Blog 9 - Abes Baumann

Calculating Lost Wages Benefits

Eric Abes on August 1, 2017

If you are receiving workers’ compensation benefits, you’re likely bringing home less money than you were when you were working. Unfortunately, workers’ compensation is not designed to pay the exact same amount you were earning before your work-related injury. After an injury, the employer or the workers’ compensation insurance carrier calculates the “average weekly wage” or (AWW). This is the average amount that the injured worker was earning at the time of the injury. The injured workers’ compensation rate could be anywhere from 66% – 90% of that AWW depending on how much the worker was earning.

Many injured workers simply assume that the employer or the workers’ compensation insurance carrier has accurately calculated their AWW and compensation rate, but they often make mistakes.

The Workers’ Compensation Act provides for different methods of calculating the AWW based on the manner in which the injured worker’s pay was determined—hourly, salary, or other methods—and how long the injured worker was employed. If the employer or the carrier use the wrong method of calculation, the AWW and corresponding compensation rate may be too low.

Additionally, the employers and/or workers’ compensation insurance carriers are required to include other payments such as the following:

Money received in a profit sharing plan;

Accrued vacation and/or sick pay;

Per diem payments (i.e., payments made to workers who travel to provide money for food and/or lodging);

Bonuses;

Supplemental Unemployment Benefits (benefits that are payable under some Collective Bargaining Agreements when a worker receives unemployment), and;

Concurrent employment (money earned from a second job at which the injured worker was employed at the time of the injury).

Employers or insurance carriers often neglect to include benefits such as these in the calculation of the AWW. When this happens, the injured worker receives less than they should in weekly compensation benefits. If you believe that you’re receiving less than you should, call us and we will be happy to review your case. If appropriate, we will file the necessary petition to compel the employer or carrier to pay you the full amount of benefits you earned.

VA Emergency Mental Health Treatment

Eric Abes on July 5, 2017

By: Edward Jaffee Abes

As a general rule, Veterans with discharges other than Honorable Discharges face many limitations to their Veterans’ Benefits. One of those limitations is being lifted.

Beginning July 5, 2017, all veterans will have access to VA Hospital emergency rooms for mental health treatment. Veterans with mental health issues, such as PTSD, suicidal thoughts, diagnosed mental diseases, can receive up to 90 days of treatment for mental health emergencies. Treatment may include residential, inpatient, or outpatient services.

Estimates put the number of veteran suicides at 20 per day. This new program is aimed at lowering that number.

The Veterans Crisis Line is also open to all veterans in need of immediate mental health assistance. To access the program, call 800-273-8255 and press 1, text 838255, or visit https://www.veteranscrisisline.net.

Treatment is important, but so is making sure once treatment concludes Veterans have a stable, secure home, food, and medical care so that they can focus on getting better. The attorneys at Abes Baumann work every day to ensure disabled Veterans get all the benefits they earned.

Pennsylvania Supreme Court Rules in Favor of Abes Baumann Client in Landmark Workers’ Compensation Case

Eric Abes on June 26, 2017

Ruling Expected to Help Thousands of Injured Workers Secure Greater Disability Benefits

The Pennsylvania Supreme Court last week declared a key provision in Pennsylvania’s Workers’ Compensation Act “unconstitutional in its entirety” in its ruling on the case Protz v. Workers’ Compensation Appeal Board.

“This is the most significant workers’ compensation ruling in Pennsylvania in the past 30 years,” said Thomas C. Baumann of Pittsburgh firm Abes Baumann, P.C., attorney for the disabled worker who was the claimant in the case. “It could open the door for thousands of severely injured workers to receive benefits more accurately aligned with the extent of their injuries.”

“We are thrilled that Mary Ann Protz, whom experts have determined is unable to work due to her injuries, will now receive the full benefits she deserves for as long as she needs them,” Baumann added.

Protz had sustained a serious knee injury on the job that led to knee replacement surgery and subsequent reflex sympathetic dystrophy. Although an expert hired by the defendant’s insurance company found Protz “unable to perform any job that exists in the local or national economy,” Section 306(a2) of the Workers’ Compensation Act requires the Bureau of Workers’ Compensation to utilize American Medical Association (AMA) guidelines in its Impairment Ratings Evaluations (IRE) to determine level of need. These guidelines set Protz’s level of disability at only 40%, capping her benefits.

“Commonwealth Court ruled and the Supreme Court has now affirmed that Section 306(a2), which delegates decision-making authority to the American Medical Association rather than the legislature, violates the non-delegation doctrine and is unconstitutional,” explained Baumann, who has been seeking justice for Protz since 2011.

The use of AMA guidelines in IREs has created hardships similar to Protz’s for injured workers not only in Pennsylvania, but across this United States. “This ruling likely will usher in a new approach to ensuring benefit levels are accurately aligned with individual workers’ injuries,” Baumann noted. “In addition to future cases, injured workers already on partial disability can consider filing petitions for total disability status,” Baumann said.

Abes Baumann was founded in 1979 as a workers’ compensation firm. Today, Abes Baumann has a reputation for making every client the priority across disciplines including workers’ compensation, veterans’ benefits, personal injury, and pro athletes.

For more information contact:

Thomas C. Baumann, Esq., 412-389-7403

tcb@abesbaumann.com

Or visit: abesbaumann.com

New Veteran Hotline

Eric Abes on June 7, 2017

By: Eric D. Abes

Last week, the White House announced a new hotline for Veterans to call with complaints and concerns about the Department of Veterans Affairs. Everything from late payments, delayed or poor medical care, to poor hospital conditions can be reported. As the Military Times reported here, the new hotline is to collect, process, and respond to the complaints of individual veterans in a responsive, timely, and accountable manner.

The hotline is currently in the “soft launch” stage. By August 15, it is supposed to have staffing by live operators 24 hours a day, 365 days a year. All calls will be confidential, but veterans will be asked for personal information if it is needed to resolve a specific problem.

The number is 855-948-2311.

At Abes Baumann Attorneys, we applaud anything that can give veterans a voice. But sometimes a voice is not enough. When you need help obtaining the benefits you deserve, let us take point.

PRESIDENT’S BUDGET CUTS VETERANS BENEFITS

Eric Abes on June 6, 2017

By: Susan Paczak

The budget proposed by the President increases the VA’s budget by 6%, but it also proposes to cut unemployability benefits for many veterans. Veterans rated at least 60% and unable to work because of their service‑connected disabilities can receive a rating of 100%. These are called Unemployability Benefits. Under this proposed budget, at age 62 the veteran would no longer be rated at 100% unemployable, they would go back to the rating they had before they were found unemployable. This means their benefits would be reduced by $1,000 or more per month. This cut would affect some of the most severely disabled elderly veterans, many of whom are in their 80s. This would plunge many veterans into poverty and possibly homelessness. For many disabilities, it is hard or even impossible to get 100% rating, but that disability rating is what makes the veteran unemployable. Additionally, for veterans with ratings for more than one disability, the formula the VA uses to combine these ratings makes it hard to get 100%, even if the separate ratings would add up to 100%. That is why unemployability benefits are so important.

Secretary of Veterans Affairs Shulkin, has defended these changes saying these veterans are still entitled to Social Security Retirement Benefits at age 62. However, at age 62, the veteran’s Social Security Retirement is a reduced retirement amount. Additionally, many veterans are not eligible for Social Security Retirement or will only receive a small amount because their service‑connected disabilities prevented them from working or forced them into part‑time or low-paying jobs.

Secretary Shulkin also said these cuts were needed to fund an increase in the VA Choice Progam. This means that the VA would take money from some veterans to pay for medical care for other veterans. This proposal does not live up to the VA’s motto, “To care for him who has borne the battle, his widow and orphan.” This motto was taken from President Lincoln’s second inaugural speech. President Lincoln would certainly not be in favor of these cuts to severely disabled veterans.

This budget is still just a proposed budget. This means that if enough pressure is put on the President and Congress, this proposal can be removed from the budget. All of the major veterans service organizations, such as DAV. American Legion, AMVETS, the Vietnam Veterans of America, the Paralyzed Veterans Association, and the VFW have come out in opposition to this proposal.

Please contact the White House, your Senators, and Representatives to tell them you oppose this proposal

Even if you do not receive unemployability benefits, please stand with your brother and sister veterans to oppose this cut in benefits.

Below are instructions for contacting the White House and your Senators and Representatives.

The White House :

To call: 202-456-6213

For email go to: https://www.whitehouse.gov/contact

By mail:

The White House
1600 Pennsylvania Avenue NW
Washington DC 2050

Congress:

You can find your U.S. Representative at www.house.gov. On the main page of this site, at the top right, you will see FIND YOUR REPRESENTATIVE. Enter your zipcode and it will display your Representative and their contact information.

You can find your Senator at www.senate.gov. On the main page of this site, at the top left, there is a drop down menu FIND YOUR SENATORS. Select your state and it will display your Senators and their contact information.

The Impairment Rating Evaluation, Revisited

Eric Abes on May 12, 2017

By: Sandra Weigel Kokal

As discussed in prior blogs, the Insurance Company may try to limit your benefits with the Impairment Rating Evaluation (IRE). An IRE is a physical examination where the doctor determines your level of disability. After receiving 104 weeks of benefits, the PA Workers’ Compensation Act requires an injured worker to submit to an IRE. If the doctor finds that your impairment is over 50%, you will continue to receive total disability workers’ compensation benefits. However, if the doctor finds your impairment is less than 50%, your status will change from total to partial disability.

A recent Supreme Court case, Duffey v. WCAB (Trola-Dyne, Inc.) has given doctors more direction on what is required in their IRE examinations. According to the Supreme Court decision, a doctor performing an IRE must consider ALL of the conditions that the doctor believes are related to the work injury, including any psychological injuries (such as depression or post traumatic stress disorder) that might occur as a result of the work injury. Therefore, even though the description of your injury on the Notice of Compensation Payable (NCP) might not include all injuries, the doctor must address all possible work related injuries. The Supreme Court stated that the doctor is required to render a detailed whole person evaluation in order to support any change in workers’ compensation benefits. This means the whole body evaluation cannot be withheld based on the employer’s description of your injury on the NCP. Your IRE could be found invalid if the doctor fails to perform a whole body impairment evaluation.

Since an IRE can limit your workers’ compensation benefits, the best way to protect yourself is to contact one of the attorneys at Abes Baumann to review the IRE and determine its accuracy.

Calculating Lost Wages Benefits

VA Emergency Mental Health Treatment

Pennsylvania Supreme Court Rules in Favor of Abes Baumann Client in Landmark Workers’ Compensation Case

New Veteran Hotline

PRESIDENT’S BUDGET CUTS VETERANS BENEFITS

The Impairment Rating Evaluation, Revisited

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