Legal Question in Workers Comp in Pennsylvania
Several years ago almost 13 my husband was injured at work. He had surgery on his lower back and shoulder. WC paid for the doctors, etc. He has never really been the same has always had pain but was told he would have to learn to live with it. Then in October of 09 he was pain in his upper back went to doctors had tests and so on everything was covered by WC. The pain subsided but never went away. So, last month it got worse again. Went to HR at work they told him to go ahead and go the doctor again-but was then told that WC denied his claim. Not sure why since it is the same pain he had in October. When he was at the doctor he did mention that if WC doesn't pay we should contact a lawyer. We're not sure what to do now my husband has been with this company for 20 years and with jobs being so scarce doesn't want to risk losing his.
2 Answers from Attorneys
It appears that the injury is work related and should be paid by comp. You need an attorney to petition the court for med payments. Call mw and I will recommend a specialist
So long as a medical bill has been paid within the last three years, your Hubbie shall be protected for WC purposes. It is important for Claimants with older injury dates to never go three years without incurring a bill and ensuring that the Carrier pays it so that the Statute of Limitations does not expire.
Your Employer pays a lot of premium money to its Carrier for WC coverage, and should not retailiate against your family for merely asserting its breadwinner's rights. If it does, google the Shick Lumber case and discuss it with an employment lawyer who knows Workers' Comp.
I'd wager that the insurance Carrier is hoping that the particular back injury is separate and distinct from the historical, acknowledged injury. They may send the matter out for utilization review by a medical peer before voluntarily paying.
It's not too early to consult with Claimants' Counsel. There should be no up-front cost since most of us work on a contingent fee.
Good Luck.
TV
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