Michael O'Donnell - O'Donnell Law

Insurance Companies Want Addictions to Cost Injured Workers More Than Their Good Health

Michael O'Donnell — Tue, 26 May 2026 14:10:22 +0000

Can Workers’ Compensation Benefits Be Lost for Smoking?

Insurance companies want addictions to cost injured workers more than their good health.

The Pennsylvania Supreme Court Takes Up a Major Workers’ Compensation Issue

The Pennsylvania Supreme Court is considering argument from an employer and its workers’ compensation defense team that an injured worker forfeits her workers’ compensation wage loss benefits when she fails to quit smoking.

The argument is rooted in Section 306(f.1)(8) of the Pennsylvania Workers’ Compensation Act, which provides that an injured worker forfeits all rights to compensation for refusing reasonable medical services.

The Wegman’s Case and the Worker’s Injury

Wegman’s Food Markets, Inc. attacks the work injury benefits of a woman who suffered significant on-the-job fracture injuries to her right leg, ultimately resulting in below the knee amputation. Prior to the amputation the worker was advised by her doctor to stop smoking and offered a prescription medication that could help with quitting smoking. She attempted the medication, was unsuccessful, and decided to stop the medication. She continued smoking and her condition worsened. Eventually amputation was required. Wegman’s sent the worker to a doctor who offered testimony that her amputation became necessary, in part, due to her failure to quit smoking. Wegman’s sought forfeiture of the woman’s workers’ compensation benefits.

How the Pennsylvania Courts Responded

The argument was successful a the trial court level before the Workers’ Compensation Judge. The worker appealed and the decision was reversed. The Appeal Board reasoned Wegman’s did not present evidence that there was a high probability of success with the prescribed smoking cessation treatment. On further appeal by the employer the Commonwealth Court affirmed the Board holding that it is the employer’s burden to first present medical evidence that the medical treatment or services at issue are reasonable, meaning, they involve minimal risk to the patient AND have a high probability of improving a worker’s work-related condition. While the trial court focused on the injured worker’s conduct, the Board and Commonwealth Court determined that the issue of a worker’s refusal of treatment really doesn’t matter and is irrelevant until the employer first meets its burden on reasonableness and high probability of success.

Why Benefit Forfeiture Is Viewed So Harshly

Importantly, forfeiture of benefits remains viewed by Pennsylvania’s Courts as one of the harshest consequences to an worker under the Pennsylvania Workers’ Compensation Act. The Commonwealth Court notes that “medical advice” without providing a means to accomplish the medical objective is not enough. Cases have passed through our judicial system on similar arguments involving detoxification from heavy medication doses, losing weight in order to increase success with a surgical procedure, and attending physical therapy. All would agree that this advice is sound. But, human beings must be viewed in the context of their injuries, pre-injury lifestyles, and where substances are at issue, addictions. Simply saying “you need to quit smoking”, which nearly everyone now agrees is a good idea, is not enough to forfeit one’s disability benefits in the face of an otherwise disabling work injury.

What Injured Workers Should Know Moving Forward

What the Supreme Court will do with Wegman’s arguments remains to be seen. But a word to the wise: if a doctor offers medical advice, provides a reasonable means to accomplish the objectives of the recommendation, and the injured worker unreasonably refuses without a good faith attempt or justification, their workers’ compensation benefits ARE at risk. This is true even in the face of addiction to substances like nicotine, alcohol, and prescription medication.

About the Author

Attorney Michael A. O'Donnell represents injured workers and negligence victims throughout Northeastern Pennsylvania. Recognized by the Pennsylvania Bar Association as a certified specialist in workers’ compensation law, Michael focuses his practice on helping injured individuals navigate complex claims and protect the benefits they deserve. At O'Donnell Law Offices, he advocates exclusively for injured workers and their families — never insurance companies or employers.

About O'Donnell Law Offices

For more than 35 years, O'Donnell Law Offices has represented injured workers and accident victims throughout Northeastern Pennsylvania, including Wilkes-Barre, Scranton, and surrounding communities. The firm’s attorneys are committed to protecting the rights of individuals facing serious injuries, workplace accidents, and workers’ compensation disputes. Consultations are always free—and you never pay a fee unless we win.

Questions About Your Workers’ Compensation Rights?

If you were injured at work and are concerned about your benefits, medical treatment, or how your claim is being handled, the attorneys at O'Donnell Law Offices are here to help. Our team has spent decades fighting for injured workers throughout Northeastern Pennsylvania.

Consultations are always free — and you never pay a fee unless we win your case.

The post Insurance Companies Want Addictions to Cost Injured Workers More Than Their Good Health first appeared on O'Donnell Law.

Pennsylvania Supreme Court agrees that factual issues could allow for civil liability against co-worker

Michael O'Donnell — Fri, 06 Mar 2026 16:27:02 +0000

Author: Attorney Michael O’Donnell

On February 18, 2026, the Pennsylvania Supreme Court affirmed the Superior Court’s ruling reversing a Trial Court’s entry of summary judgment dismissing an injured man’s negligence lawsuit against his co-worker.

Brown v. Gaydos, begins as a result of September 1, 2016 incident where John Brown suffered injuries while working for American Concrete Solutions, Inc (ACS). Brown suffered crush injuries when the arm on a piece of industrial equipment, a skid loader, malfunctioned. There was no dispute that Brown was working for ACS at the time of injury and the workers’ compensation insurer for ACS paid benefits.

The skid loader was owned by George Gaydos, a part owner and a fellow employee at ACS. Factually significant, Gaydos owned, maintained, stored, and insured the skid loader individually and separate from his employment relationship with ACS. Gaydos occasionally loaned the skid loader to ACS for use in connection with ACS’s operations.

Section 72 of the Pennsylvania Workers’ Compensation Act (77 P.S. § 72) provides immunity from civil liability to a co-employee whose negligence caused injuries to a co-worker, so long as the injuries occur while the co-employee was in the same employ as the injured worker and acting within the course and scope of employment at the time of the incident.

Brown filed a negligence lawsuit against Gaydos in his individual capacity arguing that because Gaydos maintained the skid loader outside of his work with ACS, inspected, maintained, stored, and insured the skid loader in that individual capacity, and that because Gaydos was not present at ACS at the time of injury, that Gaydos did not enjoy the protections of co-employee immunity. The Trial Court sided with Gaydos finding that he was a co-employee of Brown and, as a result, was automatically immune from civil liability under Section 72. A three (3) Judge panel of the Superior Court reversed finding a factual dispute existed as to whether Gaydos and Brown were acting “acting in the same employ” when Brown was injured. The Superior Court found facts presented by Brown could establish co-employee immunity does not apply because of the custody and control over the skid loader. It was also noted that because Gaydos was not on the ACS job site at the time Brown was injured raises additional course and scope questions preventing entry of summary judgment.

Gaydos sought review by the Pennsylvania Supreme Court, which was granted.

A majority of the Supreme Court Justices affirmed the Superior Court’s ruling citing it’s 1971 decision in Apple v. Reichert, holding that co-employee immunity applies to acts occurring when the alleged negligent actor is in the same employ as the injured worker and acting within the course and scope of their employment at the time of the worker’s injury. Brown had alleged that Gaydos was negligent in maintaining the skid loader outside of the co-workers’ employment relationship with ACS. Additionally, Gaydos was not on site when Brown was injured leaving a factual dispute as to course and scope of employment at the time of injury. If Brown’s position is accepted by the fact-finder, it is possible for a jury to conclude that co-employee immunity did not apply making entry of summary judgment improper.

In short, a co-worker is not automatically immune from civil liability simply because the injured worker is employed by and works for the same employer. A closer analysis must be given to whether the alleged negligence occurred within the co-employee relationship and whether the negligence occurred while both workers were acting within the course of scope of employment at the time of injury.

About the Author

Attorney Michael A. O’Donnell is a lawyer at O’Donnell Law Offices in Wilkes-Barre, Pennsylvania. His practice focuses on representing individuals and families in personal injury and workers’ compensation matters throughout Northeastern Pennsylvania. Michael writes regularly about developments in Pennsylvania law and court decisions that may impact injured workers and their families.

The post Pennsylvania Supreme Court agrees that factual issues could allow for civil liability against co-worker first appeared on O'Donnell Law.

Are there workers’ compensation deadlines in Wilkes-Barre?

Michael O'Donnell — Sun, 07 Dec 2025 22:50:02 +0000

Don’t Wait on Your Workers’ Comp Claim: Why Timing Matters for Injured Workers in Wilkes-Barre, PA

When you’re hurt on the job, the last thing you want to worry about is paperwork or legal deadlines. But in Pennsylvania—especially for workers in Wilkes-Barre and across Luzerne County—timing can make all the difference in whether you receive the benefits you deserve.

Workers’ compensation cases are strictly enforced, and deadlines often land quietly. Many injured workers don’t realize they’re running out of time until it’s too late. Understanding these time limits is essential to protecting your rights.

At O’Donnell Law Offices, our Workers’ Compensation team—including certified specialists—helps Wilkes-Barre workers navigate these deadlines every day. Here’s what you need to know.

Why Workers’ Compensation Deadlines Matter in Pennsylvania

Pennsylvania law sets strict timelines for reporting workplace injuries and filing claims. Missing a deadline can prevent you from receiving wage-loss benefits, medical coverage, and other protections you may be entitled to.

1. You Must Report a Work Injury Quickly

In Pennsylvania, you typically have 120 days to report a work-related injury to your employer. Many workers put this off hoping they’ll recover—but delaying can jeopardize your claim.

However, unless the employer has knowledge of the injury—or the employee gives notice of the injury within 21 days—no compensation is owed until notice is given.

For workers in industries common around Wilkes-Barre—such as healthcare, manufacturing, logistics, and construction—slow-building injuries are common. Back injuries, repetitive-motion injuries, and strain-related conditions often worsen over time, and workers sometimes wait too long to notify their employer.

2. Filing a Claim Petition Has a Deadline

If your employer or insurer denies your claim or refuses to pay benefits, you usually have three years from the date of injury to file a formal Claim Petition. That clock doesn’t pause for holidays, slow HR departments, or ongoing treatment.

This deadline can easily fall near the end of the year if your injury occurred in November or December of a prior year.

3. Appeal Deadlines Are Even Shorter

If you received a denial letter or a notice modifying, suspending, or terminating your benefits, you may have as little as 20 or 30 days to challenge the decision.

Appeal windows often overlap with:

scheduled days off or office/facility closures
year-end staffing shortages
delayed mail delivery
workers simply trying to get through the season

That’s why so many people unintentionally miss their opportunity to respond.

Attorney Michael O’Donnell explains it this way:

“We see too many hardworking people lose their workers’ compensation rights simply because they waited too long to get help. The deadlines in Pennsylvania are unforgiving. The sooner we can step in, the better we can protect the benefits you’re entitled to.”

- Attorney Michael O'Donnell

How Our Wilkes-Barre Workers’ Compensation Team Helps

O’Donnell Law Offices is proud to represent workers throughout Wilkes-Barre, Plains, Hanover Township, Kingston, and the entire Wyoming Valley. Our Workers’ Compensation team includes two certified specialists—Attorneys Neil O’Donnell and Michael O’Donnell. Their combined experience allows us to provide knowledgeable, strategic guidance to injured workers facing complex or time-sensitive claims.

We help injured workers by:

Ensuring the injury is properly documented and reported
Challenging denied or delayed claims
Securing medical benefits and wage-loss payments
Handling appeals when insurers try to stop or reduce benefits
Guiding clients through every step of the workers’ comp system

And at O’Donnell Law Offices, there is never a cost until we win your case.

If You Were Hurt at Work in Wilkes-Barre, Don’t Wait

Whether your injury happened yesterday—or months ago—acting quickly is the best way to protect your claim. If your workers’ compensation case is approaching a deadline, even a few days can matter.

Our team is here to help you understand your rights, review your situation, and give you a clear path forward.

Contact O’Donnell Law Offices today for a free consultation.
We proudly serve Wilkes-Barre and all surrounding communities in Luzerne County.

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The post Are there workers’ compensation deadlines in Wilkes-Barre? first appeared on O'Donnell Law.

What Happens to Workers’ Compensation Specific Loss Benefits After Death in Pennsylvania?

Michael O'Donnell — Mon, 13 Oct 2025 23:33:44 +0000

Written by Attorney Michael O’Donnell

Generally speaking, the Pennsylvania Workers’ Compensation Act provides for three (3) forms of benefits to injured workers:

Wage loss benefits when an injury interrupts a worker’s ability to earn a wage;
Medical benefits covering 100% of the reasonable medical expenses necessary to treat a work injury; and
Specific loss benefits, which are cash benefits to the injured worker when they suffer the loss of use of a body part (often by way of dysfunction or amputation) or scars to certain areas of their body caused by an on-the-job injury.

Understanding How Specific Loss Benefits Work

The law is set up in such a way that an injured worker cannot collect both total disability wage loss payments and payments for a specific loss simultaneously. The law provides that specific loss benefits are paid after an injured worker stops receiving weekly total disability wage loss payments.

Because of these legally imposed limitations, it is common for an injured worker who has suffered an amputation, permanent scar, or loss of use of a body part to pursue an award of specific loss benefits from a Workers’ Compensation Judge and not begin receiving those payments until they stop receiving their weekly total disability payments.

Workplace injuries involving both total disability and specific loss are frequently some of the most serious and severe injuries we see in this area of the law. I have personally observed situations where these injuries are so devastating that they have, tragically, led to loss of life. When that occurs, the injured worker’s surviving dependents are generally eligible to receive fatal claim benefits and coverage for a set amount of funeral expenses.

What Happens to Specific Loss Benefits After Death?

But what happens when an injured worker suffers a total disability, a specific loss due to amputation, loss of use, or disfigurement, and then passes away before their specific loss benefits are finally decided by the Court and before those payments are made? Does the insurance company just get to keep the specific loss money? Keep in mind, the law provides that specific loss payments do not become payable under the law until after the injured worker’s total disability wage loss checks stop. Like most issues in the law, the answer to the earlier question is: it depends.

Case Example: Recovering Benefits for a Deceased Worker

I had represented a gentleman who suffered a severe work-related injury to his leg. He appropriately received total disability benefits for that injury. Despite best efforts from his medical team, the injury eventually required amputation of his leg below the knee.

With that, he became eligible for specific loss benefits, which were awarded by a Judge. Because my client was receiving total disability payments, the law provided that his specific loss payments would not yet begin. Not long thereafter, my client succumbed to a non-work-related medical ailment and he passed away. He was still receiving total disability wage loss benefits for his work injury when he passed. He never received a penny of the specific loss benefits awarded by the Court.

This brings us back to the question raised earlier: Does the insurance company just keep the specific loss money that had been awarded by the Court? Not this time. After my client’s passing, we took the issue back to the Court with his surviving spouse substituted in his place as the “Claimant.” The law was on our side, but not necessarily for the reasons most would believe.

Section 306(g): Payment of Specific Loss Benefits to Survivors

Section 306(g) of the Workers’ Compensation Act provides that specific loss benefits are payable to the surviving spouse or dependents of the injured worker if they have not yet been paid to the injured worker prior to his death and the injured worker’s death was due to causes unrelated to his work injury. The key factors in our case were that the specific loss benefits had actually been awarded by a judge prior to my client’s passing and his death was due to a medical ailment unrelated to his work injury. Securing the award of specific loss benefits during the injured worker’s lifetime was an important fact to our success in recovering payment of the benefits to his surviving spouse. Additionally, under then-existing precedent, proving that his passing was due to medical ailments unrelated to his work injury provided for a favorable result under Section 306(g).

But what is the result if the injured worker dies while their specific loss benefits claim is still unresolved by the Court, their passing is due to the work injury itself, and the injured worker leaves behind no dependents?

**The Pennsylvania Supreme Court recently tackled this issue in Steets v. Celebration Fireworks (WCAB), 335 A.3d 1076 (Pa. 2025).**

The key factors for purposes of this analysis are that (1) the injured worker’s passing was due to the injuries she suffered as a result of the workplace incident; (2) the injured worker did not leave behind dependents as defined in the law; and (3) the question of whether the injured worker was owed specific loss benefits was being actively contested and litigated in the Courts at the time she died.

The Pennsylvania Supreme Court, in overruling earlier precedent dating back to 2004, held that Section 306(g) does not limit recovery of post-death specific loss benefits to only those circumstances where the injured worker’s death is due to non–work-injury-related causes. The High Court further examined Section 410 of the Pennsylvania Workers’ Compensation Act and determined that Section 410 allows for the payment of specific loss benefits to an injured worker’s Estate under the circumstances presented in Steets because the injured worker died as a result of her work injuries, did not leave behind dependents, and maintained an active claim for specific loss benefits that had not yet reached a final adjudication at the time of her death. The employer or insurance carrier’s continued contest of the injured worker’s entitlement to specific loss benefits at the time of her death was a key factor in allowing for the application of Section 410 and thus the Estate’s ability to recover the specific loss benefits at issue.

About Attorney Michael A. O’Donnell

Attorney Michael A. O’Donnell is a certified specialist in Pennsylvania workers’ compensation law who represents injured workers and their families across the Commonwealth. A partner at O’Donnell Law Offices, he is known for his strong advocacy, community involvement, and leadership in professional organizations, including the Pennsylvania Bar Association and the Federal Bar Association’s Middle District Chapter. Learn more about Attorney Michael O’Donnell.

O’Donnell Law Offices is a leading personal injury and workers’ compensation firm serving Wilkes-Barre, Scranton, and communities across Northeastern Pennsylvania. Our experienced team of trial attorneys represents clients in complex cases involving workers’ compensation, specific loss benefits, personal injury, motor vehicle and trucking accidents, premises liability, and Social Security Disability. With decades of proven results and board-certified expertise in Pennsylvania workers’ compensation law, we fight to protect the rights of injured workers and their families—ensuring they receive the full benefits and justice they deserve.

The post What Happens to Workers’ Compensation Specific Loss Benefits After Death in Pennsylvania? first appeared on O'Donnell Law.

Motorcycle Accident in PA: What One Couple Did Right

Michael O'Donnell — Tue, 22 Jul 2025 23:09:10 +0000

Motorcycle Accidents Are Almost Always a Matter of When—Not If

When it comes to riding a motorcycle, it’s not a question of if you’ll be involved in an accident—it’s when. As personal injury attorneys, we’ve seen it time and again: even the safest, most experienced riders are vulnerable on the road. The reality is, the automobile almost always wins—and when a crash happens, the injuries can be life-altering.

Real Case: A Pennsylvania Couple’s Motorcycle Accident

I recently had the privilege of representing a husband and wife who were out enjoying a quiet Sunday afternoon ride on their Harley Davidson. As they traveled down a straight stretch of State highway with the right of way, a pickup truck pulled out from a side street and collided with them—striking the husband directly on his left leg. The force of the impact caused multiple fractures, including a compound fracture, where the bone broke through the skin.

There were no weather issues, no visibility concerns—just a driver who failed to observe two motorcyclists lawfully using the road.

Why Motorcycle Insurance Coverage Matters

Thankfully, my clients were prepared. They carried multiple first-party insurance policies with the same insurer—an often overlooked but critical form of protection. In motorcycle cases, we frequently see policies that lack sufficient coverage to handle the full cost of medical care, lost wages, and other damages. In this case, the at-fault driver had modest liability limits, meaning my clients had to rely on their own policies to pay for immediate expenses.

We were able to resolve all insurance claims at maximum value. While the compensation couldn’t take away the surgeries, the pain, the permanent hardware placed in his leg—or the anniversary trip they had to cancel—it did help restore some measure of stability. And that’s exactly what the civil justice system is meant to do.

Lessons for Pennsylvania Motorcycle Riders

Many riders never experience this kind of trauma—but some do. And when they do, preparation is everything. Max out your coverage. Stack your policies. Always wear protective gear. In this case, the wife escaped relatively unharmed thanks to her gear and her husband’s quick thinking. But it could have easily been a different story.

Contact a Motorcycle Accident Lawyer in Wilkes-Barre Today

If you or a loved one has been injured in a motorcycle accident in Pennsylvania—including Wilkes-Barre, Kingston, Scranton, or Hazleton—don’t wait to get help. Contact O’Donnell Law Offices today for a free consultation. We’ll fight to get you the justice and compensation you deserve.

The post Motorcycle Accident in PA: What One Couple Did Right first appeared on O'Donnell Law.

Top 5 Injuries That Could Happen on a Golf Course (And How to Avoid Them)

Michael O'Donnell — Wed, 09 Jul 2025 00:41:01 +0000

Summertime in Northeastern Pennsylvania means golfers are back on the greens enjoying the fresh air and friendly competition. With beautiful courses across Luzerne County and Lackawanna County, it’s easy to forget that golf—while low-impact compared to other sports—still presents risks for serious injury.

At O’Donnell Law Offices, we’ve seen firsthand how a relaxing round of golf can take a dangerous turn. Personal injury attorney Michael O’Donnell offers this reminder:

“My number one safety tip for folks out on the golf course this summer—number one, stay hydrated. It’s getting hot. But number two, be careful on those golf carts. We’ve actually had a number of cases where people have been injured going down hills or taking sharp curves on the golf cart.”

Michael O'Connell

Attorney

Below are the top five injuries golfers in NEPA should watch out for:

1. Golf Cart Accidents

Golf cart crashes are more common than you might think. From tipping on sharp turns to losing control on steep hills, these incidents can lead to serious injuries like broken bones, concussions, or spinal damage. In Luzerne and Lackawanna Counties, where hilly terrain is part of the landscape, extra caution is required.

Tip: Drive slowly, especially when going downhill or turning. Avoid distractions and never overload the cart.

2. Slip and Fall Injuries

Wet grass, uneven paths, or poorly maintained walkways can cause golfers to slip or trip—often resulting in twisted ankles, knee injuries, or even head trauma.

Tip: Wear golf shoes with good grip and watch your step around tee boxes, bunkers, and cart paths.

3. Dehydration and Heat Exhaustion

With rising summer temperatures across Northeastern PA, staying hydrated is more important than ever. Symptoms of dehydration can escalate quickly into heat exhaustion or even heat stroke, especially during long rounds.

Tip: Bring plenty of water, wear a hat, and schedule early tee times to avoid peak heat hours.

4. Struck by a Ball or Club

While rare, stray golf balls or accidentally swung clubs can cause serious injuries, including eye damage and facial fractures. These incidents are more likely on crowded courses or during tournaments.

Tip: Always be aware of your surroundings, and never tee off if players are within range ahead of you.

5. Repetitive Stress and Overuse Injuries

Golfer’s elbow, back strain, and wrist injuries can develop over time due to poor swing mechanics or inadequate warm-ups. These chronic conditions may not seem urgent but can sideline a golfer for months.

Tip: Stretch before every round, and consider lessons to improve your form and reduce strain on joints.

Injured on the Course? We’re Here to Help.

Whether you’re golfing in Wilkes-Barre, Scranton, or anywhere in Northeastern Pennsylvania, accidents can happen when you least expect them. If you or a loved one is injured on a golf course due to someone else’s negligence—such as unsafe conditions, faulty equipment, or reckless driving—O’Donnell Law Offices is here to help.

We’ve served clients across Luzerne and Lackawanna counties for over 35 years. Contact us today for a free consultation and get the trusted legal guidance you deserve.

The post Top 5 Injuries That Could Happen on a Golf Course (And How to Avoid Them) first appeared on O'Donnell Law.

5 Things You Should Know About Pennsylvania Workers’ Compensation

Michael O'Donnell — Tue, 15 Apr 2025 22:38:11 +0000

Written by Attorney Michael O’Donnell
Representing injured workers in Pennsylvania workers compensation cases over the last 15+ years has consistently led to addressing various misconceptions about the way the system works (or is supposed to work). Whether these “myths” are born from misinformed shop talk among co-workers or accepted tactics of employers and their insurance carriers, there is no difference. The bottom line is that they are out there and people believe them. Don’t go it alone. Get advice from a certified Pennsylvania workers’ compensation specialist and someone who knows the law.

“I have to get my medical treatment from the doctor my employer uses”

Many new clients come in saying they received less than satisfactory treatment with a company doctor, but didn’t seek better care because they were told or led to believe that they couldn’t. While it is true that under Pennsylvania Workers’ Compensation laws the employer and its insurance company have some limited ability to control an injured worker’s treatment after a work injury, that ability is not absolute.

There are a number of regulatory requirements that employers must satisfy in order to limit the injured worker’s ability to choose their own doctor. Further, the employer’s so-called control does not allow them to send the injured worker to a specific doctor or facility. The injured worker is entitled to a list of doctors from their employer and gets to choose from the providers on that list. Most importantly, the injured worker can always go wherever they want for medical care after a work injury. The question really boils down to one of, “Who pays?” It’s a complex and often misunderstood area of the law that requires careful legal analysis, especially when time is of the essence in choosing the best healthcare provider to handle your injury.

“Workers’ comp pays two-thirds of my lost wages when I can’t work, right?”

Sometimes. It depends on how much money you were making before you became injured. Each year, the State puts out figures regarding the Statewide Average Weekly Wage for all Pennsylvania workers. From there, your workers’ compensation payment rate is determined based on where you fall on the State’s compensation scale.

In some instances, the injured worker is eligible for 2/3 of their pre-injury wages; in others, the injured worker can actually receive more than 2/3, and in some, the injured worker is eligible for up to 90% of their pre-injury wage. It all depends on properly calculating your pre-injury wage rate and fitting it into the State’s payment scale.

“My employer fired or laid me off while I was out on workers’ comp. They can’t do that”

This happens a lot. Generally, unless there is a pre-injury employment contract, union collective bargaining agreement, or Family Medical Leave Act (FMLA) protection in place at the time the worker is relieved of their position, the termination is not automatically illegal.

The trade-off, however, is that so long as the injured worker has medical limitations related to their work injury that impair their earning capacity, then the workers’ compensation insurer must continue to pay wage loss benefits even after the termination letter comes out. Employees eligible for FMLA can take advantage of the law to hold their job for up to 12 weeks following a work injury. Otherwise, unless an employment contract or union agreement provides for the position being held, the employer is free to end the employment relationship.

Oftentimes this will lead to litigation at a later time through something called a “Labor Market Survey,” where the insurer tries to show that the injured worker can still work somewhere else and make some kind of wage even though their job has been eliminated and limitations from their injury remain. There are a number of ways to fight back against these types of challenges, but thorough advance preparation and communication is key.

“I was sent for an IME with the insurance doctor who said I’ve recovered. My case is over”

Also incorrect—especially when your own doctor, who actually has a doctor-patient relationship with you, has a different opinion. IMEs (Independent Medical Exams) are medical-legal exams coordinated by insurance companies to secure an opinion about the injured worker’s injury description, extent of disability, and more.

More times than not, these exams are pre-determined. Insurance companies often pick doctors who they have a past relationship with and who they know will offer an opinion that is less favorable to the injured worker than their own doctor. Just because the IME doctor says you are better or can do more than your own doctor says does not mean your doctor’s treatment plan and opinions are meaningless. To the contrary, your doctor’s opinions are now more important than ever.

Follow your own doctor’s recommendations—it’s often the best way to recover from your injuries. Also, just because a doctor hired by the insurance company says you’ve recovered does not give the insurance carrier the right to suddenly stop your benefits. Additional legal process is required before the insurer can cut you off.

“My doctor says I have a permanent injury. I can stay on workers’ comp for life, right?”

While possible in some circumstances, it is not likely. When an injured worker is receiving full total disability benefits, there are a number of tools the defense can use to challenge the ongoing right to benefits. The insurer can request additional medical examinations, seek job modifications, or try to cap the claim through an Impairment Rating Evaluation.

They may even seek full recovery opinions from their own doctors in an effort to terminate the claim. Insurance doctors will frequently acknowledge limitations but blame them on factors other than the work injury, such as natural aging or degeneration.

It’s also important to understand that workers’ compensation claims in Pennsylvania can be settled via a lump sum payment. Once an injury reaches a permanent status and all reasonable avenues of treatment have been exhausted, it may be time to consider settlement options. Having your own attorney involved early on to defend against strategic efforts by insurance carriers is your best weapon.

About the Author: Attorney Michael O’Donnell

Michael A. O’Donnell is a certified specialist in Pennsylvania workers’ compensation law, recognized by the Pennsylvania Bar Association since 2015. With over 15 years of experience, he exclusively represents injured workers and their families, never employers or insurance companies.

Before attending the Penn State Dickinson School of Law, Michael earned his Pennsylvania teaching certification from Bloomsburg University. His background in education has fostered strong connections with unionized community members, including teachers, nurses, police officers, firefighters, corrections officers, and carpenters.

Michael holds leadership positions as the President of the Middle District Chapter of the Federal Bar Association and has been active in the Pennsylvania Bar Association, Northeastern Pennsylvania Trial Lawyers Association, and Pennsylvania Association for Justice. He also contributes to the community as a member of the Advisory Council for Junior Leadership Northeast and as a coach in the Back Mountain Little League.

He resides in Pennsylvania with his wife, Jill Zapotoski, a pharmacist, and their two children.

The post 5 Things You Should Know About Pennsylvania Workers’ Compensation first appeared on O'Donnell Law.