>Cynicism Towards Injured Workers- A Perspective from a Work Comp Attorney in Pennsylvania

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As a workers’ compensation attorney in Philadelphia for the past 8 years or so, I have witnessed tremendous cynicism from society. It is directed at the injured worker. It stems from a lack of understanding, and I believe, from a media that highlights the negative aspects of our judicial system. Virtually every client of mine voices concern at co-workers who start harrassing them once a claim for a work injury is filed. Until it happens to them, a co-worker is unlikely to understand the insidious effects of a work injury, – not only upon the worker, but his/her family as well. From losing substantial wages, to undergoing treatment for their affliction, from marital strain, to potentially losing a career that was fought hard for, there are many pitfalls of a workers’ compensation claim- and very little incentive to file a false claim. Although it happens, I firmly believe the amount of false claims is exagerrated. For every exagerrated or false claim, there are hundreds of legitimate injuries that occur every day in the work place. This isn’t to say that employers and their insurers do not have the right to investigate and present a defense. Indeed, they deserve to look into claims, review medical records and do their “due diligence”.

I would like to engage in discussion surrounding this cynicism, where it stems from, how it affects injured workers, how it intimidates workers from filing claims, and how we can erode it.

3 comments

  1. >Cynicism- not Cynacism. Sorry for the misspelling folks.

  2. >One question…and possibly the reason for some of the cynicism out there. Do workers who are injured collect more money by just sitting home? Or do they just get a percentage of their usual pay? If it’s just a percentage, why would people make a false claim?

  3. >Erik, you identified a big reason for the cynicism. In reply to your question, injured workers receive just two-thirds of their pre-injury average weekly wage. Many people erroneously believe that injured workers receive full pay, but this isn’t the case- at least in Pennsylvania and I believe, most, if not all, the other states as well. As such, there is little financial incentive to fake an injury. In addition, many medical bills don’t get paid by the insurance companies, – either b/c a claim is denied, or because the particular treatment is challenged in what’s called a Utilization Review process, or simply because an adjustor just failed to do his homework. Another reason a medical bill may go unpaid is because the insurance company believes the treatment is not causally related to the accepted work injury. Also, a medical provider sometimes fails to send the proper forms to the insurance company- and the insurer doesn’t have to pay, under the Workers Comp Act in Pennsylvania, unless and until the medical bills are provided on the appropriate HCFA forms along with the commensurate medical report. These claims are quite stressful for injured workers. And, the above scenarios wreak havoc on the Claimant’s credit. Many Claimants lose their house in the process- especially when a claim is denied- due to months and months of litigation. Thanks for your question, Erik.

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