It is estimated that for every 100 full-time employees, 3.1 will file a workers compensation claim in a given year. But when you're that injured employee at work, you may be wondering, how to get workers' compensation benefits in Pennsylvania.
At Munley Law Personal Injury Attorneys, our workers' compensation attorneys will guide you through the process to help make your workers compensation claim a smooth transition from work to recovery.
How to File A Pennsylvania Workers' Compensation Claim
Before you begin the process of filing a workers' compensation claim, you need to know if you even have a case.
In Pennsylvania, almost all workers' are entitled to workers compensation benefits from their employers with some exceptions. So, if you are a Pennsylvnia employee who meets the employee status criteria, that's one step closer to filing a successful claim.
From there, you need to consider the cause of your injuries. The first part of this being–did it occur at work, or did the illness emerge because of a work-related condition or exposure? If you happened to fall before leaving for work, that won't qualify for workers' compensation. But, if you fall at work because of a condition of the environment or are hurt in an accident, you likely have a claim.
Accidental injuries are most often covered by workers' compensation, so long as they are not self-inflicted, or caused by intoxication on the job.
Once you have determined that your injuries were in fact caused by a work-related condition or accident, you can begin the workers compensation claims process.
When to Notify Your Employer
The first step in filing a Pennsylvania workers' compensation claim and to get your workers' comp benefits is to notify your employer of the accident or illness. The person you report to may differ by employer but it often means your supervisor or manager, human resources, etc. Do not just tell a coworker and think that counts as a report.
Instead, you may have a verbal conversation with the appropriate person, then request the report in writing. This helps preserve your case in the event your workers' compensation benefits are denied.
In Pennsylvania, you have 21 days to report the injury to your employer to get the full amount of workers' compensation you're entitled to. If you report the injury past the 21 days but within 120 days of the injury, you can still file a claim, but it will only be for a fraction of your lost wages.
After 120 days, in most cases you have forfeited your right to get workers' comp at all.
Seek Immediate Medical Attention
Seeking medical attention as soon as you can following the workplace accident or illness emerges will be critical to preserving the integrity of your workers compensation claim. In general, your employer will have a curated list of medical providers you can seek care from. In the first 90 days following the accident, you must see your company approved provider. Their medical testimony will be an integral part of your workers' compensation claim.
Once the 90 days have passed, you can usually go back to your own doctor to continue medical care. But be sure to keep a record of everything because it may be needed later on if your initial workers compensation claim is denied.
Filing a Claim with the Pennsylvania Bureau of Workers' Compensation
At this point, you have nothing else you can do but wait. This may include getting on a modified work-schedule including light-duty, or if your doctor insists you stay out of work, you may be resting and recovering at home.
Instead, your employer is in charge of the next phase of the workers' compensation process. Here they will take the needed information and paperwork and submit it to the Pennsylvania Bureau of Workers' Compensation.
This is typically done in tandem with the workers' compensation insurance company your employer utilizes. The insurance company then has 21 days for the date of notification to issue a notice of your claims approval, denial, or temporary approval.
If the request is on a temporary approval, this extends the investigation period of your claim by 90 days.
Appealing a Workers' Compensation Decision
In the event an injured workers' workers' compensation claim is denied or being disputed, you can file an appeal. This is done by you–not your employer. You have up to three years from a denied claim to file an appeal. If you do not, you are not eligible for future benefits.
Once you file your appeal–the sooner the better– you will be assigned to a judge where you and the insurance company will present your sides of the case. The judge then has to either settle the claim, or take the case to mediation.
However, if the judge rules the denial of your claim once more, you have 20 days to appeal. It may travel to the Workers' Compensation Appeal Board, then the Commonwealth Court of Pennsylvania, and finally to the Supreme Court of Pennsylvania.
Collecting Workers' Compensation Benefits
Whether your workers' compensation claim is approved on the first round, or takes several forms of appeal, you may eventually be able to collect your workers' compensation benefits. This is when you will receive a Notice of Compensation Payable and start to receive the workers' compensation benefits you are entitled to. In general, you will receive payments 21 days after your employer has been notified.
In Pennsylvania, your workers' compensation benefits may offer financial support for:
- Lost-wages
- Medical expenses
- Specific loss benefits for loss of function of a specific body part(s)
- Death benefits to your survivors if you die because of the accident or illness
I Followed the Steps For Workers' Compensation Benefits, But My Employer Delayed My Claim. Now What?
Your employer is legally obligated to follow the rules and regulations of the Pennsylvania Workers' Compensation Act. However, if they do not, you may be able to file a penalty petition. Reasons you may choose to file a penalty petition against your employer include:
- The employer delayed payment without cause
- You suffered a termination of benefits without cause
- Your claim was denied because your employer did not properly investigate the situation
- You were not notified within 21 days of the claims status
- Your medical bills were not covered by the appropriate parties
If your penalty petition is successful, you may be eligible for up to 50 percent of the past-due amounts owed, plus interest, and attorney fees.
Seeking Workers' Compensation in Pennsylvania? Call Munley Law Personal Injury Attorneys.
When you suffer a workplace injury, the last thing you want to deal with is battling your employer and the insurance companies over who is paying for your medical expenses. Unfortunately, undergoing the workers' compensation claims process is not always a smooth one, but with the proper guidance it is manageable.
At Munley Law Personal Injury Attorneys, our workers' compensation attorneys will help you get workers' compensation benefits in Pennsylvania in a timely manner. We know the loopholes your employer and the insurance companies will try to take, which is why it's so beneficial to have us on your side from day one.
If you seek workers' compensation in Pennsylvania, our workers' comp lawyers will review your accident claim, help you gather the needed medical files and reports, and calculate the total value of your injury.
For a no-obligation, free consultation, contact the workers' compensation attorneys at Munley Law Personal Injury Attorneys at 570-399-0406 oronline.
