Workers Compensation is legislated under two separate Acts. The Workers Compensation Act was adopted in 1915. Originally, it was known as the Workmens Compensation Act. It has been amended many times since its original enactment. Occupational diseases are governed by the Occupational Disease Act of 1939. The administration of both Acts is under the supervision of the Pennsylvania Department of Labor and Industry which has extensive rule and regulation making powers.
At its simplest, an employee injured in the course and scope of his employment is entitled to receive payment of wage loss benefits and payment of medical expenses. When an injury occurs, the employer is required to report the injury to the Workers Compensation Bureau. The employer can accept liability and file the appropriate document which will result in payments beginning to the injured employee and payments of medical expenses paid directly to the medical providers. In this situation, an injured employee rarely requires consultation with counsel.
However, when an alleged employer fails to accept responsibility for the injury, the employee is required to file a Claim Petition. At this point, even the most sophisticated layman will find himself or herself trapped in a maze that cannot be navigated without the help of counsel knowledgeable in the interpretation of the Statues as amended and the case law that has developed over many years.
Examples of hurdles that may be encountered are: distinction of employee versus independent contractor, was the injured individual within the course and scope of employment when the injury occurred, and did the injury occur while on or off the premises.
Most injuries which occur on premises are compensable, while many off premises are not. In a case recently handled by our firm, we were able to extend the definition of on premises to an unusual situation.
In summary of that case, a worker parked her car in a garage off the employer’s campus at a reduced rate as an employee benefit. The employer provided shuttles from the garage to the employer’s campus. The employee parked her vehicle at the garage and slipped on sidewalk ice as she prepared to board the employer-provided vehicle. After being denied benefits by the Workers’ Compensation Judge, the Board on appeal reversed the decision and benefits were granted.
The Board reversed the WCJ and concluded that the claimant sustained her injuries on the extended premises of the employer and her injuries were compensable. The Board found that the employer posted “drop off and pick up” areas where
employees were required to board and disembark from the company-provided shuttle. The Board found the claimant’s injury was caused by the operation of the Defendant employer’s shuttle bus at that location. In short, the Board found that the shuttle pickup
and disembark area was an extension of the employer’s property and the employee was injured as a result of the condition of the extended premises. The lesson to be learned is that consultation with counsel should always be had in cases where an injury occurs when going to or leaving employment.
The Workers Compensation Law is extremely complex and issues arise constantly over the benefits owed to claimants who are injured in their employment. Some of those issues are:
- Compensation for Specific Loss such as:
- Disfigurement and determining the amount of compensation
- Benefits in respect to fatal injuries, accruing to the employee’s
- (a)thumb, fingers and hand;
- (b)forearm and arm;
- (c)lower leg or leg
- (d)toes and foot
surviving spouse and children, parents and brothers and sisters.
Settlement of Claims
By Section 449 of the Act, settlements for the first time were sanctioned, and as amended in 2006, the settlement approval process was streamlined. This procedure is known as a Compromise and Release Agreement (C & R) and in the proper case, will provide a lump sum payment to the claimant. It is also used in disputed cases to obtain a final resolution.
In summary, counsel should be consulted immediately in the event the employer disputes an injury claim. Counsel is also desirable in all cases when a Compromise & Release Agreement has been offered or suggested by the employer or its carrier.
If you have a Workers Compensation issue, you can’t afford to make the wrong decision in choosing a lawyer. Contact us today for your free no obligation evaluation.
Update Regarding Workers’ Compensation Act
Protz V. Workers Compensation Appeal Board (Derry Area School Board)
On June 20, 2017, the Pennsylvania Supreme Court found Section 306(a.2) of the Pennsylvania Workers Compensation Act to be unconstitutional. This Section allowed employers to demand that claimants undergo an impairment-rating evaluation (IRE) to determine the claimant’s “degree of impairment” due to the claimant’s compensable injury.
In almost every case, the degree of impairment found was less than 50%, which permitted the employer or its insurance carrier to change total disability benefits to partial disability benefits, limiting disability payments to 500 weeks.
With the decision in Protz, an injured claimant can continue receiving total disability benefits for as long as the work-related disability prevents a claimant from returning to work regardless of the degree of impairment.
Employees who, in the past, have had their benefits limited by IRE findings or have otherwise entered into settlements influenced by IRE evaluations or the expected results of an IRE Evaluation should have our firm review your case for possible re-opening.
The Heart and Lung Act
It should be recognized at the outset, that The Heart and Lung Act is somewhat of a misnomer as it applies to injuries sustained by certain public servants engaged in hazardous occupations. It would include, but is not limited to, the State Police Force, Enforcement Officers and Investigators of the Pennsylvania Board of Probation and Parole, Department of Corrections Employees, Special Agents at the Office of Attorney General, and many other officers engaged in hazardous occupations at State, County and Local Municipalities.
The Heart and Lung Act provides for what is essentially a salary continuation during temporary disability without the deduction of taxes.
While Heart and Lung benefits and Workers’ Compensation are separate programs, benefits can be received concurrently and upon happening of an injury in the course of employment, a claim should be made for both The Heart and Lung Act Benefits as well as Workers’ Compensation Benefits.
Heart and Lung Act Benefits are paid only during the period of temporary disability, and should that temporary disability become permanent, The Heart and Lung Benefits will cease; however, Workers’ Compensation Benefits will continue.