I have been handling Pennsylvania Work Comp cases for 13 years and I haven’t seen many fakers. This doesn’t mean they don’t exist. Of course they do. But it’s not as prevalent as many people believe. In virtually every conversation I have with a new client, he/she mentions that they are aware of all the fakers. This perspective comes from the media- which reports the outrageous cases. The media doesn’t report about the other 99% of legitimate work-related injuries- the cases that we Claimants’ lawyers are fighting for in the trenches, day in and day out.
It is important to realize that we have many layers of protection against fraud in Pennsylvania Work Comp cases. First, the injured worker treats with a licensed medical doctor- and usually a doctor hired by the Employer itself, for the first 90 days after an injury occurs. The doctor examines the injured workers and renders a diagnosis based on clinical findings, the history reported, and sometimes diagnostic studies which are largely objective in nature. (there is always some room for interpretation and disagreement between physicians depending on their backgrounds, training, prejudices, expertise, etc). If a claim survives beyond the 90 day period, there is often an independent medical examination performed as well- which can be done every six months until a case is resolved, wherein a hand-picked doctor by the insurance company examines the injured worker, reviews the medical records, and writes a report as to the nature and extent of any work injury. Then, we have adjustors for the insurance companies examining the medical records both for 1) extent of disability and 2) causation (ie, was this a work injury?). When cases go into litigation, we then have attorneys reviewing the records to make sure everything makes sense. On top of that, the records (and/or deposition from the doctors) are examined by a Pennsylvania Work Comp Judge.
Between the doctors, the adjustors, the lawyers, and the judges, it is very difficult for an injured worker to slide through the “system” with a completely made up condition. That being said, there is no doubt that people have varying abilities to deal with pain. Some people have incentive to stay out of work because they didn’t like their job, etc. But the same safeguards are in place to spot these people and to keep them honest.
I remind my clients that the vast majority of injured workers I see are not interested in sitting home depressed, getting needles plunged into their spines, waiting for an erratic work comp check, being spied on, going to court to testify, losing out on job skills, or having their significant other angry at them for bringing home less pay. Yes, there are always some lunatics out there who have motivation to lie, cheat, and steal. But most people are good, hard working, and straightforward- and they are not happy about being caught up in the constant stress of a workers’ compensation system that is set up not to provide injured workers with a life long income, but as a temporary safety net until their earning power is restored.
For more info about PA Work Injuries, call Pennsylvania Work Injury Attorney Michael W. Cardamone at 215-206-9068 for a free and prompt consult or email Michael@Cardamonelaw.com