Who Will Pay For The Treatment After Your Work-Related Injury?

Picture this: you’re a licensed ER nurse and, one day, while moving the bullet-riddled body of a gunshot victim to a stretcher, you hear a distinct snap.  You take a quick revealing glance at the 320-lb. man you just tried to move and realize a horrifying (and potentially expensive) reality: you’ve just thrown out your back.  It’s a classic case of an employment-related injury and one that loosely describes the experience of a friend of the firm who is a licensed Pennsylvania nurse at a prominent Philadelphia hospital.

Now, picture this: you’re in a holistic medicine treatment center in Mumbai, India, receiving a head massage for that back injury in a procedure known as “panchakarma”, part of a whole-body approach to medicine.  It’s called Ayurvedic medicine and has been practiced for centuries for a variety of ailments and illnesses.  With its own set of medical preparations and surgical procedures, it is integrated into the national health care systems of countries like India and Sri Lanka.  But in the United States, much like traditional Asian medicine and osteopathy, it’s considered an alternative form of medicine.  Never heard of Ayurvedic medicine?  Neither did you until about a year after your injury.  And certainly neither did the judge who ruled it wouldn’t be covered under Pennsylvania’s worker compensation law.

WORKERS’ COMP MAY PAY FOR TREATMENT, BUT DOES IT PAY FOR EVERY TREATMENT?

Workers’ compensation laws can be a jungle to leaf through.  In Pennsylvania, under the Pennsylvania Workers’ Compensation Act, nearly every employee is protected unless covered by another compensation law (for example, federal civilian employees).  And the Act covers any illness, injury, or disease that is work-related unless it was intentionally self-inflicted or resulted from intoxication.  And it provides several benefits including the following:

• Payment for lost wages: available if you are totally disabled and unable to work or partially disabled and, as a result, receiving wages that are less than what you were making before the injury
• Death benefits: available to surviving dependents of the deceased employee
• Specific loss benefits: available if there is a permanent loss of use of an appendage or digit or if there is a serious disfigurement to a body part
• Medical care

Specifically regarding medical care benefits, you are entitled to reasonable medical and surgical services.  These can include medicine, supplies, prostheses, and orthopedic appliances.  But Pennsylvania courts have ruled only those that are causally related to the injury can be compensated.  Whether the treatment you seek, however, is “causally related to the injury” can admittedly be a confusing question.  And whether the alternative treatment you sought and ended up being successful – where traditional, Western allopathic medicine has failed – will be one that a court recognizes as compensable is another confusing question.

HOW CAN STAMPONE LAW HELP YOU?

It’s important to understand you have rights despite the type of treatment for the employment-related injury you may have pursued.  An attorney at Stampone law can help you understand those rights and fight for them.  Employers and their insurance companies will likely pay out as little as possible, given the increasing costs of workers’ compensation insurance.  And they may have their own lawyers to fight as hard as they can to pay you as little as possible.  The attorneys at Stampone law want to make sure you can have a fair fight.