PA Workers’ Comp: Employee Petition To Review
The Pennsylvania Workers’ Compensation Act outlines the Employee Petition to Review process. This legal process allows corrections of mistakes and modifications in the Notice of Compensation Payable (NCP) or compensation agreements.
Both employees and employers can use petitions for review to correct errors. They can expand the description of injury, or challenge issues related to medical treatment, billing, or compensation benefit offsets.
Functions Of The Employee Petition To Review
The Employee Petition to Review helps injured workers correct any material errors in the original NCP. Such as, mistakes in the description of the injury, miscalculations of average weekly wage, or incorrect dates of injury. Filing the petition provides injured workers the chance to fix such errors. This helps to ensure that they receive the correct worker’s compensation benefits under PA workers’ comp laws.
Sometimes, an employer or their insurance carrier may also file a petition to correct a mistake in the NCP. For example, if the insurance company incorrectly calculated the offset amount for Social Security Disability Benefits. This might cause them to file a petition to review to make the adjustments. This helps to ensure that workers’ compensation insurance accurately pays on the claim.
Beyond correcting errors, the petition can also modify or expand the description of injury. Work-related injuries may evolve or worsen over time, and additional conditions can arise. A workers’ compensation judge (WCJ) may modify or expand the description of injury. This ensures the injured worker continues to receive adequate workers’ comp benefits for their medical needs.
Employers may use the petition to review medical treatment and billing. Or, to challenge compensation benefit offsets that reduce the amount of worker’s comp benefits for the employee. If a worker receives other income, Social Security Disability Benefits or pensions, a reduction of benefits may occur.
Filing a petition allows the injured worker to dispute this offset amount. This ensures that workers’ comp provides the correct benefits without needless reductions.
Correcting Mistakes In The Notice Of Compensation Payable (NCP)
When an error occurs in the NCP, the process for correction starts with the filing of a Petition to Review. An injured worker can file a petition if they believe a mistake occurred in the NCP issued by the employer. This often involves misclassification of their injury or an error in the calculation of their average weekly wage. The WCJ has the authority to review the case and make changes to the NCP if necessary.
However, injured workers do not always have to file a petition to correct mistakes. Cinram Mfg., Inc. v. WCAB (Hill) established that the WCJ can correct an NCP at any time. This may occur without a formal petition, if the employer has a fair opportunity to contest the correction.
The burden of proof falls on the party seeking the change. They must show a material mistake occurred at the time of issue of the NCP.
This could involve proving an incomplete description of injury. Or, a miscalculation of the average weekly wage, which can impact the employee’s partial disability payments. Without sufficient evidence, the WCJ may reject the request to amend.
Specific time limitations exist for filing a Petition to Review. Typically, one must file the petition within three years of the most recent payment of compensation.
Even if the mistake occurred at the issue of the NCP, the three-year statue still applies. The court clarified this in Fitzgibbons v. WCAB (City of Philadelphia). A petition filed after this period, will likely end up dismissed.
Expanding or Modifying the Description of Injury
Sometimes, a work-related injury worsens or other conditions develop, not part of the original NCP. In these situations, the Employee Petition to Review can expand or modify the description of injury. In such cases, the burden of proof lies with the injured worker. They must show that the new conditions directly relate to the original work injury.
Again, one must file the petition within three years of the last payment of compensation to remain valid.
Reviewing Medical Treatment and Compensation Benefit Offsets
The Petition to Review also plays a key role in disputes regarding medical treatment, billing, or compensation benefit offsets.
Use of this petition settles disputes. Like, when a worker and their employer or insurance carriers disagree over the necessity or appropriateness of medical treatment. The petition enables them to have the issue reviewed by a WCJ. Under workers’ compensation laws, the WCJ has the power to determine the reasonableness and necessity of the medical treatment.
The petition also addresses compensation benefit offsets. This occurs when employers reduce the amount of benefits paid because the employee receives other forms of income. Injured workers can file a petition to review if they believe an incorrect or unfairly applied calculation exists .
Wrap Up
The Employee Petition to Review plays a key role for injured workers. It enables them to address errors, expand injury descriptions, and dispute issues with medical treatment or benefit offsets. It helps to ensure that workers receive accurate and fair compensation and medical treatment following a work-related injury. This not only enables injured workers to get the compensation they deserve, it helps to get them better so they can return to work.
For questions about your specific case, give us a call 24/7 at (215) 609-4183. Our workers’ comp lawyers can help get you the compensation you deserve.
