By: James R. Burn, Jr.

In Pennsylvania Workers’ Compensation, once your claim has been accepted by the insurance company, the defendant’s insurance company is entitled to have you examined two times per year. These exams are called Independent Medical Evaluations.

Occasionally, the workers’ compensation claims adjuster will send medical authorizations to you at your home. They want to check on your medical status. Be wary of these authorizations. Blank authorizations, if signed, allow insurance companies to go after any medical record for any reason even for items that are not connected to your work-related injury.

Insurance companies are always looking for reasons to get out from underneath their workers’ compensation obligations. If you are treating for an ailment or an issue that is non-work related, the defendant’s insurance carrier could try to pin your disability on one of those non-work-related issues in an effort to get out of their obligations to pay your workers’ compensation benefits.

Records in the hands of an insurance company adjuster that are irrelevant to your workers’ compensation claim could be sent to an independent evaluator in conjunction with an exam potentially causing a misinterpretation of those records to occur. In other words, an independent evaluator could attribute your disability to non-work related issues by a misinterpreting or misunderstanding those records.

Never sign blank medical authorizations. Medical authorizations should always be specifically listed for a provider that is treating you for your work-related injury and time limitations should be on those authorizations. We at Abes Baumann are always available to answer any questions about medical authorizations and the “do’s and don’ts” associated with them.

By: Sandra Weigel Kokal

If you file a claim for workers’ compensation benefits and your employer fires you, you may have a claim for retaliatory discharge.

To do so you must establish a “prima facie” case of retaliation. This means you must prove the following:

1. You were engaged in a protected activity (you were properly performing your job);
2. your employer took an adverse employment action against you (fired you); and
3. a casual nexus existed between the protected activity and the adverse employment action (you got hurt doing your job, filed for workers’ compensation and employer fired you).

Once you establish a “prima facie” case of retaliation, the burden shifts to your employer to prove otherwise. Your employer must provide a legitimate reason for firing you. If your employer offers a legitimate reason for firing you, you have to prove that  reason was a pretext and that the real motive was the workers’ compensation claim. You must show that the employer’s reason for firing you was fake and/or made up.

In a recent case, an employee was injured on the job and the company doctor stated his injury was work-related. The employee was in the process of applying for workers’ compensation benefits with the help of the company doctor. The employer fired him 2 days later for “working unsafely.” The Court found this was a retaliatory discharge.

If you are injured on the job, file for compensation benefits and are then terminated, you should seek the help of an attorney.