Philadelphia + Delaware County Nursing Home Injury Workers’ Compensation Lawyer
Work injury lawyer, Mark R. Schmidt of Schmidt, Kirifides & Rassias, settled the claim of a 53-year old Certified Nursing Assistant (CNA) for $65,000.00. The number of legal issues involved in this case would make for a Law School Final Examination all by itself.
The injured healthcare worker’s Claim Petition alleged that she injured her lower back after lifting a home-bound patient in 2011, while working as a home care aide. She also requested Penalties, alleging the claims representative failed to file formal documents with the Bureau of Workers’ Compensation (BWC), as required by Pennsylvania law. The Insurance Company denied the claim, contending that no incident ever occurred; that claimant failed to give the employer timely Notice of her injury; that she suffered no injury or disability if an incident did occur; that any injury she may have is the result of a pre-existing, underlying condition; and that there was videotape surveillance of her activities showing her to be physically active. In other words – every defense imaginable.
We Will Fight Workers’ Comp Insurance Companies for You
Attorney Schmidt fought the insurance company on each issue, with expert medical testimony establishing the nature and severity of her injuries – as well as proof that the investigator taped claimant’s daughter – rather than claimant! The Judge not only awarded claimant benefits, but also determined that the employer did not have a reasonable basis to challenge the Petition, AND that the employer had violated the requirements of the Workers’ Compensation Act – thereby awarding attorney’s fees and penalties to be paid by the employer. The employer filed an Appeal.
While the Appeal remained before the Workers’ Compensation Appeal Board (WCAB), employer had claimant undergo a second Independent Medical Examination (IME) – which is really a Defense Medical Examination – because the doctor is selected and paid for by the insurance company. Based on the doctor’s opinion (which contradicted the Judge’s Order as to what the work injury really was) the insurance Company filed a Petition to Terminate the injured worker’s benefits.
Meanwhile, claimant filed multiple additional Petitions for Penalties, arguing that the insurance company was refusing to pay medical bills in violation of the Court’s Order, and that her wage loss benefits were intentionally, or negligently being sent to a wrong address. Shortly after receiving those petitions, and arguably as a means to retaliate against the injured worker, the insurance company filed a Request for Utilization Review, challenging the reasonableness and necessity of treatment being provided by each of claimant’s doctors. Pursuant to the Law of Pennsylvania – the mere Request allows an insurance Company to withhold payment of medical bills during the entire, lengthy review process. [The result is that many doctors will stop providing treatment to injured workers, once their bills are challenged – without even waiting for a decision to be made.]
During the course of fighting the Appeal and 6 new petitions before the Judge, Attorney Schmidt negotiated the agreement of the Insurance company to ensure payment of all benefits dating back to 2011, including every medical bill being challenged, all in addition to the lump sum payment, which represented 4 years of future wage loss benefits.
Skilled Philadelphia and Delaware County Workers’ Comp Lawyers Handling Nursing Injury Claims
If you have been injured at work, you need the knowledge and skill of an experienced work injury lawyer who will aggressively fight back against the insurance company, to ensure that you receive all of the benefits you deserve. For a free consultation, call the work injury team at Schmidt, Kirifides & Rassias at (484) 679-5239 or contact the law firm online. With offices in Media and Philadelphia Pennsylvania, as well as in Wilmington, Delaware, we have a location convenient to serve workers injured throughout Southeast PA, including Philadelphia County, Montgomery County, Bucks County, Berks County, Delaware County and Chester County.