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Philadelphia

106 Chesley Drive

Media, PA 19063

P: (610) 627-9100

F: (610) 627-9717 

Pittsburgh

6000 Brooktree Road

Suite 300

Wexford, PA 15090

P: (724) 940-2977

F: (724) 940-2970 

Delaware

Barley Mill House

3701 Kennett Pike

Suite 100

Greenville, DE 19807

P: (302) 308-6100

F: (302) 308-6106

Copyright© 2019 Carpenter, McCadden & Lane, LLP

Handling a Multi-State Desk

November 7, 2016

 

Before becoming a paralegal for CML, I was a lost time adjuster on a multi-state desk, and at one point was handling 6 different jurisdictions.  It was hard to keep all of them straight, so I collected handouts from every defense firm I worked with and tried to compare everything to the first two states I learned: Pennsylvania and New Jersey.  For example, West Virginia is like Pennsylvania in that it is a wage loss state, but also like New Jersey because there is permanency and you can cut a claimant off.  Over the years of handling claims, I developed a quick-reference chart to help me keep everything straight.  I hope this helps for you too!  If you would like a laminated copy of this to keep at your desk, please email me at esooy@cml-law.net

 

                    Pennsylvania                        New Jersey                           West Virginia 

 

Waiting         7 days                                   7 days                                     3 days

Period           Retroactive at 14th day           Retroactive at 8th day               Retroactive at 8th day

 

AWW             52 weeks of pre-injury            26 weeks of pre-injury              1 year pre-injury wages

Calculation    wages, divided into 4              wages; AWW is average           divided into quarters; AWW is

                      13-week periods; AWW                                                         weekly average from best

                      is average of the highest                                                        quarter

                      3 period weekly wages

 

Comp. Rate   4-tiered chart, subject to         70% of AWW, subject to            66 2/3% of AWW, subject to

                      annual maximum                    maximum and minimum             maximum and minimum

 

Suspension   Form/Order from Judge           Unilateral suspension                 Adjuster to issue Order

                      required

 

Medical         Must treat with panel               Lifetime control of medical          - Cannot control providers, 

Control          physician for first 90                treatment                                  but treatment must follow 

                      days                                                                                       Rule 20

                                                                                                                   - Change of treating                                                                                                                                physicians requires                                                                                                                                  preauthorization

 

Medical         Fee schedule                           Usual & Customary                    - Fee schedule

Payments                                                                                                   - Medical bills must be

                                                                                                                   submitted within 6 months of                                                                                                                    DOS

 

IMEs             Every 6 months                        - No specific time                       Required if claimant is off 

                                                                   constraint                                  work for more than 120 days

                                                                   - Possible takeover of

                                                                   treatment

 

Settlement    Can settle full & final                - Section 20 for disputed             Can settle full & final, 
                                                                   claims (cannot be reopened)       however Claimant must have 

                                                                   - Order Approving Settlement      counsel to resolve medical                                                                        for accepted claims (can be        portion of occupational          

                                                                   reopened for additional med       disease claims

                                                                   & temp or PPD)

 

Available       - Temporary Total                   - Temporary Total Disability      - Temporary Total Disability

Benefits        Disability                                 - Permanent Partial Disability     - Non-Awarded Partial

                      - Temporary Partial                 - Permanent Total Disability       - Vocational Rehabilitation

                      Disability                                - Death                                    - Permanent Partial Disability

                      - Specific Loss                         - Medical                                  - Permanent Total Disability

                      - Death                                                                                 - Death

                      - Medical                                                                               - Medical

 

SIF                No                                         Yes                                          No

 

Relevant        - Report to Employer:             - Report to Employer: 90            - Report to Employer:

Time              120 days                                days                                         Immediate

Frames          - File Claim Petition: 3 years    - Report Inguinal Hernia: 48       - File WC-1: 6 months

                      - Issue Form/EDI: 21 days       hours                                       - Issue Order: 15 business
                      - Answer CP: 20 days              - File CP: 2 years from DOI        days (can be tolled)

                      - Pay Decision: Immediate       or last payment                         - PPD Awards: 30 days

                                                                   - Answer CP: 30 days

                                                                   - Pay Decision: 60 days

 

Forms/EDI    Forms & EDI                          EDI                                          Orders & EDI

 

Who to           Eastern Pennsylvania              Chris Bridgman                         Patty McEnteer 

Contact            Mike McCadden                    cbridgman@cml-law.net            pmcenteer@cml-law.net

With                 mmccadden@cml-law.net     610-627-0143                           724-940-2480
Questions        610-627-9066

                      Western Pennsylvania

                         Lisa Lane

                         llane@cml-law.net

                         724-940-2975

 

These recommendations are not intended to serve as specific legal advice on individual claims but are intended to serve as general considerations.  Each case is unique and should be discussed with your defense attorney before developing a strategy.

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