To receive workers’ compensation benefits after a workplace accident, you must report your injury to your employer within 21 days, seek medical treatment, and make sure your employer fills out the First Report of Injury to the state. Once your employer and insurer receive notice of your injury, they generally have 21 days to accept or deny the claim.
If your employer refuses to report your injury, your claim is denied, or your benefits are delayed, you still have options. An experienced workers’ compensation attorney can protect your rights, gather the evidence needed to support your claim, and represent you throughout the appeals process.
Contact a Workers’ Compensation Attorney at Munley Law
Call Us At 844-686-5397 How to File a Pennsylvania Workers’ Compensation Claim
Before filing a workers’ compensation claim, determine whether your injury or illness is covered by Pennsylvania’s workers’ compensation system. Most Pennsylvania employees are eligible for workers’ compensation benefits if they are injured while performing their job duties or develop a work-related illness, although there are some exceptions. To determine whether your injury is covered, consider how it happened.
Did the injury occur while you were working, or did your illness develop because of a work-related condition or exposure? For example, if you slipped and fell at work because of a workplace hazard, you likely have a claim. If you were injured before arriving at work, your injury generally would not be covered.
Most accidental workplace injuries are covered by workers’ compensation unless they are self-inflicted or caused by intoxication on the job.
If your injury is work-related, the next step is notifying your employer.
When to Notify Your Employer
The first step in filing a Pennsylvania workers’ compensation claim and getting 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, or someone similar. 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 if 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
Seek medical treatment as soon as possible after a workplace accident or once you discover a work-related illness. In general, your employer will provide a list of approved medical providers. During the first 90 days after your injury, you must generally treat with one of your employer’s approved providers. Their medical records and opinions can play an important role in your workers’ compensation claim.
After the first 90 days, you can usually return to your own doctor for continued treatment. Be sure to keep copies of your medical records and bills in case your claim is delayed or denied.
How Your Workers’ Compensation Claim Is Processed
At this point, you have nothing else you can do but wait. This may include getting on a modified work schedule, such as light-duty, or, if your doctor insists you stay out of work, 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 from the date of notification to issue a notice of your claims approval, denial, or temporary approval.
If the request is for temporary approval, it extends the investigation period for your claim by 90 days.
Appealing a Workers’ Compensation Decision
If your Pennsylvania workers’ compensation claim is denied or disputed, you may challenge the decision by filing the appropriate petition with the Pennsylvania Bureau of Workers’ Compensation. The case is then assigned to a Workers’ Compensation Judge, and both sides may present evidence.
If the judge rules against you, your attorney will normally file an appeal to the Workers’ Compensation Appeal Board on your behalf and enter an appearance. The appeal must be filed within 20 days of the circulation date of the Judge’s decision, so your attorney will monitor the deadline and handle the filing unless you instruct otherwise. If you are not represented, the deadline is still your responsibility, which is one reason many injured workers have an attorney handle the appeal.
Further appeals may proceed to the Commonwealth Court of Pennsylvania and, in limited cases, the Supreme Court of Pennsylvania. Deadlines in workers’ compensation cases are strict and can vary depending on the type of claim and the facts involved.
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 an 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
- You were forced to use PTO
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, the workers’ compensation claims process is not always smooth, but with the proper guidance, it is manageable.
At Munley Law Personal Injury Attorneys, our workers’ compensation attorneys will guide you through the claims process and advocate for the benefits you’re entitled to. 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 or online.
