Pennsylvania Workers' Comp FAQs
At Monheit Law, we've represented injured workers throughout virtually all occupations and professions. We understand the common concerns people have when they're trying to get the financial help they need to recover from a job-related injury.
We've compiled a list of some of the most common questions we hear during consultations and meetings with clients. Our answers can give you a better idea of what to expect from the WC process, but remember that every work injury case is unique. In order to best plan for your recovery, it's usually necessary to discuss your situation with an experienced lawyer.
- What types of injuries qualify for Workers' Compensation?
- What should I do immediately following a work injury?
- Am I covered by Workers' Comp insurance?
- How much money will I receive under Workers' Comp?
- Are my Workers' Comp payments taxable income?
- Does Workers' Comp cover all medical expenses?
- What types of benefits are provided by Workers' Comp?
- Can I collect Workers' Comp and Social Security disability benefits at the same time?
- How long will it take to receive my benefits?
- Can I sue my employer?
- Is a personal injury lawsuit ever an option?
- Do I have to see a company doctor?
- What should I do if my claim was denied?
- Do I need to have a lawyer to file a claim or appeal?
- How much are lawyers fees?
- When should I hire a lawyer?
- Are there settlements for Workers' Comp claims?
- Can part-time workers get Workers' Comp benefits?
- Are preexisting conditions covered?
- What is the time limit for filing a Workers' Comp claim in Pennsylvania?
- What if I've been wrongly classified as an independent contractor?
- Is the insurance company on my side?
What Types of Injuries Qualify for Workers' Compensation?
Any injury, illness, or occupational disease caused by your job duties is eligible for Workers' Compensation. This includes sudden accidental injuries and also repetitive motion injuries which build up over time, such as carpal tunnel syndrome and musculoskeletal disorders. Workers' Compensation insurance is a no-fault policy, meaning that you're entitled to compensation even if the injury was your fault.
What Should I Do Immediately Following A Work Injury?
Every worker should be prepared for the possibility of getting injured on the job. Taking the right steps in the early stages can make it much easier to receive compensation. Specifically, injured workers should make sure to:
- Quickly report the injury to a supervisor.
- Complete an incident report with as many details as possible.
- Seek medical care and provide details about your medical history and how you got hurt
- Consider discussing your case with a work injury lawyer
Am I Covered By Workers' Comp Insurance?
Nearly every Pennsylvania worker is covered, with a few exceptions. Your employer is required by law to provide this coverage, regardless of the size of the business. There are certain occupations which have industry-specific compensation systems, including:
- Railroad workers covered under FELA
- Longshoremen covered by the Jones Act
- Federal employees
How Much Money Will I Receive Under Workers' Comp?
You will receive roughly 2/3 of your average weekly wage while you're out of work. These payments are capped at a maximum of the statewide average weekly wage. In 2017, this maximum amount is set at $995.
Are My Workers' Comp Payments Taxable Income?
No, these benefits are not taxable. That's why you only receive 2/3 of your average weekly wage - this reduction accounts for taxes.
Does Workers' Comp Cover All Medical Expenses?
Yes, your employer and/or their insurance carrier are required to pay for all of your injury-related medical expenses during your recovery.
What Types Of Benefits Are Provided By Workers' Comp?
There are several different types of benefits available, and some of them depend on the severity of your injury:
- Payments for approximately 2/3 of your lost wages
- Medical expenses
- Specific loss benefits if you have lost the use of a body part, including fingers, toes, hands, feet, arms, legs, vision, and hearing.
- Payments for disfigurement and scarring
- Death benefits for surviving dependent family members after a fatal injury
Can I Collect Workers' Comp And Social Security Disability Benefits At The Same Time?
Yes, some workers are eligible to receive both of these forms of benefits at the same time. However, your Workers' Comp payments will be reduced to account for the other compensation you're receiving through Social Security.
How Long Will It Take To Receive My Benefits?
If your claim is accepted, you will begin to receive payments about 21 days after you first reported the injury. Denied claims will involve a lengthy appeals process which could last between 8-12 months. However, a knowledgeable work injury lawyer can help you get through appeals faster.
Can I Sue My Employer?
In Pennsylvania, employers are almost always protected from lawsuits after work injuries. This is the compromise of Workers' Comp - employees are guaranteed coverage even if the injury was their own fault, and employers are protected from lawsuits even if their negligence causes an injury.
There are rare exceptions in cases of gross misconduct, such as failing to provide Workers' Compensation insurance in the first place.
Is A Personal Injury Lawsuit Ever An Option?
While you usually can't sue your employer or co-workers, there are certain situations where a personal injury lawsuit is an option. If a negligent third party played a role in your accident, you could hold them liable for further damages, such as pain and suffering or loss of life's pleasures.
Examples of possible negligent third parties in work injury cases include:
- Independent contractors and subcontractors in construction site injuries
- Property owners who failed to repair hazardous conditions
- Negligent motorists who cause accidents, such as a drunk driver hitting a commercial vehicle
- Manufacturers of defective products
Do I Have To See A Company Doctor?
Your employer can require you to see a company doctor for the first 90 days after your first medical treatment, as long as they provide a list of at least 6 providers. After the first 90 days, you are permitted to receive treatment from any doctor you choose.
What Should I Do If My Claim Was Denied?
Many injured workers may get frustrated and give up after a denied claim, but don't lose hope. You can file an appeal within 20 days of receiving your denied claim letter. The appeals process is difficult and complex, but an experienced work injury lawyer can help you get the benefits you need.
Do I Need To Have A Lawyer To File A Claim Or Appeal?
While you're not required to have a lawyer, it would be wise to at least speak with one about your options. The insurance company is going to have their own lawyers who are knowledgeable in how the Workers' Comp system works and they're skilled at finding reasons to deny coverage. In most cases, claims and appeals are far too complex to deal with on your own.
How Much Are Lawyers Fees?
Lawyers fees are calculated as a small percentage of your total paid benefits. At Monheit Law, we operate on a contingency fee basis, meaning you owe us nothing unless we secure payment for you. Additionally, we'd be happy to evaluate your case for free in an initial consultation.
When Should I Hire A Lawyer?
It's best to meet with a lawyer shortly following your injury. Many injured workers don't do this until they've already received a denied claim letter, but having an experienced work injury lawyer in your corner dramatically increases the chance that your claim will be accepted the first time.
Are There Settlements For Workers' Comp Claims?
The insurance company may offer you a lump sum settlement, but you should not accept it without first speaking with a lawyer. The dollar amount may be tempting, but these settlements often fall well short of the total benefits you'd receive through weekly payments.
Can Part-Time Workers Get Workers' Comp Benefits?
Yes, both part-time and seasonal employees are entitled to the same Workers' Compensation benefits as full-time workers.
Are Preexisting Conditions Covered?
If a preexisting condition was made worse by your job duties, then you qualify for Workers' Compensation. However, preexisting conditions in and of themselves are not covered. In these cases, you must provide detailed medical evidence that your condition worsened because of your work conditions. This can be hard to do, but an experienced legal team with reliable contacts in the medical field can help.
What Is The Time Limit For Filing A Workers' Comp Claim In Pennsylvania?
In Pennsylvania, you technically have up to 120 days to file a report after a work injury. However, your payments will likely be delayed if you wait this long. Generally, you should file a claim within 21 days to limit the risk of complications. However, it's best to file the claim much sooner - immediately after your injury, if possible.
What If I'm Been Wrongly Classified As An Independent Contractor?
Some employers try to weasel their way out of providing Workers' Comp and other benefits by classifying their employees as independent contractors. If you work for a boss-like figure and your job duties resemble those of an employee, you may be a victim of this type of fraud.
Independent contractors are permitted to file a lawsuit against anyone involved in their work injury. Whether you're a legitimate independent contractor or a misclassified one, you should discuss all of your options with an experienced lawyer.
Is The Insurance Company On My Side?
Insurance companies may present themselves as well-intentioned institutions looking out for injured workers, but this is very rarely the case. Insurance companies make revenue by denying as many claims as they possibly can. Unfortunately, many workers who suffer from serious work-related injuries get their claims denied because of this thirst for profit over all else.
These companies and their lawyers know how to work the system and take advantage of injured workers who choose to represent themselves. This is why legal guidance is so important in work injury cases. You need someone on your side who can protect you from the dirty tricks insurance companies like to play.
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