When an injured worker files a Claim Petition, in order to win, all elements of a claim petition must be met. So what does that mean?
The court has stated the case law on a claim petition. “In a claim petition, a claimant bears the burden of proving all the necessary elements for an award of workers’ compensation benefits. Inglis House v. WCAB. (Reedy), 634 A.2d 592, 595 (Pa. 1993). The claimant must prove not only that he sustained a work-related injury, but also that the work-related injury is the cause of his disability. Cardyn v. WCAB. (Heppenstall), 534 A.2d 1389, 1390 (Pa. 1987). The claimant also must establish that his disability continued throughout the pendency of the claim petition. Innovative Spaces v. WCAB. (DeAngelis), 646 A.2d 51, 54 (Pa. Cmwlth. 1994), appeal denied, 663 A.2d 696 (Pa. 1995).
First, the injured worker has to prove that Pennsylvania has jurisdiction over the claim. Pennsylvania has a long arm statute regarding injuries that occur outside Pennsylvania. However, most cases involve injuries that occur in Pennsylvania. If the injury occurs in Pennsylvania, Pennsylvania has jurisdiction.
Second, the injury had to occur within the course and scope of employment. In the past, this was a heavily litigated element. However, over time and development of case law, these issue are not as prevalent as they used to be. Issue still arise regarding this element, but in most cases, course and scope is not a disputed element.
Third, the injured worker must provide timely notice of injury to the employer. There are statutory deadlines on providing notice. Rather than go too far into the notice requirement, you can read more here.
The issues in most litigated cases today revolve around causation, extent of disability, and duration of disability.
With causation, many times an employer disputes the occurrence of a work injury or that the injury is work-related, rather than a non-work related condition, such as arthritis. Presentation of medical evidence and testimony can help meet causation.
Employers and injured workers often litigate the extent of injury. Even when an employer accepts an injury, acceptances are usually based on limited descriptions of injury, such as sprain/strains or contusions. After some medical treatment, insurance carriers begin denying medical treatment and bills due to the description of injury. That is why it is critical to hire an experience workers compensation attorney who will litigate to expand the accepted description of injury.
Employers often dispute duration of disability. This comes in one of two ways with an accepted injury. First, they may dispute any and all disability, accepting the work injury as a medical only, but denying that disability is a result of the injury. The result is an injured worker with an accepted medical claim, who is out of work, and not getting paid any benefits. Second, the employer may have filed a Modification, Suspension, or Termination petition alleging that the injured workers benefits should be reduced or stopped. Of course, there are also many claims that are denied where the employer is disputing the fact a work injury even occurred.
The point is, when a work injury occurs, cases get complicated quickly. That is why you need an experienced workers compensation attorney on your side, fighting and protecting benefits afford to injured workers by the Workers Compensation Act. Insurance carrier’s have attorneys watching and reviewing your claim. Shouldn’t you have your own attorney protecting you? Mooney Law has recovered tens of millions of dollars in benefits for injured workers across Pennsylvania. We are experienced, proven, and trusted in workers compensation. Call today for an absolutely FREE CONSULTATION at 833-MOONEYLAW or 717-200-HELP.