SUBROGATION - WC and MVA claims

Under Pennsylvania law, an injured worker can not "double dip." This means that an injured worker cannot receive double payment of benefits for a car accident, from both the Third Party  [the negligent driver who caused the accident] and the workers compensation insurance company. The workers compensation insurance company is entitled to recover the money they paid to the injured worker from the employees Third Party lawsuit. This is called subrogation. It applies to the wage loss benefits and medical benefits paid by the workers compensation insurance company.

If the amount of money recovered from the Third Party lawsuit is less than the total amount paid by the workers compensation insurance company (both past and future), the workers compensation insurance company may recover ALL of the Third Party settlement (after attorneys fees are deducted). Because an injured worker is not "required" to pursue a claim solely for the benefit of the workers compensation insurance company, there are frequently situations where the insurance company will "compromise" the amount of their recovery, to provide incentive for the claimant to proceed with the case against the Third Party. Otherwise, the injured worker might simply decide to "drop" the Third Party lawsuit, leaving the insurance company with no recovery at all.

If the amount of money recovered from the Third Party lawsuit is greater than the amount of workers compensation benefits paid, there are several different possibilities. If the workers compensation claim is closed, and there are no further benefits being paid, then the insurance company is only entitled to recover up to the total amount they paid. Any greater amount is payable to the injured worker. [Once again, this is after attorneys fees are paid.]  HOWEVER, if the workers compensation insurance company is continuing to pay benefits to the injured worker, there is a mathematical formula to be applied to the Third Party money recovered. The injured worker will receive less weekly wage loss benefits, and may even be required to pay a portion of their medical bills, until the full amount of the Third Party Recovery is "absorbed" (based on the Worker's Compensation Company paying less money).

In addition to benefits payable by the insurance company for the negligent driver, an injured worker may also have Underinsured (or Uninsured) motorist benefits on the policy of the car they are in. If that insurance policy was paid for by the employer, subrogation may apply to any benefits recovered in the UM/UIM claim, as well. However, if that car insurance policy was paid for by the injured worker themself,  then the workers compensation insurance company does NOT have a right of subrogation. Standish v. American Mfrs Mutual Ins. Co., 698 A.2d 599 (PA Super 1997); Entertainment Partners v. WCAB (Caparelli), 749 A.2d 551 (Pa Cmwlth  2000); American Red Cross v. WCAB (Romano), 745 A.2d 78 (Pa Cmwlth. 2000). COMPARE: Schwaab v. WCAB (Schmidt Baking Co.), 832 A.2d 1164 (Pa Cmwlth. 2003).

[Note: there are different "rules" where the UM/UIM benefits are paid for by someone OTHER THAN the injured worker or employer.]

If you have been injured in a work related car accident, you NEED the advice and skill of a TEAM of attorneys, knowledgeable in both Workers Compensation claims AND Motor Vehicle Accidents, in order to maximize your recovery under these separate sections of Pennsylvania Law. The law offices of Schmidt, Kirifides & Fridkin have Trial Attorneys, EACH  with over 20 years of experience handling these unique claims. For a FREE consultation, call us toll free at 877-268-6466 or contact us online at SKFtrialattorneys.com.  With offices in Philadelphia, Media and Wilmington, DE - there is a location convenient for you.

Employees’ Entitlement to Workers’ Compensation Medical Benefits

Generally, an injured worker can go to the doctor of his or her choice for medical care, and the employer must pay for the medical care based upon a fee schedule set up by the state legislature in Harrisburg. If there is a billing dispute, or if your employer or its insurance company believes that the care was not “reasonable, necessary or related to” the work injury, the employer is responsible to file documents formally objecting to the care. This is the case in Delaware County, Chester County, Bucks County, Berks County, Montgomery County, Philadelphia County, or in any county across the state.

If your injury was caused by an incident or accident at work, your employer’s Workers’ Compensation insurance carrier cannot simply refuse to pay. The insurance company must file a petition for a hearing before a Workers’ Compensation judge or a Request for Utilization Review. A Decision from the Court or Utilization Review could have a serious impact on your right to past, present and future medical treatment. You NEED the advice and representation of a Workers’ Compensation attorney with the knowledge and skill necessary to ensure the Decision is issue in your favor. Once your claim is accepted, your Pennsylvania employer must cover all related medical expenses including your hospital stays, any surgeries or procedures, home nursing care, or modifications to your home necessary to keep you mobile and self-sufficient. You will not have to pay co-pays or deductibles.

Media Workers’ Compensation Lawyers Will Fight for Your Rights

The Workers’ Compensation lawyers at Schmidt, Kirifides & Fridkin have decades of experience dealing with reluctant and suspicious insurance carriers. Call one of our knowledgeable attorneys today for a free consultation at 610.892.9300 or contact us online. You can rest assured that your medical bills for diagnosis, treatment and follow-up visits for a compensable injury will be properly paid by the Workers’ Compensation policy provided by your employer once you have the support of an experienced work injury lawyer at Schmidt, Kirifides & Fridkin.

Helpful Advice

Managing partner, Mark Schmidt, talks about coordination of benefits and offers helpful advice.  See how we can help you by visiting Schmidt, Kirifides & Fridkin or send us an email.  We want to hear from you!

Pennsylvania Wrongful Death Claims for Work-Related Accidents

The death of a family member, whether in a workplace accident or as the result of an illness caused by occupational hazards, is one of the most horrific events a family can face. No amount of money will ever come close to compensating your family for the loss of a loved one due to a fatal accident at work. The pain and loss associated with a sudden death after an injury at work can leave a family feeling lost, angry and confused. A Workers’ Compensation claim is one way a family can seek assistance from the deceased family member’s employer.

The Media, PA Workers’ Compensation attorneys at Schmidt, Kirifides & Fridkin represent families in fatal work accident claims against the employer in an attempt to secure benefits and money damages to replace a loved one’s lost income. Sometimes the actual employer is not at fault for the fatal accident on the job, but the employee’s death happens at work because of defective equipment manufactured or installed by a third party. In either case, family members may be entitled to Workers’ Compensation survivor benefits.

Experienced Workers’ Compensation Lawyers Representing You

At the Media law firm of Schmidt, Kirifides & Fridkin, we combine substantial legal experience with a unique perspective of the insurance industry to offer confident representation to people dealing with the loss of a loved one from a work-related accident or illness. Our lawyers have a combined total of more than 60 years of legal experience and a background in working with Pennsylvania Workers’ Compensation laws and the insurance carriers. Our knowledgeable Workers’ Compensation attorneys will help you file claims to hold responsible parties liable for your losses, and bring in additional counsel as necessary on third-party claims.

Our Attorneys will Protect Your Family’s Interests in This Time of Tragedy

Our Workers’ Compensation lawyers at Schmidt, Kirifides & Fridkin have the best interests of the grieving family in mind, and they will protect your rights in obtaining the money damages to which you are entitled. We represent the families of those who were tragically killed in a work-related accident or as the result of an occupational disease. While nothing can ever bring back a lost family member, hiring an experienced attorney can help you obtain the monetary compensation you are entitled to. Our Delaware County attorneys blend substantial legal experience with a unique perspective of the insurance industry to provide confident representation to people dealing with the loss of a loved one, whether in Delaware County, Bucks County, Berks County, Montgomery County, Philadelphia County, Chester County, or anywhere across the state. Call today for a free consultation with an experienced Workers’ Compensation attorney at 610.892.9300 or email us..

Workplace Accidents: Injuries to Your Leg, Ankle, Knee or Foot

Whether it is due to a fall or repetitive movements, injuries on the job can often affect a worker’s leg, thigh, knee, ankle, or foot.

• Broken Bones in the Leg, Foot or Toes

The femur, the biggest bone in the entire body, is able to support over 25 times the weight of an average adult. Still, femur bones can break. The lower legs each have three bones, the patella, tibia and fibula, which are also at risk for trauma-related fracture. About 10% of all broken bones suffered are foot fractures. The feet are actually made up of more than twenty bones and are often in vulnerable situations or unprotected. When walking at work, especially if you are carrying something, or are distracted by the activity around you, it is very easy to accidently kick a hard object and break your toe(s).

• Sprains to Toes, Ankles, Ligaments and Tendons

Any joint in the body can be sprained, but the most common ligament sprains include sprained ankles, high ankle sprains, and toe sprains. Spraining a ligament or tendon can happen very quickly. Leg ligament sprains are common while working due to long hours, repetitive motions and the need to continually do a job faster. The most common ways employees hurt their leg ligaments while on the job include: tripping, falling, lifting heavy objects, accidents with work, factory, farm or construction equipment, and stopping or rotating too quickly.

• Knee Sprains and Other Types of Knee Injuries

Knee ligament sprains and tears are common at work, as are or strained anterior cruciate ligament (ACL) sprains, medial collateral ligament (MCL) sprains, lateral collateral ligament (LCL) sprains, posterior cruciate ligament (PCL) sprains, or patellar tendon (PTL) injuries. These knee problems can happen due to slipping on wet surfaces at the jobsite, and even just walking up and down the stairs at your workplace. Thousands of Pennsylvania workers suffer with knee injuries, which can cause life-long pain, reduced mobility, and medical bills that are often difficult to pay. Other common knee injuries include tendonitis, cysts, dislocated kneecaps, bursitis, and aggravations of preexisting degenerative join disease (DJD) which may also be compensable.

Other foot, ankle, leg, knee, or thigh injuries that can occur due to the nature of your job or an accident at the workplace are chondromalacia, medial meniscus tear, plantar fasciitis, fractured patella, stress fractures, and crush injuries. The end result of some of these injuries could range from chronic moderate pain to total knee replacement surgery.

If your knee, leg, foot or toe injury was caused by an accident at work, you will be entitled to Workers’ Compensation benefits. Even if your injury has worsened slowly over time because of repetitive motions on the job, it may well become a compensable chronic condition because of the arthritis and joint stiffness that develops over time. The Media PA Workers’ Compensation attorneys at Schmidt, Kirifides & Fridkin help workers investigate the validity of a claim for benefits so that they can seek medical attention, treat the symptoms, and rehabilitate the knee without the additional worry of medical bills and costly chronic pain management.

Whether your injury occurs at your job in Berks County, Bucks County, Chester County, Delaware County, Montgomery County, Philadelphia County, or any Pennsylvania county, please call 610.892.9300 for a free consultation about your case today. The Media Pa Workers’ Compensation attorneys at Schmidt, Kirifides & Fridkin will be happy to help you assess your benefits claim for a leg, knee, ankle or foot injury.