Pennsylvania Case Law

Batting 1000 – Attorney Dan Siegel is 6 for 6 in the Pennsylvania Supreme Court

On Tuesday, the Pennsylvania Supreme Court accepted our arguments completely and issued a landmark decision in Feliccia v. Lackawanna Universityholding that (1) a university “had a duty to provide duly licensed athletic trainers for the purpose of rendering treatment to its student athletes participating in athletic events,” and (2) a Waiver of Liability is unenforceable as to claims of gross negligence and recklessness. The Majority Opinion agreed with plaintiffs’ claim that the university assumed a duty toward the football players, noting that “the present factual scenario supports a determination that ‘affirmative conduct’ by appellants created a ‘special relationship’ with and increased risk of harm to its student athletes such that appellants had a duty to ‘exercise reasonable care to protect them against an unreasonable risk of harm arising’ from that affirmative conduct. … the record supports a finding appellants undertook a duty to provide duly licensed athletic trainers for the purpose of rendering treatment to its student athletes participating in athletic events, including the football practice.” Click here to read the Opinion.

Attorney Dan Siegel Has Never Lost a Case He Has Litigated in the Pennsylvania Supreme Court

A few people have asked me this week what my track record is in the Pennsylvania Supreme Court. It turns I am 6 for 6, winning four cases as counsel, and winning two as appellate counsel. To say I am proud of this accomplishment is an understatement.

What’s more important, however, is that we live in a world in which every lawyer seems to have “participation trophies,” which are often nothing more than “pay to play.” Everyone is a Super Lawyer, or is ranked as a Best Lawyer, or has a 10/10 rating on some other site. While many of these attorneys are excellent, how many can say they have never lost a case in the Pennsylvania Supreme Court, or that insurance really are more likely to settle cases with Attorney Dan Siegel because they know that, if needed, we will take cases on appeal, and we win? Not every appeal, but a large majority.

So, when you search for Dan Siegel on those “rating” sites, you may not find me because I don’t pay to have a high ranking, or to have my name displayed.

I prefer to let the “reporters” – the books that contain Supreme Court, Commonwealth Court and Superior Court opinions – display my name. They don’t charge, your name is published on merit.

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Commonwealth Court Enhances Medical Providers’ Rights Against Workers Compensation Carriers

Attorney Dan Siegel Was Lead Counsel in Decision Affirming That Medical Providers Have a Right to Payment Under the Pennsylvania Workers’ Compensation Act

The Commonwealth Court today affirmed that insurance companies and their attorneys may not take actions that prevent medical providers from being paid for care for injured workers. The decision, in Workers First Pharmacy Services, LLC v. Bureau of Workers’ Compensation Fee Review Hearing Office (Cincinnati Insurance Co.), disallowed a procedure used by an insurer and its counsel intended to prevent a pharmacy not only from being paid, but also from having a hearing about its right to payment.

Havertown workers’ compensation and appellate Attorney Daniel J. Siegel, whose cases have dramatically expanded the protections available to medical providers caring for Pennsylvania’s injured workers, was counsel and argued the case before the Court.  Before this and other decisions in which Siegel was counsel, Pennsylvania courts had never ruled that doctors, physical therapists, orthopedic surgeons and other medical caregivers cannot be cutout from payment without a hearing.

“I am proud that this case, and others my office has handled, have expanded the rights of every medical professional in Pennsylvania. My firm’s recent cases have extended the rights of more injured persons and their medical providers than any other firm’s,” said Siegel, founder of the Law Offices of Daniel J. Siegel, LLC. He also credited attorneys Christa Frank High and Nicole A. Kratzer, who also handled the case.

In this case, a workers’ comp claim settled, and the insurance company’s lawyer included a provision in the settlement saying that (1) the injured worker was not obligated to pay for medicine he received, and (2) the insurer agreed to be bound by the separate fee review process used by medical providers to assert and protect their right to payment.  As soon as the settlement was approved, the carrier’s lawyer argued in the fee review that the pharmacy was not entitled to any payment because the insurer had never “admitted” that the worker was injured. The Fee Review Officer agreed and dismissed the matter, barring the pharmacy from any compensation. The Commonwealth appeals Court disagreed, stating: “Employer accepted full liability for the debt to Pharmacy. Employer’s counsel told Claimant that even if Employer was found not liable, Pharmacy could not hold Claimant responsible for the debt. Stated otherwise, Employer accepted “responsibility” for the debt to Pharmacy when it released Claimant from any obligation to pay Pharmacy in the C&R Agreement. Accordingly, the Hearing Office has jurisdiction to decide the three fee review contests.”

Click here to read the decision authored by President Judge Leavitt.

 

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Attention Doctors, Pharmacies & Medical Providers Treating Pa. Workers’ Compensation Patients

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.

When you need an attorney, contact our office. Over half of our clients are attorneys; that’s why we’re known as the Lawyers Other Lawyers Call for Advice.

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A Message to Insurance Companies, Self-Insureds and Others: Some of Your Lawyers Aren’t Always On Your Side

Imagine that one of the law firms that you hire to defend you and your insureds wants you to pay more, a lot more. It’s true.

One law firm proudly states that it defends employers, self-insureds, and [insurance] carriers in matters involving workers’ compensation, auto claims, slips and falls, and many other types of personal injury lawsuits.

But whose side are they really on? After all, this law firm wants to void and eliminate all medical fees schedules based on Medicare and other non-Pennsylvania guidelines, thus increasing the amount that its clients would have to pay for medical care, and even for future medical care in some cases.

You don’t have to imagine it. It’s true.

This Pennsylvania-based insurance defense firm is arguing in a case in the Commonwealth appeals Court that every fee schedule based on an outside formula is unconstitutional. This means that according to a law firm that exclusively represents insurance companies, employers and self-insureds, the fee schedules that they use to determine how much to:

  • Pay for medical bills
  • Pay for hospital bills
  • Pay for medical tests
  • Pay for diagnostic tests
  • Pay for medical equipment
  • Pay for pharmaceuticals, and
  • Pay for every other type of medical care

would be void (in other words – all of these fee schedules would be eliminated) if they were based on a Medicare fee schedule, the Red Book for medications/pharmaceuticals, and any other guidelines that the Pennsylvania legislature did not create.

That’s right, every doctor, every hospital, and every type of medical provider could charge and would be entitled to be paid whatever amount it asked for based on this logic. I am certain that insurance companies would be thrilled to know that their lawyers are taking a position that would cost them millions, all because they don’t like how a small group of pharmacies is compensated under the Pennsylvania Workers’ Compensation Act for dispensing medication to help injured workers deal with pain without exposing them to cheap, addictive opioids.

Here is what the firm wrote in their Commonwealth Court brief:

It was unconstitutional for the legislature to delegate the law on pricing of pharmaceuticals to a private company without providing that company with any policy direction, limits, or guidance, and with the ability of that private company to change the rules at rates at its whim, in secrecy, and without legislative review.

Analogously, this also means that it is unconstitutional for the legislature to delegate the law on pricing of medications and other care to Medicare without providing any policy direction, limits, or guidance, and with the ability of Medicare to change rates at its whim, in secrecy, and without legislative review.

Our office does not and never will represent insurance companies, we represent injured workers, victims of auto accidents, slips and falls and other negligence. We also recognize that fee schedules are necessary, and that they are best when derived from reputable sources like Medicare and the Red Book. Otherwise, the cost of medical care would have no boundaries.

Imagine that.

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Pa. Supreme Court, Citing Dan Siegel’s Brief, Issues Landmark Car Accident Ruling

The Pennsylvania Supreme Court ruled today that, in car accidents claims against Pennsylvania governments and governmental agencies, “operation of a vehicle” is the continuum of activity from when a vehicle begins its journey until it reaches its final destination.  This case will impact every auto accident claim against the Commonwealth of Pennsylvania, every municipality, and every governmental agency, such as SEPTA.

In the case, known as Balentine, the Supreme Court specifically cited and adopted the standard suggested by Attorney Daniel J. Siegel of the Law Offices of Daniel J. Siegel, LLC, who authored the Amicus/Friend of the Court Brief for the Pennsylvania Association for Justice. The Opinion reverses 30 years of inconsistent and illogical decisions, and creates a uniform and logical standard for evaluating the responsibility of a governmental entity in motor vehicle accident cases. Our law firm is proud that over the past 13 years since we opened, our cases have protected and expanded the rights of more injured workers and car accident victims than those of any other law firm in Pennsylvania! Last year, our Pennsylvania Supreme Court case expanded the statute of limitations in all uninsured and underinsured motorist cases.

The Opinion in Balentine specifically cited Attorney Dan Siegel’s Brief, “The approach set forth in the Warrick dissent, as advocated for by Amicus Curiae Pennsylvania Association for Justice, does not contradict the ‘intent of the Tort Claims Act to insulate local government agencies from liability.'”

Click here to read the Opinion in Balentine v. Chester Water Authority.

Click here to read Dan Siegel’s Brief.

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Pennsylvania Workers’ Compensation Settlements Cannot Bar Medical Provider From Being Paid Without Notice

In a precedential decision that will impact every Compromise & Release (Settlement) Agreement under the Pennsylvania Workers’ Compensation Act, the Commonwealth Court ruled today that “The parties to a C&R agreement can bind each other, but they cannot release themselves from liability to a person who is not a party to the C&R agreement and who has been given neither notice nor opportunity to be heard on the C&R Agreement.” Attorney Dan Siegel of the Law Offices of Daniel J. Siegel, LLC was lead appellate counsel, and argued the case for the medical provider; he was assisted by Attorney Nicole Kratzer.

The Court also ruled that “A C&R Agreement cannot be employed to avoid the procedures in the Act for challenging a provider’s invoice or a fee review determination that the invoice must be paid. To hold otherwise would eviscerate Section 30l(f.1)(5) and (6) of the Act and violate the due process of law guaranteed to providers.”

Click here to read our latest appellate victory, which yet again impacts virtually every injured worker in Pennsylvania.

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Influencers of the Law – They Aren’t All in Large Firms

Today’s Philadelphia Inquirer has an entire section devoted to advertising for, oops, I meant highlighting the achievements of large law firms. Called “Influencers of the Law,” the section focuses on the accomplishments of many large law firms in the Philadelphia area. It also includes (not inexpensive) advertisements for 15 of the firms whose attorneys are featured in the section.

But there was something missing, a big something.

That something was a list of attorneys who practice in solo and small firms whose efforts on behalf of their clients are as admirable and worthy of recognition as the attorneys the Inquirer chose to feature. I could name a dozen such attorneys off the top of my head, whose omission is inexplicable. Because it’s not just the large firms who cases influence the law.

Consider our two-attorney firm. In the past year, for example, we were counsel in two landmark Pennsylvania Supreme Court cases – Protz and Bristol – both of which will have a dramatic impact on future claims for countless injured workers and persons injured in auto accidents. In addition, we are counsel in three pending Supreme Court cases – which are likely to have a similar impact. But like our counterparts in other small injured victim-focused firms, the Inquirer chose to ignore us. Click here to view a summary of some of our cases that changed the law.

Protz, for example, has been called the most important Pennsylvania workers’ compensation case since 1983. In the case, the Pennsylvania Supreme Court ruled that the Pennsylvania Workers’ Compensation Act’s impairment rating examination violated the Pennsylvania Constitution. By declaring this provision unconstitutional, the Supreme Court invalidated the arbitrary 500-week limit on wage losses that reduced the rights of the overwhelming majority of injured workers.

In Bristol, the Pennsylvania Supreme extended the deadline (statute of limitations) for filing claims by underinsured motorists. Before this decision, the deadline for filing these claims was dramatically and arbitrarily limited. This is a game-changing case and one where lawyers have commented how Attorney Dan Siegel’s oral argument made a difference.  Click here to view Dan Siegel’s oral argument before the Pennsylvania Supreme Court.

So when you need an attorney, remember that small firms are just as impactful as large firms, but we typically have lower fees, are client-focused (after all, some large firms are paying newly-minted lawyers fresh out of law school $190,000 a year, when they have never handled a case as a licensed attorney – who do you think pays for these lawyers’ on-the-job education?), and our lawyers have been there and done that.

I remember years ago learning about one now-retired lawyer, Steve Feldman, who was a solo his entire career. What did I discover? That Steven was involved in virtually every major case that addressed the rights of injured persons – and he was a solo. Lawyers practice as solos and in small firms for many reasons, just as do lawyers in massive corporate firms. It’s not the size of the firm that matters, it’s the lawyer handling the case. In that vien, the Inquirer’s “Influencers of the Law” missed the mark.

 

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Pennsylvania Supreme Court Opens The Door For Plaintiffs To Recover Non-Economic Damages

The Pennsylvania Supreme Court has ruled that persons who file Whistleblower claims are entitled to compensation for embarrassment, humiliation, loss of reputation, and mental anguish, also known as non-economic damages. The unanimous March 27th decision in Bailets v. Pennsylvania Turnpike Commission affirmed that a $1,600,000 verdict for non-economic damages was not excessive. This ruling should incentivize government employees to report wrongdoing and waste, and open the door to expanding the definition of recoverable damages in other types of lawsuits.

In Bailets, the plaintiff, a 20-year managerial employee responsible for preparing financial reports for the Pennsylvania Turnpike Commission, had received excellent performance reviews, but was fired after complaining about waste, impropriety, and politically motivated “pay-to-play” actions of the Commission. The Commonwealth Court entered a verdict in favor of Bailets and against the Commonwealth, awarding $3.2 million in damages, including $1.6 million in economic damages, i.e. past and future wage loss, and $1.6 million for non-economic damages, i.e. his mental and emotional suffering.

The Turnpike Commission appealed, insisting it was not liable for non-economic damages because the Whistleblower Law states the agency is only liable for “actual damages.” The Supreme Court disagreed, explaining that the overriding purpose of the law is that a whistleblower be put in “no worse a position for having reported the wrongdoing.” The Court refused to interpret the phrase “actual damages” to exclude damages for humiliation, embarrassment and mental anguish, noting that “if no recovery for such items of loss are available, a whistleblower cannot be made whole.” This ruling further affirms that plaintiffs are entitled to compensation for more than just the bare amount to cover their bills or lost wages.

If you have been wrongfully terminated based on your age, sex, race, or other discriminatory factors, or in retaliation, call our office at 610-446-3457 to set up a consultation with our attorneys. We also handle all types of personal injury matters, and will fight to get you compensated for economic damages and your pain and suffering. We can guide you through the process, and advise you about what you should expect and consider when pursuing your claim.

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Commonwealth Court Rules that Pre-Protz IREs are Invalid When a Petition to Reinstate is Filed Within Three Years of the Most Recent Payment

The Commonwealth Court ruled today that injured workers in Pennsylvania whose benefits were limited because of an impairment rating examination (IRE) may seek additional benefits if they file a petition within three years of the date of the most recent payment of compensation (wage losses). Applying the Pennsylvania Supreme Court’s landmark 2017 decision in Protz v. WCAB (Derry Area School Dist.), the Commonwealth Court – in Whitfield v. WCAB (Tenet Health System Hahnemann LLC)  – invalidated an IRE that modified the Claimant’s benefits in 2008, holding:

Because Claimant filed her Petition within three years from the date of her last payment of compensation as permitted by Section 413(a) of the WC Act, she was entitled, as a matter of law, to seek modification of her disability status based upon the Protz decisions, which found the IRE provision unconstitutional. Allowing Claimant to seek modification under these circumstances does not prejudice employers or insurers by upsetting their expectation of finality because such determinations are not yet truly “final” until three years have passed since the date of last payment.

The en banc Opinion by Judge Renée Cohn Jubelirer contains a thorough history of the decisions in Protz v. WCAB (Derry Area School District), in which the Pennsylvania Supreme Court declared as unconstitutional the impairment rating evaluation (IRE) provision in Section 306(a.2) of the Workers’ Compensation Act, as well as other cases that have addressed IRE issues.

In the underlying litigation in Whitfield, the WCJ found that Claimant was not entitled to reinstatement of her benefits. The Commonwealth Court disagreed, concluding that Claimant had a statutory right to seek reinstatement because she filed her Petition within three years of her most recent compensation payment, and had not waived her constitutional challenge:

The impediment that rendered her partially disabled under the WC Act, i.e., the impairment rating, is no longer a valid means of changing a claimant’s status. There was no longer a legal basis for Claimant’s disability status to remain partial because the IRE upon which the change in status was predicated was found, as a matter of law, unconstitutional and invalid. This change in the law was a basis upon which Claimant could seek reinstatement.

The Court remanded the case for a determination whether Claimant continues to be totally disabled irrespective of her IRE status. The Opinion did not address whether Protz applied to cases in which the last payment was made outside the three-year period under Section 413(a) of the Act. Judge Covey was the lone dissent.

Click here to read the Whitfield opinion.

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Voting has closed in the Delco’s Best Lawyers poll.

Thank you for voting for the Havertown Law Offices of Daniel J. Siegel, LLC in the Delco’s Best Lawyers poll in our major practice areas: Appellate; Personal Injury; Workers’ Compensation.  Voting ended Thursday, March 8th.

Here’s why we believe we have earned your support.

  • In 2017, we were appellate counsel, and won, two Pennsylvania Supreme Court cases, that expanded the rights of injured workers (workers’ compensation) and auto crash victims (personal injury). No other firm in Pennsylvania can say that! We won many other cases at trial, or on appeal, and settled numerous other matters without the need for trial.
  • 2/3rds of our clients are lawyers. They hire us to serve as appellate counsel or to assist them in preparing their complex workers’ compensation and personal injury cases. As part of these services, nearly 2,000 attorneys and judges read our monthly newsletter highlighting recent Pennsylvania appeals court decisions.
  • We are especially proud of our reputation for representing our friends and neighbors throughout Delaware County and the Main Line in their cases.

Our office is proud of our reputation for providing high quality legal services in an affordable client-focused manner.

We are also proud that we have been recognized by our peers in Super Lawyers and Best Lawyers in America.

For these reasons, we thank our clients and friends who voted in the poll for Delco’s Best Lawyers.

THANK YOU FOR NEARLY 13 YEARS OF REPRESENTING OUR FRIENDS, NEIGHBORS & COLLEAGUES THROUGHOUT DELAWARE COUNTY, THE MAIN LINE, AND THE PHILADELPHIA AREA!

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