What is workers’ compensation?

Workers’ compensation is a benefit available to most workers in Pennsylvania when they are injured while performing their job duties or suffer from an illness related to their employment.

What benefits are available under workers’ compensation?

The most common benefits are wage loss benefits and medical benefits.  When injured at work, you are entitled to a benefit check based on a formula set by the Pennsylvania Department of Labor and Industry which takes into account your recent wages prior to being injured.   All of your medical bills for the treatment of the work injury are payable. There are no co-pays or deductibles to be paid by the worker.  Other benefits are also available in special circumstances, such as when the work injury causes scarring or disfigurement or loss of use of a certain body parts. There are also provisions for the payment of death and funeral benefits.

Who pays the benefits?

All employers in Pennsylvania are required by law to either carry workers’ compensation insurance or to apply to allow the employer to self-insure.  The great majority of employers carry workers’ compensation insurance and do not self-insure. All benefits are paid by the workers’ compensation insurance company or the self-insured employer.

What if my employer does not carry workers’ compensation insurance and is not self-insured?

Your employer’s failure to carry workers’ compensation insurance has no effect on your right to benefits. You should contact a workers’ compensation attorney who will assist you in filing a claim against a special fund set up for this circumstance.

What should I do when I am injured on the job?

You should report any injury that you suffer on the job as soon as possible to your employer, or a supervisor or manager. This report can be made verbally or in writing. If your employer does not complete a special form called an “Employer’s Report of Injury”, you should ask them to do so. If they do not, contact a workers’ compensation attorney for advice on how to proceed. Providing prompt notice of your injury to your employer is very important. There are strict time limits on reporting a work injury. Failure to report the injury within the time limits may limit or prevent your ability to pursue benefits.

Can I get workers’ compensation benefits for a pre-existing condition?

Yes. If you have a pre-existing condition, such as arthritis or degenerative disc disease, you can still collect workers’ compensation benefits if it can be established by medical evidence that your employment caused the pre-existing condition to worsen and cause disability.

Can I choose my own doctor to treat my injury?

In some instances, the employer can direct your medical attention for the first 90 days of treatment. However, if your employer or its insurance company attempts to have you treat with their doctor, you should always consult with a workers’ compensation attorney to confirm whether you must treat with their doctor. Very often, you will not have to. In any event, after 90 days of treatment, you can treat with any doctor of your choosing.

What if my initial claim for benefits is denied?

If your employer or its workers’ compensation carrier is not willing to voluntarily pay you workers’ compensation benefits, you have a right to file a Claim Petition and get a hearing before a Workers’ Compensation Judge.

What if I am already receiving benefits?

Can my employer stop my benefits before I am ready to return to work?

While you are on workers’ compensation benefits, your employer or its workers’ compensation carrier will almost certainly attempt to limit or stop your benefits at some point. They can have you examined by an “independent” medical examiner, who may assert that you are fully recovered when, in fact, you require additional treatment. Your employer may an alternative-duty position that is not suitable for your physical restrictions. While on workers’ compensation benefits, it is important that you respond quickly and appropriately to these attempts to stop or limit your benefits. Banks Law provides no-fee consultations during this period. We won’t charge a fee until and unless the employer files a Petition to go before a Judge to stop or reduce your benefits.

Can I get a lump sum settlement of my workers’ compensation benefits?

Yes. Very often, the workers’ compensation insurance carrier will offer the injured worker a lump sum amount in exchange for the injured worker giving up their right to any future weekly checks and/or forfeiting their right to have their future medical bills paid. While such lump sum offers can be tempting, it is strongly advised that you consult with a workers’ compensation attorney to ensure that you fully understand the implications of accepting the offer and that you are getting a fair settlement amount.