Returning to Work During Workers’ Comp Claim
After an injury on the job, you will have many questions about how to proceed. One may be: “Can I get a settlement from workers’ compensation if I go back to work?” The answer to that is yes. If your doctor has cleared you to work, and your injury won’t get in the way of performing your normal duties, then you are expected to return. This will not impact your workers’ compensation claim.
The workers’ compensation insurance program is a sure way to protect both employers and employees in the state of Pennsylvania. The Workman’s (Workers’) Compensation Act of 1915 ensures that employees’ medical needs and lost wages are covered in the event of a workplace accident. At the same time, it protects employers against crippling lawsuits from injured workers.
You should always remember, as an employee in the state of Pennsylvania, you have options regarding workers’ compensation settlements. Munley Law Personal Injury Attorneys workers’ compensation attorneys, who are experts in their field, can offer legal advice and strategies so you receive the maximum amount of compensation for the injury you sustained.
The workers’ compensation process can be complicated and intimidating for an employee. Questions fill your head: What if my boss fires me for filing a claim? What if my claim is denied? This is where Munley Law Personal Injury Attorneys steps in. You have enough on your plate just trying to recover from your work injury. There is no need to go through this process by yourself.
Here we will provide insights into the workers’ compensation system in Pennsylvania – who is eligible, how to negotiate a settlement, what to do if your claim is denied, and how a Munley Law Personal Injury Attorneys workers’ compensation attorney can carry the weight of the claims process so you can focus on a full and complete recovery.
How Do I File a Workers’ Compensation Claim?
Workers’ compensation is financial coverage for an employee who is injured on the job. The process can seem daunting, but if you follow the steps below and have a seasoned workers’ compensation attorney by your side, you should be successful in your claim:
Notify your Employer of Your Injury
An employee must notify their employer about their injury within 120 days of discovery. If you do not notify your employer within the 120-day window, you will not be able to claim compensation for the injury.
Employer Notifies Insurance Company
Your employer will notify their insurance company of your injury within 7 days. If your injury or illness causes you to miss a shift or day of work, then your employer must file a report with the Bureau of Workers’ Compensation within 7 days.
After the insurance company is notified, your employer has 21 days to inform you whether your claim will be accepted or denied. Your employer must tell you the outcome within this time frame. If you are still waiting to hear back from your employer and it has been over 21 days since you told them about the injury, speak to a Munley Law Personal Injury Attorneys workers’ compensation attorney immediately.
There are four outcomes to your workers’ comp claim:
- Your workers’ comp claim is denied: If your employer does not accept liability for your injury, they will deny the claim and your case will be closed. If this happens, you still have options to recover compensation. Contact a Munley Law Personal Injury Attorneys workers’ compensation attorney following the denial of your claim so you can begin the appeals process right away.
- Your employer wants an investigation: If your employer needs more time to investigate your injury claim, they will ask for a 90-day extension before accepting or denying responsibility for your injury. During this time, you will receive compensation until the investigation is over and your claim is either accepted or denied.
- Your claim is accepted: This is when your employer accepts full liability for your injury and agrees to pay reasonable medical expenses and lost wages that resulted from the injury.
- Agreement for compensation: This happens when the employee’s injury is permanent or leaves them with a disability. In this situation, the employer accepts responsibility for the work-related injury that led to disability and provides damages to the employee.
Seek Medical Attention
You should seek medical attention immediately following a work-related injury. If you hold off going to the doctor, your employer and their insurance company can use that gap to deny your claim. They can argue that the injury must not have been serious because you waited to get medical care.
Keep detailed records of each visit. Make sure to inform your doctor you are there because of a work injury and ask him or her to make a note of that in your records. Keep all the bills for hospital stays, ambulance rides, physical therapy, prescription medicine, and follow-up appointments. Your workers’ compensation lawyer will use all this documentation for your claim.
Who is Eligible to Receive Workers’ Compensation?
Every employee in the state of Pennsylvania is eligible to receive workers’ compensation on the first day of work. However, there are certain fields in the state that may not be able to receive benefits. If you belong to one of the following industries and were injured on the job, contact a Munley Law Personal Injury Attorneys workers’ compensation attorney today to discuss legal options, including the Uninsured Employers Guaranty Fund:
- Federal workers
- Railroad workers
- Casual employees
- Domestic workers
- Agricultural laborers
- Employees with personal religious exemptions
- Executives who opted out of workers’ comp coverage
- Volunteer workers
What is a Workers’ Compensation Settlement?
There are two types of settlements you can reach with your employer regarding your workers’ compensation claim:
Lump Sum Settlement
A lump sum settlement, or a compromise and release agreement, is when an employee settles a workers’ comp claim by giving up all rights to the workers’ compensation benefits in exchange for a sum of money.
Lump sum settlements are a good option for the employee if you have reached your maximum medical improvement. Maximum medical improvement is when you’ve recovered as much as possible from your injury and no further recovery is possible. If this is the case, the lump sum payment would be based on total permanent disability.
A lump sum settlement may be reached when you suffer a specific loss injury. A specific loss injury is when your injury results in permanent scarring and/or disfigurement. It could be the loss of a limb or impaired use of a body part. Specific loss injury compensation can continue to be paid even if you return to work.
There are situations where the employee is already receiving payments for their workers’ comp benefits but requests them in a lump sum. This is called “commutation of compensation.” When you request this type of lump sum, you will not have to give up your other benefits, such as medical treatment.
A structured settlement is when you negotiate to receive your money in a structured payout over time, either monthly, yearly, or every few years. This may be the best option for you if you are concerned about any tax implications of a lump sum settlement or if you’d rather stretch the payments over time to cover future expenses.
Munley Law Personal Injury Attorneys workers’ compensation attorneys offer free consultations so you can discuss all your legal options with a seasoned lawyer. Call today for a no-obligation consultation to discuss all your workers’ compensation options that would work best for you and your family.
How Much Will I Receive in My Settlement?
There is no exact estimate of what you will receive in your settlement as it depends on different factors:
- Pre-injury wages
- Severity of your injuries
- Ability to return to work
- Conflicting evidence in your claim
The best way to ensure a high settlement is to document as much as possible regarding your claim. Your workers’ comp attorney will use medical bills, witness testimonies, photos, and videos to ensure you receive the maximum amount of compensation for your work injury.
Will I Get My Settlement if I Go Back to Work?
If your doctor clears you for work, even if it is restricted, you are obligated to go back to work while you are receiving workers’ compensation benefits. Your employer may not offer your specific job back to you following a work-related injury. However, they may offer a different position with:
- Fewer working hours
- Lighter duties, such as going from factory work to a desk job
- Different work setup, such as being able to sit for work rather than stand all day
You are still entitled to receive benefits if you go back to work, especially if you are in a lower-paying job than you were prior to your injury.
What Happens if My Claim Gets Denied?
If your workers’ compensation claim was denied, contact a Munley Law Personal Injury Attorneys workers’ compensation attorney to help you through the appeals process. Your attorney will be able to investigate the workplace accident, speak to any witnesses, and use evidence gathered to ensure you are properly compensated for your workplace injury.
Here are the steps you should take if your claim is denied:
File a Claim Petition
The employee has three years from the date of the injury to file a claim petition to reopen the case. After a petition is filed, a workers’ compensation judge will be assigned to your case. The judge will then schedule a hearing for the case. Instead of rendering a judgment, the judge may decide mediation is the better way to settle the workers’ compensation claim. If you reach a settlement with your employer, then you waive all rights of any further appeals or petitions.
Appeal to the Pennsylvania Higher Courts
If the mediation is not successful, the employee has 20 days to file an appeal to the Workers’ Compensation Appeals Board. If that appeal is unsuccessful, the employee has 30 days to file an appeal with the Commonwealth Court. Finally, if that decision is unsatisfactory to the employee, they have the right to appeal to the Pennsylvania Supreme Court within 30 days.
Hire an Experienced Workers Compensation Attorney Today
If you’ve been injured on the job, you are going to have a lot of questions on how to proceed. Don’t go it alone. An experienced workers’ compensation attorney in Pennsylvania is here to help. At Munley Law Personal Injury Attorneys, we’ve been helping hardworking injured workers recover from injuries and navigate workers’ compensation for more than 60 years. And we don’t get paid unless we win your case. Contact us today for a free consultation to discuss the specifics of your case.