LONG TERM WORKPLACE ILLNESS

Injured workers usually think of a workplace accident as a one-time event, such as a slip and fall or lifting an item and having resulting injuries.  These are certainly workplace injuries.  However, repetitive stress injuries at work are also workers’ compensation claims and entitle you to benefits and financial compensation.  So, lifting one box at work and experiencing back pain is clearly a work related injury.  But, so is lifting up numerous boxes during a work shift and feeling back pain at the end of the day or the next morning.  This is a common repetitive stress injury.  Even physical trauma over the course of years would be a long term workplace illness.  For example, if you have worked for the same company for 10 or 20 years and lifted heavy boxes every day and gradually develop back pain that worsens over time, that is a repetitive lifting injury that would give rise to a workers’ compensation claim.  Keep in mind that long term workplace illness does not have to occur with the same employer.  In other words, if you are a bricklayer and you have lifted heavy bricks, cement blocks, ladders and tools over the course of many years for many employers with shoulder pain that started over time and slowly prevented you from performing your job, this is a workers’ compensation claim. 

If you have a pre-existing condition such as arthritis in your knee or an old high school sports injury to your knee and the repetitive stress of your job worsens or “aggravates” the knee, this is an injury claim.  Many employers and insurance companies try to deceive injured workers and allege that a long term workplace illness does not include a pre-existing condition.  However, if the work you do over time makes this already present condition become more painful, you have a workers’ compensation claim.  These work related injuries entitle you to all the same financial and medical benefits afforded to all injuries by workers’ compensation laws.

Carpal tunnel syndrome is also a repetitive stress injury that we see all the time.  If your job requires you to use your hands in a repetitive manner, this can cause carpal tunnel syndrome.  We see these injuries in office workers and data entry workers, who perform a lot of keyboarding and mousing.  We also see carpal tunnel in factory line workers who perform the same activity with their hand(s) over and over during the course of a workday.  Carpal tunnel syndrome is an injury that entitles you to workers’ compensation benefits.

The workers’ compensation lawyers at Stern & Cohen have many years of experience in helping injured workers with long term workplace illnesses.  The consultation is always free and we will help guide you through the process.  Remember, your employer and their insurance company have workers’ compensation lawyers at their fingertips to help them pay as little as possible.  You should have Stern & Cohen provide you guidance on the complex workers’ compensation laws when you are injured at work to make sure you receive everything that you are entitled to.  With 25 years of experience with workers’ compensation claims, this is all we do.  We serve injured workers in Philadelphia and the surrounding counties and we have recovered millions of dollars for our clients.

Do I need to give my employer notice if I suffered a long term workplace illness?

Yes.  The law requires you to give “notice” to your employer of your injury.  Notice should be given to a supervisor.  Telling a co-worker is not enough.  You may notify your supervisor verbally.  It does not have to be in writing.  It is nice to have it in writing if there are any disputes later, but certainly not mandatory.  Make sure you tell the supervisor that your medical condition was caused by work.  Do not just say, “my back hurts” or “I need treatment on my knee,” please directly tell the supervisor that your job duties over time have caused injury.  In order to collect benefits from day one of your claim, please be sure to notify your employer of the injury within 21 days of its occurrence. If you do not notify your employer within 21 days, you may still supply notice up to 120 days from the incident.  If you give notice after 21 days, but within 120 days, you are entitled to benefits as of the day you supply this notice.  With long term workplace illness, it may take some time before you determine that your injury was caused by your work duties. You may have worked in pain for some time before you decided to address the condition. It may also be that you did not know what caused your condition until a doctor informed you.  That is okay.  Notify your employer as soon as you discover (either through your own intuition or from a medical provider) the work-relatedness of your medical condition.  The time rules for supplying notice only start to run when you knew or should have known that your diagnosis was work related.  This is very important for long term workplace illness claims. If you have any concerns about supplying notice or whether you handled this properly, do not hesitate to contact us.  The consultation is free.

How long does the insurance company have to accept or deny my long term workplace illness case?

The insurance company has 21 days from the time you report your repetitive injury to notify you in writing whether your claim has been accepted or denied.  Insurance companies will also choose to temporarily accept your claim and then later deny it.  The insurance company may accept responsibility for paying medical expenses, lost wages, or both.  It is important to note that the 21 rule is strict and failure to make this decision timely can result in you receiving penalties from the insurance company.  In our experience, insurance companies are more apt to deny long term workplace illness cases since it is easier to try and blame these cases on other causes. No matter what decision they make, it is wise to obtain counsel.  The consultation with us is completely free.

What do I do if the insurance company has denied my long term workplace illness case?

If your workers’ compensation injury claim for your repetitive trauma has been denied, you have every right to challenge that determination. This is done by filing a Claim Petition. You have the right to pursue payment of your lost wages and medical expenses. It is highly advisable that you have a lawyer prepare and litigate this Petition for you. If you are in this situation, please call us. We have no upfront fees. We only receive a fee (“contingent fee”), if we are successful in making a financial recovery.

Can the insurance company ‘temporarily’ accept my long term workplace illness case?

It is very common practice now for insurance companies to only temporarily accept a case after investigation. Although this was not the intention of our Legislature, the insurance carriers have elected this course of action as it buys them additional time to deny your case. The insurance company is hoping to develop an adequate basis to turn around and deny your claim in the first 90 days. Occasionally, even without an adequate basis to deny, they will still do so in the first 90 days, so as to not be stuck with liability for your claim. Therefore, many of your decisions in the first 90 days are extremely important and you should be counseled along the way. If the insurance company accepted temporary responsibility for your case and they do not deny liability after 90 days, the acceptance of your claim is no longer temporary. The insurance company has different obligations at that point in order to contest your ongoing receipt of benefits. If you have received notice that the insurance company has temporarily accepted your claim, please consider calling us. The call is free.

Do I have to treat with the company doctors for a long term workplace illness?

The answer to this question is one of the most common misnomers in this area of law. Clients with long term repetitive injuries will often come to me after already consulting medical providers and there is a fear that they must now see the company doctor. The reason for this is many employers and insurance companies will dispel the myth to injured workers that they “must” treat with certain doctors (often referred to as panel doctors) for 90 days. I sometimes refer to this as the “90 day myth.” There is absolutely no such requirement under Pennsylvania law. In fact, the opposite is true. You are free to choose the doctor that will care for your work injury. There are some very specific laws in terms of payment obligation during the first 90 days. If the employer has adhered to certain rules, then they may only have to pay medical bills for certain providers, but in our experience, these rules are rarely complied with. If the rules are not followed, all medical bills are payable. Even if the employer took necessary steps on their part, there are many medical providers that may still be willing to assist you in the first 90 days. Having control over your own medical care is essential to a healthy recovery and a positive outcome in your case. Unfortunately, some company doctors have inherent bias and cannot provide you the right care and advice. Discussing your medical treatment is part of most initial calls and there is no fee for our consultation.

May I receive other benefits if my long term workplace illness claim was denied?

If your workers’ compensation claim has been denied, determining a source of income while we fight your case can be very stressful. This is especially relevant in repetitive injury cases as the insurance companies like to fight these from the outset. You do have the right to collect unemployment compensation, short and long term disability, social security disability, union benefits and other forms of income in the interim. This may invoke certain offsets in your case but there is typically no detriment to you. You also have the right to return to work while your case is in Court. All of these options are commonly discussed during the first meeting. There is no charge to meet with us.

How is my workers’ compensation benefit rate for a long term workplace injury claim determined?

The amount of your workers’ compensation check is based on your earnings before you were injured. For a repetitive injury case, some strategy is used in determining what the date of injury is. It may be the first day you felt pain; it may be the day the doctor told you that your injury was caused by work; it may be the day you notified the employer; or, it may be your last day of work. Whatever day is utilized, we typically look back one year (52 weeks) to analyze wages. The average of your gross weekly earnings is used to calculate your benefits. Workers’ compensation benefits are not taxable, so they are paid at a percentage of your pre-tax earnings while you worked. You should be paid at the same frequency as your pay structure at work – weekly or bi-weekly. All of your earnings, including overtime, must be considered in the calculation. Additionally, if you had more than one job at the time of your injury, the earnings from your other job(s) must be included in calculating your rate. If you have any questions about how much your benefits should be, please call us. The consultation is free.

Can I settle my long term workplace injury case?

Yes, you can settle your repetitive injury case. Workers’ compensation cases can settle in a variety of ways. You can settle the wage loss part of your claim, the medical portion, or both. Far more often than not, the insurance carrier will only be willing to settle both. Settlement is a voluntary process. No one can force you to settle and no one can force the insurance company to settle. Cases commonly resolve when both sides are ready. The timing of this is extremely variable. In exchange for giving up your rights concerning your injury, the insurance company will pay you a lump sum of money. There are numerous factors that go into determining that lump sum. There are no “pain and suffering” damages in workers’ compensation cases, nor “punitive” damages. Typically, the value of your case is determined by what the insurance company will or may pay in the future before your claim ends. It really takes a lawyer with a tremendous amount of experience to guide you through this process. I have settled thousands of cases. If you wish to discuss settling your case, call me – the consultation is free.

What can I do if the insurance company is not covering all my long term workplace injuries?

This is a very common situation. The insurance company will always seek to accept the least amount of body parts injured as possible and the most minimal description of your diagnoses. You have every right to add additional injuries to your claim. For example, over time at work, you may have hurt your low back and knee and the insurance company may only cover the knee. Or, the cumulative nature of your job duties may have caused a tear in your shoulder and the insurance company is only agreeing that it is a “sprain.” I can file a Review Petition and ask a Judge to expand the injuries the insurance company must cover. Unlike many lawyers, I usually do not charge my clients to go to Court for this purpose. It is free to call me and discuss any problems you are having getting the insurance company to cover all your long term workplace injuries.

What can I do if my medical bills for my long term workplace illness are not being paid?

It is against the law for the insurance company to refuse to pay for medical bills that are related to your work injury. The insurance company can be assessed penalties up to 50% of the amount of your unpaid bills. The penalty gets paid to you, not the doctor! Thus, it is worth your while to pursue this illegal conduct from the insurance company. A Penalty Petition will be filed in Court to address this behavior. If you let the insurance company get away with not paying the treatment for your work injury, the doctor may bill you. Hence, it is critical that you do not let this occur. If your medical bills are not being paid for your repetitive work injury, please call me. The consultation is free.

What if I returned to work after my long term workplace injury and I can no longer perform my job?

This is a very common situation. Clients often want to make an effort to return to work but have fear that they cannot physically do the job. This always starts with a conversation with your doctor. If your medical provider approves your return to work, you may certainly make a good faith effort to do so. You must be very careful about what you sign or what you receive in the mail from the insurance company after such a return. These documents can be time sensitive and contain language that could compromise your future rights, so you will want a lawyer to review. Significantly, if you return and discover that your pain and limitations make it too difficult to continue, you will want to visit your doctor again and obtain documentation that you should cease working. In many situations, the insurance company will voluntarily reinstate your lost wage benefits. If they do not, we can file a Petition on your behalf seeking reinstatement of these benefits. Under the law, often times, there is actually a legal presumption that you are out of work due to your injury and this is an easier case to prove in Court. Your good faith effort to return to work – even if it ultimately proves to be unsuccessful – is typically viewed favorably by Judges as they see that you were, in fact, motivated to continue working, but your work injury ultimately stood in the way. If you have returned to work following an injury or you are contemplating a return and wish to discuss your legal rights, the consultation with us to discuss this is free.

Can I be fired for bringing a long term workplace injury claim?

The answer here is “no.” You cannot be terminated in retaliation for sustaining a work injury – this includes an allegation that you hurt yourself at work over time. If this happens to you, there may be additional legal remedies. We are available to discuss all components of your claim.

Let Our Firm Handle Your Claim

If you were injured at work, get in touch with us right now. Don’t put it off, Contact us now about your case.  We will let you know how much compensation that your claim is potentially worth.

2001 Market Street, Suite 3400
Philadelphia, PA 19103

Call for a FREE, 100% No-obligation
consultation - (215) 999-1443

Contact Us

Let’s build a meaningful relationship that you and your family can count on.

Please fill out the form on the right, below, so that we can learn more about your worker compensation needs. We will be in touch with you shortly to discuss your matter in more detail.

2001 Market Street, Suite 3400
Philadelphia, PA 19103
(215) 999-1443

Thank You!

Form was successfuly submitted. We will contact you shortly.