Cruz vs. Workers’ Compensation Appeal Board- What Is The Proper Allocation Of The Burden of Proof Between An Employer And A Workers’ Compensation Claimant Regarding The Injured Employee’s Legal Eligibility Under Federal Immigration Law To Obtain Suitable Employment When The Employer Seeks To Suspend Disability Benefits?

In this Supreme Court of Pennsylvania Decision, the Court held that the Employer bore the burden to prove that the loss of earning power of its employee, David Cruz, was due to his lack of United States citizenship or other legal work authorization in order to obtain a Suspension of his workers’ compensation disability benefits.

The Court also held that Claimant’s invocation of his 5th Amendment right against self-incrimination when questioned at the workers’ compensation hearing before the Work Comp Judge did NOT constitute substantial evidence of his alleged lack of legal authorization to be employed in the United States.

The 23 page Decision by the Pennsylvania Supreme Court was well organized and reached the right result. Per previous case law, the burden of an injured worker to prove eligibility for benefits is two-fold, 1) he or she was injured in the course and scope of employment, and 2) the injury resulted in a loss of earning power. Thus, a claimant’s eligibility to lawfully work in the US is not a relevant factor. Once an injury is established as work-related, to suspend benefits, it is the Employer’s burden of proof to show the factors necessary for a Suspension of benefits. In this regard, it’s the Employer’s burden to prove, through competent evidence, that claimant’s loss of earning power is due to her employment eligibility status under federal law.

If you have questions about Pennsylvania Work Comp Law, call or email Attorney Cardamone 7 days a week at (215) 206-9068 or myphillyworkerscomp@gmail.com

The Cardamone Law Firm, LLC

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Case Review: Pennsylvania Workers’ Compensation Subrogation, Medical Expenses, and Reimbursement

In a Commonwealth Court Decision dated June 30, 2014, the Court affirmed the Order of the Workers’ Compensation Appeal Board which affirmed the Workers’ Compensation Judge’s decision that $29,995.59 of work-related medical expenses were not directly payable to Claimant. See Evans v. WCAB (Highway Equipment And Supply Company) No. 2252 C.D. 2013.

Claimant had filed and won a Claim Petition- the Work Comp Judge awarded ongoing work comp benefits for total disability and medical expenses. Claimant’s counsel submitted a letter to Employer informing it of the amount due and also submitted a subrogation lien of Highmark Blue Shield for payment of medical expenses in the amount of $29,995.59.

Claimant contended that pursuant to Frymiare v. Workers’ Compensation Appeal Board (D. Pileggi & Sons), 524 A.2d 1016 (Pa. Cmwlth. 1987), the WCAB erred by not directing payment directly to Claimant. However, the Commonwealth Court distinguished this instant case from Frymiare because there an employer must still pay for medical expenses to a claimant even if a third-party, such as Highmark (private insurer), has already defrayed the cost but has not asserted its subrogation lien. Here, Claimant had already submitted into evidence a letter from Healthcare Recoveries stating that Highmark had a subrogation lien for the awarded medical expenses. As such, they had preserved their lien and the WCJ did not err in finding that the medical expenses should not be paid directly to Claimant.

This case isn’t terribly interesting to most injured workers. But it underscores the notion that the assertion of a lien can affect where payments go for medical expenses. Timing is everything in this regard.

For more information about Pennsylvania Work Comp Law, call or email Attorney Michael W. Cardamone 7 days a week at (215) 206-9068 or myphillyworkerscomp@gmail.com

 

The Cardamone Law Firm, LLC

100% Work Comp; 100% For Injured Workers

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Pennsylvania Workers’ Comp And Repetitive Work Injuries Information

Do repetitive work injuries count as work-related injuries in Pennsylvania?

Yes! Whether your injury was sustained suddenly, or from repetitive work activities, it is a work injury so long as 1) you were an employee at the time, 2) it occurred in the course and scope of your employment (ie, while you were working), and 3) your doctor agrees that it was caused by your work activities. (also make sure to meet the 120 day notice requirement under the Act)

Now, this doesn’t mean that your Employers’ doctors or an IME doctor won’t have another opinion. For example, in carpal tunnel cases, many times the medical experts will have different opinions as to what caused the condition. These claims are frequently denied. Do not let this discourage you!  You can, and should, pursue any repetitive work injury. How is this done? Hire an experienced Pennsylvania repetitive work injury lawyer. We are here to help you at The Cardamone Law Firm, LLC– a specialty boutique firm solely dedicated to injured workers. TCLF gives you the individual attention your case needs to succeed.

If my injury occurred from repetitive work activities, what is the date of my injury? Good question. If you are not working currently, it’s usually the last day of work-since each day of work is considered a new injury under the Pennsylvania Workers’ Compensation Law. If you are continuing to work, it’s often the day you gave notice of the injury to your Employer. Sometimes, the date of injury is the day of the diagnosis by a doctor. It’s obviously not as cut and dry as a traumatic work-related injury, but it’s just as valid as a matter of law.

The most common repetitive trauma work injury that I see in Pennsylvania is carpal tunnel syndrome. Some other repetitive work injuries in Pennsylvania Workers’ Compensation cases are low back injuries from repetitive lifting, or shoulder injuries from repetitive lifting or assembly line work. These are just a few examples.

It is very important for an injured worker in Pennsylvania to describe the specific mechanism of injury– that is, a description of what work activities caused the symptoms. This is a key foundation for the medical expert opinions. Sometimes the doctors will race through the history portion of the examination, so be sure to slow them down to explain and document what you were doing at work which caused your problem. Make sure to tell the provider if you had previous symptoms in the same body part- even if it was many years ago. Sweeping a prior injury or treatment under the carpet can significantly damage a work comp case. Always always always tell the truth. And remember, an aggravation of a pre-existing condition is still a work-related injury under the Pennsylvania Workers’ Compensation Act.

Repetitive work injury cases in Pennsylvania Workers’ Compensation cases are not treated any differently regarding the litigation process. You still need to produce a medical expert who opines, within a reasonable degree of medical certainty, that the work activities caused the diagnoses- or were a substantial contributing factor.  In addition, the injured worker will have to testify about the circumstances surrounding the injury.

If you need a Repetitive Work Injury Lawyer in Philadelphia or Pennsylvania, call one of Pennsylvania’s Most Experienced Work Comp Lawyers Michael W. Cardamone, Founder of The Cardamone Law Firm, LLC 7 days a week at 215-206-9068 to reach him directly or email MyPhillyWorkersComp@Gmail.com for a free analysis of your case.  TCLF is here for you.

 

TCLF– 100% Work Comp; 100% For Injured Workers