paid through Workers’ Comp. The only way to claim damages for the physical pain, mental suffering, lost function, and other intangible effects of a torn meniscus is a lawsuit.
FAQs for Meniscus Tears in Pennsylvania
Does Workers’ Comp Cover Everyone?
All employees who work in Pennsylvania should be covered under their employer’s Workers’ Comp insurance from the first day of employment. This does not include federal workers, who use a different system, or certain workers excluded from the system.
Independent contractors do not get Workers’ Comp, but the classification should be based on actual facts, not what the employer calls you or how you are paid.
Can You File for Workers’ Comp if Your Injury Wasn’t Your Employer’s Fault
Yes. Workers’ Comp covers injuries caused by outside parties and even accidents that are no one’s fault.
What if You Caused Your Own Injury?
Similarly, Workers’ Comp also covers injuries victims cause themselves. As long as you did not cause your own injury intentionally, through illegal acts, or through drug/alcohol use, it should be covered.
Call Our Workers’ Compensation Lawyers in Pennsylvania Today
For a free case evaluation, call Cardamone Law’s Philadelphia Workers’ Comp attorneys at (267) 651-7945.
