Please select a topic that you are interested in obtaining more information about:
Automobile Accidents
Workplace Injuries
Defective Product
Medical Malpractice
Nursing Home Negligence
Social Security Disability
This information is meant only to provide answers to questions frequently posed by injured people. If the specific question you have or the area of law you have questions about is not listed, please contact us directly to speak with one of our experienced lawyers or one of our trained paralegals. We can be contacted by any of the following methods:
For PA questions:
By phone:
800-394-0036
412-471-6226
By fax:
412-471-6658
By email:
info@lawforworkers.com
For WV questions:
By phone:
800-394-0036
304-723-4540
By fax:
304-723-4541
By email:
info@lawforworkers.com
Q: If you live in Pennsylvania, what is the importance of your tort election (full tort v. limited tort)?
A: If you live in Pennsylvania, you are required to select full tort or limited tort coverage. If you selected full tort , you are entitled to recover for pain and suffering caused by the other person's negligence no matter how serious your injuries are. However, if you elected limited tort , you are prohibited from recovering for pain and suffering unless you are seriously injured. The law defines serious injury as death, serious impairment of a bodily function or a permanent serious disfigurement. Although you may consider a broken bone or chronic back pain to be a serious injury, the courts and juries have said they are not. It is therefore not worth the small savings in premiums to give up your right to recover for pain and suffering. No such designation exists in either West Virginia or Ohio.
Q: If the accident was not my fault, why is my insurance company paying for my medical bills?
A: In Pennsylvania, your first party benefits, which are the benefits you pay for and receive through your automobile insurance company, are primary. That means, they must be used up before any other benefits are paid. Your first party benefits are primary regardless of whose fault the accident was. In West Virginia or Ohio, your policy may contain medical benefits coverage. If it does, you must use those benefits before you submit a claim to your health insurer. The person you go to for treatment will ask for both your automobile insurance information and your health care information and will submit your claim first to your automobile insurer.
Q: What happens when my medical coverage benefits under my insurance policy are spent?
A: In Pennsylvania, once your first party benefits under your automobile insurance policy are spent, you are required to submit your medical bills to your health insurance carrier. Your health insurance carrier will then become responsible for paying your bills. If you have a co-pay requirement or if you have referral restrictions, you will be required to follow your health insurer's requirements to have your treatments covered. In West Virginia and Ohio, the same process will be followed once your medical benefits are exhausted. It is important to ensure your doctor has both your automobile and healthcare insurance information so they can submit their bill for payment.
Q: Does the person at fault pay for my medical bills while my claim is being pursued?
A: Regardless of whether you live in Pennsylvania, West Virginia or Ohio, the answer is no. Once your medical benefits under your automobile policy are used up, your medical insurance pays your bills. Even if you do not have medical insurance you cannot recover from the at-fault party's insurance until your claim is fully settled.
Q: Do I have to pay my insurance company back for the medical payments made on my behalf?
A: In Pennsylvania, the answer is generally, no. However, if your private medical insurance plan is an ERISA plan or if you receive state assistance, Medicare or Medicaid you do have to repay those benefits. We can assist you in determining what type of plan you have, whether you are obligated to repay any of the benefits and how much of the benefits must be repaid. In Ohio and West Virginia, the answer is yes. All medical payments made on your behalf are subject to what is called subrogation rights. That means the party who made the payments is entitled to seek reimbursement for the payments made on your behalf. In many cases, our office can assist you in lowering the amount to be repaid through negotiations.
Q: Am I entitled to recover my lost wages?
A: If you live in Pennsylvania and you paid for wage loss coverage as part of your automobile insurance policy, you must submit a claim for wage loss to your insurance company. Our office can help you complete your first party benefits application and ensure that all the necessary information is sent into your insurance company. If you live in Pennsylvania and do not have wage loss coverage under your insurance policy, or if you live in West Virginia or Ohio where such coverage is typically not offered, your lost wages can be presented to the court when your case is heard. In order to do so, we will need to document your wage loss. Therefore, it is important that your doctor provide you with a medical excuse from work. It is also important that your employer provide us with a letter stating the time period you were off work, how many hours per week you typically worked before your injury and what your hourly wage was. We can assist you in getting this.
Q: Do I need to get a copy of the police report?
A: If you have a copy of the police report, or have the ability to get a copy, you should do so. This is the first step in ensuring that the proper names of the other people involved in the accident are obtained. It also assists our office in tracking down a valid address for the other people involved in your accident. If you have a copy you should let us know when we talk to you. Otherwise, it is very important for you to let us know which police department responded to the accident scene and the name, address and social security number of the other drivers, as well as the license number of the other vehicles.
Q: Do I need to get a copy of my declaration sheet from my insurance company?
A: Regardless of where you live, the answer is yes. This is very important in determining what type of coverage you have and what types of payments you are entitled to under your insurance policy. Once we review your declaration sheet, we know whether you are entitled to pursue a claim for wage loss and what the value of your medical payments are. Your declaration sheet also contains other information useful in determining what other types of coverage you have available. In Pennsylvania, it is also necessary for us to have a copy of your declaration sheet if suit is filed. Your insurance company mails you a copy of your declaration sheet, which outlines for you the type of coverage you have, every time your policy renews. If you did not maintain a copy of your declaration sheet, you should call your insurance agent and ask him to mail you a copy for the time period during which your accident happened.
Q: Should I take pictures of my car?
A: Yes. As the saying goes, a picture is worth a thousand words. Photographs of your car will show the extent of the damage done to your car and the areas which were damaged. Photographs are very helpful both as we value your case and as we try to settle your case. They are also crucial if your case goes to trial, since they will be shown to the jury. Although the insurance company may have taken pictures, they are not always willing to produce them to our office until suit is filed. It is therefore important that you take them so we can have them early in the process and use them when trying to settle your case.
Q: Do I need underinsured/uninsured motorist coverage?
A: Regardless of where you live, the answer is yes. Although all states require those operating a vehicle to carry at least a minimum amount of automobile insurance, your uninsured motorist coverage protects you in the event the person who hits you has violated the law and has no coverage or in the event the person who hits you does not have a valid driver's license and therefore does not have insurance. It also protects you if the driver of the other vehicle flees the scene and is not apprehended. Underinsured motorist coverage provides protection in the event the person who hits you does not have enough coverage to fully compensate you for your injuries. For example, say the person who hits you has $15,000.00 in coverage. However, as a result of the accident, you have missed 30 days of work and were in the hospital for 15 days. You went to therapy for 3 months after getting out of the hospital. The $15,000 in coverage the person who hit you has is not enough to fully compensate you. If you have underinsured coverage, you can make a claim for those benefits once you recover from the party at-fault.
Q: Do I need an attorney?
A: Regardless of where you live, if you were injured in an automobile accident, you should consult with an attorney BEFORE you sign any papers. By signing papers the insurance company provides, you may be permanently giving up your right to seek future compensation regardless of whether you knew the nature and extent of your injuries. The insurance company does not need to explain what rights you are giving up by signing their paperwork. It is important that you talk to someone who can explain your rights to you. Your initial consultation with our office is free. Your case will be handled on a contingency fee basis , which means we do not recover a fee unless we recover money for you. You are not charged for your future calls. You can call our office at any time to get your questions answered, or get a status on your claim.
WORKPLACE INJURIES : back to top
NOTE: These Questions and Answers are particularly tailored to Pennsylvania Workers' Compensation Claims. If you are receiving Workers' Compensation in either West Virginia or Ohio, please contact our office at 1-800-394-0036 for direct assistance.
Q: I was told I have an asbestos related disease. Does this mean I can seek benefits from my employer?
A: In Pennsylvania, you may be entitled to bring a claim. Contact our office and we will be able to help you determine whether you are entitled to pursue a workers' compensation claim against your employer.
Q: I was told I have a repetitive injury disease (i.e., carpal tunnel.) Does this mean I can seek benefits from my employer?
A: In Pennsylvania, you may be entitled to bring a claim. If the repetitive injury is related to the work and/or job tasks by your medical doctor you have every right to seek both wage loss and medical benefits. Upon notification from your doctor of this condition, you should immediately notify your supervisor and ensure that an incident report is completed.
Q: I was told I have hearing loss caused by occupational exposure to excessive noise. Does this mean I can seek benefits from my employer?
A: In Pennsylvania, you may be entitled to bring a claim. If your medical doctor correlates the hearing loss to your work environment and/or the noise levels to which you have been exposed at your work site, you have every right to seek both wage loss and medical benefits. Upon notification from your doctor of this condition, you should immediately notify your supervisor and ensure that an incident report is completed.
Q: Do I have to go to the doctor my employer wants to send me to?
A: Yes. For the first 90 days you are required to see a company approved doctor.
Q: How long do I have to report my claim?
A: You should immediately report any claim or injury to your supervisor and request that an accident/incident report be filled out. In Pennsylvania, by law, an employee must give the employer notice of an injury within 120 days of the date of injury or a compensation claim can be denied.
Q: Am I required to file a workers' compensation claim, or can I sue my employer for negligence?
A: In Pennsylvania you are not entitled to sue your employer regardless of whether his negligence, or the negligence of your co-employee, resulted in your injuries. However, you may be entitled to sue your co-employee. We will be able to determine whether you are entitled to bring such a claim. In Ohio and West Virginia you may be able to sue your employer if you meet certain requirements. Call us and we will be able to evaluate your case and determine whether you are entitled to sue your employer.
Q: I was hurt at work and am getting workers' compensation. My employer just notified me that my position has been eliminated. What can I do?
A: In Pennsylvania, if you are not subject to a collective bargaining agreement, your employer has the right to eliminate your position even if you are receiving workers' compensation benefits. However, you may still be entitled to continue to receive both your wages and medical benefits.
Q: I was hurt at work and am getting workers' compensation. My employer just told me he hired someone else to fill my position. What can I do?
A: In Pennsylvania, if you are not subject to a collective bargaining agreement, your employer has the right to hire another person to perform your job duties. However, you should still be entitled to continue to receive both your wages and medical benefits.
Q: Do I need an attorney?
A: If you were injured at your workplace, you should consult with an attorney to determine if you have any other claims, such as a claim against the company that manufactured the product that caused your injury. Our office can also assist you in determining whether you are entitled to file for social security disability benefits and in handling any problems that develop in connection with your workers' compensation claim. Your initial consultation with our office is free. Your case will be handled on a contingency fee basis , which means we do not recover a fee unless we recover money for you. You are not charged for your future calls. You can call our office at any time to get your questions answered, or to get a status on your claim.
DEFECTIVE PRODUCT: back to top
Q: Do I need to keep the product?
A: Yes. You must keep the product and you must keep it in the condition it was in at the time of your injury. If it is a product used outside, make sure it is covered or moved into a garage or storage shed. If it is a product used inside, make sure it is kept in a place that others cannot get to it. Most importantly, make sure the product is not used again.
Q: What if the product was destroyed by the accident?
A: It is important that you keep what is left of the product. The remains will need to be examined by both our office and an expert. All parts, no matter how small, should be kept. Do not do anything to further damage the product and keep all pieces in a safe, secure location.
Q: The product that hurt me was borrowed from a friend. Do I still have a claim?
A: You do not have to be the owner of a defective product to bring a claim. In many instances even if you borrowed the product from a friend, family member or neighbor you will be able to pursue a claim.
Q: I don't know who made the product but I know where I bought it. Can I bring a claim?
A: Yes. With a defective product both the manufacturer and the retailer are responsible for an injury caused by a defective product.
Q: The store where I bought the product is no longer inbusiness. Can I bring a claim?
A: Yes. With a defective product both the manufacturer and the retailer are responsible for an injury caused by a defective product.
Q: How soon should I contact a lawyer?
A: The sooner you contact an attorney the better. Defective product cases are very complex. Once you contact our office, we can determine if the product was defective and whether any recalls were issued on the product. We can also help ensure that the product is maintained, which is very important, and coordinate having it inspected by an expert. Your initial consultation with our office is free. Your case will be handled on a contingency fee basis , which means we do not recover a fee unless we recover money for you. You are not charged for your future calls. You can call our office at any time to get your questions answered, or get a status on your claim.
MEDICAL MALPRACTICE: back to top
Medical malpractice cases are very complicated. In order to prevail, it must be shown that your doctor deviated from the standard of care. What that means is that your doctor must have failed to do what another doctor would reasonably be expected to do under the same circumstances. In addition, the failure of your doctor to act must have caused you a new injury. If your doctor's delay in diagnosing your condition caused you greater injury than otherwise would have resulted, you may have a claim. A greater injury can result from:
• Your doctor's failure to timely diagnose your true condition
• Your doctor's misdiagnosis of your true condition
• Your doctor's failure to prescribe the right treatment for your true condition
If you are in the hospital, there are other factors that need to be considered. Those include:
• Was your anesthesia properly administered?
• Did the nursing staff act timely in reporting any change in your condition to your doctor?
• Did your doctor act timely when notified by the nursing staff of a change in your condition?
• Were your medications administered in a timely and proper manner?
• Were you sent home from the hospital too soon?
Due to the complex nature of a medical malpractice case, it is best that you speak directly to one of our staff members, who can take down all of your information, ask you questions specific to your claim and address your questions. A staff member can be reached 1-800-394-0036 .
NURSING HOME NEGLIGENCE: back to top
As a resident of a nursing home, your loved one has the right to be treated as a human being, with dignity and respect. Your loved one also has the following rights:
• To be free from physical restraints (unless they are needed to protect your loved one or the other residents AND they are ordered by a physician);
• To be free from physical and mental abuse, including involuntary seclusion;
• To privacy in connection with his or her accommodations, medical treatment, written and telephonic communications;
• To have his or her medical records treated confidently;
• To review his or her own medical records;
• To voice a grievance without fear of reprisal;
• To have his or her grievances timely reviewed by the facility;
• To examine the most recent survey of the nursing home as conducted by the State Licensing Agency;
• To equal treatment regardless of the source of payment for the facility;
Like medical malpractice cases, nursing home cases are very complicated. They may involve two potential claims, one against the nursing home and its staff and one against the doctor who was caring for your loved one while he or she was in the nursing home.
There are many things a nursing home can do that exposes it to liability. For example, the nursing home could over medicate your loved one, causing respiratory or organ failure. The nursing home could fail to address your loved one's hygiene needs, resulting in the development of bedsores and/or an infection. The nursing home could fail to properly monitor your loved one's condition, allowing an otherwise manageable change in his or her mental or physical condition to escalate into a serious medical emergency or the nursing home staff could leave your loved one unattended, permitting him or her to fall and suffer a broken hip.
There may also be problems with the way your loved one's doctor managed his or her condition. The claim against your loved one's doctor is a medical malpractice claim and to prevail on the claim against the doctor, it must be shown that your loved one's doctor deviated from the standard of care. What that means is that your loved one's doctor must have failed to do what another doctor would reasonably be expected to do under the same circumstances. In addition, the failure of your loved one's doctor to act must have caused a new injury.
Due to the complex nature of nursing home negligence cases, it is best that you speak directly to one of our staff members, who can take down all of your information, ask you questions specific to your claim and address your questions. A staff member can be reached at 1-800-394-0036 .
SOCIAL SECURITY DISABILITY: back to top
Q: What does “disabled” mean?
A: The Social Security Administration (“SSA”) defines “disabled” as a medical condition which prevents a person from working. The medical condition must be severe enough that it will last for at least a year. The SSA does not provide benefits to someone who is partially disabled or who has only a short-term disability. In determining whether you are disabled, the SSA looks at whether you can perform any job not whether you can perform your regular job.
Q: Do I have to wait a year before I apply for benefits?
A: No. You can start to receive disability benefits from the SSA after 5 months provided the administration determines you are disabled and determines that your disability is expected to last at least a year or result in death.
Q: What is the difference between SSI disability and SS Disability (“SSD”)?
A: SSI disability is a welfare-based program. It is designed to help the aged, blind and disabled who have little to no income. It is designed to provide cash for basic needs, such as food, shelter and clothing. It pays less in benefits than SSD. As of 2004, the maximum benefit paid to an SSI disability recipient is $564 per month. SSD is paid to those qualifying individuals who have worked enough time to qualify. To determine if you qualify, the SSA will look back 10 years and determine how many work credits you have. Your benefit is based on your work credits.
Q: Will I have to undergo an examination by a Social Security Administration (“SSA”) doctor?
A: Possibly. The SSA has the right to send you to a doctor to be examined. This will be a doctor in your community. That doctor will report back to the SSA as to the results of his examination. The SSA will use those results to determine whether you fulfill their definition of “disabled.”
Q: If I get workers' compensation benefits can I also get benefits through the SSA?
A: If you receive WC, you may still be eligible to receive SSA benefits if you meet the definition of disabled. Assuming you are disabled for purposes of the SSA, your WC benefits may effect your right to receive SSI and/or SSD. Contact our office and we can explain to you what effect your WC benefits may have on your right to recover SSI and/or SSD benefits.
Q: I have a terminal illness. Can I apply for benefits?
A: Yes. The requirements for disability benefits are no different for a person with a terminal illness. That is, a person with a terminal illness needs to establish that he or she is “disabled” as defined in Question 1, above. However, the claim of a terminally ill applicant is decided more quickly than the claim of a non-terminally ill individual. You should include a statement as to the terminal status of your condition on your application.
Q: I have a disabled child. Can I apply for benefits on his or her behalf?
A: Disabled children may qualify for benefits under either SSI or SSD. The requirements for each is different. Contact our office and we can help you determine if an application should be filed on behalf of your son or daughter.
Q: Do I need a lawyer to file an initial application for SS benefits?
A: No. You can complete the forms yourself at your local SSA office (these are listed in the government section of your white pages) , or you can call 1-800-772-1213 and apply over the phone. When applying, tell the person interviewing you that you wish to apply for both SSI and SSD benefits. However, a high percentage of initial applications for benefits are denied. You have the right to appeal the denial, at which time the SSA will likely gather additional information. You may want an attorney to help you through the first layer of appeals.
If your first appeal is denied, you have the right to request a hearing before an administrative law judge. You should have a lawyer for this stage. Your initial consultation with our office is free. Your case will be handled on a contingency fee basis , which means we do not recover a fee unless we recover money for you. You are not charged for your future calls. You can call our office at any time to get your questions answered, or to get a status on your claim.
We can be reached, toll free, at 1-800-394-0036. We will schedule an appointment at a time and location convenient to you.
The above FAQ are intended to be illustrative only.
Please contact our office to ensure your claim is timely pursued and that all issues particular to your claim are properly addresses.