Ex-Railroad Worker Awarded $48 Million For On-The-Job Injuries

A former Union Pacific railroad signalman in California has been awarded $48 million for awork-related car accident that rendered him quadriplegic.

A Superior Court judge last week approved a jury award for Eric Doi. He was injured in 2007 while on assignment in Tucson, Ariz. He was severely injured when the driver of a company truck lost control and rolled the vehicle down an embankment and into oncoming traffic.

At Munley, Munley & Cartwright, we handle Pennsylvania work-related accidents as well as those involving public transportation such as trains. In fact, we have a Website devoted to public transportation accidents in Pennysylvania.

Contact us for legal help with your work-related injury or public transportation accident claim.

Railroad Worker Award

The Limbo Stage- 21 Days to Accept or Deny

Once you have given notice of your injury to your employer, their insurance carrier has 21 days under the Workers’ Compensation Act to either accept or deny your claim for benefits. During this period of time, you are basically in limbo.

To accept the claim, the insurance carrier needs to file either one of two notices with the Bureau in Harrisburg. The first notice is a notice of temporary compensation payable. As the name implies, this notice temporarily accepts the claim for a period of 90 days to give the insurance carrier additional time to investigate your claim before making its final determination.

Prior to the end of the 90-day period, if the insurance carrier wishes to deny your benefits, they are required to file notice stopping temporary compensation. If the insurance carrier does not file the notice stopping the temporary benefits in the allotted time, the temporary notice will be automatically converted to a notice of compensation payable.

To accept the claim with no future investigation, the insurance carrier is required to file a notice of compensation payable. Both of these documents must list the accepted injury and also provide you with the name, address, telephone number and claim number from the insurance carrier.

It is also important to keep these documents in a safe and convenient place. These documents are the official documents accepting your claim for benefits.

To deny the claim, the insurance carrier needs to file a notice of denial with Harrisburg. On this notice they are required to list their reason for the denial by checking one or more of five general reasons or completing number 6 including their own written reason.If you receive a notice of denial and want to pursue a claim for your injury, at that point you will need an experienced workers compensation attorney to file a claim petition on your behalf and start the litigation process.

Panel Physicians and Workers Comp

So you got hurt at work and need to see a company doctor. Now what?

After you have given notice of your injury, your employer may require you to treat with one of their “panel physicians” through their insurance carrier. If your employer has a list of panel physicians or “company doctors,” you will be required to treat with one of the doctors on the list for the first 90 days of your injury.

Under the Workers’ Compensation Act, your employer is required to advise you of their list of panel physicians at the time of your hire and also at the time of your injury. They are also required to have you sign an acknowledgement that you are aware this policy and provide you with the list upon your injury.

If for some reason you do not like the doctor that you have chosen, you may switch doctors as long as you then chose another physician from the list. You are bound to treat with the doctor initially chosen but must treat with a doctor from the list provided by your employer.

If your employer does not have a list of panel physicians, then you may treat for your injury with any doctor of your choice. In this case, ask your doctor to recommend a physician that specializes in your type of injury. Doctors do know which doctors are good in their field, just like your mechanic often knows a good auto body technician.

Remember, your medical treatment is between you and your doctor. Do not let the insurance carrier dictate the type of treatment that you receive. We do not allow the insurance carrier to assign a “case nurse” or “case specialist” to dictate our clients treatment. The insurance carrier will be aware of your course of treatment. In order for the medical provider to be paid, they must submit their medical notes with their billing information to the insurance carrier. There is no reason for a case nurse to contact your physician.

Follow the Golden Rule . . . Give Notice As Soon As Possible

If you are hurt at work, the most important thing to remember is to report the injury to your employer through your supervisor at the time of the injury. Every injury should be reported, no matter how small you may think it to be. Any injury could potentially become a liability, not only to your health but also to your finances if it is unreported. Telling your employer that you are injured is your responsibility and it is called “giving notice.”

Too many times an employee will feel a “pop” in their knee, a pain in their shoulder or their back, and let it go for days or weeks. Not reporting an incident or injury can allow your employer to deny your claim through their insurance carrier. This can initially prevent your medical expenses and/or wage loss from being paid if the treating physician should later remove you from work due to the injury.

These injuries, which may seem minimal to you and appear to require reporting, can be an indicator of a more serious injury. You may feel that is it a strain/sprain and a few days rest may alleviate your pain, and it may very well. However, your injury can end up being serious you must protect yourself. The only way to protect your rights is to give notice.
The first step to protect your rights as an injured worker is to report your injury as soon as possible under the Workers’ Compensation Act. Obviously, if your are removed from work via ambulance you may not be able to report your injury at the time that it happened, but never assume that someone else has reported your injury for you. Follow-up with your employer as soon as possible to insure your injury has been documented.

Many injuries that end up being denied by the Insurance Carrier happen on a Friday. The injured worker goes home without reporting it on the assumption that after a weekend of rest, that he/she will feel better and they do not report it until Monday. On Monday, the Insurance Carrier most likely is going to deny the claim based upon their perception that the injury did not happen at work but instead during the weekend while you were out of work.

Do not assume the insurance carrier will pick up the claim and pay for your benefits because you are a good worker or because the company has employed you for many years. Unfortunately, this is rarely the case. Remember the insurance carriers are not in business to pay out money. If you give them an “out” they will take it.

In the course of our legal experience with workers’ compensation claims, we have seen family members deny that other family members were injured in the scope of their employment. We have seen long standing employees who thought they were very good friends with the owner of the company being denied for benefits. In the state of Pennsylvania, every employer is required to carry workers’ compensation insurance. This is in place to protect you. The most important way to protect yourself and your rights is to give notice of any injury at the time of injury or as soon thereafter as possible. Under the Workers’ Compensation Act, you must report your injury within the first 120 days or be forever barred from making a claim. Please keep in mind, the longer you wait to give notice the greater likelihood that the Insurance Carrier will deny the claim.

If you have any questions about a workplace injury, find some answers here.