Have questions about workers’ compensation in Wilkes-Barre? Our experienced attorneys have compiled answers to the most common questions we receive from injured workers in Luzerne County.
Need legal help with your workers’ comp claim? Contact our Wilkes-Barre workers’ compensation lawyers for a free consultation.
Filing and Eligibility
Q: How long do I have to report a workplace injury in Wilkes-Barre?
A: You must notify your employer within 120 days of the injury. Even if your injury seems minor, report it immediately, as failure to do so may cause complications if the injury worsens later.
Q: Can I get workers’ comp if I work for a temp agency?
A: Yes, but the process can be more complex. Responsibility can shift between the temp agency and the employer, so it’s essential to have an experienced attorney help navigate these complications.
Q: What if I have a pre-existing condition?
A: Workers’ compensation covers injuries caused or aggravated by your employment, regardless of your previous physical condition. However, insurance companies often dispute these claims, making legal representation important.
Q: Am I covered if I’m hurt during a break or before my shift starts?
A: Generally, you must be performing work-related duties when injured. However, there are exceptions depending on the specific circumstances.
Benefits and Payments
Q: How long does it take to receive benefits?
A: You should begin receiving benefits approximately 21 days after reporting your injury to your employer.
Q: Does workers’ comp cover my medical bills?
A: Yes, workers’ compensation covers all reasonable and necessary medical expenses related to your work injury, including doctor visits, surgery, medications, and medical equipment.
Q: How much will I receive in wage loss benefits?
A: Workers’ compensation typically pays a percentage of your average weekly wage. The exact amount depends on your injury classification and disability rating.
Q: How long can I receive workers’ comp benefits?
A: This depends on your injury classification:
- Temporary Total Disability: Up to 90 days
- Permanent Partial Disability: Up to 500 weeks
- Permanent Total Disability: Ongoing, subject to periodic review
- Medical benefits have no time limit in PA
Medical Treatment
Q: Can I choose my own doctor?
A: For the first 90 days, you must see a doctor from your employer’s list of at least six providers. After 90 days, you can choose any doctor, but you must notify your employer within five days.
Q: What is an Independent Medical Exam (IME)?
A: An IME is a medical examination by a doctor that the insurance company chooses. It’s used to evaluate your condition and determine your disability rating. Always consult with an attorney before attending an IME.
Q: Can I get a second opinion for surgery?
A: Yes, if your employer’s doctor recommends surgery, you’re entitled to a second opinion paid for by your employer or their insurance company.
Claim Denials and Appeals
Q: Why was my workers’ comp claim denied?
A: Common reasons of a workers’ compensation denial include:
- Employer disputes that the injury occurred at work
- Filing after the 120-day deadline
- Inaccurate incident report
- Accusations of substance use
- Pre-existing condition disputes
Q: What should I do if my claim is denied?
A: Don’t panic. You have options to appeal the denial. Contact an experienced workers’ compensation attorney immediately to discuss your appeal rights.
Q: How long do I have to appeal a denied claim?
A: You have three years from your injury date to file a claim with Pennsylvania’s Bureau of Workers’ Compensation.
Settlements and Legal Process
Q: Do all workers’ comp cases end in a settlement?
A: Most cases are resolved through “Compromise and Release” settlements, which provide faster payment but usually for a lower amount. Some cases may go to a judge for a ruling.
Q: Can I file a lawsuit in addition to workers’ comp?
A: If a third party’s negligence caused your injury, you may have grounds for a personal injury lawsuit and workers’ compensation. For example, if you’re injured by a drunk driver while making deliveries, you can file a claim against the driver as well as a workers’ comp claim.
Q: What injuries are NOT covered by workers’ comp?
A: Coverage may be denied for:
- Self-inflicted injuries
- Injuries while under the influence of drugs or alcohol
- Injuries from fights or policy violations
- Injuries that occur outside of work duties
Industry-Specific Questions
Q: I work in a Wilkes-Barre warehouse – what are common injuries?
A: Warehouse workers, including those at Amazon, Chewy, and True Value facilities, commonly experience overexertion injuries, back strains, and repetitive motion injuries due to the physical demands of the job.
Q: Are healthcare workers covered differently?
A: Healthcare workers face high injury risks and are fully covered under workers’ compensation. This includes exposure to diseases, back injuries from lifting patients, and needle stick injuries.
Q: What about seasonal workers during busy periods?
A: Seasonal workers are covered from their first day of employment. However, the pressure to work quickly during busy seasons can lead to inadequate training and higher injury rates.
Legal Representation
Q: Do I need a lawyer for my workers’ comp claim?
A: While not required, you should consider legal representation if:
- Your claim is denied
- You’re permanently disabled or need to apply for specific loss benefits
- The insurance company disputes your injury
- You’re facing an IME
- You have a third-party claim
Q: How much does a workers’ comp lawyer cost?
A: Most workers’ compensation attorneys work on a contingency fee – you pay nothing unless you receive benefits.
Q: When should I contact a lawyer?
A: Contact an attorney immediately after your injury, especially if you encounter any complications with your claim or if your employer’s insurance company contacts you.
Still Have Questions?
If you don’t see your question answered here or need help with your workers’ compensation claim in Wilkes-Barre, contact the experienced attorneys at Munley Law.
Munley Law Personal Injury Attorneys
1170 PA-315
Wilkes-Barre, PA 18702
(570) 399-0406
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