Does Workers’ Compensation Cover Seasonal Workers?

Does Workers' Compensation Cover Seasonal Workers?

Businesses supplement their staff in peak seasons like summertime and winter holidays by hiring seasonal employees. As the workforce grows, coverage requirements evolve, including workers' comp seasonal employees' demands.

The Pennsylvania Minimum Wage Act doesn't give a clear distinction between full-time, part-time, seasonal, and temporary employees. Some employers provide more benefits to full-time staff than other workers.

So, what happens if you are a short-term employee and you sustain a work-related injury or illness? This post explains how the Pennsylvania Workers' Compensation Act protects seasonal workers.

Workers' Compensation Coverage for Seasonal Employees

Pennsylvania worker's compensation covers nearly all workers, including part-time, temporary, and seasonal employees. Employers like corporations, nonprofits, unincorporated businesses, and even entities with just one employee must provide workers' compensation coverage.

However, you may not be eligible for workers' compensation if you fall under any of the following employee categories:

• Contractors
• Volunteer workers
• Casual employees
• Domestic workers not enrolled in workers' comp by their employers
• Agricultural employees working less than 30 hours per week
• Farmworkers earning below $1200 annually from one employer
• Company executive employees who have requested an exemption
• Workers with personal religious exemptions

Who Pays Workers' Compensation?

In Pennsylvania, workers' compensation coverage is a no-fault system. Thus, victims receive compensation for all valid claims regardless of the cause or party responsible for the injury or illness. Even when an employee gets injured due to their carelessness or negligence, they're still covered.

It's important to note that you can't sue your employer for a job-related illness or injury under the no-fault compensation system. Also, employment contract terms can define the party that should provide workers' comp for a seasonal worker.

If you got your placement through a temp agency, your employer could transfer responsibility to the firm. In such a case, your employer's insurance company can deny the claim.

Therefore, it's imperative to read your employment contract with your company to know who covers you in the event of a workplace accident.

Physician Choice Under Workers' Comp Act

Employers should provide their workers with at least six health care provider or physician options to address work-related injuries and ailments

You should select a provider on your employer's list for the initial diagnosis and the subsequent visits for up to 90 days. Your employer cannot influence your choice – they can't require you to see a specific physician.

Note that your employer can refuse to pay for treatment if you visit a doctor or health facility that's not on their list.

If your employer doesn't have six preferred health care providers, you can visit a physician of your choice. The same applies after 90 days following a workplace injury, whether or not the employer has a hospital list.

If the chosen physician recommends invasive surgery, you're eligible for a second opinion from another doctor. Your employer or their insurance workers' compensation insurance pays for the service.

Workers' Compensation Benefits for Seasonal Employees

The Pennsylvania workers' compensation law provides the following benefits to qualified seasonal employees:

Medical Care

If you qualify for workers' compensation, you're entitled to medical care and surgical services after a work-related illness or injury. You should receive sufficient health care services from a qualified physician. These include hospital treatment, medicine, orthopedic appliances, and prosthetic devices if needed.

The Pennsylvania Worker's Compensation Act calculates health care costs for occupational injuries and illnesses at the physician's fee schedule rate. That applies even when you haven't lost any time from work.

If your health care provider charges more than what your employer or their insurance company offers, you aren't responsible for the difference. However, you may have to pay the balance if you seek medical services outside Pennsylvania. It's advisable to discuss the costs with your physician before treatment.

Wage Loss Benefits

If you're a victim of a work-related injury or illness, you qualify for compensation for lost wages after a work-related injury or illness if:

1. You are totally disabled and can't work. If you're in this state, your employer or insurance company can subject you to a medical examination after 104 weeks. If your impairment is below 35 percent as per the American Medical Association standards, your status changes to partial disability.
2. You are partially disabled and earning lower wages than before the injury. Partial disability refers to when a medical examination renders you not totally disabled. It may also mean that you can return to work for a lower-paying role within regular work-related restrictions.

Eligible workers get partial disability benefits for a maximum of 500 weeks. If a physician's examination rates your impairment as equal or greater than 35 percent, you can file a petition to be considered totally disabled.

Specific Loss Payment

A specific loss benefit may apply if a work-related accident results in permanent facial scarring, sight or hearing loss, or severe disfigurement on the head or neck. It can also cover a lost finger, toe, hand, foot, leg, and other body parts.

Death Benefits

Your surviving dependents may be entitled to death benefits if you lose your life due to an illness or injury sustained on the job.

Calculating Lost Wages

Under the Pennsylvania Workers' Compensation Act, wage loss benefits are roughly two-thirds of an employee's weekly wage, not exceeding the weekly maximum. The payment can be offset for half of your social security benefits, unemployment compensation, and severance pay, among other earnings.

The Act provides various ways of calculating a worker's average weekly wage. The minimum rate is the lower of half of the state's average weekly wage or 90% of the employee's average weekly pay.

When are Wage Loss Benefits Paid?

Workers' compensation begins on your first day of employment. However, disability-related benefits are payable after being disabled for at least seven days, including weekends.

Payments for time lost from work mature on the eighth day after sustaining the workplace injury. You receive retroactive benefits for the initial seven days once you've been unable to work for 14 days.

Be sure to report any work-related injuries or ailments on time. If you can't work for at least seven days and your employer or insurance company accepts the claim, you'll have your first check within 21 days.

When Wage Loss Benefits Stop

When you start receiving compensation benefits, your employer or insurance company can instruct you to see their preferred doctor for examination. The employer can request a court order requiring you to attend the check-up if you don't comply.  Further noncooperation can see your workers' compensation benefits suspended.

Another reason to terminate wage loss payments is when your employer establishes that you have returned to work.  If your new earnings are equal to or above your wage level at the time of the occupational injury or illness, the insurance company can stop further compensation.

You may be receiving temporary benefits within the first 90 days of reporting a work-related injury. If the workers' compensation insurance has a reason to reject your claim, they may notify you that they will be terminating the payments.

A workers' compensation judge can also stop your wage loss benefits after a hearing. Another reason is if you sign an agreement or supplemental agreement to stop receiving payments. Compensation for workers who become partially disabled after an injury or ailment while working expires after 500 weeks.

Timelines for Workers' Compensation Claims

An employee who suffers a workplace injury must notify the employer to get compensation. It's advisable to give the notice within 21 days to hasten the process. Be sure to file the statement within 120 days, or you will lose your benefits. 

Your employer or their insurance company can deny your workers' compensation benefits for various reasons. If you disagree, you can file a petition within three years from the date of the accident. 

Occupational Health Disorders

Are you suffering from an occupational illness? You might qualify for compensation if the injury or disability happened within 300 weeks after your exposure. Your petition should not come later than three years after the injury.

Workers' Compensation Benefits Reinstatement

What happens when the insurance company or your employer terminates your workers' compensation benefits unfairly? You can file a petition for compensation reinstatement within three years since the most recent check.

Failure to file a petition within the required timeframe can result in the forfeiture of your right to workers' compensation benefits.

Workers' Compensation Dispute Resolution

When you get injured while working, you should inform your employer immediately. They should facilitate your medical treatment and offer the compensation you deserve. Unfortunately, it doesn't happen all the time.

The employer or their workers' compensation insurance can deny the claims, sometimes over flimsy reasons. That's where a workers' compensation lawyer comes in handy.

Importance of a PA Workers' Compensation Attorney

The laws governing workers' comp for seasonal employees can be confusing. If you have a case, you should consult a knowledgeable workers' compensation attorney to achieve the best possible outcomes.

You can represent yourself in court, but it might be the worst mistake of your life. Your employer or their insurance company will hire seasoned lawyers to undermine your claims. The judge might dismiss the case or award you inadequate compensation.

Where Can I Find a Work Injury Lawyer Near Me?

If you have a workers' compensation dispute in Pennsylvania, the lawyers at Munley Law Personal Injury Attorneys will stand at your side. We offer you a thorough consultation without demanding any upfront fees.

Contact us and an experienced workers' compensation attorney will assist.