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INJURED ON YOUR WAY TO WORK – THE COMING AND GOING RULE

By: Sandra Weigel Kokal

Generally, if you are injured on your commute to or from work, you are not eligible under the PA Workers’ Compensation Act for workers’ compensation benefits. This is generally known as the “Coming and Going Rule.” However, there are four exceptions to this rule:

1. The employment contract includes transportation to or from work;

2. The employee has no fixed place of work;

3. The employee is on a special assignment or mission for the employer; or

4. Special circumstances are such that the employee was furthering the business of the employer.

The Commonwealth Court of Pennsylvania addressed these exceptions in a recent case where the employee was seriously injured in a car accident on his way to work. As a result of his injuries, he was unable to return to his job as Director of Maintenance, a position where he was required to respond to all emergencies. If an emergency occurred on a day he was off, the employer gave him “comp time.” The “comp time” would run from when he was called to work until he arrived back home.

The employee in this case was sick on the morning of his car accident. He was in the process of calling off work sick when he received a phone call from his employer telling him he needed to come in to handle an emergency with one of the security cameras. Employer told him there was no one else available to handle the emergency. The car accident occurred on his was in to handle the emergency.

The employer denied workers’ comp benefits, taking the position he was hurt on his commute. The Workers’ Compensation Judge found otherwise and granted his benefits finding that employee was on a special mission for employer – “Claimant was sick…, and except for the special need of the Employer…Claimant would not have gone to work.” The Workers’ Compensation Appeal Board upheld this decision but called it a “special circumstance” exception.

The Commonwealth Court agreed. The Court found that the only reason Claimant went in to work that day was to help Employer with an emergency. He was entitled to “comp time” which covered his travel time. Workers’ compensation benefits were properly awarded.

Cases involving injuries sustained commuting to work are always difficult and are dependent on the specific facts of each individual case. Consult one of our attorneys to discuss the facts of your case.

WORKERS’ COMPENSATION FRAUD

By: James R. Burn, Jr.

If you have filed a claim for workers’ compensation benefits or you are receiving benefits for lost wages or medical care, workers’ compensation insurance carriers will frequently “check up on you” by sending you forms for updated information. These forms ask if you are receiving any other benefits or working.

As with any type of document, these forms need to be filled out truthfully and accurately. Anyone receiving these documents should avoid entering any information which could be perceived as an attempt to mislead the insurance company.

These forms state quite clearly that fraudulent, inaccurate, or misleading information could be used against the injured worker.

Recently, an injured worker was receiving a salary while receiving workers’ compensation benefits at the same time. He misled the insurance company and withheld this information. Not only was he charged with a crime, but he was also ordered to pay restitution in the amount of $80,000.

Workers’ compensation fraud is what makes it difficult for us in our battles with the insurance company. The insurance companies are of a mindset of suspicion on all claims even the legitimate claims of our hard-working clients.

If you receive any of these forms, we would be happy to discuss them with you. We urge you to share all relevant and accurate information with your insurance carrier to avoid any misunderstandings or problems. Abes Baumann attorneys can help you with your workers’ compensation problems in Pennsylvania.

Prosecuted for not Having Workers’ Compensation Insurance

Failure to have workers’ compensation insurance is a crime in Pennsylvania; one which the state does prosecute, as a business owner found out. George Limberiou of Bern Township pleaded guilty to charges stemming from his failure to have insurance from 2009 to 2012 for Riveredge, his restaurant and banquet facility. He was sentenced to seven years of probation and ordered to pay $111,000.00 in restitution. As is often the case, no one found out about his lack of insurance until one of his workers was injured on the job.

If you suspect your employer does not have insurance, be sure to protect yourself. If you are injured, contact an attorney immediately, even if your employer says they will take care of everything.

The Consumption of Alcohol Is Not Always Admissible at Trial

By: Roger D. Horgan

It is perfectly legal for a driver over the age of 21 years to drink and drive in the Commonwealth of Pennsylvania! That may come as a surprise to people, given the popular admonishment, “Don’t Drink and Drive!” In reality, there is a prohibition only against driving while under the influence of alcohol to such a degree that it renders the driver incapable of safe driving. Impaired driving may be proven by behavior such as swaying, slurred speech, etc., coupled with a police officer’s opinion of intoxication. It can also be proven by testing the driver’s blood alcohol level. In Pennsylvania, the blood alcohol limit is .08%. That is the criminal side.

What happens in a civil lawsuit when the injured party, the Plaintiff, has consumed alcohol? One might think that proof of the consumption of any alcohol whatsoever should be admissible into evidence. It should be left up to the jury as to what weight should be placed upon the consumption of minor amounts of alcohol, right? Historically, that has not been the case. Pennsylvania courts have ruled that in the absence of proof of alcohol induced impairment, the mention of alcohol consumption is too prejudicial to allow a jury to hear. In 1956, the Pennsylvania Supreme Court said, “While proof of intoxication is relevant where reckless or careless driving of an automobile is the matter at issue, the mere fact of drinking intoxicating liquor is not admissible, being unfairly prejudicial, unless it reasonably establishes a degree of intoxication which proves unfitness to drive.”

The interplay of the factors surrounding alcohol as evidence in an auto accident case is demonstrated in a recent Pennsylvania Superior Court case of Rohe v. Vinson in 2016. Mr. Rohe was a motorcyclist who was injured in an accident involving a truck which turned into his lane of travel. Mr. Rohe admitted to having drunk several beers over the course of an afternoon of riding and dining, but denied that he was intoxicated. He asked the trial court to prevent any evidence of his consumption of alcohol from being presented to the jury. The trial court denied that request, and Rohe lost his claim for damages.

He appealed to the Superior Court, which reversed the decision of the trial court, and ordered a new trial at which evidence of Rohe’s alcohol consumption will not be presented to the jury. The Superior Court concluded that the defendant had no viable proof that Mr. Rohe was unfit to drive as the result of alcohol consumption. The record established that none of the individuals with whom Rohe interacted after the accident, including a State Trooper, observed anything in Rohe’s demeanor to indicate that he was under the influence of alcohol. Further, his blood alcohol level as tested two hours after the accident was found to be below the state limit of .08%, at .0706%. The Court also ruled that the defendant’s efforts to calculate the blood level at the time of driving by way of the expert opinion of a toxicologist amounted to no more than speculation, and that the opinion should not have been admitted. The Court was critical of the expert’s methodology, and found the opinion to be too unreliable to have been submitted to the jury.

While one is best served refraining from driving after consuming any alcohol, the law remains that evidence of alcohol is only permitted where it can be shown that the alcohol the driver consumed rendered him unable to drive safely.

Upgrading Improper Discharges

By: Eric D. Abes

The Veterans Administration recently announced an effort to review and potentially upgrade the discharge status of Veterans who may have been discharged improperly. Many times when a soldier suffers from PTSD, the effects of a sexual assault, addiction, or other psychological traumas, they are booted out of the military for misconduct, instead of receiving the help and benefits they deserve.

The military occasionally breaks someone but refuses to take responsibility for putting them back together. Now the VA is working to fix that problem. The 2017 National Defense Authorization Act contains bipartisan language to help Veterans in these circumstances.

If you suffer from PTSD, are a survivor of a sexual assault, or any other psychological trauma, contact Abes Baumann for help getting the benefits you earned. You never have to go it alone.

Will the VA Add New Diseases to the Agent Orange List?

By: Susan Paczak

The Veterans Administration periodically reviews its list of Agent Orange disease to decide if new diseases should be added. If a disease is added, a veteran who was exposed to Agent Orange will be eligible for benefits for that disease. The VA is currently considering adding hypertension, also known as high blood pressure to the list. Additionally, based on scientific evidence, various veteran groups are pushing he VA to add bladder cancer and certain thyroid conditions.

If disease are added, veterans can file claims for those conditions. If the veteran was previously denied, that claim can be reopened, with veterans receiving benefits back to the date of their initial application.

The criteria for obtaining benefits is complicated. Don’t try to navigate the process alone. Contact an Abes Baumann attorney for help.

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