A person who has experienced a workplace-related injury or illness involving days away from work is covered by a state-mandated employer-funded insurance program called Workers’ Compensation. In Pennsylvania, the program is administered through the state Department of Labor and Industry, Bureau of Workers’ Compensation (BWC). See their website for information about the program at: https://www.dli.pa.gov/Individuals/Workers-Compensation/publications/Pages/LIBC-100-WC–The-Injured-Worker-Pamphlet.aspx
The program is intended to provide benefits so that an injured worker has the ability to recover and return to work, if possible, while shielding the employer from legal liability. The benefits provided vary from state to state but usually provide payments for the following:
- A fraction of lost wages, about 66 percent of average weekly wage
- The cost of reasonable medical services and surgical procedures
- Ongoing medical treatment such as medicine, medical supplies, and hospital treatment
Disability Benefits Under Workers’ Compensation
If a worker’s injury or illness is so severe that the worker is considered disabled, they can receive either total or partial disability depending on the degree of impairment. A worker who is totally disabled and unable to work can receive compensation for lost wages for about 100 weeks. After this, the worker is reevaluated medically. If the worker is at least 35 percent impaired according to American Medical Association standards, he or she can continue receiving benefits under the total disability standard.
If a workers’ impairment is considered a partial disability, the worker can receive Workers’ Compensation for up to 500 weeks. The lost wages benefit may be reduced by an amount of wage earned if the worker returns to employment at a lower paying job with work-related restrictions.
How Do I Get Workers’ Compensation Benefits?
To get benefits, an injured or ill worker must report the event to their employer, including the date and place the injury occurred or the illness was contracted. The worker may be free to choose their own health care provider or may be expected to see one of at least six doctors posted on a list of providers in the workplace. The employer is required to notify their employee of their rights and duties and to report the claim to the BWC.
What Should I Do if My Employer Challenges My Claim?
Sometimes employers will dispute a Workers’ Compensation claim and either deny the claim or end coverage for necessary medical treatment and other benefits too soon. These cases will need to be adjudicated in court for the worker to have their claim upheld so that payments can continue. It is best to be represented by an experienced Workers’ Compensation lawyer in any disputed claims.
What is Disability Insurance?
Disability insurance is a form of income protection that typically covers injuries and illnesses that are not work related. Some people choose to purchase these policies and can use them to provide income if they become disabled. In addition, some employers automatically enroll their employees in these policies as a benefit. The terms of the policy and state laws dictate coverage amounts. Sometimes Workers’ Compensation benefits are reduced by the amount received by supplemental insurance. Sometimes the reverse is the case.
The Social Security Administration offers Social Security Disability Insurance (SSDI) to qualified individuals based on their age, experience, and skill level. It is a federal program that provides for payments to those who have become disabled and are unable to work. It may be possible to collect both Workers’ Compensation and SSDI at the same time. Generally, the combined lost wage benefit will be no more than 80 percent of the average weekly wage.
Exton Workers’ Compensation Lawyers at Wusinich & Sweeney, LLC Defend Injured Workers
If you have been injured at work, the experienced Exton Workers’ Compensation lawyers at Wusinich & Sweeney, LLC can guide you through the bureaucracy of filing for Workers’ Compensation benefits and also evaluate your case for calculating the average weekly wage benefit and assist in obtaining correct documentation of impairment. We will focus all our efforts toward getting you the benefits for which you are entitled. Contact us online or call us at 610-594-1600 for a free consultation today. We are located in Exton, Pennsylvania, and we serve residents of Downingtown, West Chester, Exton, Coatesville, Phoenixville, Malvern, Lyndell, Wagontown, Uwchlan Township, Parkesburg, Chester Springs, Lancaster County, Reading, and Morgantown.