I went to my workmen comp. mandatory meditation hearing and find out my company is handling the case not the insurance company.

I went for my mandatory meditation hearing last week and found out that my company is handling this settlement and not the insurance company like we thought, what does this mean? I am getting advice from so many people and my lawyer isn't saying much except to wait until they (him and the company's lawyer) meet with both my doctor and IME. Can the judge make the decision ? wouldn't she have to have a medical back round to rule on this? I am hearing that when this happens the company is bring in the "big guns" and I should do the same but I am not sure if my lawyer is right for the job. I am very worried about this because I don't think I will ever be able to work a "normal" job again and I have a family I have to think about. I need some honest and good advice fast.

Wexford, PA -

Attorney Answers (6)

Robert Alan Huber

Robert Alan Huber

Workers' Compensation Lawyer - Philadelphia, PA
Answered

It is always smart to ask questions. The only stupid question is the one you didn't ask. I highly encourage you to reach out to your attorney and make sure you are on the same page. You need to be comfortable with your attorney and have confidence in him/her. It is not unusual to have an employer be self-insured and have an insurance company act as an administrator of your claim.

You will need to weigh the evidence, yours v. The other side's, who the judge is, and many other intangible factors best discussed with your attorney.

It's a matter of how much risk you can handle as well as what kind of light duty work you might be able to do. The amount of money could could earn pre-injury v. Post-injury wil I'll also weigh into the value of your case.

Hang in there. Litigation is soul searching.

Lawrence R. Chaban

Lawrence R. Chaban

Workers' Compensation Lawyer - Pittsburgh, PA
Answered

These are questions that you should pose to your current attorney. I would recommend making an appointment with the attorney to discuss all these issues. It is important that you let your current attorney know of your concern about what is happening and that you would like to understand the process.

As noted by another answer, it sounds like the employer is self-insured or there is a third party administrator handing the claim. Neither of these things are unusual in workers' compensation claims. It also sounds like the mandatory medication was unsuccessful so that both parties have to present medical evidence for the WCJ to make a decision. The WCJ is skilled at hearing these cases and will understand the medical issues. You certainly do not want a case heard by a "medical professional" as that person will not understand the WC law. You want a WCJ who understands the law and has learned how to determine which of the doctors to believe. Credibility, both yours and the doctors', is the key in the case.

Good luck.

Richard Alan Jaffe

Richard Alan Jaffe

Workers' Compensation Lawyer - Philadelphia, PA
Answered

From the sound of your question, you already have an attorney who should be able to answer your questions rather than posing them on this website.

With that stated, it sounds like your employer is self-insured and that what you believe to be the Insurance Carrier is really a 3rd Party Administrator who handles your employer's money. In such cases, your Employer will have a much bigger role in the Defense of your Case as well as any settlement negotiations.

Please note that not all cases settle at the Mandatory Mediation Conference and in many instances it is better to continue to litigate the claim and continue to negotiate rather than accepting the Defendants Offer as a Mediation Conference.

As it sounds like you are not satisfied with your current Attorney, it is my recommendation that you posed these questions to your Attorney and if not satisfied with his or her response you are free to seek counsel elsewhere. If you choose this route, it is my recommendation that you seek and Attorney who is a Certified Specialist in Penciling Workers Compensation Law. The initial consultation be free of charge and the Attorney will accept your case in a Contingent Fee Basis. Further, a "fee splitting" arrangement will more than likely need to be entered into between your current attorney and future attorney so that you do not end up paying more than the requisite 20%.

Before taking such drastic action, I recommend that you attempt to work out the issues with your current Attorney. If still not satisfied, there are many qualified Attorneys here on this website.

This answer to your legal inquiry is based upon the limited facts stated in your question. Accurate legal advice... more
Terence Sean McGraw

Terence Sean McGraw

Workers' Compensation Lawyer - Blue Bell, PA
Answered

Sometimes it is better to prosecute your case than to settle it. Cases frequently do not settle after an early mandatory mediation. It is easier for both sides to evaluate the case after all the evidence is developed. That can take six months or more. That is a long time if you are trying to "get on the check" rather than fighting to keep your checks coming. If you are trying to get on the check, you need talk to your lawyer about seeking other benefits like social security disability, short term disability, or unemployment comp.

Be frank with your lawyer. Be specific about your concerns and your needs. If you remain uncomfortable, seek a new lawyer. You cant get charged more than 20%. The system requires that you be free to make such a change. The lawyers will work out the fee split or the judge will do it for them. But you need to be comfortable with and confident with your lawyer.

This answer to your legal inquiry is based upon the limited facts stated in your question. Accurate legal advice... more
Thomas Stoddard Cook

Thomas Stoddard Cook

Workers' Compensation Lawyer - Harrisburg, PA
Answered

You raise a number of questions and more information would be helpful. I will try. 1. The relationship between your employer and the insurance company depends on many variables. Sometimes, employers are very involved, sometimes they aren't. Sometimes they attend hearings and mediations and sometimes they don't. Your employer may be self insured for WC which means they are both the employer and the insurance company although sometimes they will hire an adjusting company to do the paperwork. The relationship between your employer and the insurance company is not regulated by the WC law and it is quite possible that they are very involved. The mediation would generally have been handled by the defense attorney who generally is hired by the insurance company. 2. Your lawyer told you that nothing will happen until they speak to the Employer's doctor and your doctor. This probably means that the medical issues are not developed; that depositions will be taken and that settlement is premature. 3. WC Judges make decisions and decide contested questions of law and fact including medical questions. 4. Your question about big guns is unclear. I suggest that you speak with your attorney to make sure that your questions have been answered to your satisfaction

John Francis Kennedy

John Francis Kennedy

Workers' Compensation Lawyer - Scranton, PA
Answered

I cannot give your any legal advice about your case because you are represented by another lawyer. The ethical rules that apply to lawyers prevent us from giving advice to someone who already has a lawyer. However, I can say, in general, lawyers should always answer their clients questions, fully, quickly, and without any hesitation. We might not always know the answer immediately, but if we don't know the answer, we should tell our clients that we don't know the answer, and we will find out what the answer is, or point you to another lawyer that knows the answer. People should in my opinion always hire a lawyer who is an expert in the field. I would never handle a serious federal tax-related IRS case. I don't know the first thing about that. But workers compensation and employment related litigation I can do in my sleep.

This is not to be considered legal advice and we have no attorney/client relationship.

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