If I Am Injured At Work In Another State Outside of Pennsylvania, Can I Still Pursue Workers’ Compensation Benefits In Pennsylvania?

Yes, but only in limited circumstances. This falls under the extraterritorial provisions of the Pennsylvania Workers’ Compensation Act, added in 1974.

Here are situations where an injured worker can pursue Pennsylvania Workers’ Compensation benefits if the injury takes place outside of Pennsylvania:

1) the employment is principally localized in Pennsylvania;  OR

2) the employee is working under a contract of hire made in Pennsylvania in employment not principally localized in any state; OR

3) the employee is working under a contract of hire made in Pennsylvania in employment principally localized in another state whose workers’ compensation law is not applicable to his or her employer; OR

4) the employee is working under a contract of hire made in Pennsylvania for employment outside the United States and Canada.

[note that you have a choice- thus the “OR“, rather than “AND“]

Naturally, the next question is what does “principally localized in Pennsylvania” mean? Section 305.2(d)(4) defines it as follows: “A person’s employment is principally localized in this or another state when (i) his employer has a place of business in this or such other state and he regularly works at or from such place of business, OR (ii) having worked at or from such place of business, his duties have required him to go outside of the State not over one year, or (iii) if clauses (1) and (2) foregoing are not applicable, he is domiciled and spends a substantial part of his working time in the service of his employer in this or such other state.”

Additionally, there may be questions in a particular case as to what “regularly works” means as well. These are often complicated fact patterns and I am happy to work through your facts and apply them to the framework above to render my opinion as to whether Pennsylvania will have jurisdiction. Pennsylvania has more favorable workers’ compensation laws, generally speaking, for injured workers than many surrounding states. We are a lost earning power state so wage loss benefits can be payable, theoretically, without end, so long as the work-related injury causes a loss in earning power. (noting that once a conversion to partial disability applies, there is a 500 week cap).

If you were injured outside of Pennsylvania, but believe one of the above circumstances may apply to your case, call or email Certified Pennsylvania Work Comp Attorney Michael W. Cardamone TOLL FREE at (877) 560-7090 or MyPhillyWorkersComp@Gmail.com  for a FREE CONSULT 7 days a week.

The Cardamone Law Firm

The Firm For Injured Workers In Pennsylvania

Eleazar Ortiz v. WCAB- Does An Employer In Pennsylvania Have To Show Job Availability To Suspend An Unauthorized Alien’s Temporary Total Disability Benefits Under The Pennsylvania Workers’ Compensation Act ?

No! In Eleazar Ortiz v. WCAB, the Commonwealth Court of Pennsylvania held that Claimant’s status as an undocumented alien does not preclude the award of temporary total disability benefits under the Pennsylvania Workers’ Compensation Act. However, if an employer wants to suspend a claimant’s TTD, it does not have to show job availability under a case called Reinforced Earth. Once an undocumented worker, who is receiving TTD benefits, is released to any type of work, it is his or her immigration status which is causing the loss of earning power, not the work-related injury, and thus, a suspension of wage loss benefits is warranted.

[Note– suspension deals with wage loss benefits only, not medical.  To end medical benefits, a termination must be granted by the Work Comp Judge.]

For injured workers who are working in Pennsylvania lawfully, the employers have a heightened burden when attempting to suspend a claimant’s wage loss benefits. They must prove that an actual job offer was made within the claimant’s restrictions and that the injured worker failed to follow up in good faith, (see Kachinski 4 pronged analysis) or they must show that work is generally available under the Labor Market Survey principles in the Act and commensurate case law. There are some instances where suspensions are automatic such as when a claimant fails to return the LIBC forms within 30 days or a return to work at earnings equaling or exceeding the pre- injury average weekly wage.

As an attorney for injured workers in Pennsylvania Work Comp cases, I disagree with this Decision. If you are going to allow unauthorized workers to receive TTD benefits as a public policy exception, you should not then change up the standard when it comes to proving a loss of earning power post-injury. That being said, the Decision could have been worse- at least TTD benefits have survived in these circumstances.

For more information about How Pennsylvania Workers’ Comp Works, call or email Certified Work Comp Specialist Michael W. Cardamone TOLL FREE at (877) 560-7090 or Local at (215) 206-9068 for a Free Consult 7 Days A Week

If The IME Doctor Says I Am Fully Recovered From My PA Work Injury, Is My Pennsylvania Work Comp Case Over?

Absolutely not.

The IME report is simply an opinion from a hand picked doctor by the insurer. The IME doctor does not have the final say- the Work Comp Judge does! You will be able to have your doctor’s reports, or deposition, taken to defend any allegation of a recovery, in addition to your own testimony.

If the IME doctor claims you are fully recovered from your work injury, the insurer’s attorney will file a Petition to Terminate benefits. The mere filing of the petition, or the receipt of the IME report, does NOT stop your checks if you are currently receiving them. The checks can only stop via Court Order in this context (there are a few exceptions which we’ll discuss later). Once the petition is assigned to a Work Comp Judge, then a notice of hearing will be sent. The first hearing is called a Supersedeas hearing. The insurer’s attorney will submit a copy of the IME report and ask the Judge to cut off the wage loss benefits. The Judge will allow the Claimant (ie, injured worker) time to respond. It is imperative that you retain an experienced Pennsylvania Workers’ Comp Attorney right away to defend the request for Supersedeas. If you win the Supersedeas issue, your checks will continue as the litigation takes place. Winning at the Supersedeas level is critical because the litigation can take up to a year or longer so you will need that cash flow as the months pass by.

Short of a Court Order cutting off the wage loss checks, there are only a few situations where the insurer can stop sending you your work comp checks. One situation is if they send you LIBC forms asking you about whether your condition has changed, whether you are working, whether you are receiving unemployment, social security (old age), pension, or severance payments. If you fail to return these forms within 30 days, the insurer can cease payments until they receive them. Another example of the insurer being allowed to stop your checks (or reduce them), short of a Court Order, is if you return to work of course- you must report the earnings so that the insurer can calculate what if any payments are due based upon your pre-injury average weekly wage and the amount of current gross weekly earnings.

Do not panic if you receive a Notice of Ability to Return to Work and/or an Independent Medical Exam (it’s not “independent”- it’s a defense exam). If you are receiving work comp checks, the receipt of these documents will not stop your checks in and of themselves. For more info about how Pennsylvania Work Comp works, call or email me 7 days a week.

Michael W. Cardamone – Certified Pennsylvania Work Comp Lawyer For Injured Workers

The Cardamone Law Firm, LLC

Should I Allow A Nurse Case Manager To Help Me With My Pennsylvania Work Comp Case?

NO!

So many injured workers mistakenly believe that their nurse case manager is their friend and looking out for them. WRONG! They are essentially a spy hired by the employer or insurer to interfere with your medical appointments and to put pressure on the doctor to release you back to work. You are an adult and do not need a nurse case manager to interfere in your case. While many of them are nice, hard working people who are just doing their job, you have to always remember that they do NOT have the same interests as you. Your interest is to obtain all the benefits you deserve given your medical condition. Their interest lies in getting you off of work comp as soon as possible without regard to how it affects your life.

Insurers love nurse case managers because they act almost like an investigator. The nurse case managers can obtain information from the injured worker and perhaps take it out of context, thereby prejudicing the doctor and/or adjustor. Injured workers often feel intimidated and believe that the nurse case manager is a requirement. This is not true.

Having an experienced and Certified Pennsylvania Work Comp Lawyer on your side is a way to maximize your benefits. Having a nurse case manager involved is a way to minimize your benefits. It’s true.

If you want more information about the role of Nurse Case Managers and Pennsylvania Workers’ Compensation, call or email me 7 days a week.