Accurate Work Injury Descriptions Are a Must in Workers' Comp Cases

When a Pennsylvania worker sustains an injury at work, whether it is physical or mental, notice of the injury must be promptly given to the employer.

• Once the employer’s workers’ compensation carrier is advised of the injury, the assigned adjuster has 21 days within which to investigate and accept or deny the claim.
• If the claim is accepted, it will be accepted either through a Notice of Compensation Payable or a Notice of Temporary Compensation Payable.
• If the Notice of Compensation Payable (NCP) is issued, the claim is outright accepted, and payments of wage loss benefits, if any, and medical benefits will be paid by the workers’ compensation carrier.
• If the Notice of Temporary Compensation Payable (NTCP) is issued, the claimant is temporarily accepted for 90 days, and can thereafter be accepted or denied by the workers’ compensation carrier.
• Regardless of which notice is issued, there will be a section noted on the designated workers’ compensation form entitled “INJURY INFORMATION” which will list the body parts affected, type, and description of injury. This information will be critical to the injured worker, as it will affect their future medical treatment and receipt of benefits.

Why the Big Fuss?

Many times, workers suffer injuries — for example, to their backs. When the workers’ compensation adjuster initially receives the file, they may have very limited medical documentation and simply list “back sprain or strain.” Sometimes more severe injuries and symptoms do not immediately surface after the work injury, but can actually result in, for example, disc herniations with either upper or lower extremity numbness, tingling, loss of range of motion, etc.

If the injured worker has these more severe injuries and symptoms and seeks treatment for them, there is the risk of the workers’ compensation carrier denying the bills, indicating that they are not part of the accepted injury. This unfortunately happens all too often, with people being turned away from physical therapy, occupational therapy, conservative treatment, injections, and even much-needed surgery. This obviously leads to an increase in symptoms, aggravation, and frustration.

Initial Interview

As a workers’ compensation claimant’s attorney, it is critical during the initial interview to have the injured worker fully describe the body parts he or she believes were injured by the work trauma, as well as all of the symptoms and limitations — including a very descriptive outline of the pain experienced from the time of the injury, and for the months and even years following the date of injury.

Once the client is retained, the claimant’s attorney should order all of the Bureau of Workers’ Compensation records pertaining to the client, obtain all of the medical records regarding treatment for the work injury, and correspond with the workers’ compensation adjuster to obtain their file.

If, in reviewing the Bureau records, it is discovered that the description of injury is not accurate, then the claimant’s attorney can file the relevant petition in order to expand the description of injuries to be accepted and paid for by the workers’ compensation carrier.

The Judge

A Pennsylvania Workers’ Compensation Judge, pursuant to the Pennsylvania Workers’ Compensation Act, does have the power to amend NCPs at any time and in any type of procedural situation, if it is substantiated that the NCP was in any material way incorrect.

To appear before a Workers’ Compensation Judge to properly accomplish this, you must have a knowledgeable workers’ compensation attorney to get you there. Robinson Law LLC, with 26 years of experience, can get you there with aggressive yet compassionate representation. Call today (215) 804-9924!