If you’re cruising down the road, going 48 in a 40 mile-per-hour zone and a police officer is camped out on the side of the road with a radar gun, will he pull you over and give you a ticket? It depends somewhat on the mindset of the officer – a strict one may nab you because you exceeded the speed limit, but a more relaxed cop may not stop you because you were over the speed limit by less than 10 MPH.
If you punch in late for your job by five minutes one day and ten minutes two days later, will your supervisor write you up? A boss that’s hard-nosed and by-the-book who doesn’t tolerate lateness could be inclined to give you a warning. However, a more laid back boss may overlook minor occasional latenesses as long as you’re doing a good job.
If you injure yourself at work and the insurance company denies your claim or accepts your claim but later petitions to cut off your benefits, will the mindset of the Workers’ Compensation Judge who hears your case influence how the case is decided? Just like the examples above with the police officer and supervisor, which judge hears your case will play a key role in whether you win or lose, and how much you’re able to settle your case for.
We’ll give you a hypothetical to explain what we mean. Suppose you injure your neck carrying a 20-pound box at work. The insurance company denies your claim, and you hire a lawyer to file a petition for benefits on your behalf, which is called a Claim Petition. Not long after your injury, you undergo an MRI to your neck, and it shows you have degenerative disc disease (arthritis) at several levels, as well as a disc protrusion. While your case is being litigated, you are evaluated by an insurance company doctor who finds that if you sustained an injury at work, it was a minor neck sprain, and by the time of the evaluation, you fully recovered. Your treating doctor believes that you sustained significant injuries as a result of lifting the box – an aggravation of your underlying degenerative disc disease, as well as a disc protrusion, and you have not fully recovered from these injuries. Furthermore, one of your co-workers, who worked side by side with you, testifies for your employer that after you lifted the box that day, you kept working for another week and never complained that your neck hurt.
So which judge will decide your case? The Bureau of Workers’ Compensation in Harrisburg will randomly assign your Claim Petition to a Workers’ Compensation Judge. If you live in Philadelphia, it will be one of 17 Judges in the Philadelphia Workers’ Compensation office. If you live in one of the surrounding counties – Chester, Montgomery, Delaware, Bucks, Berks, Lancaster, or Lehigh – there are fewer judges in the office, between four and six. Regardless of where you live, and which office your case is heard in, there are judges who are sympathetic to injured workers, judges who are sympathetic to insurance companies, and judges who are more middle-of-the-road. The judge’s tendency can be based on what type of work that he or she did as a lawyer. Most Workers’ Compensation Judges practiced workers’ comp. law before becoming a judge. Somebody who represented injured workers, or claimants, for 20 years is more likely to exhibit a tendency to rule in favor of claimants. On the other hand, someone who spent a long time defending employers and insurance companies will be more likely to rule against claimants. Some judges practiced on both sides, and they are normally more middle-of-the-road.
In this hypothetical, the judge can make one of three decisions: (1) grant your Claim Petition and find that you sustained injuries which prevent you from doing your job and from which you have not recovered; (2) grant your Claim Petition but find that by the time you were evaluated by the insurance company doctor, you fully recovered and can return to your regular job (3) deny your Claim Petition on the basis that you did not sustain an injury at work. A claimant-friendly judge is more likely to gravitate toward decision #1, a neutral judge, who has a tendency to compromise, may go with #2, and an employer-friendly judge may lean toward
the third scenario.
Regardless of which judge is assigned to your case, at some point, there will probably be a mediation or settlement conference held by another Workers’ Compensation Judge, different from the one hearing your case. The mediating judge will try to facilitate a settlement in your case – in other words find an amount of money that you’re willing to accept and the insurance company is willing to pay. Let’s say that the insurance company’s settlement offer is $40,000. (The value of your case depends on several factors, including how much money you earned at your job, how physically demanding your job is, and what body parts you injured.) If your case is before a pro-employer judge, your lawyer may recommend that you accept the $40,000 because that’s more money than you will receive if you let the judge decide your case. However, if you’re before a claimant-friendly judge, your lawyer may recommend against you accepting that offer because you can get more if you wait and allow the judge to render a decision in your case.
If you are injured at work, it’s very important that you are represented by an experienced lawyer with expertise practicing workers’ comp. law. At Pearson Koutcher Law, workers’ comp. is all we do. Our lawyers regularly practice before all the judges in the Philadelphia area and beyond, and we know the tendencies of every judge, and how that affects your chances of winning or losing. Call us right away for a prompt, free, comprehensive consultation.