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Does Workmans Comp still follow you when you no longer work for the same company?

Allentown, PA |

I am on unemployment and am considering starting my own business.I still need meds for an injury with my present employer.If I start my own business will my workmans comp be terminated?

Attorney Answers 4


The first issue is that generally workers comp and unemployment are mutally exclusive. Second, if your case is settled, the medical aspect normally remains open regardless whether you change employment. Anyone injured in the course of employment should retain a workers compensation attorney. Workers compensation attorneys do not charge for an initial consultation and most fees are paid directly by the insurance company. An attorney representing you has a duty to pursue all benefits due to you. Insurance company claims adjusters are not going to notify you as to all of the benefits to which you are entitled. Their interest is to close the file as early and efficiently – to them – as possible.

This answer is provided for informational purposes only. Actual legal advice can only be provided in an office consultation by an attorney licensed in your jurisdiction, with experience in the area of law in which your concern lies.

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Since I am a Pennsylvania Workers Compensation and Unemployment Compensation lawyer, I am going to try to give you a more specific answer to your question.

My first advice is a warning. Any significant effort toward starting your own business disqualifies you from receiving unemplyment compensation. This rule applies whether you make money or lose money forn the self employment activity. For example, once you place an advertisement, you may be ineligible to receive benefits even though you have not earned dime one. There are some limited exceptions to this rule, but you should not do anything to start your own business without talking to a lawyer familiar with Pennsylvania Unemployent Compensation Law.

My second response is a question. If you are out of work due to a work injury you suffered with your last employer, why aren't you collecting workers' compensation rather than unemployment compensation? If you returned to work after your injury and worked a different job or your old job in a modified fashion, and then were laid off, you are entitled to have your workers compensation benefits reinstated. Again, I encourage you to talk to a lawyer familiar with both unemployment compensation and workers compensation and how they interact. You may be leaving money on the table.

Medical benefits related to a work injury can be settled in Pennsylvania. They can also be terminated if you are found fully recovered or if you suffer an additional injury or aggravation to the same body part. Assuming none of those have occurred in your case, neither employment with a new employer nor self employment will affect your employer's obligation to pay your medical bills.

If your medical records, after returning to work, show that your new work is aggravating your old injury (e.g., causing you to need more medication), the old employer may seek to challenge its obligation by arguing that your need for medication is no longer related to the old injury. Your old employer can also submit your treatment for "utilization review" by an independent medical expert to determine whether your treatment continues to be reasonale and necessary.

I fear that you might not be asking all the right questions. As you can see, your situation might be more complicated than you realize. If I had the opportunity to talk to you, I might learn more about your situation that would allow me to make specific recommendations about how to proceed. At the very least, I would be able to lay out your options.

Workers compensation lawyers always provide such consultations for free. I would be happy to talk to you. Feel free to check out my Avvo profile and give me a call on my toll free number. Whether it is me or someone else, I would encourage you to talk to a Pennsylvania Workers' Compensation attorney. There are may fine Work Comp lawyers here on Avvo. Pick one or two and give them a call. The advice is free. You have nothing to lose.

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First: be aware that any "substantial step" toward self-employment can be enough to disqualify you entirely from UNEMPLOYMENT benefits -- even if you are making nothing or even loosing money trying to start your own business. Tread lightly or pay an experienced lawyer for some advice before going down this road, unless your UC benefits are already at an end.

Second, as to workers' compensation, your workers compensation benefits would not be "terminated" in the legal sense merely by changing jobs or starting your own business. However, where you are receiving only medical benefits and not suffering even ongoing partial disability from the work injury, adjusters do like to play games. Regardless of what you are doing for work, there may come a time when the WC insurer starts telling your pharmacy they will not pre-authorize payment for prescriptions, sometimes even giving the pharmacy false information about the status of your claim. Also, adjusters will sometimes argue that your new work is contributing to your injury or disability, complicating your workers' compensation claim in various ways.

Third, the fact that you have a work injury for which you require medication, while out of work on UC benefits, makes me wonder whether you have a partial disability. What are the medications for? Do you have symptoms and limitations due to your work injury? Would those limitations limit you to restricted duty work to any degree? Is the date-of-injury employer unable to give you such light duty work (hence your unemployed status)?

If you have medical support indicating you are restricted from your pre-injury full duty job, yet the responsible employer is not providing light duty, you could well be entitled to Workers' Compensation wage loss benefits, which would be more than your UC benefit rate. Such benefits would also hold the possibility of a lump-sum settlement. Depending on how your claim was acknowledged by the employer and its workers' compensation insurance company, you may have the benefit of certain legal presumptions which would help you establish your right to WC wage loss benefits.

I strongly encourage you to call me or another experienced workers' compensation attorney immediately to discuss your situation.

A lump sum settlement of your workers' compensation claim could give you the start-up money you need to begin a business where you have control over what you do and when, as a way of self-accommodating any restrictions you may still have from your work injury.

Feel free to contact me at 610 924 5667 to further discuss.

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Focusing just on the medical aspect of your claim only, your right to get medical treatment that is related to you work injury will continue until you fully recovery from the work injury, the treatment is found neither reasonable nor necessary for the work injury, you are found to have recovered from your work injury or you resolve your right to future medical treatment. My recommendation, get an experienced PA WC attorney and discuss your claim with them. Trust this is helpful and best of luck to you!

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