The Experienced Legal Advocates to Trust in Injury Cases
The main factors in assessing an injury case are liabilities (fault) and damages (injuries).
The factors in determining liability include:
- Conduct of Drivers
- Admission by Fault
- Statements by Parties or Witnesses
- Witness Statements
- Police Report
- Pictures and Videos
- Criminal Charges or Traffic Citations/Violations of the Vehicle Code
- Accident Reconstruction
Damages are determined by two factors—seriousness and permanent, which include the following:
- Type of Injury
- Physical Injury
- Broken Bones
- Bodily Injuries
- Mental and Emotional Injury
- Health Injury
- Cognitive/Memory Loss
- Post-Traumatic Stress
- Scars, Burns, or Ongoing Changes
- Preexisting Injuries or Diseases
- Types of Treatment
- Need for Any Surgery
- Length of Hospital Stay
- Implantation of Any Metal, Plates, or Screws
- Physical Therapy
- Home Exercises
- Tens Units
- Amount of Recoverable Medical Expenses
- Medical Bills Paid by Insurance
- Type of Insurance Coverage
- Amount of Unpaid Medical Bills and Out-of-Pocket Expenses
- Work Loss
- Past, Current, or Future
- Working at the Time of Accident
- Amount of Wage Loss
- Length of Any Disability
- Subrogation or Reimbursement
- Any Wage Loss of Medical Bills Paid by Other Insurance or Government Benefits Which Must Be Repaid
- Back and Neck
- Broken Bones
- Spinal Cord
- Brain Injury
- Head Injury
- Auto Injury
- Motorcycle Injury
- Truck Injury
If you sustain a job injury or work-related illness, the Pennsylvania Workers’ Compensation Act provides for your medical expenses. In the event that you are unable to work, wage-loss compensation benefits until you can work again. Additionally, death benefits for work-related deaths are paid to your dependent survivors.
Benefits are either paid by private insurance companies (including third-party administrators), the State Workers’ Insurance Fund (a state-run workers’ compensation insurance carrier), or the employers themselves if they are self-insured.
The Pennsylvania Workers’ Compensation Act covers nearly every Pennsylvania worker. Employers must provide workers’ compensation (WC) coverage for all of their employees, including seasonal and part-time workers. Nonprofit corporations, unincorporated businesses, and even employers with only one employee must comply with the Act’s requirements.
If your work causes an injury, illness, or disease, you may be entitled to a WC. Schedule a free consultation today to find out what you are eligible for.
Coverage begins on the date of hire. Medical benefits are payable from the first day of the injury.
Prompt reporting is key. Report any injury or work-related illness to your employer or supervisor immediately. You must tell your employer that you were injured in the course of employment and inform them of the date and place of injury. Failure to notify the employer can result in the delay or denial of benefits. Once you have lost a day, shift, or turn of work, your employer is required to report your injury to the Bureau of Workers’ Compensation by filing an Employer’s Report of Occupational Injury or Disease.
The employer may choose to either accept or deny the claim. If your application is rejected, you have the right to file a claim petition with the bureau for a hearing before a WC judge.
The law provides several types of workers’ compensation benefits:
- Payments for Lost Wages
- Death Benefits
- Specific Loss Benefits
- Medical Care
If your employer has posted a list of six or more physicians or health care providers in your workplace, then you are required to visit one of them for initial treatment. You are to continue treatment with that provider or another on the list for 90 days following the first visit. You may see any provider on the list although your employer may not require or direct you to any specific institution.
If you need help in determining what options are available for you, schedule a free consultation today.
Occupational diseases under the Act are covered if they are caused by or aggravated by employment. Your disability must occur within 300 weeks of your last job in an occupation where you were exposed to the hazard.
For certain lung diseases, you must have worked in an occupation with a silica, coal, or asbestos hazard for at least two years in the Commonwealth of Pennsylvania during the last 10 years before your disability.
Total Disability Benefits Status applies to injured workers for a period during which they are considered disabled and unable to work. After 104 weeks of such status, the employer or insurer can require a medical examination to determine if the employee is at least 50% impaired based upon his or her work injury according to American Medical Association standards. If the 50% threshold is not met, the employee’s status can change to partial disability.
To find out for what you may qualify for, schedule a FREE office visit today!
Wage-loss benefits are equal to approximately two-thirds of your average weekly wage up to a weekly maximum. WC wage-loss benefits can be offset for 50% of Social Security “old age” benefits, the employer-paid portion of a retirement pension, severance pay, unemployment compensation, or earnings the employee receives. The law does not allow for a cost-of-living increase.
Under the Act, any worker who has filed a petition for total or partial disability benefits or is receiving such benefits is required to report (in writing) to the insurer any information that is relevant in determining entitlement to information regarding the receipt of wages from another employer or self-employment. The worker is obligated to cooperate with the carrier in an investigation of employment, self-employment, wages, and physical condition.
The reports mentioned above and other WC forms must be completed to avoid violating Pennsylvania fraud provisions.
You must be disabled for more than 7 calendar days (including weekends) before WC payments for disability become payable. Benefits for time lost from work are payable on the 8th day after the injury. Once you have been off work for 14 days, you will receive retroactive payment for the first 7 days.
If you report the injury promptly, miss more than 7 days of work, and the insurance carrier accepts your claim, you should receive your first compensation check within 21 days of your absence from work. After that, you will receive a check regularly.
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If, after you begin to receive benefits, your employer has evidence to prove that employment is available to you, within your medical restrictions and in your local area, you may receive an offer of employment. You have the right to either accept or decline the job offer.
If you decline, the employer may then petition a WC judge to either modify or terminate your benefits based upon that job. The insurer or employer must continue to pay the benefits during the hearing process unless the judge orders otherwise.
In open hearings, the judge will evaluate medical evidence—both from you and your insurer or employer—on the availability of the work and your ability to do it before rendering a decision.
An employer or insurer can stop wage-loss benefits if they have evidence you have returned to work at wages equal to or more than your earning’s level.
If you think you haven’t received benefits due to you, contact your employer or your employer’s insurance carrier. The insurance carrier is allowed 21 days from your notice of your disability to decide to accept or deny your claim or make payments of temporary compensation for up to 90 days.
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Unless an employer knows of the injury or the employee gives notice to the employer within 21 days of the injury, no compensation is due until notice is given. The notice must be provided no later than 120 days after the injury for payment to be allowed. If your employer or your employer’s insurance carrier denies your request for WC benefits, you have 3 years from the date of injury to file a claim petition.
In occupational disease cases, an injury or disability must occur within 300 weeks from the date of your last employment in an occupation in which you had exposure to a hazard, and a petition must be filed no later than 3 years from the date of injury or disability.
No, because the law makes the employer responsible for a worker’s injuries regardless of the employee’s carelessness. The law also provides that employees do not have the right to recover from the employer in any legal action other than a WC. However, if the employer fails to carry the appropriate WC insurance coverage and is not self-insured for WC, the employee can sue for damages. If a third party causes your work injury, that party is subject to a civil suit.
- Do not sign any incomplete papers.
- Do not sign any papers or statement unless you completely understand them.
- Do not sign any written statements about your injury or exposure to disease unless you have a witness, union representative, or your attorney present, and you fully agree with the written statements. Always get a copy of any statements you sign.
- Do not sign any Supplemental Agreements unless they correctly represent the current status of your disability. It may also help to have the Supplemental Agreement reviewed by a lawyer.
- Do not sign a final receipt of compensation unless you are fully recovered from your injury.