How Do WC Claims Work?
In order to qualify for a claim, you must satisfy several requirements. To give yourself the best chance of receiving a claim, make sure to follow these steps:
- Report the injury in writing - Required within 120 days, but ideally, you would report it to your supervisor immediately.
- Seek medical attention - Your employer may require you to see a company doctor for the first 90 days following your injury, as long as they provide a list of at least 6 provider options.
- File a claim - File a claim with the PA Workers' Compensation Board.
- Get medical reports - Within 48 hours of your medical treatment, request an initial report from your doctor.
- Employer reports injury - Make sure that your employer has reported the injury to the Board and insurance company.
- Request insurance statement - Get a written statement of your rights from the insurance company.
Should I Speak With An Insurance Adjuster?
Insurance adjusters are employed to limit or deny claims. Insurance companies are big business, and they want to maximize their profits as much as possible. These adjusters are very skilled in finding reasons to limit or deny coverage. Your employer will likely require you to speak with one.
Before you give a statement, make sure to consult with a reliable work injury attorney first. Such an attorney can give you advice on how to protect yourself from manipulative adjuster tactics.
Can I Be Punished For Filing A Claim?
No. Your employer is prohibited from retaliating against you for filing a claim. If you believe that you were unjustly fired for this reason, you should consider enlisting the services of a lawyer who will protect your rights.
Workers' Comp claims filed after being fired or laid off are usually looked at with suspicion, and may have a higher likelihood of being denied.
Is A Personal Injury Claim Ever An Option?
Unfortunately, sometimes healthcare workers suffer serious injuries because of a nonemployee's negligent or dangerous behavior. Additionally, defective products in the workplace occasionally end up hurting employees.
If you've suffered injuries which weren't caused by your employer or coworkers, you may be eligible to recover additional compensation via a personal injury claim. For example, you would likely have a valid personal injury claim if a violent patient assaulted you or stuck you with a contaminated needle.
Workplace injuries often cause far greater damages than doctor's bills and lost wages. Those who suffer serious injuries often face a long and difficult recovery. They often require additional needs which Workers' Comp doesn't cover. A successful PI claim would provide compensation for:
- Pain and suffering
- Loss of quality of life
- Emotional distress
- Loss of consortium in fatal injuries
What Injuries Are Covered?
Healthcare workers of all types face many unique hazards on the job. In order to save others, these brave individuals show up to work every day knowing that they are risking serious injuries. Any injury or illness acquired at work is eligible for WC. The Center for Disease Control (CDC) has identified several specific hazards in this industry:
Because of the nature of their work, those in the healthcare industry are at a higher risk of coming into contact with various infectious agents. This could happen through direct contact or by handling contaminated equipment. Specific infections include:
- Bloodborne pathogens - HIV/AIDS, Hepatitis B, Hepatitis C
- Influenza - Seasonal, pandemic, avian, swine
- Staph infections (MRSA)
- Severe Acute Respiratory Syndrome (SARS)
- Middle East Respiratory Syndrome (MERS)
Every day, healthcare facilities use a variety of different chemicals for different reasons. All hospital staff and patients are at risk of exposure to these chemicals. Examples include:
- Chemicals used to treat patients - Antineoplastic drugs, aerosol medications, anesthetics
- Cleaning chemicals - Chemicals used to disinfect and sterilize surfaces, medical supplies, and instruments
- Fixatives - Used for tissue specimens (e.g. formaldehyde)
When a healthcare worker suffers health problems because of chemical exposure, they may qualify for a Workers' Comp claim.
Healthcare work is often physically demanding, which can result in certain physical health risks. Workers are often required to lift and reposition patients on a regular basis. This can cause an accumulation of physical stress which may lead to musculoskeletal disorders.
Additionally, healthcare workers are at a high risk of becoming the victims of violence. These brave workers are obligated to treat anyone and everyone who comes through their doors. Sometimes, this may mean a violent criminal or someone with extreme psychological disorders.
Do I Need A Lawyer?
If you've been injured while working in Pennsylvania, rest assured that you are eligible for financial compensation through Workers' Comp. However, as we've already discussed, the claims process is often complicated and many claims are denied the first time. Having an experienced work injury lawyer by your side is the best way to avoid any headaches throughout this process.
A lawyer who knows how these claims work can help you to:
- Get your claim accepted the first time
- If you've been already been denied, guide you through a difficult appeals process
- Determine if a personal injury lawsuit is feasible
Each case is unique and must be evaluated separately. At Monheit Law, we gladly offer free consultations for injured workers, and only require payment on a contingency fee basis. This means that you pay nothing unless we win. For more information about how we can help you earn the compensation you need to recover from your injuries, contact us to schedule a consultation today.