The process for reporting a work-related injury or illness varies by state. Following your state’s workers’ compensation timeline is critical to meeting all required deadlines. If you do not, you could lose out on benefits entirely. The following paragraphs highlight the important milestones in the Pennsylvania workers’ compensation process.
Report Your Injury or Work-Related Illness
The workers’ compensation timeline begins when you report your injury or work-related illness to your supervisor or employer. It is in your best interest to report the accident as soon as possible after you receive medical attention, or as soon as you obtain knowledge that your illness or disease is work-related. Pennsylvania state guidelines call for workers to report a work injury within 21 days after an incident. However, if you fail to notify your employer within 120 days of the accident or after obtaining knowledge that your illness is work-related, you will not receive workers’ compensation. You must also follow a prescribed process for reporting your work-related injury or illness to your employer/insurance carrier.
Wait for Your Employer’s Response
After you report your injury or illness, your employer must notify you within 21 days if they choose to deny your claim. At that point, you will lose any potential benefits unless you seek legal help. A qualified Downingtown workers’ compensation lawyer will evaluate your claim if your employer denies liability. You have up to three years to appeal your claim if it was denied.
If your employer/insurance carrier agrees to pay your claim, they must issue you a Notice of Compensation Payable within 21 days of receiving your injury report. The insurance company may offer a lump sum payment, but it may be less than the amount to which you are entitled. Instead of a denial or acceptance, your employer and their insurance carrier may instead choose to issue a Notice of Temporary Compensation Payable. This gives them additional time to investigate your claim before denying or accepting full liability for your injury.
Calculate Your Benefits
If your claim is accepted, your employer’s insurance carrier is required to pay your medical expenses within 30 days after receiving any bills. Your employer is also required to file a Statement of Wages form with the Pennsylvania Bureau of Workers’ Compensation and provide you with a copy as well. This form will be used to calculate your benefits that cover lost wages. Typically, these benefits will amount to about two-thirds of the wages you earned prior to your accident or illness.
Responding to a Change in Benefits
The severity of your illness or injury will dictate how long you will be able to receive benefits. While every case is different, a medical expert will usually diagnose your condition as temporary or permanent. After you begin receiving compensation, your benefits could be reduced or terminated later, based on information submitted to the employer/carrier by vocational or medical experts. If you receive a notice that your benefits have been reduced, suspended, or terminated, it is imperative that you seek legal counsel.
Downingtown Workers’ Compensation Lawyers at Wusinich & Sweeney, LLC Advocate for Injured Workers
If you are suffering from a work-related injury or illness, contact a Downingtown workers’ compensation lawyer at Wusinich & Sweeney, LLC today. For a free consultation, contact us online or call us at 610-594-1600. From our office in Exton, Pennsylvania, we assist injured workers throughout Downingtown, West Chester, Exton, Coatesville, Phoenixville, Malvern, Lyndell, Wagontown, Uwchlan Township, Parkesburg, Chester Springs, Lancaster County, Reading and Morgantown.