Supersedeas And Fund Reimbursement In PA Workers’ Comp
Dealing with issues like supersedeas and supersedeas fund reimbursement can present challenges. This blog post aims to explain these concepts for injured workers.
Supersedeas In Pennsylvania Workers’ Compensation
Supersedeas in PA workers’ comp involves the suspension or reduction of benefits while resolving a dispute. This allows employers to file a petition to temporarily stop the payment of benefits. This may occur if they believe the injured worker has recovered or that the compensation requires adjustment.
Changes to Supersedeas
In Baksalary v. Smith, a federal court ruled that the automatic supersedeas provision was unconstitutional. This decision lead to changes to the application of supersedeas, ensuring due process for injured workers.
How does Supersedeas Work Today?
Today, employers must file a petition. Next, a Workers’ Compensation Judge (WCJ) must review and decide on the request within 14 days. If granted, the benefits may face suspension or modification until a final decision on the case.
How The Process Works
Requesting Supersedeas
An employer must file a petition when they believe a worker has recovered or that benefits need adjustment. The petition needs a medical affidavit from a doctor who examined the worker within 21 days before filing.
The Hearing Process
The court schedules a hearing within 21 days of filing the petition. During this hearing, the WCJ will review evidence, which may include medical reports, witness testimonies, and other relevant documents. The WCJ must make a decision within 7 days if prima facie evidence exists that supports the employer’s claims.
What Happens After the Decision?
If granted, the supersedeas results in the suspension or reduction of the worker’s benefits. If denied, the employer must continue to pay the benefits until the final resolution of the case. One cannot appeal the decision on supersedeas.
Supersedeas Fund Reimbursement
Supersedeas fund reimbursement allows employers to recover compensation paid, if later determined the benefits were not actually payable. This reimbursement comes from a special fund maintained by assessments on all insurers and self-insurers in PA.
Criteria For Fund Reimbursement
To qualify for supersedeas fund reimbursement, the employer must meet the following:
- The employer made a request for supersedeas in a proceeding.
- The court denied the request.
- The employer continued to pay compensation because of the denial.
- A final determination found that the compensation was not due.
Filing
Employers must file an Application for Supersedeas Fund Reimbursement (LIBC-662) with the Bureau of Workers’ Compensation.
Common Scenarios
Denied Supersedeas Requests
When the court denies an employer’s request, but the final decision concludes compensation was not actually payable.
Payments Made in Error
When the employer paid benefits based on incorrect information or determined the worker had fully recovered.
Legal Adjustments
If changes in legal interpretations or settlements occurred.
Tips for Injured Workers
Know Your Rights
As an injured worker facing a supersedeas petition, you need to know your rights. You have the right to present evidence and challenge the employer’s claims.
Talk to a workers’ compensation lawyer. An experienced lawyer will promptly respond to notices and petitions and gather medical records and documentation for your case. In addition, they will update you on any changes and court rulings that may affect your case.
Wrap Up
For wage loss due to a work injury, or the enforcement of a judgment related to your case, you need a lawyer. For questions or assistance with your workers’ compensation claim, reach out to our offices 24/7 at (215) 609-4183. The insurance company has a lawyer on their side and so should you. Let us help!
