Cindy Speaker: Good afternoon, and welcome to this live broadcast on Facebook. I have with me today Debra Matherne, who is a Workers’ Compensation Attorney. She’s also a Workers’ Compensation Certified Specialist. I don’t know if I said that exactly right, but very qualified, and she’s going to talk with us about workers’ compensation, so Debra, thanks for being with us today.
Debra Matherne: Thank you.
Cindy Speaker: Well, we have a lot of questions about people get injured at work, and we want to know: Well, what exactly do you do when you’re injured at work? But let’s start off, Debra, by talking about: What is workers’ compensation?
Debra Matherne: Workers’ compensation benefits is a state-mandated benefit system that all employers must have in Pennsylvania to cover an injured worker in case they’re injured, either they have a physical injury, if there’s death, if there’s disability or even specific loss. So it’s something that an employer must maintain to cover that employee in the event of that happening.
Cindy Speaker: Okay, and what types of benefits are available to injured workers?
Debra Matherne: Well, there are benefits to cover any lost wages you might have, and that can be either if you’re out of work altogether or if you just are making less money after you have a work-related injury, and the reason you’re making less money is related to that physical injury. It can also cover your medical benefits as well.
Cindy Speaker: Okay.
Debra Matherne: So any medical bills or for medical treatment, prescriptions or anything like that that you need.
Cindy Speaker: Okay, so what is the process? When you get injured, what do you do? How do you kind of make a formal complaint or something like that?
Debra Matherne: If you’re an employee, and you’re injured, the first thing you have to make sure that you do is that you report that injury to your employer. And it’s not enough to just mention it to a co-worker or to report it to someone who’s not in a position where they should be receiving that report. You actually want to go to and find out who is responsible for receiving that type of report, such as a supervisor, a human resources person, and then you want to be very specific. Even if it’s not an actual incident that occurred where, for example, you fell or you were injured, even if it’s something like a repetitious type of injury, you want to be very specific not just simply that you have a physical problem, but you want to say, “And I believe that this is related to either my work duties or the work injury that occurred.”
That is a pitfall often that people can fall into where they think, “Oh, well I mentioned that my back was hurting at work.” That is not enough. It has to, first of all, be mentioned to a specific type of person to which an injury should be reported, and then you have to be specific to say, “And I think this is related to a work injury or my work duties.”
Cindy Speaker: Okay, that’s great information. Now let me ask you this: What if your employer or whomever you report this to, what if through the process they deny it and say, “Well we don’t believe that’s related to work,” what do you do then?
Debra Matherne: Well, there’s different stages at which they can do that. Sometimes I’ll hear from people that they go in to try to report the injury, and the employer or their representative will actually refuse to take their report or try to talk them out of it. This is a time when you have to absolutely be insistent that you want an injury report filled out and that you are reporting that injury. At that point, you have to insist that that is done, and they’re actually legally obligated to take that report from you. And then later it can be that the employer has actually reported it to the insurance carrier, and the insurance carrier is now denying it. In that case, you would probably want to seek the advice of an attorney who could help you in that regard, because if it’s being denied by the insurance company, you’ll probably have to file what’s called a claim petition.
Cindy Speaker: Okay.
Debra Matherne: And then pursue that through the courts or legally pursue that.
Cindy Speaker: Right. Debra, you mentioned repetitious work. If it’s an injury that you believe occurred because of repetitious type work, is that more difficult? Are those claims more difficult?
Debra Matherne: They can or cannot be. It depends, because when you’re claiming a repetitious injury under Pennsylvania workers’ compensation law, what you need to prove is you need to show that the work duties you were doing and what those duties specifically are that you’re doing repetitively, that those have caused you a physical injury. And in order to be able to do that, you have to have a physician who will support that for you.
Cindy Speaker: Yeah.
Debra Matherne: So if you have a doctor whom you’ve communicated with, who really understands what you do and can make a good argument for you medically that the type of work you’re doing is the type of work that would cause that injury from the repetitious activity, then you probably won’t have a difficult time. Sometimes the challenge is finding that medical person who will support you in that regard.
Cindy Speaker: Yeah, and along those lines with medical personnel-
Debra Matherne: -Yeah-
Cindy Speaker: -So when you begin to treat with a physician, are you able to use your primary care physician who also is saying that, yes, this is a real injury?
Debra Matherne: Not always. Under Pennsylvania workers’ compensation law, if your employer follows certain procedures where they provide to you what’s called a panel list of physicians, which lists certain specific physicians that you must treat with after and that’s following your work injury. If they do that after your work injury, then you’re obligated to treat with those doctors, or the bills will not need to be paid by the workers’ comp insurance carrier. In most cases, however, employers don’t do that. They sometimes give the list before the injury but don’t do it again after the injury, or they may not have a list. So if there’s no list, you can treat with anyone you want, including your primary care physician.
However, if they do give you that list, then you should look at that list, and if you need to go off the list and there’s certain things you may want to do, that’s another time where as attorneys we’re often helpful in providing advice to people, both with what to do, whether there’s a list, what type of doctor to see. That’s actually an important part of it. We get so tied up in the legal part, we forget the medical injury, and how that’s treated really is the most important thing in any case.
Cindy Speaker: Yeah, that’s a great point. And also what you’re saying, and I can certainly see where an attorney could be very helpful, because this is complex information that you’re giving us today.
Debra Matherne: This is why I don’t do domestic relations or any of these other types. I got into workers’ compensation years ago and found out that it’s actually a growing area. There’s a lot of attorneys who do it now in Pennsylvania since the time I started doing it, but it’s often better to ask questions early on and make the right decisions, and it can prevent a lot of problems further down the road in your case.
Cindy Speaker: Yeah, yeah. Debra, so if someone engages your services or some attorney’s services, how does that work financially? Is it percentage based? How does that work?
Debra Matherne: It is. There’s not a regular type of bill that is sent to a claimant. There’s never any type of bill for our services that is sent. It’s a contingent fee. It’s generally 20% in Pennsylvania, and that is in workers’ compensation cases if there’s something that we do where we receive the benefits and there’s an award or a settlement, or something is done in court where we save benefits that you’re already getting, then a judge will issue a decision where he’ll approve the 20% attorney fee, and it is taken out of the workers’ compensation checks or out of the amount that would be paid to the claimant. So there’s not a separate bill for our services.
Now that being said, there are separately litigation costs in case, which are not to pay us for our services as your attorney, but it would be for things such as obtaining medical records, depositions, that type of thing that would further your case.
Cindy Speaker: Okay, okay.
Debra Matherne: That’s one of the areas, again, that people sometimes can be confused on, where they’ll say, “Wait, I thought there was no charge ever,” but there are separate considerations for the litigation costs versus the fees for the attorney services.
Cindy Speaker: Okay, okay. Nevertheless, from what you’re saying, there is no fee to come in and speak with an attorney and get some information.
Debra Matherne: No, and that’s something I’ll often say to people who are not sure whether they want to get an attorney. There’s no charge whatsoever. It can prevent problems. There’s no permanent obligation, so why not?
Cindy Speaker: Right.
Debra Matherne: I think it’s always good to get information, and the more information you have or the advice from somebody, the better decisions that you can make.
Cindy Speaker: Yeah.
Debra Matherne: And when we have a client too, you know, when they have a case, we have to work together as a team with them. The client has to understand that we’re there for their advice, and then hopefully they’ll follow it so that we’re all in a better position in the case.
Cindy Speaker: Yeah, yeah. Debra, what about if someone is traveling to or from work, and they have an injury or some kind of an accident, is that covered by workers’ compensation benefits?
Debra Matherne: Again, that’s generally no. That’s called the “coming and going rule,” but if you’re traveling to and from your fixed workplace, a place where you work from, then generally that’s not covered. However, if it’s something where you are traveling somewhere for work that’s not just coming and going to a fixed place of employment, such as you being sent on a special assignment, or you’re going to a different location, there are times when you can be covered when traveling in the car to and from the workplace or any other place. So again that’s another time where we can provide … Sometimes people don’t file, because they don’t realize they might be covered. Again, since it’s free, you always should ask.
Cindy Speaker: Right.
Debra Matherne: I can think of several cases through the years where the person was pushed to call by a relative or somebody else, only to find out they were absolutely deserving of it, even though the general rule is just traveling to and from a fixed place of work, you’re not covered, there are exceptions to that rule, so you should always find out before giving up.
Cindy Speaker: Okay, okay, excellent. And one more thing: What if your injury is so severe that you can really never work again? Do you stay on workers’ compensation benefits the rest of your life?
Debra Matherne: That’s not usual, but you know workers’ compensation benefits are different rules that apply. I suppose theoretically, in some rare cases, that might occur, but generally they’re not a lifetime benefit by the way that they’d work out. They’re covering you under the idea that you’re not working because of that work-related injury. However, there are limitations. For example, after you’ve been on workers’ compensation for a certain period of time, 102 weeks, they can get what’s called an “impairment rating evaluation.” This is getting a little bit technical, but if you’re not over 50% whole-body impairment, then you’re limited to only 500 more weeks. There’s multiple types of petitions they’ll file for terminating or suspending benefits, making job offers, or saying you’re fully recovered, so generally they’ll try to, at some point, put a limit on the claim, which is often when we get involved.
That’s at the beginning of the case, we often get involved, but there’s a great number of cases that we have where we get involved because it’s: How is this claim going to end, and what’s most beneficial to me?
Cindy Speaker: Okay.
Debra Matherne: And often people at that point will consider settlement. Sometimes there’s additional type of the things they’re going to do in the future that are either lighter duty jobs, or they might be going on another type of benefit, but the beginning and end of the case are both times when you really need to seek advice on what to do.
Cindy Speaker: Yeah, you know, and I didn’t know that, so even if someone-
Debra Matherne: -And before you sign anything-
Cindy Speaker: -Okay, so even if someone is kind of going along and collecting, but they’re getting towards the end of the case, a lawyer could be very helpful in kind of negotiating that end plan or some kind of a settlement. Is that correct?
Debra Matherne: That is correct.
Cindy Speaker: Okay, interesting.
Debra Matherne: And there are some catastrophic injuries where there might be something arranged. Sometimes there are even other types of things that are set up like annuities, that type of thing, or there are arrangements made where they have to have modifications to their home, and they’re going to be on that for a certain period of time. But often, again, as people even approach when they’re on an injury, they’re approaching retirement age, they’re approaching that they might consider other types of benefits. They often will try to look at: Is this something that’s beneficial to me to stay on this benefit, or is it more beneficial to me to look at other choices?
Cindy Speaker: Okay.
Debra Matherne: We get so caught up in just the workers’ compensation case, we sometimes forget what else is out there.
Cindy Speaker: Right, right. Well, I want to go back to another thing you said, if you don’t mind, and that is the impairment rating. What exactly is an impairment rating? How does that factor into a workers’ compensation claim?
Debra Matherne: Once you’re receiving workers’ compensation benefits, there are different kinds of medical examinations that the insurance company can require you attend. One would be independent medical evaluations, which they can obtain to see your status and how you’re doing and to make decisions on whether they believe you can work or are recovered. The other type is the impairment rating evaluation that you’ve just mentioned, and an insurance company will get that once you’ve hit the required number of 102 weeks, to see how severe is your injury, and are you over 50% whole-body impairment. Actually there are a few cases, actually I think statistically, that when a person has over 50% of their body totally disabled in a workers’ comp case.
Cindy Speaker: Wow.
Debra Matherne: If you’re over that, then those can continue, as you talked about earlier, potentially for a long or forever period of time. But if you’re less than 50% whole-body impairment, which many cases are, then there’s a limit, and there would only be 500 weeks. So again you have to look at: What do I want out of this case? How do I want to proceed? What are all of my options that I have once that is attained? You can fight that impairment rating evaluation, but again finding a medical doctor … I always tell people, “If you’re walking into the courtroom, you’re probably not going to find a doctor to say you’re 50% whole-body impaired.”
Cindy Speaker: Yeah.
Debra Matherne: Which is joking to some extent.
Cindy Speaker: Yeah.
Debra Matherne: But if you think about 50%, no matter where you take those pieces from, that’s a fairly severe injury.
Cindy Speaker: Yeah, that makes sense. Well, Debra, I’m actually glancing over at the Facebook Live page as we’re talking. We’ve got some viewers here. Let me just say to them, if anybody has questions, feel free to type your questions out, and we’ll answer them. But, Debra, I want you to tell us how we can reach your office, because honestly, what you’ve said here, I think it’s almost really a no-brainer that someone needs to at least consult with an attorney in these situations. When you talk about impairment ratings and a panel of physicians, the average person is not … I certainly don’t know those things … and if I was hurt at work, I think you want to be fully educated so that you can get the benefits that you deserve. So how can someone reach you? What’s the best way to do that?
Debra Matherne: Well, www.oconnorlaw.com, and I always tell people it’s O-C-O-N-N-O-R-L-A-W. I have people who put the E-R in for O’Connor, and then they get somebody else, or they don’t get us. Or it’s 1-800-518-4529, which is “4LAW”-
Cindy Speaker: -Okay, okay-
Debra Matherne: -So 518-4529.
Cindy Speaker: Very good.
Debra Matherne: You know, in this day and age, you can always google Michael J. O’Connor and Associates, and go check them out.
Cindy Speaker: Yeah, very good. Well, let’s also say to our viewers that are going to watch this after the fact, in fact you know, those that have joined us … Betty, I see Betty’s on … and any others that are watching it, I’m not sure, I don’t see your names there, but I can see you’re watching us. If you’re watching it after the fact, feel free to type you’re questions in the comments, and we will respond to them.
Debra Matherne: Right-
Cindy Speaker: -So Debra, thanks for being with us-
Debra Matherne: We’re always happy to hear from people. Oh, thank you.
Cindy Speaker: Absolutely, thank you. To all of you out there, thanks for joining us. We’ll talk to you again soon. Have a great rest of your day.
Debra Matherne: Thank you.