Workers’ Compensation Guide

Regardless of the type of work you do, there is a chance that you will be injured on the job. Being injured while at work or carrying out a work-related task, may entitle you, and even your loved ones, to benefits and financial compensation under Pennsylvania workers’ compensation law.

  • Temporary Partial Disability Benefits
  • Temporary Total Disability Benefits
  • Scarring and Disfigurement Benefits
  • Specific Loss Benefits
  • Lump Sum Payments
  • Widow’s Benefits
  • Death and Funeral Benefits

  • Ankle Injury
  • Broken bones
  • Brain Injury
  • Eye Injury
  • Hearing Impairment
  • Heart Attach
  • Knee Injury
  • Nerve Injury
  • Shoulder Injury
  • Soft Tissue Injury

Notify your employer. As soon as you’re injured or discover a work-related illness, you must contact your supervisor immediately and provide him/her with full details of the incident, including the date and place of the injury. Make sure you provide your employer with a descriptive illustration as to what occurred in addition to requesting any witnesses (example – coworkers who saw the accident occur) to provide a statement on your behalf. Once you have lost a day, shift, or turn of work, your employer must report your injury or illness to the Bureau of Workers’ Compensation. Note, if you fail to properly inform your employer about your work-related injury within 120 days from the date in which it occurred, then you will be barred from filing a claim against them. This is why it is so important to act with haste in providing them with the required notification. You will not receive compensation for your injuries until you file a claim.

Your employer may choose to either accept or deny the claim. If denied, you have the right to file a claim with the bureau for a hearing before a workers’ compensation judge. Further, if your employer does not have workers’ compensation insurance to cover your damages, you may be eligible for benefits from the Uninsured Employer Guaranty Fund.

Depending on the specific circumstances of the work-related injury, there are a variety of types of workers’ compensation benefits:

Medical Care:

Of course, the most important and immediate need is for you to have medical care. Your employer is responsible for advising you in writing of your rights under the workers’ compensation law. This notice is required at the time of injury or as soon afterward as is practicable. Generally, you are entitled to payment of reasonable medical and surgical services provided in Pennsylvania. That includes medicine, supplies, orthopedic appliances and prostheses as well as hospital treatment and services. All of this is without cost to you: if there is a difference between the health care provider’s charge and the amount your employer pays, you are not billed for the balance. Depending on whether your employer provides proper notice of providers, you may be free to choose your own health care provider or you may have to initially seek treatment from a list of providers selected by your employer. Once you begin receiving benefits, your employer or the workers’ compensation insurer has the right to ask you to see a doctor of their choice for an examination every six months. For more information about your employer’s medical care requirements pertaining to your work-related injury, see Section 306(f.1) (1) (i) of the Act.

Lost Wages:

If you are totally disabled and cannot work, or if you are partially disabled and are receiving wages less than your pre-injury earnings, you may be entitled to wage-loss benefits. Generally, these benefits are equal to approximately two-thirds of your average weekly wage, up to a weekly maximum. Certain time limits, though, may apply.

Death Benefits:

If the injury or illness results in death, surviving dependents may be entitled to 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, and hearing — or otherwise have a serious and permanent disfigurement on your head, face or neck — you may be entitled to a specific amount of compensation.

Occupational Diseases:

There are special rules for occupational diseases. They are covered if caused, or aggravated, by your employment, so long as the disability occurs within 300 weeks of your last employment in a job where you were exposed to the hazard.

Under the Workers’ Compensation Act, you are entitled to two-thirds of your pre-injury average weekly wage. This is subject to both a minimum and a maximum. Your average weekly wage is determined by analyzing your earnings during the year prior to your injury. Often, your employer or the insurance company will miscalculate your average weekly wage and you will be underpaid. An attorney will make sure that your benefits are properly calculated and he will get you the retroactive benefits you are entitled to, plus interest.

This is a legal term that refers to one party being accountable for the actions of another when damage or injury occur even when there was no active involvement in the incident by the liable party. Both individuals and entities can be charged including:

  • Contractors
  • Employers
  • Corporations
  • Manufacturers
  • Hospitals
  • Medical Groups
  • Parents
  • Service Repair Groups

Simply put, these are slip, trip, and fall accidents caused by any number of unsafe or poorly maintained conditions inside or outside any type of facility. Common causes:

  • Wet floors
  • Icy or snowy driveways, sidewalks, and stairs
  • Broken stairways or no railings
  • Unsecure carpets or uneven flooring
  • Improper lighting
  • Negligent security
  • Inadequate signage

  • Boiler Room Accidents
  • Electrocution and Electrical Burns
  • Heavy Equipment Accidents
  • Explosion Accidents
  • Falling Object Accidents
  • Forklift Accidents
  • Ladder Accidents
  • Pallet Jack Accidents
  • Air Powered Tool Accidents
  • Roof and Scaffolding Falls
  • Scissor Lift Accidents
  • Sidewalk Slip and Falls

Generally, Pennsylvania employers must provide workers compensation insurance to both full time, part time and seasonal employees with only a few exceptions: some volunteers, agricultural laborers, and domestic employees to name a few. Further, certain categories of workers receive benefits under separate compensation benefit laws such as federal civilian employees, railroad workers, longshoremen, and shipyard workers. Simply put, if you incur a work-related injury (or death), illness or disease, you may be entitled to benefits, however, if the injury or death is self-inflicted or caused by your violation of law (for example, drug use or intoxication), there is no relief available.

There are certain, periodic reporting requirements if you are seeking or are receiving benefits. Workers’ compensation insurance fraud is a crime and failure to complete the required forms may result in the suspension of benefits so, it is important to be truthful.

The Pennsylvania workers’ compensation is a great program for both workers and employers. It streamlines the process of getting you the medical treatment you need and the money you deserve and it save your employer from costly litigation; however, it is not always smooth-sailing. The law is complex and your employer and insurance company will be supported by attorneys. You will need someone on your side to protect your rights.

NO! As long as the insurance company doesn’t try to stop or reduce your benefits, there is no fee. When you hire an attorney during that time to monitor your case, it costs you nothing. Your attorney will advise you with regard to independent medical examinations and vocational interviews. If your check is late or your bills aren’t being paid, your attorney will contact the insurance company on your behalf and make sure that those things are taken care of. The only time you will pay a 20% fee is if your attorney defeats a petition to reduce or cut off your benefits or if the attorney gets you benefits you are not currently receiving, either through settlement or a judge’s award.

ADR refers to any means of settling disputes outside of a courtroom and typically includes early neutral evaluation, negotiation, conciliation, mediation, and arbitration. Rising litigation costs and time delays plaque litigants and ADR attempts to move parties to agreement.

You can receive total disability benefits for the rest of your life. You can receive partial disability benefits for 500 weeks. You receive partial disability benefits if you return to work and earn less than you did per week before your injury. In addition, once you have received 104 weeks (two years) of total disability benefits, the insurance company can request that an impairment rating examination take place. A doctor selected by the Bureau of Workers Compensation will assess your “impairment rating”. If that rating is less than 35%, then you will be deemed “partially disabled” and you will only be entitled to another 500 weeks of benefits.

Settlements are based on many factors. The extent of the injury, the type of work performed, the age and education of the claimant are some of the factors that go into calculating value. However, the most important factor is the pre-injury average weekly wage. This is the weekly amount of money that the insurance company calculated that you earned prior to your date of injury. If it was improperly calculated this could lead to your case being undervalued for settlement. An important factor that is not part of the calculation is pain and suffering. While workplace injuries are often highly traumatic and place great pressure on the injured worker and his family, the Pennsylvania Workers’ Compensation Act does not provide for compensation for pain and suffering. Sometimes, if there is a third party, other than your employer, that is responsible for your injury, you can pursue additional damages through a third party lawsuit against the negligent person or entity.

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Sally

Jim was with me from start to finish in my workers compensation claim against the national company that I worked for. I was with the company for 44 years before the injury happened and he was right by my side making sure that the company and their insurance company continued to provide me with my benefit until the claim came to a final and satisfactory conclusion. I would highly recommend Jim as a true workers compensation attorney that will fight for you and your rights under the worker compensation law.

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