Philadelphia PA Workers Comp Attorney Michael W. Cardamone Of The Cardamone Law Firm, LLC Wins Utilization Review Litigation For Injured Worker

Certified Pennsylvania Work Comp Specialist, Michael W. Cardamone of The Cardamone Law Firm won a Petition for Review of a Utilization Review for his client. The central issue in the case was whether chiropractic treatment was reasonable and necessary. In this context, the burden of proof is on the employer to establish that the challenged treatment is not reasonable and necessary. Cardamone successfully argued that the treatment helped his client to continue working  and provided functional improvement.  After all, what could be more useful than treatment allowing an injured worker to keep his or her job?

In the litigation, Cardamone presented his client’s testimony and a narrative report of the treating physician which outlined why the treatment was reasonable and necessary. In December 2013, the Workers’ Compensation Judge issued her Decision finding that the Employer failed to prove the chiropractic treatment was unreasonable or unnecessary. Accordingly, the Employer/Insurer has to pay for the treatment, and litigation costs were awarded.

It is important for injured workers to challenge Utilization Review Determinations that find treatment unreasonable or unnecessary. Call me if you are not already represented by a Certified PA Work Comp Lawyer, so I can challenge the Determination by filing a Petition to Review. There are strict deadlines for appealing these Determinations so be guided accordingly and act quickly.

For more information about Pennsylvania Work Comp Procedure, call Michael directly at (215) 206-9068 or email MyPhillyWorkersComp@Gmail.com 7 days a week.

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How Does A Pennsylvania Workers’ Compensation Judge Decide My Case?

The main issue for the Pennsylvania Work Comp Judges is credibility. When writing a Decision which decides a particular issue- for example, whether a work injury took place, the extent of disability, whether a recovery has been reached, whether the injured worker has an earning power, or whether medical treatment is reasonable and necessary- the Judge has to determine which medical expert’s opinion is most credible. Additionally, the Judge will make a determination in most cases as to whether he or she finds the testimony of the claimant (ie, injured worker) to be credible.

Let’s look at a hypothetical case. John Doe hurts his back while lifting boxes at work. The employer/insurer denies his claim, citing a pre-existing condition. John Doe’s attorney files a Claim Petition and litigation ensues. John Doe’s attorney takes the deposition of the treating doctor and also presents his client’s testimony. The insurance company hires an Independent Medical Examiner- who doesn’t treat John Doe, but who merely examines him, takes a history, and reviews medical records- and writes a report with his or her findings. The insurance company’s attorney takes the deposition of the IME doctor who disagrees with the treating doctor, blaming the symptoms on longstanding arthritis while the treating doctor opines that the work activity either caused a new condition and/or aggravated the underlying condition.

The parties are unable to settle the case. The insurer offers $10,000.00- which is about 9 months of work comp checks. John Doe wants $40,000.00. or more so that he can pay his bills and feed his family as he continues to recover.

The parties then have to write Briefs- these are the written arguments from the respective attorneys, with an overview of the applicable law, the facts of the case, and the arguments as to or why not the parties have met their burdens of proof. The litigation takes 12 months.

The Pennsylvania Workers’ Compensation Judge has to review the Briefs and issue a written Decision outlining all the facts, the applicable law, and most importantly, make credibility determinations.

A typical Decision, in this specific regard, might look something like this:

“This Judge finds the testimony of Dr. Smith (John Doe’s doctor) to be more credible and persuasive than that of Dr. Johnson (IME doctor). Dr. Smith had the opportunity to treat Claimant and observe him over many different occasions. Dr. Smith’s testimony is consistent with that of Claimant and supported by the objective, diagnostic studies.”

“This Judge finds the testimony of Claimant to be credible. Claimant’s testimony is supported by his treating physician, the diagnostic studies, and is internally consistent. Claimant admitted his prior back treatment, and even tried working after this injury before he was terminated.”

The credibility determinations are the most critical aspects of a Pennsylvania Workers’ Compensation case in terms of the Judge’s Decision. The Judge is charged with the obligation to issue a “reasoned Decision” so that the parties can make sense of the outcome based on the facts. The Judge has to resolve conflicting testimony and have support in the nature of “substantial evidence” for the findings.

Can The Decision Be Appealed?

Yes, any party can appeal the Decision of the Workers’ Compensation Judge within 20 days. It goes up to the Appeal Board who hears oral arguments in most cases and review appellate Briefs. The written Decision from the Appeal Board can take up to a year or more.

What If I Don’t Like The Appeal Board’s Decision?

You can take an appeal to the Commonwealth Court of Pennsylvania within 30 days. The written arguments and rules are more stringent at this level. Eventually, the Supreme Court of Pennsylvania may decide to review a case but this does not happen too frequently.

Do Many Decisions Get Overturned?

I do not know the statistics. But, in my practice, I find it to be fairly rare for a Decision by the Workers’ Compensation Judge to get overturned. Why is this? The appellate courts give deference to the Workers’ Compensation Judge in terms of credibility determinations and as I’ve said, these are the most crucial aspects of the Decisions. What is not rare is a remand- that is, when the Appeal Board sends the case back to the Workers’ Compensation Judge to issue a new Decision addressing issues that he or she may not have addressed originally. For example, suppose John Doe had an EMG study done which showed an S1 radiculopathy and the Judge failed to address this in the Decision- the Appeal Board may remand the case to the Judge to address the EMG and how it affects the outcome.

Our goal at The Cardamone Law Firm, LLC is not to keep injured workers in the dark about the Pennsylvania Workers’ Compensation process. Our goal is to explain it and make sense of it. I am shocked at how many clients I get from other firms who have failed to explain how things work. The big picture is important to understand.

The Cardamone Law Firm, LLC is a rare firm that only handles PA Work Comp cases- and only for injured workers. If you are tired of being bounced around to different attorneys at a bigger firm, call Michael Cardamone directly at (215) 206-9068 for a free consult 7 days a week.

Certified PA Work Comp Specialist

MyPhillyWorkersComp@Gmail.com

The Cardamone Law Firm, LLC

The Firm For Injured Workers In Pennsylvania

 

Why Is The Cardamone Law Firm, LLC The Best Choice For Pennsylvania Workers’ Compensation?

The Cardamone Law Firm, LLC known as MyPhilly WorkersComp Attorney, is a unique law firm with convenient offices in Philadelphia and Blue Bell. Founded by Certified Pennsylvania Work Comp Specialist, Michael W. Cardamone, The Cardamone Law Firm, LLC is a rare firm that is dedicated 100% to fighting for injured workers in Pennsylvania. No dabbling in personal injury, or social security, or other types of cases.  No jumping sides to represent insurance companies when it’s convenient to make money. Just 100% Pennsylvania Workers’ Compensation For Injured Workers. NOTHING else.

Representing Injured Workers Across Pennsylvania

When you hire The Cardamone Law Firm, you get Michael W. Cardamone handling your case. When you call The Cardamone Law Firm, you reach Michael directly. You don’t get a runner or a paralegal on the phone who takes down all your information when you make your first phone call. You don’t sent into a voice mail system that never gets checked. You get Michael W. Cardamone- and you get access!

Access is a hallmark of The Cardamone Law Firm. Michael wants his clients involved in their own cases. He encourages questions, calls, emails, and even texts. MyPhilly WorkersComp is a brand that symbolizes access and hard work. Let Michael’s 14 years of experience handling Pennsylvania Workers’ Compensation cases benefit you.

While no one is perfect, The Cardamone Law Firm strives to keep clients informed each step of the way. The Pennsylvania Workers’ Compensation system can be extremely stressful for injured workers. Our goal is to ease the burdens as much as possible and information is the key to lowering anxiety. We don’t like talking in archaic legal language. We try to explain things in an easy to understand way so that you can follow what’s happening in your case.

Some of Michael Cardamone’s achievements include:

-Lawline Faculty Member Speaking On PA Work Comp Topics

-Voted a Pennsylvania Super Lawyer In Workers’ Compensation Law By Other Attorneys

-Rated “Superb” by Avvo Legal Ratings- The Highest Rating Possible

-Certified Specialist In Pennsylvania Workers’ Compensation Law

-Graduate of The Villanova University School Of Law, Boston College, And St. Joe’s Prep

If you want an honest, hard working attorney who fights tenaciously for your benefits, you’ve found the right PA Work Comp Attorney. Free Consults 7 Days A Week at (215) 206-9068 or via email at MyPhillyWorkersComp@Gmail.com

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