Abington Workers’ Compensation LAWYER

The adjuster’s job is to save insurance companies money. No matter how nice they may seem, they are not working for you and cannot be relied upon to provide you with the truth. That is because they are paid to work against your best interest. No law requires them to tell you the truth or explain your legal rights. They are not lawyers. You hire an attorney because you understand you will get a better result than representing yourself. You hire an attorney to make your life easier and to get meaningful guidance at a difficult time. You hire an attorney to get you every dollar you are entitled to. Retaining an attorney allows you to focus on healing from your injury because we handle all the confusing legal stuff for you. We will deal with the insurance company, answer your questions, and even help you find the right doctors.

Bigger is not always better. You can’t be an effective attorney with too many cases. If you don’t have the time to talk with and listen to your clients, you can’t represent them well. You can’t get the best results for people you barely know. At large firms, cases are tossed around like footballs. When you call, you never know which attorney has possession of your case. Jenifer is a solo practitioner and handles all the important legal stuff herself. She is there for you however long your case lasts. She knows who you are and what’s happening with your case when you call. She recognizes how stressful being out of work can be and that you will have questions and concerns about your future. You deserve to understand the process. She also understands that being injured affects you and your family in so many ways. Unlike large firms, you don’t need to make an appointment to talk to Jenifer; you just have to call. She’s at her office every day, conveniently located in Abington. You don’t need to drive to Center City or pay to park to meet with her. She will meet you closer to home if you can’t come to the office.

Workers’ compensation attorneys work on a contingency basis, meaning they only get paid if they successfully get or defend your right to wage loss benefits and a Judge approves their fee. The standard workers’ compensation attorneys’ fee in Pennsylvania is 20% of wage loss benefits awarded to you. No attorney can legally charge you more than 20%. Unlike many attorneys, we never charge a fee for medical benefits. If we are successful, the insurance carrier will deduct our fee and send it directly to us. You never write us a check, and we never charge you for our costs. If we are successful, most of these will be reimbursed by the compensation carrier.

The answer to both of these questions is no. That may seem unfair, but let us explain why that is. The workers’ compensation system is limited to medical coverage and payment for any wage loss. There are also some special payments if you lose hearing or vision, suffer an amputation, get a scar on your face, or are killed on the job–but that’s it. Even though being injured on the job causes real pain and suffering, there is no additional financial compensation for it. We empathize and recognize that it is unfair, but that’s the law. Relative to suing for negligence, in Pennsylvania, it is the law that you are not allowed to sue your employer if you are hurt at work. Your only choice is to seek workers’ compensation benefits. That is because workers’ compensation is an exclusive remedy. The exclusive remedy is not all bad, though. The flip side of the law not allowing you to sue for employer negligence is that workers’ compensation, as a result, is designed to be a “no-fault” system. Unlike in personal injury cases, the Judge does not make an initial determination if you were at fault for causing the accident. Even if you were not as careful as you could have been on the job, you could still get workers’ compensation (with the exceptions being self-inflicted injuries and the injury being caused by you being under the influence). Ultimately, no-fault means you get workers’ compensation regardless of whether your actions, employer, or some combination caused your injury.

After you are hurt at work, your employer may give you a list of approved “panel” doctors that can treat you.  Some Employers will advise that a certain doctor MUST treat you. You are then told that it is the law that you are required to treat with their doctors for the first 90 days after an injury.While there is technically a 90-day treatment rule in workers comp, it is very rare that you are legally required to treat with the company doctor at all, let alone for the first 90 days.  For the 90-day treatment rule to apply, your Employer must do all of the following and accept liability for your injury.  If your claim has been denied, you 100% do not have to treat with the panel doctor:
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- Give you the list of approved panel doctors at the time you are hired
- Give you the list after you are hurt
- Post the list in a common area such as a breakroom or a lunchroom
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If your Employer does not do all three, you are NOT required to treat with their doctors. It is actually very uncommon for an Employer to do all three things above unless they are a very large or municipal employer. To recap, you do not need to treat with the company/panel doctor if: 
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- You were not provided a list of doctors to choose from
- You were told you have to see a certain doctor or not told where to treat
- You did not get the list when you were hired and when you were hurt
- Your claim has been denied, even if you were given the list

Even when a proper list is not provided, many injured workers feel they should be treated by the doctor their employer sends them to. They believe that seeing the panel is in their best interest. Unfortunately, that is not generally the case. The workers’ compensation insurance company chooses hires, and pays the panel doctor. They are working under contract for the insurer, who sets all the rules. The panel doctor is required to make medical decisions that are in your Employer’s best interest, even if they are not in your best interest. The panel doctor is expected to save your employer money by getting you back to work (even light work) as soon as possible. If the panel is unsure whether you can work or not, he or she must break the tie by sending you back to work. They also avoid getting MRIs to save your employer money and to hide your full diagnosis from you. On top of that, many panel doctors are not doctors, but are nurse practitioners or physician assistants. At some panel medical practices, you will never see a doctor, let alone see the same person twice. It is always best to select a doctor who is looking out for you, not the insurance company. Panel doctors see many patients daily and often do not have the time nor the incentive to listen to you and provide the treatment you need. This can delay the healing process and lead to missed diagnoses.

Sometimes, the insurance carrier will assign a Nurse Case Manager to your case. This will most likely happen if you have a severe or complex injury. This person is usually very sweet and nice and, like the government, will say she is here to help you. But make no mistake, the NCM is working on behalf of the insurance company, not you. Her job is to limit the duration of your medical treatment, to keep the cost of your medical treatment as cheap as possible, and to get you back to work quickly. NCMs also try to keep you treated with the panel doctors who are also working for the insurance company.

NCMs sometimes even attend your doctor’s appointments with you and often discuss your case with your doctors when you aren’t around. Some of the lies they might tell you with a friendly smile include: 

- The NCM/insurance company gets to pick where you get MRIs done and that only they can schedule the appointment
- Telling you that you need their approval to see a specialist or a different doctor
- Telling you that you can’t schedule your own doctor’s appointments and that only they can
- Telling you that you must treat at a certain physical therapy practice. 

None of these things are true. NCMs may also tell your doctor which medicines to prescribe you based on the cheapest option or try to get the doctor to stop giving you medication altogether. Sometimes, they even get your doctor to change your work restrictions so a light-duty job can be offered. At Kaufman Workers’ Compensation Law, we can help. We can get the NCM off your back and your doctors’ back so you can take control of your medical care. While we can’t make them disappear altogether, we can make their job harder by not allowing them to talk with you or your doctors.