Pennsylvania Workers' Compensation
PA Workers Comp: FAQ
1. WHAT AM I OBLIGATED TO DO IF I AM HURT ON THE JOB?
Under the Pennsylvania Compensation Act, an employee is obligated to notify his or her employer of any injury which occurs on the job. An injured employee has up to 120 days to report the accident. All employers have ACCIDENT REPORTS which you should fill out immediately after your injury.
2. WHO PAYS MY MEDICAL BILLS WHEN I AM TREATING FOR A WORK-RELATED INJURY?
Under the Pennsylvania Compensation Act, if an employee is injured on the job, the employer is responsible for all medical treatment resulting from the injury. However, the employer is entitled to choose the doctor with whom the employee will treat for the first 90 days. A doctor chosen by your employer to treat a work related injured is called a “Panel Doctor”. Therefore, it is vital that you notify your employer as to your injury and treat with an Panel Doctor for the first 90 days. If you fail to treat with a Panel Doctor during this time period, you may be personally liable for all medical bills arising from the work injury. After the 90 day period ends, you are free to select any licensed physician for further medical care. At that point, the compensation carrier may contest your medical treatment through a process called “Utilization Review”.
3. HOW DO I PAY MY BILLS DURING THE TIME I AM OUT OF WORK AS A RESULT OF MY WORK INJURY?
Under the Pennsylvania Compensation Act, you are entitled to receive Temporary Total Disability Benefits for the time period during which you are out of work, under medical restriction, and suffer a wage loss. Temporary Total Disability Benefits are generally 66 2/3 % of your gross weekly earnings.
4. WHERE ELSE CAN I LOOK FOR INCOME BENEFITS IF MY EMPLOYER REFUSES TO PAY WORKERS COMPENSATION BENEFITS?
As long as your treating doctor has released you to return to “some” level of work, you can apply for Unemployment Benefits. You can apply online or by a simple phone call.
5. IF I AM RECEIVING MONEY BENEFITS, HOW CAN THE COMPENSATION CARRIER STOP MY MONEY BENEFITS?
Under Pennsylania Law, the money benefits cannot be stopped without a Court Order. The Compensation Carrier can file various “Petitions” with the Compensation Court to stop your benefits. For example, the Compensation Carrier can allege the injury that continues to keep you out of work is no longer related to the work accident or that you failed to look for work or refused a reasonable job offer.
6. WHAT ARE MY DUTIES/OBLIGATIONS IF I WORK FOR ANOTHER EMPLOYER?
Under the Pennsylvania Compensation Act, if you receive any wages after your work accident, you must inform the compensation carrier immediately. Failure to inform the insurance carrier can result in criminal and civil actions being filed against you. In the event you receive a job offer, contact our office to discuss your rights and obligations.
7. IF THE COMPENSATION CARRIER OFFERS ME A JOB, DO I HAVE TO ACCEPT THE JOB?
If the job is within your treating physician’s restrictions and the job is in your usual employment area, you should accept the job. On the other hand, if the job is outside the medical restrictions of your treating doctor, you should contact our office to discuss your rights. Under some circumstances, you will not be required to accept a job outside your medical restrictions.
8. IF WE GO TO TRIAL AND WIN, DO I RECEIVE A LUMP SUM AWARD?
No. Unlike a pain and suffering lawsuit, a workers compensation case requires the Court to simply determine whether the benefits stop or continue. You may receive a lump sum amount of money, but this lump sum will only represent past benefits due. Only a settlement reached by all parties can result in a lump sum amount of money.
9. PRIOR CLAIMS- THE WORKERS’ COMPENSATION CARRIER HAS AN INDEX SYSTEM ON A NATIONWIDE BASIS WHICH SHOWS ALL OF THE PEOPLE WHO HAVE MADE CLAIMS BEFORE FOR OTHER INJURIES.
If you have made a claim in another work-related accident or a motor vehicle accident for the same part of the body, your name will be there and they will have this information. You are therefore urged to be absolutely honest with us in your answers throughout handling your case.
10. WHAT DO I DO IF I CAN NO LONGER PHYSICALLY PERFORM MY PRE-ACCIDENT JOB?
If you return back to work for the “time of the injury” employer (your employer at the time you were injured) and you have problems performing your job, contact your treating physician immediately. Should the treating doctor change your medical restrictions, provide a copy to your employer.
11. WHAT IF I NEED ADDITIONAL MEDICAL TREATMENT AND THE WORKERS COMPENSATION CARRIER REFUSES TO TREAT ME?
Under the Pennsylvania Compensation Laws, the workers compensation insurance carrier is obligated to pay your medical bills until you reach Maximum Medical Improvement (MMI). If medical treatment is not being paid the compensation carrier, contact our office immediately.
12. TERMINATION FROM EMPLOYMENT OR DISCRIMINATION UPON A RETURN TO WORK.
Some clients after a work injury encounter problems when attempting to return to work. If you are terminated from employment, or are discriminated against due to a work accident, you must consult an employment attorney outside our firm. OUR FIRM ONLY REPRESENTS YOU IN YOUR PENDING WORKERS COMPENSATION CLAIM.
13. THIRD PARTY CASES
Although you are bound by the compensation act of Pennsylvania to sue your employer in the workers compensation forum, you may have a case against some other than your employer, such as a “third party”. PLEASE BE AWARE THAT IF OUR FIRM DOES NOT HAVE YOU SIGN A SEPARATE RETAINER FOR A THIRD PARTY CASE, WE WILL NOT FILING A THIRD PARTY COMPLAINT ON YOUR BEHALF.
14. THERE ARE 2 TYPES OF SETTLEMENTS:
There is one main type of settlement in Pennsylvania called a “Compromise and Release”. This type of settlement considers both your medical benefits and your money benefits. It is possible to settle one without the other. Call our office to discuss this matter. At the time of any settlement in your case, we will discuss these issues with you.
The information contained in this brief statement is necessarily general in its terms. Each and every case we have in our office is handled on an individual basis. Although one attorney is assigned to your case and has the responsibility for it, you have the benefit and assistance of the entire firm, including non-legal staff, in connection with the case.
We will make an effort to keep you informed by sending you copies of all papers, but it is impossible for us to call you and give you a report on this case every week. Do not hesitate to contact us if you have any questions. Always contact us if you are getting worse or acquire new injuries. IF YOU EVER RECEIVE ANY DOCUMENTS FROM THE COMPENSATION CARRIER OR YOUR EMPLOYER REGARDING YOUR ACCIDENT, PLEASE CONTACT OUR OFFICE AND SEND US A COPY.
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