"How Do I Get Workers' Compensation in Pennsylvania?"
- Who decides?
- What's covered?
- Where do I apply?
- When do I apply?
- Why should I?
Get Straight Answers From A Trusted Philadelphia Lawyer Who Gets Results
When you get hurt at work, your life can be turned upside. Suddenly, you might need emergency medical care. You might be in serious pain. Or you may be unable to walk or perform other routine tasks. And while you're recovering from your injury, you can't work. Fortunately, most injured workers in Pennsylvania can receive workers' compensation.
But how do you go about actually getting such benefits? Where should you start? Where do you apply? What's covered? And what's not? These are just some of the questions we regularly hear at the Law Offices of Richard A. Jaffe, LLC in Philadelphia. We want to hear your questions as well. That's because we want to help you get your life back on track.
Attorney Jaffe and his talented legal team have been tackling tough cases involving workers' compensation claims in Pennsylvania for decades. We know how the system works and how to navigate our way through it to achieve favorable results. Below, you'll find our step-by-step guide. We also encourage you to contact us right away to discuss the details of your case.
What is Workers' Compensation?
Before workers' compensation existed, if you got hurt at work, there were no guarantees about what would happen to you. No guarantee your employer would pay for your medical treatment. No guarantee your job would be there for you when you got better. No guarantee your life would ever be the same again.
Fortunately, lawmakers realized that injured workers needed protection. So in the early 1900s, many states began enacting laws designed to protect injured workers. In 1915, Pennsylvania enacted the Workers' Compensation Act. This law requires most employers (some industries are exempt) to have insurance in case of a workplace accident or injury.
The Pennsylvania Department of Labor & Industry oversees the state's workers' compensation system. Most injured workers can receive workers' compensation benefits, including part-time and seasonal workers. Significantly, workers' compensation benefits are awarded on a "no-fault" basis, meaning that you don't have to prove that your employer's negligence caused your injury. Even if your on-the-job injury was your fault, you are generally still able to claim workers' compensation.
What's covered by workers' compensation?
If you are hurt at work in Pennsylvania, workers' compensation benefits often cover the following expenses:
- Medical bills for work-related injuries
- A portion of your lost wages (due to not being able to work)
- Compensation for permanent injuries
- Occupational diseases (long-term health problems that develop slowly over time)
In addition, workers' compensation can pay for job retraining if you have to switch professions due to your workplace injury. You can also receive partial workers' compensation benefits if you can only work limited hours or need to take on "light duty" work at lesser pay due to your workplace injury.
Many scenarios exist in which injured workers are eligible to receive such benefits. That's why it's important to talk to attorney Jaffe as soon as possible.
What You Should Do
As soon as you sustain an injury at work or realize you have an occupational disease, it's important to take certain steps right away to protect your health and your rights. That's why we strongly advise people hurt on the job to do the following right away:
- Report Your Injury
- Get Medical Care
- Hire A Lawyer
- File Your Claim
- Receive Your Benefits
- Receive Continued Care
You also might need to take these additional steps if your application for workers' compensation benefits is denied, suspended or terminated.
The most important thing you must do after sustaining a work-related injury is to notify your employer that you were injured at work. This can be as simple as telling your direct supervisor about your injury as soon as is practical.
By law, you must report your workplace injury to your employer in order to be eligible to receive workers' compensation benefits. We can help you write the letter informing your employer you were hurt at work. This letter should be as detailed as possible.
There are two deadlines you need to consider when notifying your employer of your injury. The first deadline to consider is the first 21 days after your workplace injury. If you wait longer than 21 days to tell your employer you were hurt at work, you will likely not be able to receive retroactive workers' compensation benefits back to the date you were hurt.
Even if you fail to notify your Employer of your injury within 21 days, you still have a total of 120 days to notify your employer you were hurt at work. The 120-day timeline starts from the day of your injury. The filing of a Claim Petition by our office can be sufficient notice to your employer. If you do not report your injury within that time period, you will likely lose all your rights to receive workers' compensation benefits.
If you have an occupational disease, you have up to 300 weeks (5 years and 40 weeks) to report your claim. The 300-week deadline starts from the date you were last employed at the job which caused your occupational disease.
This is the most important thing you need to do immediately after your injury. You need to seek immediate medical attention. This means personally calling 911 or having a co-worker do so if you are unable to operate a phone.
And if your injury happened recently and you haven't seen a doctor yet, make an appointment to see your doctor right now. It's critical that you have a doctor diagnose your injury as soon as possible for several reasons. First, your life could be at risk depending on your injury. Second, you need documentation proving you have an injury to receive workers' compensation benefits.
After you reported your Injury to your employer, they may instruct you to treat with the "Company Doctor." This is often done even when your employer does not have the legal right to control your medical treatment. In order to make you treat with the "company doctor," your employer must have you sign the Required Notice of Employee's Rights and Duties and also have a List of Designated Physicians posted at a readily accessible place at your worksite. If they do not do so, you are able to treat with your own physicians. Regardless, you are always permitted to seek treatment at an emergency room.
The sooner you hire an attorney to help you with your workers' compensation claim, the better. When you have a lawyer who understands how the system works on your side, you can make sure that your request for workers' compensation benefits receives the attention it deserves.
Just because you got hurt at work does not guarantee that you will automatically receive workers' compensation benefits in Pennsylvania. Legitimate claims are sometimes denied for no good reason.
An experienced attorney can make sure your application for workers' compensation benefits contains all the essential information. That's because even the smallest mistake can sometimes result in your claim being denied or reduced. That's why we're eager to meet with you.
It is your employer's responsibility to file your workers' compensation claim with the Pennsylvania Bureau of Workers' Compensation.
Your employer must also inform its insurance provider "immediately" that you have been hurt on the job, according to the rules for Pennsylvania's Department of Labor and Industry. If you employer fails to meet any of these deadlines, we can help you hold them accountable for their failure to act. Your employer's insurance carrier will then have 21 days from the date you provided Notice to either accept your claim with a Notice of Compensation Payable, deny your claim with a Notice of Workers Compensation Denial, or issue a Temporary Notice of Compensation Payable which allows for payment of wage loss benefits without an admission that your claim was accepted. This latter document can be "stopped" within 90 days.
If your workers' compensation claim is accepted, you should start receiving workers' compensation checks within 21 days. You should continue to receive these checks while you're recovering from your injury, even if your recovery lasts years.
If you suddenly stop receiving workers' compensation checks, immediately contact our office. Your workers compensation checks should continue unless you sign a Supplemental Agreement, then return to work and your Employer sends you a Notification of Suspension or Modification, or a Workers Compensation Judge decides that you are no longer entitled to benefits. We can help you take immediate legal action to have your benefits restored and take other legal action if necessary.
Workers' compensation benefits can vary widely depending on different circumstances, including if you can return to work in a limited capacity and the severity of your injury. In general, you can receive two-thirds of your weekly pay prior to your injury. There is a maximum amount of money you can receive weekly, which changes every year based on state wage data.
Often, an important part of your recovery process after your workplace injury involves receiving continued medical treatment. During the first 90 days of your recovery, your employer or your employer's insurance company can choose which doctor or doctors treat you, if you signed the Required Notice of Employee's Rights and Duties and your employer had a List of Designated Physicians posted at a readily accessible place in your worksite. If not, you can treat with whomever you choose.
After 90 days, you can choose your own physician to treat your work-related injury in most cases. If your employer or its insurance company tries to prevent you from choosing your doctor, contact our law firm. We can help you get the proper medical treatment you deserve with to see the doctor of your choice.
Sometimes, employers or insurance providers deny a workers' compensation claim. In such cases, you must file a Claim Petition with the state Workers' Compensation Office of Adjudication. Even after you have begun receiving workers compensation, your employer or its insurance carrier may file a petition to either stop or reduce your entitlement to worker's compensation benefits. After they do so, you will need to appear in court to resolve this dispute.
Workers' compensation judges in specialized courts rule on such cases in Pennsylvania. We can appear with you in court to present your case. Prior to your court appearance, we can conduct our own investigation and gather evidence to support your case. We leave no stone unturned.
If a workers' compensation judge rules that you are not eligible to receive benefits, or that you are no longer entitled to receive benefits, you can - and should - appeal the judge's decision. To do this, you will need to file a Claim Petition with the Pennsylvania Bureau of Workers' Compensation. You have 20 days to file your appeal.
Successfully appealing a denied workers' compensation claim can be very challenging. And if you fail to do so, your financial future could be at risk. That's why it's critical that you schedule an appointment with attorney Jaffe right away.
Our law firm has decades of experience working with people who deserve to be compensated for their workplace injury. That's why we have such a strong track record of success. There's no substitute for doing such work, for fighting for the rights of injury victims and their families.