Workers’ Comp 101 - Abes Baumann

Injured Playing on Company Sports Team – Eligible for Workers’ Compensation?

Eric Abes on June 18, 2018

In order to be eligible for workers’ compensation benefits, the law requires that the injury must be sustained in the “course of employment.” When discussing injuries which occur while playing on an Employer’s Sports Team, the following criteria determine whether an injured worker is entitled to benefits: where the employee, whether on or off the employer’s premises, is injured while actually engaged in the furtherance of the employer’s business or affairs.

If you are injured while participating on the employer’s softball, baseball, basketball or any type of team, you may be eligible for workers’ compensation benefits. The analysis by the court will be based on the specific facts of your situation. If the employer sponsors the team, pays a membership fee for the team, provides the team uniforms, and in general supports the team, then you will be eligible to collect workers’ compensation benefits if you are injured while playing on the team. The Courts have held that participation on the team actually furthers the business or affairs of the employer.

The same is true if you are injured at a company-sponsored picnic or while volunteering at a company-sponsored event. Again, the Courts have held that attendance at the picnic promotes the employer’s interest in good relationships with and among the employees, which in turn fosters good morale and furthers the business or affairs of the employer. If volunteering at company-sponsored charity run, the participation promotes a positive image of the company which furthers the business of the company. In both these situations, if you are injured while participating, you may be eligible for workers’ compensation benefits.

The facts surrounding your injury should be carefully looked into to determine your eligibility for workers’ compensation benefits. If you have suffered an injury while engaging in an employer-sponsored event, please contact us to discuss your specific situation.

Impairment Rating Evaluations (Insurance Company Cutting Your Benefits)

Eric Abes on November 10, 2015

Even if you win your case, Workers’ Compensation Benefits are not a lifetime guarantee. The insurance company may try to limit your benefits with the Impairment Rating Evaluation (IRE). An IRE is a physical examination. A doctor determines your level of disability on a scale from 0 to 100. After receiving 104 weeks of benefits, the law requires an injured worker to submit to an IRE.

A doctor will examine you under the guidelines of the latest edition of the American Medical Association’s Guidelines for Permanent Impairment. The doctor must be licensed in Pennsylvania; in active practice at least 20 hours per week; and approved by the Licensing Board. While you can only be required to submit to two IRE’s in a 12 month period, there is no requirement that your condition change prior to an exam. The insurance company can use the exam to see if your condition has changed.

If the doctor finds that the worker’s impairment is over 50%, the worker will continue to receive total disability benefits, but if the doctor finds the impairment is less than 50%, the worker’s status will change from total disability to partial disability. Partial disability means your benefits will be limited to 500 weeks, as opposed to possible lifetime benefits for total disability.

One defense to an unfavorable IRE is that the injured worker was not at maximum medical improvement (MMI) at the time of the IRE. MMI means that the injury/impairment is permanent, stabilized, and unlikely to change in the next year. If surgery or some form of treatment within a year might help the worker, then the worker is not at MMI.

As with most aspects of Workers’ Compensation claims, an Insurance Company may use an IRE to limit your benefits. The best way to protect yourself is to call an attorney.

120 and 3—The Two Most Important Numbers in Workers’ Compensation

Eric Abes on January 9, 2015

Everyone makes mistakes. Thousands throughout our lives. Most end up causing little to no harm. These mistakes are often beneficial as the damage caused is outweighed by the lesson learned. Some mistakes are more severe. Some can never be undone. In Pennsylvania, if you are injured at work, 120 days and 3 years are two mistakes that cannot be fixed.

If you are injured at work in Pennsylvania, you have 120 days to report the injury to your employer. If you do not report the injury to your employer within this period, you will likely not be able to obtain any Workers’ Compensation benefits.

Reporting an injury is usually simple. You are at work, you slip and fall and break your wrist. You tell your boss what happened and that you are going to the ER. You just satisfied notice. In order to be safe, never assume that just because your boss was there when you got hurt that she knows you are hurt. Make sure you tell her. Email is a great way to ensure you satisfied notice, and it gives you a record of when you provided notice and what you said.

Besides 120 days to notify your employer of an injury, you have 3 years from the date of injury to file a claim with the Pennsylvania Bureau of Workers’ Compensation. This is called a Statute of Limitations. This is a fancy way of saying there is a limit to how long you have to pursue some legal action. This is to ensure that things are done without delay; records will be easily obtainable; and witnesses’ memories are fresh.

The best thing you can do to protect yourself is to contact Abes Baumann as soon as you are injured. That very day. There is no charge to talk. A few minutes of talk now, can save you a lifetime of pain later.

Injured Playing on Company Sports Team – Eligible for Workers’ Compensation?

Impairment Rating Evaluations (Insurance Company Cutting Your Benefits)

120 and 3—The Two Most Important Numbers in Workers’ Compensation

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