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Workers’ Compensation Questions & Answers

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Workers’ Compensation Questions:

Q: I’ve been in an accident at work, what’s the first thing I should do?

A: Right after any accident, no matter how minor it may seem, you should immediately report your injury to your supervisor and make sure that a written record is made. After you report your injury, you will receive calls from insurance adjusters asking for details. Do not allow yourself to be pressured to sign away your Workers’ Compensation rights by an insurance company. In fact, never sign any insurance document until a lawyer has reviewed it first. Also, you should seek legal advice before undergoing any medical examinations requested by an insurance company. Without realizing it, you may be waiving some very important legal rights.

Q: Is there a statute of limitations for workers’ compensation cases?

A: Under Pennsylvania law, notice of any injury suffered must be provided to a supervisor at your place of employment within 120 days of the date of injury. Failure to tell your employer can result in your claim being denied, so it is very important that you make the report immediately after the accident. Keep in mind that to be successful, any workers’ compensation case must be filed no later than three years from the date of injury or disability.

If you or a family member suffer from a disease that was contracted during your employment (such as Black Lung disease from working in a coal mine, or mesothelioma due to asbestos exposure), the laws are a bit different.  According to Pennsylvania law, the disease and inability to work must occur within 300 weeks from the date you were last employed in the job where you contracted the disease.

Q: Am I covered under workers’ compensation?

A: Almost every PA employee is covered under the Workers’ Compensation Act. This includes all full-time, part-time, and seasonal workers. Nearly all businesses, no matter how big or small, are required to have workers’ compensation insurance. Workers in certain  industries may be covered under different compensation laws specific to that particular industry, such as railroad or shipyard workers. However, if you work on a volunteer basis, or are an independent contractor, you may not be considered an employee and therefore may not be covered.

Q: Can I choose my own doctor?

A: For the first 90 days of medical care, you are required to choose from a list of doctors provided by your employer. Your employer must give you at least six doctors to choose from, and your employer cannot choose for you. If your employer does not provide a list of options, you are free to choose your own. You may also choose another doctor from the list if the first doctor selected is unsatisfactory.

If you require treatment beyond 90 days, you then have the option to choose your own doctor. If, after 90 days,  you do decide to choose a doctor not on your employer’s list, you must notify your employer within five days after your first visit.

Q: How much will I be compensated?

A: Your compensation will depend on whether you are totally or partially disabled. If you are totally disabled by your work injury and are unable to work at all, you are entitled to weekly benefits equal to about  two-thirds of your weekly pay, or a maximum of $951, as of 2015. This number changes yearly.  After two years, your disability status may be reviewed. At this time, if you are no longer at least 50% disabled (based on American Medical Association guidelines) your disability will convert to a partial disability. A partial disability that reduces your ability to work and your earning capacity may be compensated by a weekly amount that is two-thirds the difference between your present earnings and what you earned prior to the injury. You may receive these partial disability benefits for 500 weeks or for as long as you are working at the lower wage.

Q: When will I receive workers’ compensation payments?

A: As long as you are not denied compensation, you should begin receiving benefits approximately 21 days after you reported your injury to your employer.

 Q: What should I do if my workers’ compensation claim is denied?

A: It is not uncommon for an insurance company to deny a workers’ compensation claim. If you are denied workers’ compensation, you have three years from the date of your injury to file a claim with the Bureau of Workers’ Compensation. In this case, it is best to hire a lawyer who is familiar with the entire claims process and who knows the intricacies of workers’ compensation laws. The right lawyer will be instrumental in ensuring that you receive the compensation you deserve.

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