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Who Can Terminate My Heart and Lung Benefits?

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Who can terminate my Heart and Lung Act benefits?

Who Can Terminate My Heart and Lung Act Benefits?

Heart and Lung Act benefits offer full salary and medical benefits to qualified civic workers such as police officers, firefighters and others. Pennsylvania lawmakers enacted the Heart and Lung Act, which is officially titled the “Enforcement Officer Disability Benefits Law,” in 1935. They also amended it in 2006 to include sheriffs and deputy sheriffs.

Unlike workers’ compensation, Heart and Lung Act benefits cover the full amount of salary for these workers, recognizing the unique contribution these employees make to our cities and state.

Who Is Eligible for Heart and Lung Act Benefits?

The Heart and Lung Act covers civic workers employed in activities such as law enforcement, firefighting or correctional activities. They include:

  • Firefighters employed by a city, a county, a borough, a township or a town
  • Police Officers employed by the same county or municipal entities as firefighters
  • State Police Officers
  • State Park Guards
  • Sheriffs
  • Deputy Sheriffs
  • Parole Agents
  • Correctional Employees responsible for the care or guarding of inmates
  • Psychiatric Security Aides working for the Department of Welfare or the Department of Corrections
  • Drug Enforcement Agents
  • Delaware River Port Authority Police
  • Liquor Board Enforcement Officers and Investigators

Volunteers, such as volunteer firefighters, are not covered by the Heart and Lung Act. Only paid civic workers are covered. However, volunteer firefighters can apply for workers’ compensation.

How Is Eligibility Determined for the Heart and Lung Act?

For an injured civic worker who falls in one of the above categories to be eligible for Heart and Lung in benefits, they must also meet the following requirements:

  • Their injury happened or they contracted an illness while they were performing an official duty.
  • The injury or illness is temporary.
  • That injury prevents them from fulfilling an essential function of their job.
  • Their employer will not or cannot restructure their essential duties to accommodate any medical limitations.

How Is “Official Duty” Defined?

When an employee is injured or contracts an illness, their injury must meet certain standards set out in legislation for them to be eligible for either workers’ comp or Heart and Lung benefits. The Heart and Lung Act requires a stricter standard than workers’ compensation:

  • An employee whose injury occurs “in the course of employment” is eligible to receive workers’ compensation benefits. This is the case whether the injury is temporary or permanent.
  • An employee whose injury occurs during “the performance of duties” would be eligible for Heart and Lung benefits. This is known as the compensability standard. The way employers or courts determine the standard is by investigating whether the employee was carrying out an obligatory task or function that arose from their status of being a police officer or firefighter or if the injury resulted from an event, such as a police chase or fire alarm, that caused an official police or fire response. The Heart and Lung Act only covers temporary injuries.

So if an employee worked in a fire station or in a police department, but the job did not meet the requirement of “the status of being a police officer or firefighter,” they would not be eligible for Heart and Lung benefits.

What Benefits Are Available From the Heart and Lung Act?

If a civic worker falls into one of the above categories, and if their injury or illness is temporary, during the entire time they are incapacitated, they will receive their full salary and payment of all medical costs.

Heart and Lung benefits, however, do not include overtime, vacation pay or income from any second job. They also do not include death benefits. Workers’ compensation, on the other hand, does include all revenue streams when determining wage-loss payments, which are 66 2/3% of an employee’s average weekly wage. There is a maximum amount available through workers’ compensation in Pennsylvania, which is $1,049 a week.

If you are considering applying for Heart and Lung benefits, also consider speaking to an attorney experienced in the Workers’ Compensation Act and the Heart and Lung Act. You may earn more income if you applied for workers’ compensation rather than Heart and Lung benefits. An experienced attorney can help you determine which is the better choice for your situation.

Can I also apply for workers' compensation benefits while receiving Heart and Lung benefits?

Can I Also Apply for Workers’ Compensation Benefits While Receiving Heart and Lung Benefits?

In fact, the Heart and Lung benefits that you receive come from workers’ compensation. Instead of being sent to you, however, these benefits are sent to your employer or their insurance carrier, which uses them to offset the cost of paying your full salary.

What If My Injury Is Caused by A Third Party?

If you are an on-duty police officer or firefighter, and you are injured by a third party, you may be entitled to Heart and Lung benefits. For instance, if another vehicle hits you while you are in a police car or a fire truck. You can also sue the driver of the vehicle that struck your vehicle.

If you do receive compensation as a result of your lawsuit, your employer cannot demand any of the monies that you receive be used to offset their share of your Heart and Lung Act benefits. While an employer can seek compensation from an injured worker on workers’ compensation who in the same situation, a 2018 Commonwealth Court decision ruled that an injured worker receiving Heart and Lung benefits does not need to share a civic judgment with their employer.

Can My Employer Use My Vacation Time or Sick Days to Account for Missed Time?

No. The Heart and Lung Act states that no employer can use an injured or an ill civic worker’s vacation time or sick days to account for time off while they are temporarily incapacitated.

What Happens If My Temporary Injury or Illness Becomes Permanent? Will I Continue to Receive Heart and Lung Benefits?

No. If your illness or injury becomes permanent, your Heart and Lung benefits end. You may still be eligible to receive workers’ comp benefits.

If your Heart and Lung benefits end, you may still be eligible for workers' comp benefits.

Employers and their insurance carriers hate paying benefits of any kind, particularly Heart and Lung benefits. So they are constantly looking for ways to deny or limit an injured employee’s access to these benefits. They often try to “prove” that the injured civic worker’s illness or injury is of “indefinite duration,” a loose standard without any real definition but one that allows for the termination of Heart and Lung benefits.

If an injured civic worker who falls into one of the above categories applies for Heart and Lung benefits, their employer will ask them to file an injury report that is very similar to the one filed for workers’ compensation benefits. The employer normally then asks for a statement explaining the details of the accident, why the injured worker believes that their injury or illness is only temporary, and how this injury or illness prevents them from carrying out the essential functions of their job.

The employer may investigate the circumstances behind the injury or ask another member of the governmental organization to investigate. This person will then write a report based on their investigation, which they will send to you and your employer. If the investigator determines that you should receive Heart and Lung benefits, compensation starts on the first workday following the date on which you were injured or your illness was diagnosed.

If the investigator determines that you are not eligible, you will receive a letter telling you that your request for Heart and Lung benefits has been denied, your employer’s reasons for why your application was denied and that you are entitled to appeal the decision at a due process hearing.

What Happens at a Due Process Hearing?

There are no set guidelines for a due process hearing about Heart and Lung benefits. Every government entity deals with it in a different way. The employer is only required to tell the injured or ill civic worker where and when the hearing will take place. They do not need to give them any other information about the guidelines.

In some cases, the appeal will take place in front of the employer. In other cases, it may be as many as three individuals, all of whom work for the employer. Many attorneys experienced in Heart and Lung benefits cases consider these due process hearings to be stacked against the injured or ill civic worker.

You have the right to have legal representation at these hearings, and it is advisable to have an attorney present to protect your rights. In addition to the initial hearing, you can appeal to the courts if your benefits are terminated.

Should I Get a Lawyer to Help Me Keep My Heart and Lung Benefits?

Yes. It is critical to hire an attorney who understands the interplay between the Workers’ Compensation Act and the Heart and Lung Act.

It's critical to hire an attorney who understands the interplay between the Workers' Compensation Act and the Heart and Lung Act.

Employers or their insurance companies will often try to deny or limit claims that involve these work-related illnesses or injuries. This creates an opportunity for an attorney familiar with both Acts to transfer the injured or ill civic worker’s claim to a workers’ compensation forum.

This is when the advantage can shift back to the injured or ill civic worker. The rules that govern workers’ compensation hearings are much more stringent than those used in a Heart and Lung Act hearing. Workers’ compensation hearings involve testimony from medical experts, more definitive rules about how to present evidence and, ultimately, a workers’ compensation judge adjudicates the hearing.

Also, the Pennsylvania Commonwealth Court decision in 2010 ruled that when an injured civic worker receives Heart and Lung benefits, and their attorney successfully litigates their rights in a workers’ compensation forum, their employer or employer’s insurance carrier must pay their attorney’s fees. The employer pays these fees from the workers’ compensation fees that go to the employer or their insurance carrier that help pay for the injured or ill civic worker’s full salary on Heart and Lung benefits.

This means that an injured or ill civic worker who falls into one of the above categories does not pay to hire a personal lawyer to help them fight for the Heart and Lung benefits. If the attorneys are successful, their fees will be paid by the employer. If the attorneys are unsuccessful, since they work on contingency, the injured or ill employee still doesn’t pay anything.

Why Not Use a Lawyer From My Union?

Every attorney who works in Pennsylvania will do their very best for their client. It comes down to experience. Union lawyers may be extremely experienced in issues that concern union questions but may not be as experienced in dealing with workers’ compensation or Heart and Lung benefit issues. Also, unions sometimes sign deals with legal firms to help cut costs. Therefore, a lawyer assigned to your case by the firm working with the union is likely to be a junior member of the firm with little actual legal experience and very little in Workers’ Compensation Act or the Heart and Lung Act.

When you hire an attorney who knows and understands the interplay between the Workers’ Compensation Act and the Heart and Lung Act, you greatly increase the likelihood of a successful appeal if your employer has terminated your benefits.

What If My Employer Offers Me a Pension or Offers to Help Me Receive Disability Benefits?

Before you accept any pension or disability benefits, it is very important that you speak with an attorney experienced in workers’ compensation and Heart and Lung benefits. Your employer is not trying to help you if they make you an offer like this — they are trying to prevent you from receiving the workers’ compensation benefits to which you are entitled.

If your injury becomes permanent, or if your employer shows that it is of “indefinite duration,” you are still eligible to receive workers’ compensation benefits. In the case of a permanent illness or injury, it is likely that you will be eligible for a sizable lump sum payment.

If you accept a pension or disability benefits, however, you forfeit your right to receive workers’ compensation benefits. Therefore, it is essential that you first speak with an experienced attorney before you accept any offer of a pension or disability benefits from your employer. They can help you receive a lump sum payment and often a pension or disability benefits as well.

Contact KBG Injury Law If Your Heart and Lung Act Benefits Are Being Terminated

If your Heart and Lung Act benefits are in danger of being terminated, contact KBG Injury Law for a consultation. The attorneys at KBG Injury Law have worked with many civic workers covered by Heart and Lung Act benefits and many workers’ compensation cases. Our attorneys have the resources and knowledge to represent you in initial hearings, negotiations and court.

You can call us at 800-509-1011 or visit our contact us page where you can leave us some details about your case and questions you may have about how we can help you. A member of our team will get back to you as soon as possible.

Contact KBG Injury Law if your Heart and Lung Act Benefits are being terminated.

During this challenging time, our attorneys are advocating more than ever. While our physical offices are closed, we are all working remotely to ensure you still get the Results You Deserve. To all of our current clients, you can connect with us the same way you always do via email, phone, fax or text. To all of our prospective clients, the best way to get in touch with us is by using our contact form or by calling (800) 509-1011