Pennsylvania Appeals Court Eliminates Defense That Prevented Countless Workers’ Compensation Providers From Getting Paid
Doctors and every other entity providing medical care or services to injured workers under the Pennsylvania Workers’ Compensation Act will benefit from the Commonwealth Court Opinion today in Armour Pharmacy v. Bureau of Workers’ Compensation Fee Review Hearing Office. The unanimous court eliminated the ability of insurers and employers to simply allege a few “magic words” to halt the process used to determine how much they should be paid for caring for injured workers. Attorney Dan Siegel of the Law Offices of Daniel J. Siegel, LLC represented the medical provider in the case.
In the case, the Court ruled that that “where the employer challenges a fee determination of the Medical Fee Review Section for the stated reason that the medical service was not rendered by a ‘provider’ within the meaning of the Act, the threshold question must be decided by the Hearing Officer.” This means that insurers and employers must now provide evidence why they are disputing a medical bill, eliminating the often-bogus defenses that have prevented a Hearing Officer from deciding how much they are owed.
This case applies to every doctor, hospital, chiropractor, medical equipment company, pharmacy and any other entity providing medical care or services to workers injured and receiving benefits under the Pennsylvania Workers’ Compensation Act. This case also affirms that these medical providers have a due process right to compensation, as established in Armour Pharmacy I, another case handled by Attorney Dan Siegel.
Our office regularly represents medical providers and other entities seeking to be paid for treatment to injured workers. In the past week, Attorney Dan Siegel has received numerous honors for his work: (1) Philadelphia Inquirer Influencer of Law (Personal Injury) award, (2) voted Delaware County’s #1 personal injury attorney by Delaware County Daily Times readers, and (3) honored as a Pennsylvania Best Lawyer in workers’ compensation law, based upon voting by other attorneys.
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