We are proud to announce that Thomas Baumann has been named a 2023 Pennsylvania Super Lawyer, and was ranked in the top 50 in the Pittsburgh region as part of a peer-influenced and research-driven selection process in recognition of his outstanding legal expertise. This honor means that Baumann, a top-rated Workers’ Compensation lawyer, is among the top five percent of attorneys in this specialty area in the state.
Tom and Abes Baumann partner Doug Williams were also recognized recently as Best Lawyers 2023, and our firm was ranked as a Tier 1 Law Firm in Pittsburgh.
Congratulations to Tom and Doug, whose expertise and tireless efforts have consistently garnered positive outcomes for our clients.
At Abes Baumann we take tremendous pride in the accomplishments of our team, as they reflect our dedication to serving workers and veterans and delivering the highest standards of client service.
Thank you for entrusting us with your legal needs. We remain committed to guiding you through the legal process and providing you with the personalized attention you have come to expect from us. We are proud to represent you and help you get the benefits you deserve.
HARRISBURG — Commonwealth Court has ruled that workers’ compensation should cover the cost of medical marijuana for treatment of injuries suffered on the job.
The court on Friday handed down two decisions in cases brought by workers who were hurt on the job and were initially prescribed opioids for treatment. But in both cases, the workers sought to get their cost of medical marijuana covered by workers’ compensation, asserting that the marijuana has been more effective in treating their pain.
In Teresa L. Fegley, as Executrix of the Estate of Paul Sheetz v. Firestone Tire and Rubber (Workers’ Compensation Appeal Board), Sheetz had been injured at work in 1977, according to the opinion written by Judge Anne Covey. He underwent two back surgeries and over the years, he treated the pain with opioid and narcotics.
In 2019, “at the recommendation of his doctor,” he began using medical marijuana to deal with his back pain in the “hope of eliminating the need for the opiates and narcotics he had been taking for approximately 30 years. Medical marijuana afforded Claimant pain relief and reduced his need for the opiates and narcotics,” according to Judge Covey’s opinion. She added that Sheetz also reported that taking medical marijuana apparently provided psychological benefits and in 2019, he began seeking to have the cost of his medical marijuana covered by workers’ comp.
Sheetz died before the court made its decision and his estate continued the case.
In the case of Edward Appel v. GWC Warranty Corporation, Mr. Appel was injured at work in 2006 and was prescribed opioids for the pain. He obtained a medical marijuana card in April 2018 and by September of that year was able to “wean himself off all the opioid medications” despite suffering a “tremendous amount” of withdrawal during that process, according to a separate opinion also written by Judge Covey. In October 2018, he sought to get workers compensation to cover the cost of his medical marijuana.
In both cases, their claims were denied and the appeals board upheld those denials but Commonwealth Court’s decisions reversed the appeals boards’ decisions.
In the decisions, the court concluded that while the Medical Marijuana Law includes language specifically decreeing that insurance companies aren’t required to cover the cost of medical marijuana, it also includes language that medical marijuana patients should not be “denied any rights for lawful use of medical marijuana.”
As a result, the judges reasoned: “the General Assembly explicitly intended Commonwealth residents suffering from intractable pain to have the benefit of this therapy, and at the same time chose not to limit claimants from receiving their statutory rights.”
The judges also decreed that employers are not being ordered to break federal law because they are not being required to pay for the marijuana, but rather they would be reimbursing the patients for their medical costs.
Judge Christine Fizzano Cannon filed a dissenting opinion arguing that the law’s ban on requiring that insurers cover the cost of medical marijuana should be the deciding factor.
“Claimant argues that because the WC Act is to be liberally construed, the MMA should not be interpreted to preclude reimbursement that is otherwise required by the WC Act. The most obvious flaw in this argument is that prior to the enactment of the MMA, there was no legal medical marijuana in Pennsylvania, and therefore, no reimbursement was required for it under the WC Act.”
Judge Fizzano Cannon noted that the Legislature apparently didn’t require insurers to cover medical marijuana because the U.S. Food and Drug Administration has not approved the use of the drug for any medical conditions.
“In any event, the legislature, not the courts, must effect any change in the MMA’s stated policy and the balance struck regarding insurance coverage,” she wrote.
CNN — As of Tuesday, US military veterans in an “acute suicidal crisis” can receive free treatment including inpatient care up to 30 days and outpatient care for up to 90 days.
The expanded care was announced by the Department of Veterans Affairs on Friday, and is meant to “prevent veteran suicide by guaranteeing no cost, world-class care to veterans in times of crisis.” Veterans who are seeking that care can go to any VA or non-VA health care facility, the release said, and they do not have to be enrolled in the VA system to receive care.
“Veterans in suicidal crisis can now receive the free, world-class emergency health care they deserve – no matter where they need it, when they need it, or whether they’re enrolled in VA care,” VA Secretary for Veterans Affairs Denis McDonough said in the release. “This expansion of care will save Veterans’ lives, and there’s nothing more important than that.”
The new policy says veterans who were discharged after more than two years of service under conditions other than dishonorable are eligible for the care, which will either be paid for or reimbursed by the VA.
The policy will also apply to former service members, including those in the Reserves, who served “more than 100 days under a combat exclusion or in support of a contingency operation” who were discharged under conditions other than dishonorable, and veterans who were the victim of sexual assault, sexual battery, or sexual harassment while serving.
According to the VA’s release, the policy will “[p]rovide, pay for, or reimburse for treatment” of eligible veterans’ emergency suicide care, transportation costs, and follow-up care at a VA or non-VA facility, to include 30 days of inpatient care and 90 days of outpatient.
The policy will also allow the VA to make “appropriate referrals” after a period of emergency suicide care, determine veterans’ eligibility for other service and benefits from the VA, and refer veterans who received the emergency care to other VA programs and benefits.
The VA’s 2022 report on veteran suicide said that in 2020, 6,146 US veterans died by suicide, which was 343 fewer than seen in 2019. Suicide was the 13th leading cause of death among veterans in 2020, the report said, and the second leading cause of death among veterans under 45 years old.
A Defense Department report released in October 2022 found that 519 US service members, including active duty, Reserve, and National Guard troops, died by suicide in 2021.
Expanding care for veterans at high risk of suicide was the second priority goal of a military and veteran suicide prevention strategy released by the White House in 2021. “Individuals at imminent or high risk of suicide should be guaranteed equitable access to high quality crisis care and follow-on support,” the strategy report said.
President Joe Biden said in the 2021 report that the US is “falling short” of the “one truly sacred obligation to Americans … to care for them and their families when they return.”
“It is up to us to do everything in our power to live up to our most sacred obligations,” he said. “We owe it to the memories of those we’ve lost—and we owe it to the futures of those we might save.”
Editor’s Note: If you or a loved one have contemplated suicide, call The National Suicide and Crisis Lifeline at 988 or 1-800-273-TALK (8255) to connect with a trained counselor.
PHILADELPHIA — Two years after a pair of former players sued the NFL over the treatment of Black retirees in the league’s $1 billion concussion settlement, hundreds of men whose medical tests were rescored to eliminate race bias now qualify for awards.
The newly approved payouts, announced in a report Friday, are a victory for NFL families in the decade-long legal saga over concussions. The 2020 lawsuit unearthed the fact that the dementia tests were being “race-normed” — adjusted due to assumptions that Black people have a lower cognitive baseline score. Changes to the settlement made last year are meant to make the tests race-blind.
The new results will add millions to the NFL’s payouts for concussion-linked brain injuries. A league spokesman did not return a phone call Friday or respond to emails sent in recent weeks seeking comment on the rescoring.
Of the 646 Black men whose tests were rescored, nearly half now qualify for dementia awards. Sixty-one are classified as having early to moderate dementia, with average awards topping $600,000, while nearly 250 more have milder dementia and will get up to $35,000 in enhanced medical testing and treatment, according to the claims administrator’s report.
Former players, lawyers and advocates say they will turn to getting the word out to more players who could receive awards.
“Our work has produced some great results and has opened many eyes,” said Ken Jenkins, a former running back who, along with his wife, petitioned the federal judge overseeing the settlement to make the changes and urged the Justice Department’s Civil Rights Division to investigate. “Now we’re really focused on getting as many players who deserve compensation to be compensated.”
This first group of players had the best chance of success because they otherwise passed the testing protocols and would have qualified if they were white. Thousands of other Black former players can ask to be rescored or retested, but their cases might not be as strong based on earlier results for dementia, validity and impairment tests. About 70% of active players and 60% of living retirees are Black.
The fact that the original testing algorithm adjusted scores by race — as a rough proxy for someone’s socioeconomic background — went unnoticed for several years until lawyers for former Pittsburgh Steelers players Kevin Henry and Najeh Davenport sued the league. Factors such as age, education and race have long been used in neurology to help diagnose dementia, but experts say the formula was never meant to be used to determine payouts in a legal case.
“In 2022, how can you possibly think that another human being comes out of the womb with less cognitive ability? It’s just impossible to believe that that can be true,” Jenkins said. “It’s unspeakable.”
Advocates fear that many former players don’t know they can be rescored or retested, especially if they have cognitive issues and live alone.
“Men who are homeless, men who originally signed up but their cognitive function changed, men who are divorced or isolated — we are going to go looking for them,” said Amy Lewis, Jenkins’ wife.
The couple, once critical of class counsel Chris Seeger for his response to the issue, are now working with him to get the word out.
Seeger, the lead lawyer for the nearly 20,000 retired players who negotiated the settlement with the NFL, has apologized for initially failing to see the scope of the racial bias. He vowed in a recent interview to “make sure the NFL pays every nickel they should.”
The league’s tally just passed $1 billion in approved claims. However, appeals and audits mean the actual payouts lag behind that number and stand at about $916 million. They include awards for four other compensable diagnoses: Alzheimer’s disease, Parkinson’s disease, Lou Gehrig’s disease and deaths before April 2015 involving chronic traumatic encephalopathy.
As reviewers tackle the thornier dementia claims, the process has slowed and audits and appeals intensified.
“Their mantra is deny, deny, delay until you die,” said James Pruitt, 58, a wide receiver who played for Indianapolis and Miami from 1986 to 1991.
After his NFL retirement, Pruitt became a teacher and middle school principal in Palm Beach County, Florida. But in 2010, in his mid-40s, the district asked him to step down. He could no longer perform his duties.
Over time, he stopped calling on friends from his playing days.
“I don’t get out, and I don’t remember a lot of things. I’ve been told that I repeat things,” he said. “So I’m kind of embarrassed by the whole situation.”
After the settlement was approved in 2015, Pruitt and his wife attended meetings with the lawyers who traveled the country to pitch the plan to retired players’ groups.
“We were told … this was going to be a very easy process, you just need to go to the doctors, get a qualifying diagnosis from them,” said Traci Pruitt, 42. “Yet here we are six years later, and we’re still getting the runaround.”
The couple was twice approved by doctors only to have the decision overturned — once after their first doctor was removed from the program. Their lawyer believes they will be successful on their third try, under the race-neutral scoring formula. They are still waiting to hear.
Traci Pruitt, an accountant who works from home, said an award would ensure she gets the help she needs to care for her husband.
“While I love him, I don’t necessarily have that background and skill set,” she said.
Seeger said he believes the claims process is picking up steam after a slow start.
“I know folks have said they weren’t moving that well for a while. I think we’ve won some appellate battles with the courts,” Seeger said. “I don’t think the NFL expected to pay $1 billion — and we’re about to cross $1 billion.”
Tom Baumann discusses his landmark workers compensation victory – Mary Ann Protz vs. Workers Compensation Appeal Board – and other aspects of treatment for work-related injuries with Workers Compensation Experts.
Baumann’s work in the Protz case voided the use of the Sixth Edition of the American Medical Association’s Guide to Evaluation of Permanent Injuries as a reason to reduce severely injured workers status – and benefits – from permanently disabled to partially disabled.
“Our state does a reasonable job compensating minimally and moderately impaired workers,” Baumann said, “but the severely impaired … NO!”
The Pennsylvania legislature undid the court decision a year later, though the impairment rating level to move people from permanent to partial disability was reduced from 50% to 35%.
“It was a partial victory,” Baumann said. “A lot of people who had their benefits unfairly
reduced, saw total disability benefits reinstated. With the subsequent bill reducing the level to 35% impairment, more injured workers qualified for total disability benefits and that was a positive development. You’re always trying to come up with novel ways to help your client and I think we did that.”
Baumann goes on to discuss signs workers should see that their case needs help from an attorney; what workers compensation attorneys actually do to make a difference in the case’s outcome; and why it’s worth having an attorney on your side in a workers compensation claim.
New partners build on the firm’s more than 40-year history of fighting for workers’ rights
Abes Baumann announced today that attorneys James Burn, Susan Paczak, and Douglas Williams have been named partners at the firm. This appointment elevates the three lawyers after years of dedicated service to the firm and its clients.
Mr. Burn has more than 30 years of experience in the areas of workers’ compensation and social security disability, and has dedicated his professional life to helping injured people. Martindale Hubble ranks him, “AV,” the highest ranking that can be given to a practicing attorney. Prior to joining Abes Baumann, he was elected mayor of the Borough of Millvale, Pa. in 1994 and served until 2005; past chairman of the Allegheny County Democratic Party from 2006 to 2011; Allegheny County Council member from 2006 to 2013; and he is the former chair of the Pennsylvania Democratic Party. Outside of the office he has been training and teaching at Young Brothers Tae Kwon Do Institute in the North Hills of Pittsburgh, being promoted to sixth-degree black belt by Grand Master Young Bo Kong in 2020. A 1985 graduate of Duquesne University, he earned his J.D. from the University of Dayton in 1988.
“Jim has spent his career fighting tirelessly for injured people,” said Thomas C. Baumann, partner, Abes Baumann. “His dedication to his clients and community make him the ideal partner to help build the future of our firm.”
Mr. Williams has spent more than 25 years experience in workers’ compensation law. He began his career as a law clerk at Abes Baumann, he has also clerked for the Pennsylvania Bureau of Workers’ Compensation, researching and drafting decisions for workers’ compensation judges. Mr. Williams currently serves on the Amicus Committee of the Pennsylvania Association for Justice, writing friend of the court briefs to the Pennsylvania Commonwealth and Supreme Courts on a variety of issues. A 1991 graduate of Grove City College, he earned a J.D. from Duquesne University in 1996.
“Doug began his career as a law clerk at Abes Baumann,” added Mr. Baumann. “It has been a true honor and delight to see him grow his career as an attorney at the firm. He represents the best of our firm and I am thrilled to have him join me as a partner.”
Ms. Paczak has spent more than 30 years in the areas of workers’ compensation, social security and veterans’ benefits. She graduated magna cum laude from the University of Pittsburgh in 1980 and earned her J.D. from Duquesne University, graduating cum laude. Her experience working with veterans allowed the firm to launch its successful veterans’ benefits practice, which helps the nation’s veterans get the benefits and support they have earned. Ms. Paczak has argued precedent setting cases before the United States Court of Appeals for Veterans Claims and the United States Court of Appeals for the Federal Circuit.
“Susan’s work in veterans’ benefits has provided our firm with the opportunity to grow and expand our offerings,” continued Mr. Baumann. “Her dedication to the men and women of our nation’s armed services is a shining example of how we hope to serve all of our clients.”
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