In baseball, if teams play two games in a day, it’s called a doubleheader. In the workplace, if somebody sustains two injuries – in the same day, week, month, or year – that is one unlucky person. But how does this play out in a PA workers’ compensation case? We like to use hypotheticals to explain things in this blog, and we’re going to do that here to help you understand the process if you are unfortunate enough to injure yourself twice within a short span.
Suppose you were employed by a company as a driver and laborer; your job required you to load appliances onto a truck and deliver them to people’s homes. This was obviously a strenuous job as you had to lift and carry a number of heavy appliances, including washing machines, dryers, refrigerators, and stoves.
Last August, while you and your co-worker were carrying a washing machine down a flight of steps to the basement of a customer’s home, you felt a pop in your low back. You managed to keep a hold of the washing machine and guide it down to the basement. However, you were in so much pain that you had to stop working. You promptly reported the injury to your supervisor and were sent to your company’s occupational health doctor, who took you out of work due to your back injury. Over the next four months, you remained out of work and received workers’ compensation benefits. You underwent an MRI to your low back that showed a herniated disc. You took medication, tried a course of physical therapy, and received some injections.
After treating with the company’s medical providers for 90 days as mandated by workers’ compensation law, you started to treat with your own pain management doctor, and in December, this doctor released you to light-duty work. Your employer offered you a job that involved working in the office and occasionally driving the truck but not lifting or carrying any appliances. This job paid the same hourly rate you earned in your regular job, and because you liked your company and were eager to get back to work, you accepted the light-duty position. Because you were paid the same hourly rate in this position as you earned prior to your injury, you were no longer entitled to wage loss benefits. But the workers’ comp. insurance company remained obligated to pay for your medical bills, and since you continued to experience low back pain that limited your ability to function, you continued treating with your pain management doctor, who kept prescribing you medication and administered a different type of injection to your back.
Things went well for you in your light-duty job, but then in February, you were out driving the company truck and a tractor-trailer rear-ended you. For the second time in six months, you were injured at work. The motor vehicle accident caused an increase in your back pain, as well as pain to your neck, which you had not felt following your injury carrying the washing machine. You were taken out of work, and an MRI to your neck and follow-up MRI to your low back were ordered.
Let’s throw in another wrinkle to complicate things further. On January 1 of this year, your employer changed workers’ comp. insurance companies. It had been Anderson Insurance but effective January, Barber Insurance started to insure your employer for workers’ comp. claims.
So what gives here? Who is responsible for paying you the workers’ comp. benefits that you deserve? You already had a herniated disc from the August incident, but you had showed improvement and were doing light-duty work. You then got banged up when the tractor-trailer ran into the back of your truck. Don’t be surprised if the two insurance companies point fingers at each other: Anderson Insurance declines paying you benefits based on your motor vehicle accident, and Barber denies your claim, contending that you’re once again disabled because of the serious injury you sustained carrying the washing machine. As a result, neither insurance company is paying you, which seems very unfair because you have sustained work-related injuries in two separate incidents and are unable to work – even light-duty work – and yet you have no money coming in. This scenario has happened to other injured workers, and you could be faced with this difficult situation too.
If it does, you need a top workers’ comp. lawyer to represent you and fight, not just one, but two insurance companies, tooth-and-nail. At Pearson Koutcher Law, workers’ comp. is all we do – our lawyers handle complex cases every day. Your case will be heard by a Workers’ Compensation Judge. At the first hearing, your lawyer may make a motion, requesting that the Judge order the two insurance companies immediately to split the payment of your PA workers’ compensation benefits so that you can start receiving a check again. The Judge may or may not grant this motion. Either way, the insurance companies will battle it out on the issue of whether your disability is caused by the washing machine incident, the truck accident, or a combination of the two. This will ultimately come down to the opinions of the doctors — each insurance company can have you evaluated by a doctor, and your doctor will also render opinions on this issue. The Judge will then make a decision, finding Anderson 100% liable, Barber 100% liable, or apportioning liability between the two companies. For example, the Judge could find Anderson 75% liable and Barber 25% liable. It is also possible that the Judge could rule against you and find that you are not disabled by the injuries you sustained in August and February.
Whether you injured yourself once or twice, dealing with a PA workers’ compensation claim is very stressful and you need a first-rate lawyer in your corner. Please call Pearson Koutcher Law today for a free, comprehensive consultation, and let our knowledge and experience work for you.