Question about process? - Printable Version
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Question about process? - mom2twokids - 07-14-2009 10:19 AM
My husband has been out of work since July 2008, he got 90 days worth of wc wages and then they cut off his wages claiming they didn't think he could not return to work. They have continued to pay the medical. We have an attorney and are fighting it. We had our initial hearing where my husband testified and then the judge said there would be another court date in 6 mos (assuming by this time he would be back to work and we would be settling things). At this point the dr has said he cannot return to his old job. The judge also doesn't understand why the insurance company is even denying his injuries. They took my husband's dr's deposition and we have another hearing in Sept for the defense to present their evidence against my husband. After that hearing we are told a decision will be made. What kind of time frame are we looking at for a decision? Do they have a time limit on when the judge has to make a decision? Also at that time will they determine a disfigurement amount since my husband has a permanent scar on his head from the injury? We are in PA.
RE: Question about process? - Manley2 - 07-14-2009 10:40 AM
Sorry I don't know for sure in your case but in mine there was no time limit on them making a decision. I have another hearing later this month and don't think there is a time limit for them to make a decision on this one. I don't understand how they can still be paying his medical bills but not paying him to be off. Kind in touch with your lawyer, they need to be open with you and answer your questions. But remember nothing in WC is every quick. The laws are written to protect the employers more then the injuried
RE: Question about process? - fencer11 - 07-14-2009 11:31 AM
Odds are that the defense has no evidence against your husband. Has he done anything outside of his restrictions that they may have video or photos of? In my case the IC wanted to settle before the hearing because they had nothing against me. If they are paying medical, it sounds like liability has been established by a judge or accepted by the IC. You say your husband has a scar on his head, is it visible or hidden by hair? Some states do have seperate claims for visible scars.WC is a long dragged out process, hang in there!!
RE: Question about process? - mom2twokids - 07-14-2009 11:49 AM
I think they paid him for 90 days as a temporary investigative period? They have agreed that he was injured on the job, they are disputing the severity of his injuries? I guess they are saying they don't believe that he is disabled as a result of the injuries. And they have not offered him another position in his company within his physical restrictions. He has post concussion syndrome with a severe balance deficit now.
He hasn't done anything beyond his restrictions, the biggest restriction is no driving and he has not been driving... He is allowed to do light activity, he just cannot climb a ladder, etc like his job would normally require (he was a painter). We think their evidence is their dr that they sent my husband to last year and who said there was nothing wrong with my husband and that he was perfectly fine. The judge knows this dr and apparently the dr is known to never find anything wrong with people who are sent to him and the judge said as much in the first hearing...
The scar is very much visible, he is actually missing hair now where his scar is.
RE: Question about process? - kate - 07-14-2009 12:18 PM
In PA disfigurement benefits are as follows:
Benefits are paid if there is a serious, permanent, unsightly disfigurement to the head, face or neck area. There are no set payment amounts for disfigurement benefits. An Agreement, made and recorded on the appropriate Agreement Form, may be reached between the employee and the employer or its insurance carrier. If an Agreement cannot be reached, the employee may file a petition for a hearing before a Workers' Compensation Judge.
RE: Question about process? - capricorn - 07-14-2009 01:01 PM
Hi ..I am also from PA.....In myhusband's case the Judge took almost 6 months to make a decision. In mine (I had another Judge) it only took him 2. It depends on the Judge and case. My attorney told me in PA right now they are trying to get Judge's to make decisions and not take so long. In my area they added 3 Judges which really helped. Best of luck.
RE: Question about process? - Manley2 - 07-14-2009 01:47 PM
Are you saying they are offering him a job but he will not back? If they have a job within his restrictions he needs to go back and try to do it or they will stop paying him.
RE: Question about process? - Still in Limbo - 07-14-2009 02:50 PM
Hi Mom, I'm from Pa., and Hopefully I can Help! If Your Husbands Dr. has Him on Restrictions, and His Job has Offered Him a Job within those Restrictions, and Your Husband has not tried the Job, they will Stop His Benefits, and You will have to Fight through the Hearings Process, but if the Job is not Within His Dr.'s Restrictions, and You Win this Hearing, they will Owe You ALL Back Monies He should have been getting Paid! If You could Please Clear Up which Situation is Yours, I May be able to Help more, My Next Hearing will be Number 16, so I have been at this for a While!!
RE: Question about process? - mom2twokids - 07-14-2009 03:20 PM
He has not been offered another job by his employer. He has restrictions from the dr. and basically cannot do his previous job. They are a small company (about 5 employees).
RE: Question about process? - Still in Limbo - 07-14-2009 03:30 PM
Then He was Paid 90 Days on Temporary Disability as You Stated, and the Employer is Only Fighting the Severity of the Injury, so it's Your Dr. vs. Theirs. Depending on the County You Live in, After the Hearing, the Judge will look over the Medical Evidence Provided by Both Parties via the Depositions, and Decide which Dr. is More Credible. If Your Dr, is found More Credible, You will Receive All Back Monies Owed, Plus Interest and a Penalty anywhere from 0 -50%, Depending on the Judge. If Their Dr. is found More Credible, You can Appeal, but it is Very Hard, almost Impossible in Pa. to have a Judges Credibility Overturned, at the Appellate Level. The Time Frame for the Judges Decision is Based on that Judges Workload, anywhere from 2 to 6 Months are the Usual, My Dr. was Found More Credible after 13 Hearings, and the Decision took 4 Months. I Hope this Helps, I know it's not as Precise as You would Like, But Pa. w/c is like Entering Bazzaro World, and there is just no Set Rhyme or Reason with Some of the Things they do!! God Bless, and My Best to You and Your Husband!!
If You would Like to PM Me with the County You are in, I will Keep it Confidential and Help Further if I can!!