As we’ve pointed out, we’re always thinking Workers’ Compensation. Sometimes even ways to improve the system. This article is the last of this summer’s four proposals for workers’ compensation reform.
Here’s the problem we see every day: someone is seriously injured at work and the insurance company denies their claim for little or no reason. Our office immediately files a petition to get that injured worker paid. Ordinarily, this process takes several months, sometimes up to and beyond a year. Absent settling the case for a lump sum, or in the unlikely event that the Workers’ Compensation carrier voluntarily acknowledges the claim, the injured worker does not get paid during the course of litigation.
This is downright unfair. Workers’ Compensation was a system designed for prompt adjudication for injured workers. If an injured worker has a meritorious claim, she should get paid Workers’ Compensation immediately.
While the Pennsylvania Bureau of Workers’ Compensation has made great strides in decreasing the amount of time it takes tn injured worker to win a case, there will always be months of litigation. This stems from the fact that each party is allowed due process—their “day in court”.
We suggest that, for meritorious cases, our legislature give Judges the power to award benefits at the first hearing.
Obviously, this solution may be very popular with injured workers. Say, however, you are an employer and you are reading this article, you are probably thinking, “that’s not fair!” Before you jump to that conclusion, however, consider this: employers have for decades enjoyed the opportunity to STOP an injured worker’s benefits at that first hearing. Namely, if an employer files a petition to reduce or even terminate an injured worker’s benefits, it can request a supersedeas, which is a judge’s order. This relief is available to any employer who files such a petition. The employer need only submit convincing evidence that its injured employee should not be collecting full Workers’ Compensation. Naturally, an employer must submit compelling evidence in order for a Judge to approve that request.
So, we know that employers get the opportunity for immediate relief. Why not injured workers?
Actually, there is a section of the Workers’ Compensation Act that allows for a Judge to award benefits at the first hearing. Specifically, §410 of the Act allows for a Judge, in rare circumstances, to award a claimant benefits where there are two potentially liable Workers’ Compensation defendants. As an example, a Judge may direct both carriers to pay half when an individual is clearly disabled as a result of a work injury, and the only question is which of her two employers is responsible for the injury.
Our legislature, however, has never ventured beyond this section. So here’s what we’d like to see, Pennsylvania legislature: allow Judges to temporarily grant an injured worker wage loss benefits where it truly appears as if he will be successful in that litigation. Of course, allow each party to present documentary evidence at that first hearing. If the injured worker shows a prima facie case, grant the benefits.
Give injured workers an opportunity to get better sooner!