Paoli Workers’ Compensation Lawyers

Workers’ compensation is no-fault, and covered employees are entitled to certain benefits when they are injured on the job. In Pennsylvania, coverage is mandatory for most companies, and those that do not carry it may face criminal prosecution and lawsuits.

To receive workers’ compensation benefits, an employee’s injury or illness must be job-related. Slipping and falling when running a personal errand during a lunch break will likely not be covered, but falling off unsecured scaffolding at a work construction site might qualify for compensation. Examples of common workers’ compensation claims include:

Burns.
Contusions.
Eye injuries.
Fractures.
Lacerations.
Sprains and strains.

Employees who work with hazardous chemicals and materials can also develop work-related long-term health problems, like cancer.

Categories of Workers’ Compensation Benefits

In Pennsylvania, there is a set maximum amount of workers’ compensation, but this increases by a certain percentage each year. This reflects the employee’s pre-injury or illness weekly salary as well as the extent of the injury. Those are classified as follows:

Temporary or permanent total disability: This is when an employee is unable to return to work in their previous capacity. Payments are generally sent for the duration of the disability, but receiving benefits for life is unusual. After a certain amount of time, the employee might be required to complete a medical evaluation.
Temporary or permanent partial disability: Employees on partial disability can return to work but not in the same capacity. For example, a nurse with a spinal cord injury who cannot walk might have to accept a desk job instead of seeing patients.
Specific loss: This is when the state determines benefits for a permanent loss, like the use of certain limbs. The employee may receive benefits even if they cannot return to work, but the compensation lasts for a set amount of time.

What Is the Process of a Workers’ Compensation Claim?

The first step in filing a workers’ compensation claim is to notify your employer. These policies normally require 14 days’ notice but it is better to do it right away, verbally and in writing. You might have to see an employer-approved medical provider to treat your injury.

The evidence you provide and your subsequent actions will influence how your claim is handled. Once you have a diagnosis, follow the doctor’s orders, and keep records of your treatment and related expenses and receipts. If you have a timesheet, get a copy to show that you were working when the accident happened.

You will also need to complete the necessary forms obtained from your employer. Follow the instructions carefully, and provide the additional documentation requested. That might include medical reports, information about prior workplace injuries, and proof of previous wages. Review everything before submitting it to the insurance provider, and they will let you know if it has been approved or denied. If the injuries are serious and/or the insurer has questions, there may be requests for more evidence and meetings. The compensation awarded can cover your medical expenses and lost wages up to a certain amount.

What if My Workers’ Compensation Claim Is Denied?

Navigating workers’ compensation can be difficult, especially for injured employees who need to focus on their recovery. There is added pressure from being unable to earn wages, which gets compounded by medical bills. It is not unusual for providers to deny these claims, and the most common reasons for this include:

Not reporting an injury in a timely manner.
The injury may not have occurred while the employee was working.
The employee did not file the claim correctly.

Denied claims can be appealed, and this requires legal help. If the compensation offer is not satisfactory, you may have the option of seeking financial compensation from a negligent third party.