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Understanding How Workers’ Compensation Applies

If you are hurt at work, it is inevitable that you will need an attorney at one stage or another, so why not be represented by the best. Our workers’ compensation team is led by Attorney Lisa Benzie, Central PA’s Workers’ Compensation Attorney of the Year!

It is important that your claim is in the best shape possible should an unpaid medical bill, lost time, or other issue come about. At Navitsky, Olson & Wisneski, LLP (NOW), we prefer to meet with you sooner than later. There is NO FEE unless we help you by getting you benefits, protecting the benefits you are getting from being taken away, or settle your case.

Workers’ compensation insurance was designed to protect workers from financial hardship due to workplace accidents. When a workplace accident occurs, employees are often surprised to learn that their interests are at odds with their employer’s interests. Additionally, the workers’ compensation claim process can be hard to understand. Injured workers often find they are struggling not only with their injury and making time for treatment but also with a strained relationship with their employer and a confusing claims process. Let us help you understand the process and your rights.

What Is Workers’ Compensation?

According to the Occupational Safety and Health Administration (OSHA), a little over three percent of American workers report a workplace-related illness or injury each year. Because that proportion amounts to several million cases per annum, employers are required to carry a particular type of insurance in most states. Workers’ compensation coverage helps employees who are hurt while performing their work duties.

What Benefits Are Included?

Workers’ compensation insurance provides medical and wage replacement benefits to employees who are injured at work. This generally includes all medical bills and expenses that are needed to diagnose and treat an injury and time off of work related to the injury.

What Is My Obligation If I’m Hurt at Work?

It is important that you provide notice of your work-related injury to your employer as soon as possible. The law requires that you provide notice within 120 days, or you will be precluded from receiving workers’ compensation benefits. You then have three years in which to file a claim if your claim is not accepted by the workers’ compensation carrier. Once you provide notice, your employer has 21 days to investigate the claim and issue a denial, acceptance, or a temporary acknowledgement while they further investigate. These documents are called a Notice of Compensation Payable, Temporary Notice of Compensation Payable, or Denial. If you receive a Denial, you should consult an attorney immediately. If you receive a Notice of Compensation Payable or a Temporary Notice of Compensation Payable, it is important that you make sure all of the information is correct, including your wages and the description of the injury. You may receive a separate document on the Statement of Wages, and it is important that you review the carrier’s calculation of your wages and workers’ compensation rate of pay. There are a number of ways in which the average weekly wage in workers’ compensation can be calculated so consulting an attorney to make sure that it is calculated correctly is in your best interest.

Does Fault Matter, Either My Employer’s or Mine?

Workers’ compensation does not take into account fault. So, it does not matter if it was your fault or your employer’s fault if an injury occurs at work. You will be compensated the same in both instances. In exchange for not recognizing fault, your employer has immunity, meaning they cannot be sued for negligence simply because an accident occurred in the course and scope of your employment. Keep in mind, there are exceptions to every rule, and so if you violate company policy, are goofing around at work, etc., you can be barred from receiving benefits, even though the injury happened at work. NOW can let you know if you have a claim.

How Much Will I Get Paid on Workers’ Comp?

You are entitled to receive approximately two-thirds of your average weekly wage, up to a yearly maximum, once you miss seven consecutive days from work. If you miss 14 days, you can get paid for days one through seven. Please make sure that at every medical appointment you give the medical provider your workers’ compensation claim information so that bills are submitted properly from the beginning of your claim and do not accrue or become your responsibility and impact your credit score. It is also important that you remember to get all of your work-related restrictions in writing, even if they do not change from one appointment to the next. Make sure that you keep all of your medical appointments, and comply with all of your treating physicians’ requests and restrictions.

Can I Get Pain and Suffering, Etc.?

You are limited to the benefits provided by the Pennsylvania Workers’ Compensation Act when you are hurt at work. The Act does not contain provisions for compensation for your full wage, compensation for loss of consortium for a spouse, pain and suffering, or any other non-economic damage. This is the current status of Pennsylvania law. Of course, if there is a third party involved or negligence, you should always have your claim evaluated for a potential negligence claim by a competent attorney. NOW can assist you in this regard, as well.

Am I Entitled to a Settlement?

Many clients believe they are entitled to a settlement simply because they were hurt at work. Although most workers’ compensation cases often result in a settlement, you are never entitled to a settlement. Many factors need to be taken into account when determining if you should settle your case and the potential value of a settlement. Feel free to contact Navitsky, Olson & Wisneski, LLP for an evaluation of the settlement potential of your workers’ compensation claim.

Employer’s Responsibilities

In most states, a boss who refuses to carry workers’ compensation insurance may be subject to fines, lawsuits, or even criminal prosecution. He or she must also perform the following duties:

  • Provide a list of panel physicians available for treatment of work related injuries.
  • Complete an accurate injury report and send it to the appropriate workers’ compensation board office.
  • Comply with all requests for additional information about the injury made by the board office or the insurance provider.
  • Post a current notice of compliance with workers’ compensation laws in a prominent place.

Classifications of Disabilities

One of the reasons workers’ compensation is such an important form of protection is that it pays medical costs for all reasonable and related treatment. An injured worker may also qualify for wage loss benefits, depending on the severity of the injury and the length of time missed.

Contact Us Today

The attorneys at Navitsky, Olson & Wisneski, LLP have a general personal injury practice including medical malpractice. If you have any questions or concerns about your case and believe it touches upon the other personal injury areas, we would be happy to evaluate your case and talk with you. If we cannot assist you, we have a wide network of attorneys that we may be able to refer you to.