Pennsylvania Work Injury & Workers’ Comp. Lawyers
Pennsylvania’s Workers’ Compensation law is a comprehensive legal system that provides compensation and coverage to all employees in Pennsylvania who get injured on the job. Even with this process in place, greed-driven employers and insurance providers are a reality, and they often seek to diminish these claims and block adequate coverage.
Our boutique law firm, Cardamone Law, dedicates 100% of its resources to fighting these cases on behalf of injured workers. Michael Cardamone and Paul Silver are two of the most brilliant Workers’ Comp attorneys in Pennsylvania. Equally skilled at both negotiations and trials, they use decades of experience to create strategies that result in success.
For a free case assessment, call Cardamone Law’s Certified Pennsylvania Workers’ Compensation Specialists at (267) 651-7945.
The Broad Definition of “Injury” for Workers’ Comp in Pennsylvania
When most of us think about “work injuries,” we think about accidents that happen while at the workplace. However, in 1972, the Pennsylvania Workers’ Compensation Act eliminated the requirement of an “accident” and instead substituted the term “injury.”
Here, “injury” has been broadly interpreted to include any injury to an employee – regardless of any previous physical conditions – arising in the course of employment and related to the work being done. That includes aggravation, reactivation, or acceleration of preexisting injuries or disorders, as well as death resulting from an injury.
An injury does not even need to be pinpointed to a specific event as long as the injury arises in the course of employment and is related to the employment. Cumulative or repetitive injuries that occur over a period of time are also compensable under the Act.
The term “injury” also includes “occupational disease” under § 108 of the Act. This definition includes some particular types of illness, such as lead poisoning, silicosis, or asbestosis, but it does also have a catch-all provision. To qualify for a work-related illness under this part, you usually need to show that your illness would not have occurred were it not for your exposure to dangerous chemicals or substances at work and that you have a higher incidence of this illness in your work than in the population in general. This links your illness, cancer, poisoning, or other health issue to your work conditions and helps block out cases where the illness could have come from circumstances outside of work.
Injuries “in the Course of Employment”
An injury does not need to occur at the employee’s worksite. There are many situations where an off-site injury will still qualify you for Workers’ Comp.
Injuries that occur while working from an employer-approved home office can also be compensable. Even momentary departures from work – such as using bathroom facilities – do not “remove” an employee from being in the course of employment. Employer-run gyms on premises that employees are encouraged to use have also been held to be “in the course of employment.” Additionally, injuries from a company softball game on a company-sponsored team have also been held to be compensable, as have injuries while attending company-sponsored picnics.
An employer’s “premises” has even been broadly construed to include parking lots and building lobbies.
“Good Samaritans” are also covered under the Act. An employee injured while going to the aid of a person at the scene of an emergency is not deemed to have “abandoned” the course of employment, still entitling them to compensation.
As mentioned above, a work-related illness also has to be linked to your work conditions. If you cannot show that your work was the actual, factual cause of your illness, then you cannot get coverage for the work illness.
What is a “Certified Specialist” in Pennsylvania Workers’ Compensation Law?
Most of the time, lawyers are not allowed to call themselves “specialists” or advertise that they “specialize” in a particular practice area. This is a special certification in Pennsylvania that deems lawyers actual experts in Workers’ Compensation.
The first examination for this title was held in 2012, and Attorney Cardamone was among the small percentage of lawyers who took and passed the exam. He was again recertified in 2018.
If you are a work injury lawyer, having this certified distinction is critical as it shows the public which attorneys are highly experienced and competent with Pennsylvania Workers’ Compensation cases. The certification board allows the successful attorneys to use special language in their marketing so as to highlight their credentials and advertise their expertise.
To earn this coveted status, an attorney must establish that they have met the following prerequisites:
- Been admitted to practice in the Commonwealth of Pennsylvania;
- Been actively engaged in the practice of law for a minimum of five years;
- Devoted a minimum of 50% of practice to the specialty field of Workers’ Compensation;
- Directly participated over the past 5 years in a minimum of 7 of the following categories of Workers’ Compensation litigation:
- Claim petitions;
- Fatal claim petitions;
- Specific loss claims;
- Utilization review;
- Occupational Disease claims under § 108 of the Workers’ Compensation Act;
- Termination Petitions;
- Suspension Petitions;
- Modification Petitions;
- Compromise and Release proceedings;
- Appeals before the Workers’ Compensation Appeal Board;
- Appeals before the Commonwealth Court; and
- Appeals before the Supreme Court.
- Directly participated in both direct and cross-examination of at least 25 medical, vocational, or other expert witness depositions;
- Submitted three samples of any of the following documents authored by the attorney:
- Proposed Findings of Fact, Conclusions of Law, and Briefs submitted to a Workers’ Compensation Judge;
- Briefs filed before the Workers’ Compensation Appeal Board;
- Petition for Supersedeas and/or Answer to Supersedeas before the Workers Compensation Appeal Board and/or Commonwealth Court; or
- Briefs filed with the Commonwealth Court;
- Showed proof of completing the designated number of Mandatory Continuing Legal Education (MCLE) hours in the field of Workers’ Compensation over the specified period; and
- Passed a four-hour examination on topics related to Workers’ Compensation.
As you can see, the certified status does not come easy. Meeting these qualifications is a tall order to fulfill before you can call yourself a Certified Pennsylvania Workers’ Compensation Specialist like we can. Many law firms on TV or other media may claim to be experts in Worker’s Compensation cases, but at Cardamone Law, this is all we do.
Can I Be on Workers’ Comp Benefits Forever in Pennsylvania?
If a Workers’ Compensation claim is granted, you can continue to get benefits for the rest of your life, but this very rarely happens. Even when it is necessary, it is often difficult because Workers’ Compensation carriers have many weapons in their arsenals to terminate or reduce benefits.
The Workers’ Compensation carrier will often try to find reasons to deny a claim, and an experienced Workers’ Compensation attorney can often intercede to block these denials, appeal issues, and get the carrier to commence payments.
A worker can receive “total disability benefits” when they are totally disabled, and theoretically, these benefits can continue for the rest of the worker’s life, but that is extremely unlikely.
Our experienced Workers’ Compensation attorneys have the knowledge and experience to evaluate the worth of a claim properly and to know whether to settle or continue to litigate a case. In many cases, settling for a lump sum can help prevent the insurance carrier from later trying to cut your benefits, as you have already secured the money.
When Are You Deemed “Unable to Work” Because of an Occupational Injury in Pennsylvania?
An employee is entitled to be paid benefits at the total disability rate when the employee is either totally impaired from performing any and all occupations or is unable to perform the job they held at the time of injury. When an employee proves unable to do the same work they were doing when they were injured, the employer has the burden to prove that other work is reasonably available and that the employee is physically and vocationally capable of performing that work instead.
An employee who voluntarily retires from the workforce rather than being forced into a compulsory retirement because of a disabling injury is not entitled to benefits.
Benefits for Injured Workers Under Pennsylvania’s Workers’ Comp
Workers’ Comp pays four areas of benefits to injured workers, though you usually will not qualify for all four at once. You can receive medical benefits to cover your care costs, ongoing wage-loss benefits to cover your lost pay at a certain rate, “specific loss” benefits for amputation and similar injuries, and death benefits for a lost loved one. Usually, the specific loss benefits are paid as “scheduled” benefits instead of keeping up with specific lost wages, and death benefits are obviously unavailable if you are alive and drawing on the other benefits.
Medical Benefits
Workers’ Comp pays for your medical care following a work injury. This should cover 100% of the medical costs with no deductibles or out-of-pocket expenses, saving you from having to worry about where the funds for your treatment will come from or whether your insurance will approve certain procedures. As long as your doctors find the care necessary for your injury or condition, everything should be covered.
This also covers the consequences and side effects of your injury. For example, if you suffered a serious injury and now face PTSD symptoms, ulcers, panic attacks, or other effects because of the trauma of the injury, your benefits should cover mental health treatment, anxiety medication, surgery to repair ulcers, and any other care downstream of your initial injury.
Wage-Loss Benefits
Lost wages are inevitable if your injury is serious enough to keep you from working. In some cases, you might be well enough to go back to work while still receiving medical care, in which case the medical care would be covered, but lost wages would not.
When you do miss work, your wages should be reimbursed at 66 2/3% of your average weekly wage. This average takes the wages you received before the injury and uses them in the calculation, accounting for things like varied pay from week to week or seasonal changes in payment amounts.
Benefits are capped at a level set by the Commonwealth each year, with a maximum benefit of $1,325 per week in 2024. There are also other income thresholds where the benefit climbs up from 66 2/3%, capping out at 90% of your wage for lower earners. Our attorneys can help you understand how your particular average wage will be calculated and what range your income falls into, thus helping you determine your total benefits for lost wages.
Also keep in mind that your wage-loss benefits go down for “partial disability.” If you can still work to some extent, you will likely receive under 66 2/3% of your wages but still receive something to account for the fact that your earning power is indeed reduced because of your injury.
Note that these benefits are not paid for the first 7 days of injury unless you are unable to work for 14 or more days. At that point, the initial 7 days’ benefits are paid retroactively.
Specific Loss Benefits
In cases of amputation, permanent loss of function in a limb or body part, or certain levels of intense scarring, Workers’ Compensation will award you a number of weeks of benefits laid out in the Act. These are essentially “cashed-out” benefits that pay a certain number of weeks’ worth of 66 2/3% of your wages, according to the “schedule” listed in the statute.
Under this rule, loss of an eye results in 275 weeks of benefits, loss of an arm results in 410 weeks, and loss of a hand results in 335 weeks, as some examples.
Total loss of function in the limb counts the same as actual loss or amputation. For example, if your eye is blinded by chemicals or your arm is crushed by machinery, function might be totally lost, but the body part is still physically intact. You do not need to elect an unnecessary amputation to get benefits; these issues count as though you lost the body part.
Death Benefits
The family of a deceased worker killed in a work accident or because of a work-related illness can receive benefits for their loss. This includes a reasonable fee for burial expenses as well as replacement wages paid to the family. Usually, these death benefit wages are going to be lower than 66 2/3% paid to the family, but the wage used in the calculation is not necessarily the deceased worker’s average weekly wages. According to § 307 of the Act, the minimum wage they can use is 50% of the average wage in the state, potentially bumping up the wage used in this calculation if the deceased worker was a low earner.
The victim’s spouse and children can receive benefits, with a higher percentage of wages paid to families with more children/other dependents. In many cases, stepchildren and even siblings and disabled family members who were dependent on the deceased can be included in these calculations, too.
Can I Return to Work After a Work Injury, and What Happens When I Do?
If an employee goes back to work – either for their original employer or another employer – the employee will no longer be entitled to receive total disability benefits. If you can work, the law does not let you continue to claim to be totally disabled.
If the employee returns to work making as much money as before the injury, indemnity benefits can also be suspended. However, if an employee returns to work making less money than before the injury, benefits will change from “total disability” to “partial disability” benefits. This is usually 2/3 of the difference between your average weekly preinjury wages and your new weekly wage. These partial disability benefits are allowed for a maximum of 500 weeks.
Can the Insurer Try to Terminate or Suspend My Benefits if I Do Not Get Medical Treatment in Pennsylvania?
The insurance company may try to terminate Workers’ Compensation benefits if the employee fails to comply with medical treatment ordered by a doctor. If it is proven that the reasonable medical treatment the doctor ordered is essential for the patient’s recovery but then you do not follow through with the treatment, a Workers’ Compensation Judge may terminate or suspend their benefits.
A Judge will often weigh the benefits versus the risks of the proposed treatment as part of this decision.
In any case, you should always follow through with the prescribed treatment for your injury. If you are going to have to miss appointments for good reasons, then you should schedule a make-up appointment right away. If you attend all scheduled therapy, take the medication prescribed to you, and follow through with any necessary surgeries, it will be harder for insurance companies to pull your benefits.
Will I have to Attend an Independent Medical Exam for Work Injuries in Pennsylvania?
Another tool that insurance companies use to avoid paying benefits is available when the employee ignores a request to have a medical examination.
Under Pennsylvania law, the injured worker is required to submit to an independent medical examination by a physician chosen by the employer every 6 months while they are on benefits. The insurance company can petition to suspend benefits if the employee refuses to comply with the request.
Losing Benefits if You Go to Jail
The Workers’ Compensation carrier can also suspend benefits if an employee is sent to jail after a conviction. This is based on the theory that a person who commits a crime has voluntarily removed themselves from the workforce. However, pre-trial incarceration does not stop benefits; there needs to be a conviction first.
Do I Have to Fill Out the Forms that Workmen’s Comp Sent Me?
Another standard method that insurance companies use to suspend benefits is when an employee does not complete and return employee verification forms their employer sent them. These forms require that the employee report any jobs obtained after the injury.
Both sides of the forms must be completed and signed and returned to the insurance company within 30 days or the company can stop Workers’ Compensation benefits until the forms are completed and returned.
Converting Benefits from Total to Partial as a Result of an “Impairment Rating” Evaluation
After a worker has received total disability benefits for 104 weeks, the Workers’ Compensation insurance company is allowed to require the employee to submit to an Impairment Rating Evaluation. If the evaluating physician determines that the degree of total body impairment is less than 35%, the insurance company can convert benefits to “partial disability” even though the employee has not returned to work. Indemnity benefits can only continue for an additional 500 weeks.
Compromise and Release Agreements for Workers’ Comp in Pennsylvania
Never agree to accept a lump-sum settlement from the insurance company before talking to an experienced Workers’ Compensation attorney. This is another common method that insurance companies use to pay an employee less than what they should be entitled to.
Entering into a “Compromise and Release Agreement” will usually preclude an employee from ever reopening the claim, even if the employee’s condition worsens or the employee discovers that the injury was much more serious.
Once you accept a settlement, your case is over – which insurance companies often use to their advantage. Having a lawyer on your side can help keep you from accepting a settlement that is too low.
Death and Survivor Benefits Under Pennsylvania Workers’ Compensation
In cases of a fatal injury or illness, the employee cannot keep receiving future indemnity or medical benefits. However, your family might be entitled to survivor benefits.
The family of a deceased worker is also entitled to benefits, as discussed above.
Do I Need a Pennsylvania Workers’ Comp Lawyer?
There are many ways insurance carriers and employers can seek to shut down your benefits. Benefits can also be terminated, suspended, or modified by a Workers’ Compensation Judge if it is proven that the employee has fully recovered or is capable of gainful employment. An experienced Workers’ Compensation attorney should be retained to defend against all of these denials and refusals, especially since they often require complex litigation.
Employees should consult an experienced Philadelphia Workers’ Compensation attorney before they agree to sign a “Final Receipt” or “Supplemental Agreement” by the insurance company. When an employee signs a Final Receipt, it means that the worker agreed to stop receiving benefits. Your attorney can help you recognize these traps and avoid anything that might compromise your benefits. Similarly, signing a “Supplemental Agreement” may give up the employee’s rights to continued benefits even if the employee should have been entitled to continue to receive benefits without the agreement.
An employer seeking to terminate Workers’ Compensation benefits bears the burden of proving that the employee’s disability has ceased or that any current disability arises from a cause unrelated to the employee’s work injury.
Understanding Your Rights as an Injured Employee in Pennsylvania
If an employee feels that the injury may have some relationship to their job, they should promptly consult a Pennsylvania Workers’ Compensation attorney for guidance in filing a claim.
As seasoned work injury attorneys, we are equipped with the expertise and knowledge to analyze your case and build a strategy likely to win you the best compensation. As a boutique law firm, we provide our clients with a higher level of dedicated services that most large law firms cannot match. We are also financially leveraged to go against the big guys and come out winning.
Why I Love Being a Certified Workers’ Compensation Attorney
I have passed a first of its kind and challenging Pennsylvania Workers’ Compensation certification exam that only a small number of Pennsylvania Work Comp Attorneys sat for. As a result of this achievement, Cardamone is now Certified as a specialist in the practice of workers’ compensation law by the Pennsylvania Bar Association’s Section on Workers’ Compensation Law as authorized by the Pennsylvania Supreme Court.
This achievement stems from Cardamone’s years of dedication to injured workers. Unlike most other PA Work Comp Attorneys, Cardamone only practice in PA Work Comp Law- and only represents injured workers- never employers or insurance companies.
I’ve always liked the idea of being a lawyer. That’s probably because my dad was a lawyer. Even as a kid, I could see the passion overflowing in him. He would come home for dinner around 630 every night and he talked my mom’s ear off from the moment he walked in the door- about a trial he had, a quirky opponent, or how he would prove his case. I loved listening in, even if I didn’t understand everything. He was so charged up and seemed to have limitless energy. He didn’t have many hobbies. He didn’t really follow politics. He didn’t hang out with friends often. He was consumed by his work- but he loved it. He wasn’t into sports, but he didn’t lack competitiveness. His urgency to win was always present and unmistakable. He especially loved the process of breaking down complicated issues, layer by layer, until the truth was uncovered. My dad was better at this than anyone I have ever seen-even to this day.
I wasn’t 100% sure I would be a lawyer. I had an open mind to other options. And I was lucky that my parents didn’t push me into anything to merely satisfy themselves. They let us find our own passion. My brother is in sales, my sister a teacher. But as I started doing really well in my philosophy and English courses at Boston College, I realized that this would be a nice fit for me. I really enjoyed breaking concepts down, making arguments, writing, and interpreting ideas. Math didn’t excite me- that’s for sure.
When I was a kid, I don’t remember hearing many lawyer jokes. The sense I got was that it was a highly respected profession. I don’t always get that sense now, though. At the same time, it doesn’t bother me much. I respect it and I use every opportunity I can to show my clients why it should be respected. I think I’ve been successful at doing that- at least I hope.
Every case is a new challenge and an opportunity to help someone, and to grow intellectually. From keeping your client happy and informed, to strategizing about how to prove your case, you need to be “on your game”. Taking depositions forces you to think quickly on your feet, and writing briefs sharpens your writing and analytical abilities. But you can’t do these things without clients, so marketing and being creative is mandatory to survive. You put all of these things together and what you get is satisfaction. You won’t win every case. You will feel enormous stress and pressure at times. Some clients will be difficult from the moment they walk into your office. But you keep in mind that you are helping people and that’s the most important thing. It brings a deep sense of accomplishment. Many clients send thank you notes or emails that floor me. I come back to them often- to remind myself how meaningful the work is.
I look around and it feels like half of my law school classmates aren’t lawyers any more. The profession is well known to chew some people up. Like any business, if you don’t like the subject material that you’re working on- or the people around you- you will likely end up doing something else. It may take moving around to a few different firms to find the right match. It did for me. My brother once told me that the business world is a marathon, not a sprint. It’s true. If you hang in there and keep working hard, great things will often come.
Call Our Workers’ Compensation Lawyers in Pennsylvania Today
If you or a loved one has been injured at work, feel free to reach out to our Allentown Workers’ Compensation lawyers at Cardamone Law today at (267) 651-7945.