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Posts Tagged ‘Compensation’

Workers Compensation Medical Testimony

          The Pennsylvania Commonwealth Court has ruled that a physician’s testimony was sufficient to support a finding that there was no objective evidence to support workers’ compensation claimant’s subjective complaints of back pain.
           In Schmidt v. W.C.A.B. (IATSE Local 3), the employer had filed a Petition to Terminate compensation benefits based upon the opinions of a physician who had evaluated Mr. Schmidt and opined that he had sustained a lumbar strain with a disc herniation which was completely resolved by surgery. The testifying doctor also stated that Schmidt had pre-existing conditions in his back which were not aggravated by the work injury, with the possible exception of the pars defect- a congenital crack in the spine-which caused the bone at the L4 level to slip behind the spine. The doctor explained that a herniated disc does not usually require a fusion, but that a fusion was necessary in Schmidt’s case because of the congenital crack. He opined that the aggravation of Schmidt”s congenital crack caused by his work injury, if any, was resolved by the fusion. Therefore, his work-related disability had ceased, and Schmidt could return to work with no restrictions.
The Court ruled that a termination of benefits was proper reasoning that the doctor’s testimony that Schmidt may have some back pain with change in the weather from time to time did not support an inference that physician found objective medical findings for claimant’s pain.
 

Deep Vein Thrombosis In Truck Drivers Workers Compensation Claim

            John was an interstate truckdriver for over twenty years and never experienced any health issues. Because of the nature of his work, John would spend extended hours in a seated position driving his truck. John started to notice a numbness in both feet which had been getting progressively worse.  John finally got concerned enough to go to his doctor and was diagnosed with deep vein thrombosis. John’s doctor was very concerned that John would develop blood clots which could easily lead to a stroke. John was advised to stop driving immediately. The doctor also prescribed Coumadin, a blood thinner, for John to take and advised John that he would be on this medication for the rest of his life. John’s doctor was adamant that John’s job duties as a truck driver wherein John was immobile for hours at a time while driving was a substantial contributing cause to the development of the deep vein thrombosis.

ISSUE:          Does John have a valid claim for Workers’ Compensation benefits?

ANSWER:     Yes. It is not unusual for truck drivers such as John to develop this problem. John will be entitled to Worker’s Compensation benefits as well as medical coverage as his prescriptions may last a lifetime. In all likelihood John will never be able to return to the type of work he was doing.

Disclaimer: The above article is for instructive purposes only and each case is fact sensitive.  Consultation with an attorney should be obtained instead of reliance upon the legal issues discussed in this column. 

 

Workers Compensation Question- Is an Employee Who is “Out To Lunch” Covered?

            Karen was working as a clerk and had the choice of either eating her lunch on her employer’s premises or going out for the same. There was a strip mall across the road from Karen’s employer that included a food store and a doughnut shop. One day while on lunch break, she decided to cross the highway to get her lunch. Karen picked up a sandwich and some other food to take back to some of her co-employees. Unfortunately though, on her way across the highway, she was struck by an oncoming vehicle. As a result of being struck, Karen sustained numerous injuries which would keep her out of work for almost six months.

ISSUE:          Is Karen entitled to Workers’ Compensation benefits?

ANSWER:     No. Karen would not have been considered in the scope and course of her employment. In cases like this, Karen was actually injured off of her employer’s premises and was in no way furthering her employer’s business or affairs. If Karen had been sent by one of her supervisors to pick up the food, then quite possibly she would have been considered covered.

 Disclaimer: The above article is for instructive purposes only and each case is fact sensitive.  Consultation with an attorney should be obtained instead of reliance upon the legal issues discussed in this column. 

Workers Compensation Jurisdiction

 

            Tony was hired to work at the natural gas extraction sites In Pennsylvania at his home in Texas. When Tony signed the employment agreement, he stated that he would submit any Workers’ Compensation case to the state of Texas since his employer was principally based in Texas. Tony did not realize that the reason for this clause in his contract was because Texas Workers’ Compensation benefits for injured workers are far less comprehensive than those for injured workers in Pennsylvania.

            Tony was involved in heavy physical work on the jobsite and while lifting he sustained several herniated discs in his back. Tony was told that he had to pursue his compensation claim in the state of Texas and under the laws of that state.

ISSUE:          Is Tony’s employer correct?

ANSWER:     No. In the state of Pennsylvania, regardless of where the contract was entered into, an employer cannot compel an injured worker to only pursue compensation benefits as this employer attempted to do in one state. Pennsylvania has jurisdiction over any injuries occurring within the state of Pennsylvania regardless of where Tony’s employer is based. Tony would be wise to utilize the laws of Pennsylvania as opposed to the laws of Texas. For example in Texas if Tony is advised by any doctor including the doctor hired by Tony’s employer that he Tony has recovered, Tony’s medical and loss wage benefits would stop automatically. In Pennsylvania Tony would be allowed a hearing and would be allowed to present his own testimony including his treating physicians.

 

Disclaimer: The above article is for instructive purposes only and each case is fact sensitive.  Consultation with an attorney should be obtained instead of reliance upon the legal issues discussed in this column. 

Injuries from fall caused by diabetic coma compensable under workers compensation

   Injuries sustained asa result of hitting the ground are compensable even though fall caused by non-work related low blood sugar level.

DLP Attorneys Represent Driver Injured by Tractor Trailer on Interstate 81

The attorneys at DLP are representing a driver seriously injured in a 24 vehicle chain reaction accident that occurred on Interstate 81 in Scranton, PA.  The accident was caused by the carelessness and negligence of two tractor trailer truck drivers who were driving too fast for conditions when they lost control of their vehicles on the icy roadway.  DLP will be fighting the tractor trailer drivers’ respective insurance companies to get their client the compensation he deserves for the serious injuries he suffered in the accident. 

If you have been injured by a negligent tractor trailer truck driver anywhere in Pennsylvania, contact the lawyers at DLP for a free no obligation consultation.  DLP attorneys represent injured accident victims in counties throughout northeastern Pennsylvania.  In addition to tractor trailer truck accidents, we also represent injured victims of  auto accidents, motorcycle accidents, slip and fall accidents, product defect accidents, work accidents, professional negligence and medical malpractice.

Cohabitation and “Meretricious Relationship” In Workers Compensation

          The Pennsylvania Commonwealth recently addressed the issue of the burden on an employer in establishing that a surviving dependent spouse is party to a common law marriage. Under Section 307 of the

Pennsylvania Workers’ Compensation Act, in situations where a person is fatally injured in the course and scope of employment, compensation benefits are payable to the survivors of that person, typically, the widow/widower and their children. However, the act alos indiactes that should any dependent of a deceased employe die or remarry, the right of such dependent or widower to compensation shall cease. If a widow remarries, she shall receive 104 weeks of compensation in a lump sum. In PPL v. WCAB (Hicks), the facts indicated that Sandra Rebo (Claimant) was receiving workers’ compensation benefits as a dependent spouse following the death of her husband, George Rebo (Decedent). Mr Rebo’s employer filed a Termination Petition on June 12, 2008 seeking to cease compensation payments alleging that Claimant was involved in a “meretricious relationship”. Employer later amended its Petition to seek alternative relief based on an assertion that Claimant had remarried.
         

             Claimant testified that she was the widow of Decedent and that she has not remarried. She acknowledged that she resides in a home with Gary McDonald and that she and Mr. McDonald split expenses. She stated that  they did not currently engage in any sexual activity. Claimant admitted that she and Mr. McDonald did previously engage in sexual activity off and on through 2006. She stressed that she has no intention of marrying Mr. McDonald and that the two do not hold themselves out as husband and wife. She acknowledged that she and Mr. McDonald represented to Mr. McDonald’s employer that they were common law husband and wife for the purpose of having her placed on his health insurance coverage. She also admitted she and Mr. McDonald completed their federal income taxes as “married filing jointly.” However, she indicated that she never engaged in an official marriage ceremony with Mr. McDonald.  McDonald also testified in this matter. He agreed he represented to his employer, Phillipsburg Borough, that he and Claimant were common law husband and wife for the purpose of having her placed on his health insurance. He further agreed that the two completed tax forms as “married filing jointly.”
             

                The Workers Compensation Judge(WCJ) denied the  Termination Petition concluding that the employer failed to meet its burden of proving that the Claimant was involved in a meretricious relationship. The WCJ further opined that Employer did not establish a right to any relief based upon Claimant entering into a common law marriage. The WCJ acknowledged that Claimant and Mr. McDonald live together, that they filed tax returns as a married couple, that they engaged in sexual relations for a period of time and that they represented to Mr. McDonald’s employer that they were a married couple for insurance purposes. However, the WCJ determined that Claimant and Mr. McDonald never formed any intent to enter into common law marriage noting that“they have simply tried to ‘game the system’ by saying that they were common law married when that posture benefited them financially.” 
               The Commonwealth Court, in hearing this case on appeal,  noted that  common law marriage can only be created by an exchange of words in the present tense, spoken with the specific purpose of creating the legal relationship of husband and wife, and this is a heavy burden and must be established by clear and convincing evidence. The Court thus determined that the employer, as a matter of law, did not establish that claimant and claimant’s male roommate had entered into a common law marriage so as to require termination of benefits. The Court also indicated that evidence of words sufficient to establish a definite agreement to marry were required in order for employer to satisfy its burden. Any presumption of common law marriage based on proof of cohabitation and reputation was unavailable to employer, and claimant’s roommate stated that the two never agreed to be married.

Psychological/Psychiatric Injuries Under the Pennsylvania Workers Compensation Act

         Q. Are psychological/psychiatric injuries compensable under the Pennsylvania Workers Compensation Act?

         A. Yes. There are three types of psychological injuries that are compensable under the Act:

(1) Mental/Physical injuries, i.e. where a psychological stimulus causes physical injury;

(2) Physical/Mental, i.e. where a physical stimulus causes a psychic injury; and

(3) Mental/Mental—where a psychological stimulus causes a psychic injury.

         These categories require different standards of proof with the “mental/mental” being the most rigorous and requiring proof of an “abnormal working condition”.

         Generally speaking,  a party filing a claim for workers’ compensation benefits must prove that the alleged injury is both work-related and disabling.  Insofar as psychological injuries are highly subjective, the occurrence of the injury and its cause must be adequately established. Where the alleged psychological injury was not caused by physical injury, the claimant must submit evidence to prove (a) that he suffered a psychological injury and (b) that the injury was more than a subjective reaction to normal working conditions.  The claimant must further establish that the working conditions or work events are not merely perceived or imagined. Whether or not the working conditions are ”abnormal” is a question which relates to the cause of the injury. Pennsylvania courts have ruled that while abnormal working conditions may be sufficient to link the injury to the employment, subjective reactions to normal working conditions will not meet the claimant’s burden of proof . 

        Disclaimer: The above article is for instructive purposes only and each case is fact sensitive.  Consultation with an attorney should be obtained instead of reliance upon the legal issues discussed in this column

Course and Scope of Employment In A Workers Compensation Case

     The Pennsylvania Commonwealth Court has ruled that a denial of workers compensation benefits was proper in a case involving the issue of whether the injured worker (“claimant”) was in the course and scope of employment when the injury occurred. In Penn State University v. WCAB (Smith), the Court has determined that evidence was insufficient to establish that the workers’ compensation claimant, Mr. Smith, injured himself while in the “course and scope” of his employment.  Smith broke both of his ankles when he jumped down a flight of stairs while on his lunch break. Typically, an injury is compensable under the Workers’ Compensation Act only if the injury arises in the course of employment and is causally related thereto. An injury may be sustained in the course of employment under the Workers’ Compensation Act where the employee is injured on or off the employer’s premises while actually engaged in furtherance of the employer’s business or affairs. However, an activity that does not further the affairs of the employer will take the employee out of the course and scope of employment and serve as a basis for denial of the claim. Generally speaking, neither small temporary departures from work to administer to personal comforts or convenience, nor inconsequential or innocent departures will remove the claimant from the course and scope of employment.

     In the day of his injury, Mr. Smith was cleaning dorm rooms at Perry Hall for Employer’s Housing Department.  Claimant left Perry Hall to take his 30 minute unpaid lunch leave at Bruno’s, an on-campus dining facility where Claimant had an employer-sponsored meal plan. Claimant was walking from Perry Hall to Bruno’s on a walkway that included three flights of stairs. He intentionally jumped down the second flight of approximately twelve steps, landing very hard with his feet flat and fractured both ankles.

     The Court determined that Mr. Smith’s actions in light of the nature of his employment (performing housekeeping or cooking duties) could not be viewed as furthering employer’s business or affairs noting that he voluntarily jumped down a flight of stairs on a “whim,” and that he had thoughts of doing it before the injury date. The Court went on to state that he did not trip or fall down the stairs, but walked up to the edge and jumped off the stairs and injured himself upon landing.  The Court concluded that the employer did not encourage in any way Claimant to jump a flight of stairs during his lunch break and that the facts did not establish that Smith’s actions furthered a specific interest of Employer.

Interplay Between Workers Compensation and Social Security

                Paul had sustained a serious back injury while working and had been on Workers’ Compensation for over one year. Despite several operations, Paul’s back was not better and to return to work at any type of gainful employment seemed unlikely. After Paul’s injury,  he had developed other problems involving his shoulder as well as heart issues.

ISSUE:          Paul was wondering whether he could apply for Social Security since he was already receiving Workers’ Compensation benefits.

ANSWER:     Yes. Social Security is a Federal program that provides benefits for the disabled and Workers’ Compensation is a state program. Social Security uses a different standard and will take into consideration all of Paul’s problems regardless of whether they are work related or not. Thus his heart condition and his shoulder condition will also be considered in determining whether Paul is entitled to Social Security benefits.

            If Paul is deemed eligible back to the date of his work injury for Social Security, Paul will entitled to Medicare coverage on his non-work related medical bills as well. Paul’s monthly Social Security check will be less since Paul is collecting State Workers’ Compensation benefits as the Federal Government gets a credit to a certain extent for those benefits.

Disclaimer: The above article is for instructive purposes only and each case is fact sensitive.  Consultation with an attorney should be obtained instead of reliance upon the legal issues discussed in this column. 

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