Workers’ Compensation

Frequently Asked Questions

Attorney Cathy Surbeck discusses subrogation and liens on third party settlements.

Workers’ Compensation is a set of civil laws protecting both workers and employers in the event of workplace injuries. A workplace injury can arise from an accident at work or repetitive work conditions that cause a sickness or disability. In Pennsylvania, Workers’ Compensation laws afford injured employees and their loved ones several types of benefits.

Under Workers’ Compensation, an injured worker may be entitled to the following benefits:

  • Weekly compensation to the injured worker
  • Reasonable, necessary, and related medical treatment
  • Death benefits and burial expenses to a deceased worker’s dependents

Your employer and its insurance carrier have teams of lawyers to deny claims or minimize payments. Our Workers’ Compensation lawyers will use its experience and litigation skills to protect your rights to benefits.

Understanding the Pennsylvania Workers’ Compensation Act

The Pennsylvania Workers’ Compensation Act specifies the compensation for employees who become injured or ill as a direct result of their employment, regardless of fault. The Act is overseen by the Bureau of Workers’ Compensation and the Department of Labor & Industry (DLI). They are responsible for administration and appeal obligations. The Act protects both employees and employers. Employees receive compensation for medical expenses and lost wages, and companies pay for the cost of coverage. In turn, employers are protected from being directly sued by employees.

Workers’ Compensation coverage is mandatory for most employers under Pennsylvania law, although there are exemptions. This includes people covered under other Workers’ Compensation acts, such as railroad workers, longshoremen, and federal employees; domestic servants; some agricultural workers; and employees who are exempt due to executive status or religious beliefs. Employers who do not have Workers’ Compensation coverage may be subject to lawsuits by employees and to criminal prosecution by the commonwealth.

Other Types of Compensation Programs

The U.S. Department of Labor administers other kinds of disability compensation programs through the Office of Workers’ Compensation Program. These programs apply to federal workers and other groups, and provide medical treatment, wage replacement, vocational rehabilitation, and additional benefits.

Common Workplace Accidents

According to the Bureau of Labor Statistics (BLS) 2019 report, certain occupations are at a higher risk for work-related injuries and illnesses. The following are occurrences recorded for that year:

  • Health care and social workers: 577,500
  • Retail workers: 409, 900
  • Manufacturing employees: 430,300
  • Transportation/warehousing: 221,400
  • Construction workers: 199,200

The BLS also names the states with “Non-Fatal Workplace Illness and Injury Rates Above the National Average,” and Pennsylvania was on the list. The most common causes for workplace injuries included:

  • Overexertion/bodily reactions
  • Slips, trips, and falls
  • Contact with equipment/objects
  • Workplace violence
  • Transportation incidents

More Statistics

The BLS stated that the most common types of job-related injuries are strains, sprains, and tears; pain or soreness; lacerations, cuts, and punctures; and contusions, bruises, and fractures. Others include amputation and other traumatic injuries, tendonitis, heat burns, and chemical burns. The BLS also reported that the number of fatal workplace accidents was on the rise, compared to the previous year.

The construction industry is one business sector that has advocated for workplace safety. Year after year falls, struck-by accidents, electrocutions, and caught-in or between accidents are leading contributors to construction worker deaths. That is why OSHA has dubbed these the “Fatal Four” types of construction accidents. OSHA officials estimate that eliminating these common hazards could save more than 600 American workers’ lives every year.

Determining If the Injury is Work-Related

Employees who make Workers’ Compensation claims need to prove that their injuries or illnesses occurred during the course of employment. In general, this means that the employee must have been doing something for the employer’s benefit when the incident occurred. If the injury occurred while the employee was traveling for work, factors such as who owned the vehicle being driven or whether it was a personal or business errand will be looked at.

Injuries can also occur at company events, such as holiday parties or softball games. These could be considered work-related, but there are exceptions. If an employee gets hurt from misconduct, they may not qualify for benefits. Those who break safety rules by committing crimes, using alcohol or drugs, or are acting out otherwise could be denied benefits, depending on the situation.

Occupational Diseases and Cumulative Injuries

Repetitive stress injuries, lung ailments, and other occupational diseases and cumulative injuries can be harder to prove, as they result from long-term work exposure. This also includes psychological issues caused by workplace stress. As they tend to develop over time, it can be more difficult to establish a direct link from the workplace environment to the illness or injury. Each state has rules that apply to this, and a qualified Workers’ Compensation lawyer can be helpful in this respect.

What Qualifies as a Work Injury?

An injury that occurs at work, or an illness or disease caused by an employee’s job, is considered a work injury. It does not include an injury of a self-inflicted nature, nor does it include any injury that occurs while an employee is under the influence of drugs or alcohol.

Who is Considered an Employee in Pennsylvania?

Any person who performs services for someone else in exchange for something that has value is an employee, with some exceptions. Coverage includes when services are performed on or off-site.

Can I File for Benefits Without an Attorney?

This may be an option under circumstances where you suffered very minor injuries and your employer’s insurance is cooperating with you on the claim. Otherwise, you may find yourself surrounded by quite an alarming situation. It is always best to play it safe when it comes to this type of situation to avoid any type of conflict or delay.

When Am I Covered by Workers’ Compensation?

You are covered beginning on the very first day of work and continues throughout employment. If the accident or illness occurs off-site, employees are still covered if they were performing work-related duties. For example, if an employee is traveling for business and gets in a car accident on the way, this may be eligible for coverage.

How Much Will I Receive from Workers’ Compensation?

The wage-loss benefits you receive will be equal to approximately two-thirds of your average weekly wage, up to a weekly maximum. The DLI determines the maximum compensation. As of June 30, 2019, the weekly wage is $1,081 for injuries that occurred on and after January 1, 2020.

Can I Sue My Employer in the Wake of an Accident?

If your employer does not have Workers’ Compensation insurance, it is likely illegal, and you can request that we look into suing them if you were hurt on the job.

Can I Sue the Party Responsible for My Injury?

There are cases where you can file a civil suit to sue a third-party who is purportedly responsible for the injury. Since Workers’ Compensation does not provide full wage replacement or cover pain and suffering, some injured parties will choose to sue third parties. In these cases, you must show that a third-party was negligent.

Who Will Pay My Medical Bills?

The employer and insurance company will be responsible for taking care of your medical bills. These may include reasonable medical/surgical services, as well as medication, orthopedics, and prostheses.

Can I Collect Social Security, Unemployment, and Disability Benefits?

If you are eligible, then you may collect these benefits, although there will be a reduction in your Workers’ Compensation benefits.

Do I Need to See the Company Doctor?

If your employer has accepted your claim and posted a list of at least six physicians in your workplace, then you must choose one from the list for initial treatment. For at least 90 days following the initial visit, you must continue to attend treatment.

What Should I Do After a Workplace Injury?

Injured employees should alert their employers and seek medical attention as soon as possible, as delaying can hurt a case. The longer an employee waits to file, the more time the other side has to challenge it. As the process unfolds, it is also essential to maintain accurate records of everything that happens, such as taking pictures of where it occurred and seeking eyewitness testimonies. Your employer is responsible for completing an injury report, and documenting all medical treatment and expenses is also important.

Some employers may refuse to complete injury reports. In these situations, employees can file claim petitions for Workers’ Compensation benefits. This can be challenging, especially when the injury or illness is serious. It involves attending hearings with a Workers’ Compensation judge, and it may be in the employee’s best interest to consult with an attorney.

Are There Deadlines for Filing Workers’ Compensation Claims in Pennsylvania?

It is important to follow state deadlines for filing Workers’ Compensation claims. Employees have 21 days to notify employers about work-related injuries. If they wait longer than 120 days, they may forfeit their right to make a claim. Employees and their employers can agree on the type of compensation on or after the seventh day following the injury. Employees who wish to file claim petitions for benefits related to injuries have three years.

What Paperwork Do I Need to Sign?

The Workers’ Compensation Bureau has standard forms that should be read carefully. Signing something without fully understanding it can lead to unfortunate outcomes. Employees may also be asked to sign supplemental agreements and final receipts. Signing either of these without consulting an attorney could damage a case, especially if the employee has medical complications related to the workplace injury.

What If I Live in Pennsylvania, but Work in Another State?

This depends on the individual circumstances. If you live in a different state but were hired by a Pennsylvania-based company, you may be able to file for Pennsylvania Workers’ Compensation benefits. There may be other options worth exploring as well.

What is a Lump Sum Settlement?

Some employees receiving Workers’ Compensation can elect for a lump-sum settlement amount to pay for unreimbursed medical expenses and any other amount that comes under dispute.

How Long Will It Take to Receive my Workers’ Compensation Benefits?

The answer to this question is dependent upon your unique circumstances surrounding the case. We can examine everything involved and give you a good expectation of what will occur.

What Can I Do If I Am on Workers’ Compensation and Return to Work?

When returning to work in any capacity, do not sign any documents without speaking to an attorney first. A good faith attempt to work is required on your behalf, however, if you experience any pain, you must notify your doctor immediately and follow their directions.

Can I Be Fired for Filing a Workers’ Compensation Claim?

You cannot be fired for filing a Workers’ Compensation claim; however, some employees are fired after filing due to extended absences or other reasons. Some employers may even terminate employee health benefits. Union employees may be protected from this.

Bucks County Workers’ Compensation Lawyers at Freedman & Lorry, P.C. Stand Beside Injured Workers

When a worker incurs injuries while at their job, our Bucks County Workers’ Compensation lawyers at Freedman & Lorry, P.C. will fight for maximum compensation for their injuries. Contact us today at 888-999-1962 or contact us online for a free consultation. Located in Philadelphia, Cherry Hill, New Jersey, and Pinehurst, North Carolina, we serve clients throughout Pennsylvania.