Under the Pennsylvania Workers’ Compensation Act, if your work causes you any injury or illness, you are entitled to receive payment for your medical expenses and lost wages. In case the injury or illness is fatal, your dependents receive the death benefits.
But things aren’t this simple.
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Sometimes, employers and their insurance carriers refuse to pay the compensation you are asking for. Other times, preexisting conditions come to the surface that might make your workers’ compensation case weaker. And what if your work injury does not take place at work but on the way to work? Does that count as grounds for compensation?
To travel through this maze and have the best protection that the Pennsylvania Workers’ Compensation Act can provide, you need a competent lawyer. But a healthy bit of homework never hurt anybody.
The more you know about the Workers’ Compensation Act, the better prepared you’ll be for what’s to come.
So, here are 7 critical things you must know when you suffer a workplace injury.
1. (Almost) All Pennsylvania Workers are Covered by the PA Work Comp Act
All Pennsylvania employees – barring a few exceptions – are covered by the Act. This includes all companies including nonprofit corporations and unincorporated businesses, too. Even if you are the sole employee at your company, you are covered under the workers’ comp Act.
Some employees who may not be covered under this Act include:
- Federal civilian employees (they are covered by other compensation systems)
- Volunteer workers
- Agricultural workers
- Railroad workers
- Shipyard workers, and
- Casual employees.
For a complete list of workers who may not be covered under this Act, please visit the Department of Labor & Industry website. Or take a look at this handy document for a quick review of Pennsylvania Workers’ Compensation Act.
2. Your Work Comp Coverage Starts on the Date You Get Hired
However, for timely receiving of benefits, reporting the injury/illness promptly to your employer is critical. If you delay it too long, you run the risk of employer/insurer refusing to accept your claim or compensation.
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If that happens, you will need a workers’ compensation lawyer to properly file a claim petition with the Workers’ Compensation Bureau.
3. (Almost) All Injuries and Illnesses are Covered by the PA Work CompAct
The Act is highly comprehensive in its intention to provide the full might of law to the injured/ill worker. The only two instances where the Act may fail to cover you are when the injury or illness is:
- Self-inflicted, or
- Due to the violation of law (including intoxication or drug use, etc.)
(note also there is a defense called a Violation of a Positive Work Order)
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In such cases, no workers’ compensation will be provided to the injured employee.
4. The Act Offers Several Compensation Benefits
There are four key benefits that are provided under this Act:
- Medical Expenses: payment of medical expenses such as medicine, surgery, hospital stay, and other treatments.
- Lost Wages: monetary compensation in case of complete or partial disability where you either can’t work or the work pays less than your pre-injury wages.
- Death Benefits: paid to your dependents.
- Specific Loss Benefits: a specific loss award for permanent loss of all or part of your sight, hearing, arm, and leg, etc., or some serious disfigurement to your head, face, or neck.
The best workers’ compensation attorneys who are specialized in the field can help maximize these benefits for you.
5. Notify Your Employer Instantly to Be Eligible for Compensation
First of all, notify your employer immediately – within 21 days of the injury/illness to be precise. If 120 days pass and you fail to inform your employer of your injury, no compensation is allowed. Please remember that unless the notice is given, or your employer already knows about your injury, no benefits are allowed. You can only receive wage loss benefits once you report the injury if the claim gets accepted.
So, report your injury timely. Once you do that, your employer is required by law to file a compensation claim with their carrier for the benefits to start coming in. Your employer or their insurance carrier have to the right to accept or deny your claim within 21 days.
To safeguard your benefits, the smartest thing is to hire a workers’ compensation lawyer (or at least consult with one) as soon as you can after you suffer the injury.
6. You Can Choose Your Own Healthcare Provider From a Given List
Your employer will give you a list of six or more physicians or healthcare providers that you can consult with for your treatment. You can choose provider from that list; your employer cannot force you to visit anyone in particular.
For the first 90 days, you can only get treatment from a provider from the list. After the 90 days, you are free to visit a consultant of your choice provided you notify your employer of the physician you have chosen. Your employer and their insurance carrier have the right to receive monthly lists from your healthcare provider.
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In cases where no list of physicians is provided by your employer, you can get treatment from anyone, and your employer or their insurer will cover the medical costs.
However, if you go to a provider of your choice within the initial 90 days, your employer or their insurer may refuse to cover that bill.
7. You Must Work Within the Time Limits as per the Pennsylvania WC Act
While the law is pretty sympathetic to the injured worker, there are time limits that need to be followed to keep everything running smoothly. With the help of a competent Philadelphia workers’ comp attorney, you can easily keep ahead of all the timelines, and everything that comes with it.
Some of the important time limits to keep in mind include:
- Employer must be notified of the injury within 21 days of the incident, and no later than 120 days for the allowance of compensation.
- You have three years (from the date of incident) to file a claim petition if your compensation benefits are denied by your employer or their insurer.
- Your employer and their insurance provider have 21 days to accept or deny your claim.
- In case of occupational illness, you have 300-weeks from the time you were last exposed to the hazardous element/chemical to file for your compensation claim.
- For the first 90 days of your injury, you have to visit a healthcare provider of your employer’s choosing. After the 90 days are up, you can go to any physician that you want and your employer will foot the bill. There are some exceptions to this so speak to a workers’ compensation lawyer as soon as possible.
Call Cardamone Law Today to Make Your Workers’ Compensation Journey an Easier One
The information we have shared here today is only so you can be prepared to deal with the many ups and downs that come your way when you file a workers’ compensation claim. Before you start to feel overwhelmed, though, know that at Cardamone Law, you are in best hands. We have fought and settled hundreds of workers’ comp cases and helped secure our clients millions of dollar in settlements.
Under Michael Cardamone, all of us are trained to go after the big guys every day. This is what we do. And we are pretty good at it.
If you or a loved one has suffered a workplace injury or illness, give us a call today for free consultation. In this no-obligation meeting, we’ll discuss the details of the case and suggest you the most helpful course of action.
We are 24/7 available at (215) 206-9068 or drop an email directly to Michael Cardamone at Michael@CardamoneLaw.com