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PA workers comp questions? - mom2twokids - 11-07-2008 04:57 PM

My husband was injured in an accident back in July, he is still out of work but his lawyer mentioned that once we reach a settlement my husband is entitled to a disfigurement settlement from workers comp b/c he has scarring on his head due to the injury. What exactly is that and how do they determine what you get?

Also they suspended his workers comp pay a few weeks ago. He went to his hearing and even the defense lawyer didn't understand why they stopped it as my husband hasn't been released back to work by his dr. Both lawyers told him to go file unemployment, can his work fight that?

Thank you.


RE: PA workers comp questions? - 1171 - 11-07-2008 05:39 PM

pennsylvania pays up to 275 weeks. the exact number would be determined by a judge based on observation and prior determinations.


RE: PA workers comp questions? - capricorn - 11-07-2008 09:01 PM

It doesn't appear that there is a reason for your husbands payments to be suspended with out a hearing or petition to stop them. Maybe it's a mistake. Surprised his attorney told him to file for unemployment and isn't looking into it. I am from PA and the only time my checks were suspended was when I returned to work with no restrictions. Still in Limbo is from PA and much more knowledgeable than I am and Tim Belt is a PA attorney that I'm sure can help with your original question about a disfigurement settlement.
Best of luck.


CAP


RE: PA workers comp questions? - lfoster21 - 11-08-2008 12:11 AM

I don't know if this might help, but I am in Va, and every 6-8 weeks, the w/c check gets "kicked out" of the system and a check is not automatically sent. My lawyer call the i/c and they manually put it back into the system for the next couple of months.

Also, as for the scar disfigurment amount, here they have a set value for scars and I was able to find the info. in the state website. Perhaps you will be able to find the same in your states site.


RE: PA workers comp questions? - Still in Limbo - 11-08-2008 12:52 PM

I have been being Paid TTD for 4 Years now. The Only Way You can have Your Payments Stopped in Pa. is if the Defense Filed a Petition for Superceadeus and it was Accepted by the Judge. They could Ask for this for a Number of Reasons, too Many to Mention Here, but to Name a Few: Missing Dr. Appts., not Returning to Work if Released to do so, Fraud of the System, and the List goes On! You need to Discuss the Reason Further with Your Attorney, they should have Never Told You to Sign for Unemployment. TTD is Paid until You Reach MMI, and are Returned to Work, or You Settle. The only other System w/c has in Pa. is TPD (Temporary Partial Disability), which is Started when You are Found able to Work, and choose not to, Your Payments are Decreased and the 500 Week Clock Starts. It's Very Complicating, and I know Mr. Belt can Add Much More than Me, but unless the i/c has been Granted Superceadeus, Your Payments should Continue!!Wink


RE: PA workers comp questions? - mom2twokids - 11-08-2008 03:00 PM

Thank you. He had his hearing two weeks ago and the reason they gave was that they found him not disabled from his accident and he was cut off right around the 90 day mark. I believe they said it was Temporary disability while they investigated the facts? His Dr has not released him for work b/c of post concussion syndrome (he was drug behind a truck and his head was split open among other injuries). He did see the insurance companies dr and he said that there is nothing wrong with my husband, he also saw him 3 mos after the accident. The judge didn't really take the dr's report into account b/c he said all of the insurance companies use this dr and he never finds anything wrong with the injured parties and that he did not care for this dr.

I told him to contact his lawyer first thing monday morning, the lawyer he had was actually from another firm, his other lawyer had a court date and they use this guy to help when they have too many cases in one day. Hopefully they can just reinstate his checks.


RE: PA workers comp questions? - Still in Limbo - 11-08-2008 06:06 PM

Now I Understand why they Stopped His Checks, Sometimes they do Use a 90 Day Temporary Payment to Investigate. Your Actual Attorney May be able to Turn this around for You, and I Hope they do. Please Keep Us Informed!Wink


RE: PA workers comp questions? - Timothy Belt - 11-10-2008 12:27 PM

From what you stated, it sounds like this claim was originally addressed through a Temporary Notice of Compensation Payable. Such a notice can be withdrawn within the first 90 days without the IC admitting liability. I’m sure your lawyer will explain this to you, but there is a process required to withdraw such a notice, and if the IC has not followed the process correctly, the notice converts automatically to a Notice of Compensation Payable and the IC is then on the hook. If it has been withdrawn correctly, you will need to file a Claim Petition and prove entitlement to benefits.

A scar or disfigurement claim arises when there is scarring on the face, head or neck. Such a claim is similar to the specific loss claim, and entitles the injured worker to additional benefits after the wage loss disability has resolved. To be compensable, the scarring must be permanent, unsightly and not usually incident to the employment. The judge views the scar and determines value with a cap on value of 275 weeks of temporary total disability benefits.