Pennsylvania workers’ compensation provides financial benefits to workers for job-related accidents and occupational diseases. With very few exceptions, every employee in PA is entitled to workers’ compensation benefits if they become injured or sick as a result of workplace accidents or working conditions. When you suffer a work-related injury or disease, you have the right to file a claim for workers’ compensation benefits. The state sets strict guidelines for workers and their families to follow in order to remain eligible for benefits.
Your employer also has responsibilities to file the correct paperwork, adhere to deadlines, and ensure their incident reports are filed with the state.
If you have been injured in a work accident and your claim for workers’ compensation benefits has been denied because your employer failed to file the legally required paperwork, call the expert workers’ compensation attorneys at Munley Law today.
What is PA Workers’ Compensation Insurance?
The Pennsylvania workers’ compensation system is an insurance program that provides coverage for workers who have suffered injury or occupational disease during the course of their employment.
The Pennsylvania Workers Compensation Act of 1915 mandates that all employers in PA obtain and maintain workers’ compensation insurance for all of their employees both full and part-time, with coverage starting on their first day of employment. Full and part-time and seasonal employees are covered for the entire period of their employment.
Employers in Pennsylvania can obtain workers’ compensation insurance through a licensed insurance carrier or the State Workers’ Insurance Fund.
What Are the Steps Necessary to Filing My Claim for Workers’ Comp Benefits?
When you are hurt at work, report your injury to your employer as soon as possible.
If you miss as little as a single day of work, your employer must notify their workers’ compensation insurance company, the PA Bureau of Workers Compensation, and the Department of Labor by filing their First Report of Injury (FROI) form.
Your employer must file this report within ten days from the date they are notified of your injury. The FROI must be filed within 24 hours of a work-related fatality.
If your employer fails to report your injury, your workers’ compensation benefits could be delayed or denied.
Why Did My Employer Fail to Report My Work Accident?
You did everything right after your work accident. You reported your injury, kept your medical appointments and records and you met all your deadlines only to find out that your employer failed to uphold their responsibilities to you.
Now, not only are you dealing with the stress and anxiety from being hurt or sick, lost wages from days you missed for recovery and doctor’s appointments, and mounting medical bills, you’re now faced with the unexpected complications caused by your employer’s negligence, jeopardizing the benefits you have a legal right to.
Your employer might have any number of reasons for not filing their FROI. These can include:
- They don’t believe your injury report, your version of events, or they are dismissing the severity of your injury or illness
- They don’t have workers’ compensation insurance or they let their coverage lapse due to negligence, faulty record keeping, employee turnover, or by simply not paying their premium
- They don’t want their insurance premiums to go up
- They have been routinely misclassifying employees as contractors to avoid paying higher insurance premiums
No matter what their reasoning or excuse, when your employer fails to submit your injury report, you might now be on the hook for all of your lost wages and medical bills.
If you are a PA worker and your employer neglected to file the legally required paperwork following your work accident or illness, call the expert workers’ compensation attorneys at Munley Law today.
My Employer Did Not Report My Injury. What Do I Do Now?
When your worker’s compensation claim is denied, for any reason, you have the right to appeal the decision. In many instances, an appeal for reconsideration of the denial by the Workers’ Compensation Bureau will go before a workers’ compensation judge.
If your appeal goes to court, the judge will expect you to present evidence that your injury was work-related and that you upheld all of your duties in reporting and filing your claim paperwork.
The judge might ask you to prove:
- You were injured performing the normal, daily responsibilities of your job and
- Your injury is work-related
- You received medical treatment and a diagnosis from a licensed medical professional
- You reported your injury within the timeframe allowed by law
- Proof that if your employer was negligent in filing their FROI on time or at all
If the workers’ compensation judge rules in your favor, you will receive your workers’ compensation benefits to cover your lost wages and medical bills. In addition to this, the judge can also decide to award you additional financial compensation, paid by your employer, to reimburse you for hardships and attorney fees.
Filing a First Report of Injury is not optional. If your employer has failed to file their report, for any reason, they are breaking the law and causing you a lot of unnecessary worry and anxiety while you wait for your benefits.
Remember this. Even if your employer claims they do not believe your version of how your work injury occurred or that it occurred at all, they are still legally obligated to file their FROI. If there is any reported injury, resulting in any missed work, the FROI must be filed.
You Have Rights As a Pennsylvania Worker
Pennsylvania workers’ compensation law grants certain rights to injured workers and anyone who has developed an illness or disease due to working conditions.
You have the right to:
- Receive wage loss benefits and medical benefits
- Eligible survivors of workers who have suffered a fatal injury or disease have a right to collect death benefits to cover medical expenses, wage loss, and funeral costs
- You have the right to medical treatment in a timely manner for the duration of your recovery
- You have the right to appeal a denial of your initial claim for benefits
If you have reported your injury to your employer or reported an illness or work-related death, your employer has a legal responsibility to file their injury report with the state.
If your employer fails to file their paperwork, you can suffer a loss of timely medical treatment, physical therapy, or other necessary medical attention; if you have lost a loved one and your claim for death benefits has been delayed, you are now facing the loss of your loved one’s wages as well as mounting medical and funeral costs.
If your employer fails in their duty, they are breaking the law and risking your health and financial well-being. An experienced workers’ compensation attorney can help.
What Do Workers’ Compensation Benefits Cover?
Workers’ compensation insurance provides coverage for lost wages and medical benefits to compensate employees who are injured, contract a disease or have a condition worsen as a result of their employment, regardless of the employee’s previous medical or physical condition, and without regard to the employee’s fault in most cases.
If you have suffered from a work-related injury or illness, your employer or their insurance company must pay for reasonable and necessary medical expenses related to the injury and will cover some of your lost wages resulting from the injury or illness.
Pennsylvania state law through the Pennsylvania Workers’ Compensation Act outlines these three primary coverages:
- Medical coverage: Medical coverage includes any medical expenses related to your work injury or occupational disease. Medical coverage includes your visits to your doctor or medical practitioner, medical tests, emergency room visits, medicine and medical equipment, physical therapy, and other medically necessary treatments.
- Lost wages: If you are unable to work after an accident, you will receive a percentage of your wages, known as disability benefits. There are temporary benefits as well as permanent, depending on how long your injury or occupational disease prevents you from working. Wage loss benefits are based on your average salary at the time you became injured or sick.
- “Specific loss” payments: If your work injury resulted in permanent scarring or disfigurement, the loss of a limb or other body part or organ, or impaired use of any body part, you may be eligible for “specific loss” payments. Specific loss payments vary depending on the injury type.
What are Death Benefits?
If you have lost a loved one due to a catastrophic work accident or an occupational illness, you might be eligible for financial help to cover a percentage of the deceased worker’s lost wages, and their medical bills, including trips to the emergency room, funeral, and burial or cremation costs.
Family members who are legally entitled to death benefits include:
- The deceased’s legal spouse
- Dependent parents who lived with the decedent
- Financially dependent brother or sister under 18 who lived with the deceased worker
- Financially dependent brother or sister who lived with the deceased worker and who are enrolled in an accredited college or university until they graduate or turn 23
- A child who is under 18 years old
- A child who is under 23 years old as long as they are enrolled in an accredited college or university
Pennsylvania workers’ compensation benefits provide funeral benefits in the amount of $3,000.00 to the family of the decedent. Regular weekly death benefits or bi-weekly payments to survivors may also be paid based on the deceased worker’s wages at the time of their death.
Survivors must notify the decedent’s employer of their plan to file a claim for Pennsylvania death benefits.
If you have filed a claim for death benefits through PA workers’ compensation insurance and the employer failed to file their FROI, contact an experienced worker’s compensation attorney at Munley Law. We can help you figure out your next steps, we can help you file your appeal and we will fight for you to receive the death benefits you deserve.
My Claim for Benefits Was Denied. What Do I Do Now?
As a Pennsylvania employee, you have the right to file a claim for workers’ compensation benefits to cover your medical bills and lost wages. If your claim for benefits was denied, you might be wondering what your next steps should be. You are already stressed, trying to focus on your recovery and managing your new financial status. Navigating the complex workers’ comp laws can become overwhelming.
You might be frustrated and ready to give up.
Talking to a skilled workers’ compensation attorney at Munley Law can help. You have the right to file an appeal for your claim, even if your employer did not file your injury with the state.
Be sure to:
- Report your injury or illness to your employer in writing and keep copies of all correspondence
- Note who you speak to, and when you spoke, and keep notes of the conversations
- Keep all of your medical appointments
- Keep all of your medical records, including ER visits
- Contact an experienced attorney at Munley Law to file your appeal
An experienced workers’ compensation attorney at Munley Law has the knowledge and the skill required for putting together your appeal. We will manage your communications with your employer, their insurance company, and more. We will navigate your contested case with skill and stamina.
We will fight your denial in court and we will make sure you receive the maximum compensation you deserve. We can negotiate a lump-sum settlement if that is in your best interests.
Munley Law attorneys know Pennsylvania workers’ comp law. We have been in the corner of PA workers for more than 60 years. We can help. Chat live, email us, or call us 24 hours a day for a free case evaluation.