Many people put off notifying their employer of their injury or filing a claim for workers’ compensation benefits because they do not know where to begin. However, that delay can hurt their chances of receiving benefits. At
McCormick & Vilushis LLC, our workers’ compensation lawyer helps clients in northwestern Pennsylvania navigate the workers’ compensation claim process and get the aid they need. Don’t fall prey to the myths surrounding Pennsylvania workers’ compensation claims and the rights of
workers injured on the job.
How Long Do You Have to Report Your Work Injury in Pennsylvania?
Workers’ compensation covers injuries due to accidents while on the job and those resulting from occupational disease. Under both scenarios, it is critical to report your work injury or illness to your employer within 120 days of the injury or illness to obtain your benefits. If you just learned that your injury or illness is related to work activity, you must report it within 120 days of discovering the connection to work activities.
We assist getting the benefits you deserve including but not limited to:
To receive medical payments and wage-loss payments for your work injury from the date you were injured, you must report the injury to your employer within 21 days of it occurring. Missing this deadline could also be used by your employer as a basis to deny your claim.
Although the process could seem straightforward, an employer or an insurance carrier may deny your benefits. You may also find that you need more resources to cover your needs. Our workers’ compensation lawyer helps injury victims like you understand their rights, guides them through the process, and makes a solid case to maximize their compensation, when applicable.
Getting Medical Treatment
After you report your work injury to your employer, they should provide you with a list of panel physicians who can treat you for the first 90 days of your injury. The list of panel physicians must contain several different physicians or physician practice groups with different specialties.
If your claim is accepted, after the first 90 days, you can continue your treatment with a doctor of your choosing, and the carrier must pay for the treatment. However, if you do not seek treatment with a panelist doctor within the first 90 days of your injury, the workers’ compensation insurance company may not cover that medical treatment.
What are the Types of Workers’ Compensation Benefits in Pennsylvania?
Workers’ compensation law provides several types of workers’ compensation benefits:
Lost Wage Payments
Wage-loss benefits are available if it is determined that you are totally disabled and unable to work or partially disabled and receiving wages less than your pre-injury earnings.
Total disability benefits
Total disability benefits are payable for as long as you are unable to work. There are no specific time limits imposed by law to collect these benefits. However, after you have collected total disability benefits for two years (104 weeks), you may be asked to undergo an Impairment Rating Evaluation (IRE) by the workers’ compensation insurance carrier.
If, as a result of the examination, you are found to have less than a 50% whole body impairment rating, the amount of time you can collect total disability benefits is limited to a maximum of 500 weeks, and you will be considered “partially disabled.” Your benefit rate, i.e., the amount that you collect per week, however, will remain the same. The workers’ compensation insurance carrier can still attempt to reduce your partial disability benefit further through vocational rehabilitation during the 500 weeks of partial disability.
Partial disability benefits
Any benefits less than total are partial. Partial disability benefits are usually received in a situation in which injured workers have returned to work at wages that are less than their pre-injury wages.
Partial disability benefits are payable up to 500 weeks (9.6 years) when your partial disability status is determined from an IRE or if a judge finds that you are capable of performing light-duty work at wages less than the pre-injury wages. This means that you have the ability to earn some wages, but you have not completely recovered from your work injury.
If you are back to work but the new job pays less than the pre-injury job, you are entitled to be paid two-thirds of the difference between the average weekly wage of your old job and your new job up to the maximum rate for the year of your injury.
Medical Care Payments
If you’ve been injured at work or diagnosed with a work-related illness, you are entitled to receive medical treatment that is “reasonable and necessary” to treat your work injury. These medical costs are the responsibility of your employer and the employer’s workers’ compensation insurance carrier. Once a claim is accepted, you should never have to make a co-payment or pay any other fee for medical care associated with a work-related injury or illness.
Even if you have lost no time from work, your employer should still be responsible for health care costs for a work-related injury or illness.
Even though it is the duty of the workers’ compensation insurance carrier to pay for medical treatment related to a work injury, these carriers frequently try to get out of paying by challenging the relatedness of the treatment to work-related injuries. A workers’ compensation insurance carrier may narrowly describe an injured worker’s injury to avoid paying for treatments down the road. It is very important that an injured worker be aware of what injuries have been accepted by the insurance carrier and what injuries have not been accepted, even though the injuries all occurred in the same accident.
Death Benefits
If the injury results in death, surviving dependents may be entitled to death benefits.
Specific Loss Benefits
If you have lost the permanent use of all or part of your thumb, finger, hand, arm, leg, foot, toe, sight, hearing, or have a serious and permanent disfigurement on your head, face, or neck, you may be entitled to a specific loss award.
What To Do After A Workers’ Compensation Denial
Do not give up your right to workers’ compensation benefits simply because your claim is denied initially.
Talk to a workers’ comp lawyer as soon as possible. An attorney can help you determine whether an appeal of your workers’ compensation claim denial is the best course of action for you. The deadlines for filing a petition to appeal a denial are strict, and you do not want to lose your rights to your workers’ compensation claim.
And you should talk to an attorney before filing any petition yourself. Litigating petitions is a complicated legal process, involving rules of evidence and procedure that the judge will expect you to know. Many people risk losing their workers’ comp case by not having an experienced workers’ compensation attorney at their side to help them prepare a strong case.
Frequently Asked Questions About Workers’ Compensation Claims in Pennsylvania
Here are some of the most frequently asked questions regarding workers’ compensation claims in Pennsylvania.
Contact Our Pennsylvania Workers’ Compensation Lawyer Today
To speak with our experienced workers’ compensation attorneys about workers’ compensation claims and your potential benefits, call
814-455-5362 or
send us an email. Your consultation has no cost, and we charge no attorney’s fee unless we win your case.
