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How Do I Maximize The Value Of My Workers’ Comp. Case?

  • Dave Brown, Esquire
  • 07/27/2020

If you have injured yourself at work and cannot perform your job, you deserve the maximum amount of workers’ compensation benefits to which you are entitled. There are several things that you can do to increase the chances that the insurance company will accept your claim, or if not, the Workers’ Compensation Judge assigned to your case will rule in your favor and award you benefits. We’re going to provide you with a few tips that will help you win your case and get the highest possible settlement if you want to settle your case.

Report Your Injury Promptly—The law in Pennsylvania is that an injured worker must notify their employer of a work injury within 120 days of the injury. It will help your case, though, if you tell your supervisor about a work injury far sooner than that – ideally the same day it happens or the next day. The longer you wait to report the injury, the more likely your supervisor will be skeptical that you injured yourself at work. The insurance company and eventually the Judge may also have their doubts if there is a long delay by you in reporting your injury. We understand that initially you may feel the injury is minor and will go away quickly so you do not say anything right away. However, this can really hurt your claim. Let’s say, on the 1st of the month, that you feel pain to your back while carrying a box at work. You shake it off, keep working, take a Motrin that night, and continue to work for three weeks, taking Motrin all along to help you deal with the pain. However, your pain progressively worsens and then finally, on the 22nd, you mention your back injury carrying the box to your supervisor. You may get raised eyebrows, “You claim you injured your back three weeks ago, and you’re just reporting it now?!” If you had reported it on the 1st when it happened, or soon after, your supervisor would be much more likely to believe you.

Seek Medical Treatment Promptly – This goes hand-in-hand with notifying your supervisor promptly – get your injury checked out by a doctor as soon as you can. When you report your injury, your supervisor or an HR rep. from your company should provide you with a list of workers’ compensation panel doctors that you can see for a work injury. (The list may be posted at your workplace.) Normally, your employer will send you to an occupational doctor who will take a history from you (ask you how you injured yourself and where you feel your pain), examine you, prescribe any necessary treatment and medication, and possibly impose limitations on your ability to work. For example, you may be placed on light-duty. If your employer does not provide you with a list of panel doctors, you can go to a doctor of your choice so you can make an appointment with your primary care doctor or go to your local emergency room. Whether you go to an occupational doctor, your primary care doctor, or are seen in an emergency room, by seeking medical attention your injury will be documented, which will strengthen your claim.

Keep up with Your Medical Treatment—This seems like obvious advice – if you’re in pain, cannot do your job, and are limited in your everyday activities, naturally you’re going to want to get better and follow the recommendations of your doctors. But some injured workers do not keep up with their physical therapy, and/or miss appointments with specialists and for diagnostic studies. If you are lackadaisical about your medical treatment, this can raise red flags for the insurance company and the Judge. In other words, if you’re prescribed therapy three times per week and only attend once, and you’re referred to an orthopedic surgeon and for an MRI and you miss these appointments, the reaction from the insurance company and Judge may be – You must not be hurt badly if you only make it to therapy once a week, aren’t seen by the orthopedic surgeon, and miss your MRI. So it’s important – both for your health and for your case – to be diligent about attending all of your scheduled medical appointments.

Attend Required Court Proceedings—If your claim is denied and your case goes before a Workers’ Compensation Judge, you will have to testify at a deposition or at a hearing before the Judge. You may have to testify early in your case by deposition and at the end of your case at a hearing. (Since the pandemic started, depositions and hearings have been conducted telephonically, but this is expected to change in the coming months.) When you are notified by your lawyer – we hope it is a Pearson Koutcher lawyer – put the date and time on your calendar. It’s important that you don’t miss your deposition or hearing, as this can only infuriate the Judge and delay your case. The Judge presiding over your case will also schedule a mediation (a settlement conference) with another Judge, which is an opportunity for you to settle your case – usually this is for a lump sum of money and payment of your medical bills. By following all of the tips we have provided, you will make your case stronger, which should help you get a better settlement.

Workers’ comp. cases are complicated and make no mistake about it – the insurance company for your employer is not your friend. They will look for any reason to deny your claim and fight you every step of the way. You have to help yourself by promptly reporting your injury and seeking medical attention, keeping up with all of your treatment and tests, and attending all depositions, hearings, and mediations in which your attendance is required. You will also help yourself by hiring the firm of Pearson Koutcher Law to represent you in your workers’ comp. case. Our experienced lawyers only handle workers’ comp. cases – it’s all we do; this is our area of expertise. Please call us for a free consultation if you are unfortunate enough to injure yourself at work.