Frequently Asked Questions

Medical case FAQ

Auto/Bus FAQ

WorkPlace Injury FAQ

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Medical Negligence, Medical Malpractice, & Nursing Home Cases

1. How do I get my medical records?

You will need to submit a signed request and authorization form. Under Pennsylvania law, you have a right to a copy of your records but may be required to pay for costs of retrieval, copying, and delivery. Per page copying charges are set by state law. Fortunately, federal law caps those charges at "actual costs." Most importantly, where the hospital or doctor in the course of business maintains the records electronically (computerized) and the patient then specifically requests an electronic copy (which could be email, disc, or thumb drive) when they submit their written record request, the record keeper must comply and charge the actual cost of copying. At most that is a few minutes of a clerk’s time and the cost of a disc—often they charge only a "nuisance" charge (like $7.50) or provide the copy at no charge. This also applies to radiology studies (not just the reports of studies) requests for which should be separately directed to the radiology film library or radiology department. The computerized records are much less expensive than "paper" copies, and are easily again copied by the patient on home computers.

2. What do I need to do to protect my rights?

If you are injured, and the injuries are susceptible to photographs, take them. If your injuries limit your activities, keep a diary of the times and dates that you were so limited. Make sure you keep a list of your medical providers who treat you with addresses and phone numbers. If there are medical personnel who might know something useful to your claim, if at all possible, collect their names. Suit must be filed within strict time limits.
Consult with an experienced medical negligence attorney as promptly after the event as possible.

3. How long do I have to make a claim?

You have two years to file suit under Pennsylvania law. If you are a minor, you have two years from your 18th birthday to start suit. If you could not have reasonably discovered the nature or cause of your injury within two years, because, for instance, you had an illness or condition of which you were not aware and it went negligently undiagnosed worsening your prognosis, you may fall within an exception to the two year rule allowing two years from when you reasonably should have discovered the injury. Even that, however, is subject to certain additional limitations.

4. How can I know if I have a case?

Contact a medical malpractice attorney who will have physicians available to evaluate whether what happened to you was caused by substandard or negligent care. To proceed with a case, a physician generally in the same specialty as the defendant must report that there was negligence and it caused harm. At about the time of filing suit, such an expert must be able to at least report that negligence was likely, based upon a record review, and it contributed to harm.

5. What about the medical charges for treating the effects of the negligence? Who pays? If I have monetary recovery, must I repay?

Not a simple answer to this.

The general rule is that you or your health insurance initially pay for your care. The expenses you have out of pocket may be recovered in a successful claim against the negligent party. If medical expenses on your behalf were paid by Medicare, Medicaid, certain other "federally" created insurance programs (typically "ERISA" plans), you may recover those expenses but must repay the health insurer. Otherwise, the general rule is you may not recover those expenses incurred to the time of trial and the insurance company may not recover the expenses from you.

You may recover anticipated future medical expenses.

Who pays my medical bills for injuries in an auto accident?

Under Pennsylvania law, those insured under a policy of auto insurance are covered for medical expenses related to the accident out of the policy covering them. Often called “no fault” coverage, it does not matter who caused the accident for the bills to be paid. Medical providers are limited in what they may receive for designated services. Coverage is limited to the amount of coverage purchased. If that cap is exceeded, payment is made by applicable health insurance, if any, or out of pocket.

What is the difference between limited tort and full tort insurance?

In order to reduce the cost of auto insurance, Pennsylvania carriers must give a choice between these two types of coverage, full tort being more expensive. The right to bring suit for a pain and suffering claim is generally dependent on which of these categories have been selected by the owner of the policy. With limited tort, one may recover only in the event of death, significant scarring, or “serious” injury which generally involves injuries meaningfully limiting daily activities for a significant period of time. With full tort, one may sue for pain and suffering flowing from any type of injury.

What are “uninsured” and “underinsured” coverages?

Recognizing that many car owners either do not purchase the required insurance or only purchase the minimum liability limits to meet state law, insurance companies offer these coverages. In the former, your own company acts as though it insured the other driver and provides coverage for pain and suffering up to the “UM” limit purchased. The latter, “UIM,” works the same way with coverage available when the value of the pain and suffering claim of the insured exceeds the amount of liability coverage for pain and suffering in negligent driver’s policy. UM is also available in situations when the negligent driver flees in his car (“phantom vehicle”) and cannot be identified. It is important to carefully follow all requirements in the insurance policy (and at law) in both of these claims, for instance, notifying the police very promptly after a “phantom vehicle” accident, and where the negligent driver is known, ensuring a suit has been timely filed, but not resolved, against that driver.

How can I protect my rights after an accident?

Obviously, it is most important to help anyone needing immediate medical care to get it. At the scene, make sure you have collected all information identifying all involved drivers, vehicle owners, insurance policies, license plate and drivers’ license numbers, and addresses. If there are any independent witnesses, try to get their names, addresses and phone numbers as they are likely to be the most credible persons regarding how an accident occurred. Observe the vehicles for points of impact and damage, and the surroundings for physical conditions—overhead lights working, traffic signals or signs present and working, lines of vision obstructed? Some people carry a throw away camera in their glove compartment just in case. Report the matter to your insurance company, and speak to your lawyer to make sure all that is necessary is done.

How do I get my car repairs paid?

If you have your own coverage, then you will have an option. Your company will pay for repairs (or total loss value), but will charge your deductible. That payment is not based upon who was at fault. Your insurance company and the other driver’s company, if any, will negotiate who is responsible for what portion of the repair costs for each person’s vehicle. If the other company accepts 100% liability for the collision, your deductible should be collected by your company and return to you. Alternatively, if you have no coverage for your car, or if you chose to ignore it, you can negotiate with the other’s insurance company. A deductible will not be an issue, but the other company may negotiate over for what “percentage” of the accident you and its driver are responsible, and reduce its offer by an amount representing your share of fault. A court, if suit is brought, can do the same.

I thought that if I am injured on the job, my only possible claim was against my employer’s workers’ compensation insurance. Is this correct?

Not quite. Your only claim for injuries because of fellow employee’s negligence, or because of your employer’s negligence, almost always is against the workers’ compensation coverage (“WC”) for a portion of lost earnings, a death benefit, and medical expense coverage. You do not have an option of taking workers’ comp or suing the covered wrongdoer, and the WC process has some very important procedural requirements for the claimant to “perfect” his/her claim. However, if the injury was caused in whole or in part by the negligence (or defective product) of a “third party” (like another driver, machine manufacturer, independent contractor, for example), the worker does likely have a claim against them.

Do I have to repay workers’ compensation if I succeed in a “third party” claim?

Yes, usually there is a repayment obligation (“subrogation”). Payments comp has made

up to the time of the third party settlement, minus a credit for a share of litigation costs and attorney fees, must be repaid. Also, WC can take a credit for future comp payments against the settlement fund. This is accomplished by a reduction of the ongoing comp payments. This rule of “subrogation” can be changed by state statute as it has been if the third party claim is medical malpractice where this particular right of subrogation has been eliminated.

What should I do if I have a workplace accident to protect my legal rights?

With respect to a clam against a negligent person or entity (“third party”) who does not enjoy the protection of immunity under workers’ compensation, you should make sure you have collected information about the defendant: machine manufacturer and model and name of device, auto license plate number and driver’s license number, name and address of witnesses to any accident, make a record of medical care givers, and be in touch with an attorney early in the process. With respect to a workers’ compensation claim, you should be very careful to report any injury, large or small, and whether or not you think it requires treatment or time off. Be certain that the appropriate supervisor makes a record or report. Keep a diary of any reports you make of injury–when, where, to whom, and a list of witnesses—to the accident and to the reporting. If you need treatment, for the first 90 days you will have to treat with the doctors or facilities “posted” by your employer, but later can switch if you wish. If your employer does not accept your claim within three weeks, see an attorney. If they do, make sure their calculations of your benefits are correct. If your claim is picked up, be careful about notifications you receive. Your employer (or its insurer) might seek another doctor’s examination, or an evaluation by a vocational expert, or might ask you to accept another job. It has certain rights in this regard with which you probably have to cooperate, and often this a step in attempting to reduce or eliminate your compensation. You should consult with an attorney about them.