Philadelphia, Pennsylvania Personal Injury Blog

Construction workers are all too familiar with a dangerous work environment. Jobsites have a lot of different types of workers performing tasks in several places at the same time. It would be impossible to be able to watch everything that is happening, so workers have to trust that others are using proper safety techniques and will be focused on eliminating construction accidents.

During these difficult economic times, it has been a challenge for many people to find work. Unemployment rates remain high, and those who do have a job are doing everything they can to stay employed. Workers and employers know that there are people ready and willing to do the job if an employee's performance begins to slip.

In the case Keene v. Workers' Compensation Appeal Board (Ogden Corp.), the Commonwealth Court held that a claimant, who was receiving Social Security Disability, did not remove herself from the work force, because she testified that she stopped looking for employment for a two-year period after a work-related knee replacement. Judge Friedman wrote that before the employer could suspend her benefits, they had the burden of showing that the claimant voluntarily retired. According to previous case law the employer meets this burden of proof by providing: (1) there is no dispute that the claimant retired, (2) the claimant has accepted a retirement pension, or (3) the claimant has accepted a pension and refused suitable employment. Since, the claimant did not accept the retirement pension and could not find suitable employment, there was no basis for voluntary retirement.

Workplace safety has long been a major priority for state and local governments. The Occupational Safety and Health Administration (OSHA) has spent decades trying to improve safety conditions for workers across the country. While these efforts have reduced the number of deaths and serious injuries in the workplace, serious problems still remain.

In Gary v. Workers' Compensation Appeal Board (Phila. Sch. Dist.), the court upheld the Workers' Compensation Judge's decision which denied the Utilization Review Petition. The UR Reviewer decided that the treatment did not show a "significant improvement" in the claimant's condition and therefore continued treatment was deemed not reasonable or necessary, even though five years prior the same treatment was ruled reasonable and necessary. The court stated that because five years had passed and there was no improvement, nor was their conclusive information from the treating doctor's notes that the claimant's condition was improving, the first UR decision was not necessary for evidence. Thus basing the current review solely on the treatment within those five years, where no improvement was made.

In University of Penn. v. Workers' Compensation Appeal Board (Hicks), the court determined that an employer was not entitled to suspend a claimant's benefits after he returned to work following a work injury and was terminated for not possessing the proper certification as a campus police office. The employer had a policy that requires all its officers to posses this certification and the claimant, who was involved in a domestic dispute, had been arrested for assault, which might cause him to lose his certification. The court denied the suspension, because the claimant had not actually lost his certification and because he only might lose it in the future.

According to the Workers' Compensation Act, injured workers are entitled to indemnity (wage-loss) benefits equal to two-thirds of their weekly wage for a work-related injury. However, there are minimum and maximum adjustments provided in the Act, and the benefit rate is set using the annual maximum in place at the time of injury. The maximum is based on the Department of Labor and Industry's calculation of the statewide average weekly wage.

Workers' Compensation Rate Schedules

Pursuant to the Workers' Compensation Act, Section 105.1, the Department of Labor & Industry has determined the statewide average weekly wage for injuries occurring on and after Jan. 1, 2012, shall be $888.00 per week. For purposes of calculating the update to payments for medical treatment rendered on and after Jan. 1, 2012, the percentage increase in the statewide average weekly wage is 3.5 percent.

The schedules provided on the Pennsylvania Department of Labor and Industry's site provide weekly rates from calendar year 2007 to 2012. The maximum weekly compensation rate for calendar year 2012 is $888.00. The weekly compensation rate is to be 66 2/3 percent of the employee's average weekly wage if the average weekly wage falls between $1,332.00 and $666.01. A weekly compensation rate of $444.00 if the employee's average weekly wage is between $666.00 and $493.33. Lastly, 90 percent of the employee's average weekly wage if his/her average weekly wage is $493.32 or less. 

In the case Securitas Security Services USA, Inc. v. Workers' Compensation Appeal Board (Schuch), the claimant's treating doctor for depressive disorder went under Utilization Review. The findings were that the treatment was reasonable and necessary, with no appeal from the employer. The claimant tried to use the findings of the UR decision as the reason and evidence for his filed Review Petition to amend the work injury to include depression, stating the employer accepted the UR decision and therefore can not deny liability. The Commonwealth Court decided that legislation regarding the UR process does not impose liability and claimant must still meet burden of proof in a Review Petition.

In the case of Penn. State University v. Workers's Compensation Appeal Board (Smith), the Commonwealth Court reversed the Appeal Board's affirmation of a claim petition. There was overwhelming evidence showing that the claimant did sustain injuries, but he also intentionally jumped down a flight of stairs. The Commonwealth Court decided that intentional physical stunts are not within the course and scope of employment and therefore not subject to Workers' Compensation Benefits.

The U.S. Department of Health and Human Services announced that Medicare Part B Premiums will be lower than projected. The Part B premiums will have a 3.6% increase to coincide with the COLA increase previously decided earlier in the year. For 2012 the Medicare Part B Premium will be $99.90 and the Part B deductible will decrease by $22, however the premiums paid for Medicare's prescription drug plan will remain virtually unchanged.

Medicare Part B covers physicians' services, outpatient hospital services, certain home health services, durable medical equipment and other items. These services have been greatly improved since the Affordable Care Act was passed, which allows Medicare beneficiaries to receive free preventative services and a 50% discount on covered prescription drugs when they enter the 'donut hole.'

Medicare Part A beneficiaries will see a modest increase in monthly premiums.

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