Clemens & Vitullo P C

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Attorneys, Employee Benefits & Worker Compensation Attorneys, Malpractice Law Attorneys

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30 Years

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(610) 825-4510Call Visit WebsiteVisit Website Map & DirectionsDirections225 W Germantown Pike Ste 2Plymouth Meeting, PA 19462 Write a ReviewWrite Review

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Mon - Fri:	9:00 am - 5:00 pm

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AKA

Vitullo, Patrick

Patrick R Vitullo Attorney

Vitullo Patrick R attorney

Clemens & Vitullo Attorneys At Law

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http://cvworkcomp.com/home.html

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Attorneys, Employee Benefits & Worker Compensation Attorneys, Malpractice Law Attorneys, Medical Malpractice Attorneys, Personal Injury Law Attorneys, Social Security & Disability Law Attorneys, Workers Compensation Assistance

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Phone: (610) 825-4510

Address: 225 W Germantown Pike Ste 2, Plymouth Meeting, PA 19462

Website: http://cvworkcomp.com/home.html

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Clemens & Vitullo P C

Workers Compensation

Personal Injury
Philadelphia Workers Compensation Attorney, Personal Injury lawyer, Attorney Philadelphia PA, Media PA, Workmans Comp Law, compensation act, PA, Bureau of Workers Compensation, Medical malpractice lawyer Reading PA, Philadelphia PA
Medical Malpractice
6) $406,000 recovery for 40 year old female office worker with $250.25 compensation rate. Claimant suffered Stage IV RSD, had an IRE rating of 58%, permanent and total injury, using spine stimulator. Claimant also recovered over $575,000.00 in third party medical malpractice action.
Social Security Disability
The Utilization Review Organization (URO) issues a report adverse to claimant declaring the treatment, or anyu future treatment from the request date, “unreasonable” and “unnecessary.” Claimant files a Petition to Review Utilization Review Determination. Query how claimant’s counsel perfects a claim for attorney fees on the UR petition? Sec. 440 of the Act, 77 P.S. Sec. 999, which allows the assessment of unreasonable contest counsel fees by quantum meruit submission would arguable not apply if there is a conflict between a UR reviewer’s opinion and the treating health care provider’s opinion? Further, Sec. 442 of the Act, 77 P.S. Sec. 998, which allows for the assessment of quantum meruit fees:where the efforts of counsel produce a result favorable to the claimant but where no immediate award of compensation is made,” does not compel the employer’s carrier to pay for such fees but imposes such an obligation on the clamant, upon agreement reached with his counsel “without regard to any per centum.” Id,; See, Wommer v. WCAB (Lycoming Cty.), 479 A.2d 661 (Pa. Cmwlth. 1984). Admittedly, the scenario this writer is contemplating is a narrow, but nonetheless, ubiquitous one. Many practitioners have open Compromise/Release cases, where indemnity has been settled but the medical treatment is still the subject matter of litigation. Some of the future medical cases ca settle, but particularly in those cases with Medicare-eligible claimants concurrently receiving Social Security disability benefits, the settlement path is extremely dangerous and at best requires the approval of the third-party insurer. Medicare’s Claims Management Services branch. Thus, in the litigated UR petition for review of UR determination, involving a claimant who previously settled his wage loss benefits by prior Compromise/Release agreement, the nagging question of counsel fees presents a problem that could effectively deny claimant proper representation of counsel. At first blush, any practitioner in the field, judge, or insurance representative, may disagree with this observation. The carriers will argue that the Act now mandates the participation of healthcare providers and therefore counsel can be compensated by the providers who can participate as a third party in a UR proceeding. Unfortunately, the reality of medical review litigation is that a) the treating providers frequently write-off the challenged medical expenses and simply discontinue treating injured workers or b) there is a insufficient fund or pool of outstanding medical fees to adequately compensate the claimant’s attorney. Either way, any litigation by a Petition to Review Utilization Review Determination has frequently resulted with the claimant’s counsel sending their clients to community legal services for representation, recommending another non-reviewed provider to begin treatment, or attempting to plead with defense counsel for the self-insured employer

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