If you think your work injury case is concluded because you have started to receive your benefits checks regularly, think again.
Your employer’s insurer is trying to save as much money as possible. To that end, they may decide to invoke supersedeas and petition you to appear for an independent medical exam.
What can you do when that happens? What are your options and the way forward? Let’s find out.
Independent Medical Exams Are Not Always Independent
As an injured worker who has received an IME notice, you may be wondering: My attorney did a great job, and now I’m getting workers’ compensation benefits. Why should I continue to treat my work injuries if I’m unable to return to work? Haven’t I already proven that I was injured at work?
If you are receiving Pennsylvania workers’ compensation benefits, you can rest assured that the workers’ compensation insurance company will do whatever it can to stop your benefits.
At some point, you will receive a notice to attend an “independent medical examination.” These exams are not very “independent” since the insurance company chooses doctors that it hires and pays for, and these doctors will likely get more referrals if they find that a Claimant has recovered.
You may be asked to attend these defense exams once every six months.
The defense physician then issues a report with his or her opinion about your medical condition and your ability to return to work, and the insurance company will then likely file a Petition against you to try and stop your wage loss and/or medical benefits.
Image Source: unsplash.com/Timon Studler
But They Were Once a Helpful Tool
Prior to 1984, an employer in Pennsylvania could simply obtain an affidavit from a doctor claiming that an injured worker was fully recovered from a work injury and take an “automatic supersedeas.”
What is Supersedeas?
Supersedeas is a legal term used in Pennsylvania workers’ compensation law that allows an employer to stop your wage loss benefits immediately.
? How is supersedeas used in the PA Work Comp system?
Since 1984, Employers can no longer merely file a Physician’s Affidavit and immediately cease paying indemnity benefits. Instead, an employer must request supersedeas in conjunction with a Petition to Terminate, Suspend, and/or Modify Compensation Benefits.
A special supersedeas hearing is held before a Workers’ Compensation Judge within 21 days of the assignment of the Employer’s Petition.
? What happens at the supersedeas hearing?
At the supersedeas hearing, the Claimant’s attorney submits an affidavit from the injured worker stating why benefits should not be stopped and detailing the medical problems that the Claimant is still suffering as a result of the work injury.
The Claimant’s attorney will also submit a recent, relevant medical report from the Claimant’s treating physician stating why the Claimant is still disabled and not able to return to work.
? How is the decision reached?
Within 14 days of the supersedeas hearing, the Judge must issue a written decision on the request for supersedeas. Unless a supersedeas is granted by a written order, it will be deemed denied.
The Significance of a Qualified Work Comp Attorney at a Supersedeas Hearing
Unless an employee’s attorney provides compelling evidence that the Claimant is likely to prevail in the litigation, benefits will likely be suspended, and therefore, it’s crucial to have an experienced workers’ compensation attorney who can convince the Judge through submissions that an injured worker should continue to be entitled to wage loss benefits.
If supersedeas is denied, your checks will continue while the Employer’s Petition is litigated before a Workers’ Compensation Judge during the next several months. If supersedeas is granted, not only will weekly checks discontinue, but also the insurance company will be less inclined to make a reasonable settlement offer.
Therefore, it’s imperative to have an effective and experienced Pennsylvania workers’ compensation attorney fighting for you to get all the benefits to which you are entitled.
Can Cardamone Law Help?
We are a niche law firm with specialization and a focus on the PA workers’ compensation system. We know how it works and how to move it to help provide relief and aid to injured workers in Pennsylvania.
If you have been served with a petition that seeks to reduce or terminate your work comp benefits on any grounds, reach out to us at (215) 206-9068.
Our experienced work comp attorneys will help navigate your unique supersedeas obstacle and work with you to ensure your benefits continue so you can heal without distraction or worry.