One day you rifle through your mail – there are the usual bills, fliers from grocery stores, and coupons – and then you see an envelope that really grabs your attention: it is from the Pennsylvania Bureau of Workers’ Compensation so you know it pertains to your workers’ compensation case. Your life has been turned upside down since you injured your neck and back at work a few months earlier. You frantically open the envelope and see there is an Order from the Workers’ Compensation Judge who has been assigned to your case: “The Employer’s Request for Supersedeas is hereby DENIED.” You exclaim to yourself – what does that mean? Will my benefits continue? Be calm, we’re here to tell you all about supersedeas.
If you injure yourself at work, the workers’ compensation insurance company for your employer will have one goal: to pay out as little money as possible. Do not think for a minute that the insurance company has your best interests at heart. One of the tools it has in its arsenal to make your life difficult is a request for supersedeas, which is a temporary stay or stopping of your benefits. Let’s look at some scenarios under the hypothetical that you injured your neck and back at work and are unable to do your job. The insurance company could: (1) accept your claim and agree to pay you money for lost wages, as well as your medical bills; or (2) accept your claim for medical treatment but deny your claim for lost wages; or (3) deny your claim altogether. Under the third option, the insurance company cannot request supersedeas because you are not receiving benefits. In fact, you would need to hire a Pennsylvania workers’ compensation lawyer to file a Claim Petition with the Bureau of Workers’ Compensation and get your case heard by a Workers’ Compensation Judge.
Under Options 1 and 2, at some point, the insurance company will schedule you for an evaluation by a doctor of its choice, who may very well conclude that you have fully recovered from your work injury and can return to work. Its lawyer will then file a Petition to Terminate your benefits. The lawyer will also request supersedeas – in other words, the lawyer will ask the Judge to grant supersedeas and stop your benefits immediately. In support of its request, at the first hearing, the lawyer will submit to the Judge a copy of the insurance company doctor’s report. By this point, you will be smart if you have hired a Pennsylvania workers’ compensation lawyer, especially smart if it’s a Pearson Koutcher lawyer. Your lawyer will have a specified amount of time, probably 14 days, to submit an affidavit by you, as well as reports from your treating doctors, stating that you have not recovered from your injury and cannot return to your job.
If the insurance company has only accepted the medical portion of your claim, the law does not allow the Judge to grant supersedeas; the insurance company must continue to pay your medical bills while its petition is pending before the Judge and all the evidence is presented. If the insurance company has also accepted the wage loss part of your claim and is sending you a check for benefits every week, the Judge is permitted to grant supersedeas and stop your checks.
While it will be nerve-wracking for you waiting to hear if the Judge has granted or denied the insurance company’s request for supersedeas, you can rest assured that there is a high probability the Judge will rule in your favor unless the insurance company has a “smoking gun.” An example would be if the insurance company has conducted surveillance of you – be aware, this happens a lot – which shows that you have been working for another company when you stated in your affidavit that you have not worked since your injury. Under these circumstances, the Judge would likely conclude that you were not candid in your affidavit and on that basis grant supersedeas and stop your benefits. Another example would be if you told the insurance company doctor that you are very limited in your everyday activities, you cannot lift anything more than 10 pounds, but surveillance shows you helping a family member move; you are videotaped helping to carry a sofa out of a house and into a truck. That may be enough evidence for the Judge to grant supersedeas because you were not forthright when you told the insurance company doctor your limitations.
When you receive the Judge’s ruling on supersedeas, you may see some other terminology that baffles you – Interlocutory Order. This means the Judge’s Order is not subject to appeal – neither side has the right to appeal that Order to a higher court, which in this case is the Workers’ Compensation Appeal Board. If the Judge hears all the evidence in your case and grants your Claim Petition, the insurance company lawyer can file an appeal with the Appeal Board. Likewise, if the Judge grants the insurance company’s Termination Petition, you have the right to appeal to the Appeal Board. But when the Judge issues an Interlocutory Order ruling on supersedeas, you cannot appeal if the Judge grants supersedeas, and the insurance company cannot appeal if the Judge denies supersedeas.
An insurance company’s request for supersedeas, as well as any other action the insurance company takes in your case, is important, and for your rights to be fully protected, you need a top-notch Pennsylvania workers’ compensation lawyer on your side. At Pearson Koutcher Law, our experienced, highly skilled lawyers have handled thousands of workers’ comp. cases, and in so doing have responded to countless requests for supersedeas. If you have been injured at work, regardless of the stage of your claim, please contact us for a free, comprehensive consultation.