Workers’ compensation laws have gone through many changes since first established in 1915, but the ‘intent’ of the law remains the same: to pay medical bills and wage loss benefits to workers injured in the course of their job, “undiminished by the cost of litigation.” Workers’ compensation benefits are not taxable, so the weekly rate is below the employee’s salary, based on mathematical formulas which try to match what the claimant would have received if they had not been injured. However, when an insurance company denies the claim or challenges the duration of disability, lawyer fees and litigation costs could greatly reduce the amount benefits the injured worker actually receives.
The law has not changed (much) from the original terms, but the way the Court has interpreted those words has changed over the years. In 2021 and 2022, several Court Decisions have returned to the Workers’ Compensation Act’s original intent. An attorney’s fee SHALL be awarded, payable by the insurance company; but MAY be deducted from the injured worker’s weekly benefits where the Judge determines (and explains why) the insurance company’s challenge was reasonable – even though not successful [Lorino v. WCAB]. Where the issue involves only the payment of medical bills, and has no impact on the worker’s wage loss benefits, the attorney fee MAY be charged against the treatment Provider’s bill [Neves v. WCAB].
The litigation costs to fight the case are separate from the lawyer’s fee. Costs typically include payment to obtain medical records, transcripts of hearings and depositions, and a medical witnesses’ (usually large) expert fee. A successful claimant SHALL be awarded reimbursement of these costs, payable by the insurance company. However, over the past 20+ years, several court decisions have restricted reimbursement of costs in a manner not stated in the law, limiting reimbursement to costs directly applicable to the issue on which the claimant won; and then further restricting reimbursement to costs directly responsible for why the claimant won. If the dispute involved multiple issues, some being decided in the insurance company’s favor, many costs have been excluded from the award. In October 2022, the Court strictly applied the words of the Act, requiring reimbursement of litigation costs if the cost was incurred in relation to the issue the claimant won – even if not directly responsible for why the claimant succeeded on that issue [Lawhorne v. Lutron Electronics]. While this may seem overly ‘technical’ to the layperson – it is a significant result for lawyers who represent injured workers, who are able to recoup some of their costs. In turn, it benefits injured employees by ensuring that a lawyer will not ‘skimp’ on costs, affecting the possible outcome of a case; or may even decline representation where ‘some’ of the issues in the case appear troubling.
As with all court decisions, there are facts, circumstances and ‘conditions’ discussed in each of the above Decisions which impact whether and how they might impact YOUR CASE. If you or someone you know has been injured at work, you NEED a lawyer who knows the constantly changing laws, in order to be able to effectively protect your rights and maximize the amount YOU receive. All of the Workers’ Compensation lawyers at Schmidt, Kirifides & Rassias are CERTIFIED SPECIALISTS* each having 30+ years of experience in the field of work injury claims.
[*Specialty Certification per Supreme Court of PA and PA Bar Ass’n rules and requirements]