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My Notice Of Compensation Payable Doesn’t Have The Correct Description Of My Work Injury- What Should I Do?

The simply answer is: speak with an experienced Pennsylvania Work Comp Lawyer.

Once you are injured at work and give notice of your injury to your employer, the workers’ compensation carrier or third party administrator (which is like an insurance company but they don’t spend their own money) has 21 days to issue an acceptance of your claim, a temporary acceptance, or a denial. If your claim is accepted, the document you will receive is a Notice of Compensation Payable or a Temporary Notice of Compensation Payable. If you look at the upper left hand corner of the document, you will see a heading called “Injury Information“.  Under that, there will be “Body part (s) affected” and “Type of injury” listed. Because it issued unilaterally and within a 21 day period (often, it’s much later than this but let’s be kind and assume the insurer does the right thing- hypothetically speaking), the injury is usually minimized. For example, with a back injury, we typically see “lumbar sprain/strain” as the description of the injury. In many cases, an injured worker finds out, after an MRI or EMG study, that her injury is more severe.  But the insurer or TPA can point to the Notice of Compensation Payable- which is the controlling document until challenged successfully in court, and deny medical bills that cover treatment for diagnoses other than a “sprain” or “strain”.

It is this very dynamic that causes an enormous amount of litigation in Pennsylvania Workers’ Compensation cases. Think about it- if the injury is labeled a “strain”, it will be much easier for a panel doctor or “Independent Medical Examiner” (we all know they are hand picked and not “independent”)  to conclude the injured worker is fully recovered. Likewise, if the employer makes a job offer to an injured worker, under the pretense that the injury was a minor strain or sprain, the judge is more likely to believe the job is within the physical capabilities of the injured worker. Or, if an insurer denies a medical bill for treatment which calls the injury “lumbar radiculopathy“, it will have a leg to stand on if the NCP says the injury was merely a strain or sprain.

The way to stave off some or all of these circumstances is to hire a PA Work Comp Lawyer and have him or her file a Petition to Review to challenge the injury description. The litigation is expensive and sometimes lasts for six to twelve months (in my office, we cover all the costs so our clients pay nothing), but if the description of the injury is successfully challenged, the value of the case is enhanced- sometimes dramatically.

It may not seem fair that the employer/insurer/tpa can unilaterally decide what to call the injury. But this is the law in Pennsylvania. In some cases, the insurer will pay for treatment even if the diagnoses do not correlate 100%. But many injured workers get lulled into a false sense of security only to later be confronted with multiple petitions which are all grounded in the notion that the injury was a mere contusion or strain versus something more insidious such as a fracture or herniation.

The decision whether to forge ahead and challenge the description of injury is one that should be discussed with a PA Work Comp Attorney. There can also be Medicare implications too when settlement is discussed.

For more information about Notice of Compensation Payables, injury description, or Pennsylvania Workers’ Compensation in general, call or email Michael Cardamone at 215-206-9068 or Michael@cardamonelaw.com for a free consult.

Pennsylvania Work Comp Attorney

The Cardamone Law Firm

The Firm For Injured Workers In Pennsylvania

Awards & Recognitions

Pennsylvania Workmans Comp Attorney
Philadelphia Workmans Comp Lawyer

Cardamone Law Has Negotiated Some of the Largest Workers’ Comp Settlements in Pennsylvania

$2.2 Million
Spinal Injury
$897,000
Lower Back Injury
$650,000
Lower Back Injury
$550,000
Neck Injury
$425,000
Leg Injury
$375,000
Knee Injury
$325,000
Ankle Injury
& Hundreds More Cases
$2.2 Million
Spinal Injury
$897,000
Lower Back Injury
$650,000
Lower Back Injury
$550,000
Neck Injury
$425,000
Leg Injury
$375,000
Knee Injury
$325,000
Ankle Injury
& Hundreds More Cases

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"Cardomone law is absolutely fantastic! They are very responsive and helpful and they will fight to get you what you deserve. Shirley is also very helpful whenever you have any questions! Best Law Firm around!"

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"Cardamone Law Firm were very helpful to me since day one. Michael and Shirley are very dedicated to my case giving me updates, answering my questions, being honest with my case, and getting the maximum amount favorable to my case. Thank you so much for your service and dedication and helping me to achieve not only your case but to guide and refer me in other needs too! You guys are the best law firm friendly and dedicated. I will recommend to anyone."

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"Michael won my workers comp case after my employer insurance denied my claim."

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"[They] did an excellent job in getting me financially compensated in a fairly short amount of time."

"I recently had a work related injury and was receiving Workers' Compensation (medical benefits only). Soon after I was fired, so I contacted Paul Silver at Cardamone Law Firm who did an excellent job in getting me financially compensated in a fairly short amount of time. Paul and his assistant Shirley always responded to any questions I had about the case in a very short amount of time. Thank you for helping me with this difficult case."

- Robin C.
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"Mike Cardamone is amazing. He is "hands down" one of the best lawyers I've ever had the privilege of knowing. He is very kind, understanding, knowledgeable in his field, always very thorough and helpful. He was extremely professional and someone who truly cares about his clients. I felt completely at ease with him. He was a pleasure to work with, explained everything in detail, as well as answered all my questions with knowledge and care. If you want someone you can trust, who communicates every step of the way, will fight for you and make sure you win your case, he is it! I will refer all my family and friends to him. Thank you so much Mike, for everything. I appreciate all your hard work and dedication in helping me."

- Allie M.
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Without a doubt YOU are the best!!!

"Without a doubt YOU are the best!!! Every person who is in the horrible position of being injured at work should have someone as kind, compassionate and knowledgeable as you on their side. You never once made me feel like I was one of a hundred other clients. I always knew you had my back! You answered calls and emails at all hours. You fought every fight for me so I only had to worry about getting well. Behind your nice, calm face there’s a pit bull ready to take on any employer or judge. I can never thank you enough."

- L. Edall
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"Michael is simply the best! He was there for me from day 1 till the end, and we won the case!! He is always available to help. I had a gazillion questions and he would answer them one by one. He's a great lawyer and I feel lucky to have found him online from reading other outstanding reviews about him. Believe me, they're true!"

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"Great attorney, handled case quickly and efficiently. I would recommend him and would use him again. He was always available to answer any questions we had. Thank you, Mr. Cardamone."

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