Why my workers comp checks stop coming after the last visit I had with my doctor

Asked in Norristown, PA , on Jun 23, 2015

I have been under medical treatment for more than 2 years my job terminated me 3 months after the accident , before 3 weeks ago I had the last appointment with my doctor where he discharged me with modified duty and after that workers comp stop sending the checks

Answered on Jun 23, 2015

I agree with Tim, they are likely holding you over a barrel. The insurance company will often starve people to get the result that they want. It is a violation of the act and can be punished by a WC judge with the filing of a penalty petition. You were likely at an IME and they are gathering information to file to stop you benefits, though you may have a fight looming, they cannot just stop your benefits in advance of a judge’s determination. Quick note of concern – you didn’t receive any LIBC forms asking about your other income recently? That could be an issue that could create concerns for an automatic temporary suspension.

What it means by hearing notice and mediation notice in work-comp claims?

Asked in Douglassville, PA , on Apr 9, 2015

I had a prior work-comp claim 5 years ago. I was injured at my current job and the insurance company denied my claim?

Answered on Apr 12, 2015

It is hard to tell exactly what is going on here without quite a few more details. One of your injuries is in litigation and the mediation notice means you should already have a good idea what the case it worth to you over the long haul if you are at all thinking of settling. If not, you should be prepared to defend yourself from whatever petition has been filed. You definitely need to sit down and talk to an attorney if you have not already, it sounds like this has sat too long. Almost all WC attorneys are willing to do a free consult… you need one. Good luck.

How can I avoid light duty work after an IME doctor thinks I can do it. When I know it will be a struggle every day if I have to

Asked in Allentown, PA , on Jul 18, 2014

I have IME scheduled, what if the ime doctor says I can do light duty desk work and I disagree. My injury hurts especially in the morning getting out of bed and whenever I sit for periods of time, (plantar fasciitis). It basically hurts all day. I know the ime doctor will try to make me go back to work light duty. My doctor has me off work until further notice. I need advice on how to make this ime keep me away from light duty. I mean I’m limping when I walk but he will say I can sit all day. Any ideas would be great thanks

Answered on Jul 19, 2014

I tend to agree with the prior attorneys. The IME doctors are paid by the insurance companies, they release people that’s what they do. Every now and then you have exceptions though. One of my specific concerns for your case is – are you at the early stages of the claim and what diagnostics have been done. Early on you are often captive treating with WC doctors who are not ordering all the testing you need. Hate to say it, but it’s true. Depending on the mechanism of injury you might have some other nerve, muscle or tendon injury that is not being diagnosed. Dr. Barry Ruht is a foot doctor in the Valley who deals with that part of the body and has good experience with WC cases. You just want to be sure that you are being looked at the way you need to be.

Would I get more money from a settlement?

Asked in Quakertown, PA , on May 14, 2014

I have a work comp case open. My foot is still in bad shape and im thinking of seeing a psychiatrist because I feel depressed and stressed about it. Would seeing a psychiatrist make a possible future settlement larger or would it not matter?

Answered on May 15, 2014

I would say alot depends on the Judge, how your credibility is perceived and the expert you chose. I have actually heard judges say they are surprised more of these claims are not made. Other judges are skeptical no matter who you present. I think these claims do increase settlement value though, because it raises the specter of a longer claim and a more difficult condition to accommodate.

Is it possible to switch law firms in the middle of a workers comp case?

Asked in Emmaus, PA , on Mar 31, 2014

Got low settlement offer from insurance and current firm partners contacted me and are insisting I take it even though my attorney at the firm felt I shouldn’t. Talks with partners are gone very badly. I also have a pending PI suit and concerned about this firms abilities and interest.

Answered on Mar 31, 2014

Yes, you have the absolute right to choose the attorney to handle your matter. Ethically a departing attorney should give written notice that they are leaving and the client can choose to stay or go. In these type of cases though a fee dispute could arise, especially given that it has been worked up to settlement. Rather than pressuring you to settle, you should be advised of the risks and benefits, get the professional advise of the attorney and make your decision knowing all of the aspects of the case. Hopefully that is something that they do before you move forward.

Workers compensation. injured approximately two weeks ago. Nurse Case manager assigned today. Can I say no? In PA.

Asked in Chester Heights, PA , on Mar 13, 2014

Prescribed pt for 2 weeks

Do I need a lawyer?

Answered on Mar 13, 2014

Mr. Calhoon summed it up absolutely perfectly. You do not need to have a case nurse follow you, if they have assigned one against you, you probably have something to lose, if you have something to lose, you need an attorney. This is the period where cases are won and lost, get the help you need. Good luck and get rid of the tag along that is not representing your interests.

May an attorney from New York represent in a Pennsylvania Workers Comp case if I decide to switch counsel?

Asked in Perkasie, PA , on Mar 10, 2014

The present attorney rarely contacts me back when contacted in any form. Never an update at least monthly, I have to inquire. Injured 4/4/13 waiting for 2 surgical approvals submitted by Manhattan specialists. Injury now becoming a partial disability issue as nerve damage deteriorating extremity. Are there guidelines attorneys must adhere to and whom can I contact regarding this also? Workers Comp case in Penna. but not satisfied w/treatment after 90 days, mis-diagnosis.Thank You!

Answered on Mar 10, 2014

As indicated, you must be licensed in PA to handle the case in PA. In non administrative cases you can have pro hac vice filing for an out of state attorney. However, I have never even thought about that in the administrative context and would not know the procedure. Feasibly an out of state attorney generally does not want to get involved in administrative matters that require a hyper understanding of local agency law. As an aside, it is not clear, but it sounds like you are having a hard time treating in NY on a PA WC claim. If you looked into PA surgeons it make more a little quicker. I have seen some confusion and miscommunication in the past when treatment overlaps borders. It is compensible you just see some issues with health providers missing the translation. Also the panel doctors during the first 90 days often produce a misdiagnosis favorable to the employer/insurer, captive doctors are one of the really unfortunate parts of the PA practice. Good luck.

(Pennsylvania Worker's Comp Case) Can a IC's Nurse Case manager talk to the Dr. after my appointment without my permission?

Asked in Beaver, PA , on Feb 18, 2014

Also if not could the nurse be reported to perhaps the PA Nursing Board for privacy invasion ? I did not sign any of the papers from the nurse. No the nurse did not come in while I was with the Dr. but went in right after I came out, without asking or inviting me in.

Answered on Feb 18, 2014

The nurse case managers do everything they can to divine permission to inquire into your medical condition, you should be explicit as possible in denying them any past, present or future authority. There is often some paper on file before an attorney is involved. It is a HIPPA violation if they are not authorized. Again, just make sure you have made it clear they have no such authority.

Can i get a second opinion from a podiatrist and stay with him for my workers comp claim?

Asked in Trexlertown, PA , on Jan 28, 2014

Its 6 mos after my injury and was diagnosed with tarsal tunnel syndrome by the comp doctor without emg tests so i want second opinion and will wc insurance pay? And can i cancel my next appointment with comp doctor?

Answered on Jan 29, 2014

I generally get my clients away from the panel doctors for WC as soon as possible. I have seen some very questionable opinions from panel doctors who get many of their cases form the insurance companies. You should also be conscious that some employer’s impermissibly take action to discipline or remove injured employees to avoid liability for wage loss payments, so you should be sensitive to how your particular employer is responding. There can be pressure from the insurance companies. That said, an attorney would be helpful in most circumstances to tell you if there seems to be issues on the horizon, to help you with deciding how to move forward with treatment, timing and long term issues – I see many people’s claims permanently damaged because of going it alone and not anticipating many of the issues that come up. You should get a free consult.

I have a mandatory mediation hearing in 4 weeks are they looking to settle my case? What should I expect?

Asked in Wexford, PA , on Jan 19, 2014

My hearing is in 4 weeks and on the notice it lists my company, their lawyer, their insurance company and Sedgwick. Does this mean they are looking to settle my case? I got hurt over 13 months ago and I am still having a lot of problems and taking a lot of medications. I finished therapy about 3 months ago and he told me he didn’t think I would ever get better but I asked to do another therapy but it doesn’t seem to be doing any good. Workmens comp. asked my company 2 times if there was anything I could come and do and they said both times there was nothing and to him on workmens comp. I don’t think I will ever get better or be the same again or be able to hold a job of any kind. If I do settle would I get SSDI and what kind of health insurance would me and my family be able to get

Answered on Jan 20, 2014

Workers compensation is a very settlement driven practice, it is not just about getting the best number possible, as you seem to understand. I always feel like I spend more time working on the settlement details then I do on the case itself (liability, etc). It is hard for a non-WC attorney to deal with these issues, so you should not be doing it on your own at this point. The insurer is always looking to settle, the question is will you make a settlement that is in your best interests now and 10, 20, 30 years from now – that involves considering your potential to continue benefits, your ability to work in your profession or another profession, other potential health providers/insurers, statutory requirements to protect state or federal benefits you have already received or may receive in the future (that could came back to hurt you substantially), and the monetary figures being offered to settle the case. Your considerations related to SSD also depend on how you handle your compensation case. Best thing that you can do is get someone qualified to handle the mediation so you are prepared to deal with all of these many issues.