Workers’ Compensation Frequently Asked Questions (FAQs)
The Upstate Pennsylvania workers’ compensation lawyers of Munley, Munley & Cartwright know that if you’re injured or sick and unable to work, it’s an anxious time. We fight for the rights of the injured. Call us at 1-800-318-LAW1 or contact us online to discuss your case.
What is workers’ compensation?
Workers’ compensation is an insurance system that covers wage losses, medical expenses and other losses suffered by employees disabled by on-the-job injuries.
For more information on workers’ compensation in Pennsylvania, please visit our Worker’s Compensation: Benefits 101 page.
Who pays for workers’ compensation?
Your employer, through an insurance carrier, self-insurance, or the State Workers’ Insurance Fund.
For more information on workers’ compensation in Pennsylvania, please visit our Worker’s Compensation: Benefits 101 page.
Am I covered under the Workers’ Compensation Act?
Nearly every worker in Pennsylvania is covered by workers’ compensation. Certain workers are covered by other laws, such federal civilian employees, railroad workers, longshoremen, shipyard and harbor workers. Volunteer workers, agricultural laborers, casual employees, domestics and employees who have been granted a personal religious exemption may not be covered. Certain executive officers can choose to exempt themselves from the law.
What expenses are covered?
If you suffer an injury or disease related to your work, you may be eligible for workers’ compensation coverage. You cannot claim for any injury suffered during an illegal act at work, such as drug use, nor if you were intoxicated. Lost income, medical expenses, and certain losses such as a body part or sense (such as hearing or sight) are covered by workers’ compensation.
For more information on workers’ compensation in Pennsylvania, please visit our Worker’s Compensation: Benefits 101 page.
I’ve just injured myself at work. What should I do?
First, seek medical attention. If you’ve suffered an injury that is likely to cause you to miss work, notify your employer as soon as possible. Prompt reporting assures that your benefits can begin as soon as possible. Tell your employer that you were injured in the course of your job duties, along with the date and the place of the injury.
When do benefits begin?
When you miss your first shift or day at work because of your injury, your employer must notify the Bureau of Workers’ Compensation. On the seventh calendar day following your injury, payments begin to be made. On the 14th calendar day after your injury, payment for the first seven days is made retroactively. If you report your injury promptly and it is accepted by your company’s insurance carrier, you should receive your first payment within 21 days of your injury.
Can I sue my employer for my work injury?
Under most circumstances, you cannot sue your employer if your job is covered under workers' compensation law. There are a few exceptions to this rule. If your work is not covered by workers' compensation, you may have the right to file legal action. You should consult an experienced Upstate Pennsylvania workers’ compensation attorney for more information. Also, if your job is covered by workers' compensation, but your injury was at least partially caused by a third party that is not your employer – for example, the manufacturer of faulty equipment – you may be able to file a lawsuit against that third party.
Can my employer tell me which doctor to see?
If your job is covered by workers' compensation and you sustain a work-related injury, you may have certain limitations as to which providers you can see. Employers are allowed to designate a list of at least six doctors they want injured employees to use for workers' compensation treatment – and for the first 90 days of medical care, you must choose one of those doctors. However, your employer cannot choose from among those six doctors – that is entirely your decision. If your employer doesn't have such a list, you can select any provider. Even if you do have to see one of your employer's doctors, you may switch to another provider after 90 days.
For more information on Medical Benefits, please visit our Worker’s Compensation: Benefits 101 page.
The employer-designated doctor says that I can go back to work, but I don't feel well at all. I consulted my own physician, who does not think I should be returning to work yet. What can I do?
If you don't return to work after the doctor treating you under workers' compensation has released you for work, the insurance company will probably try to suspend your benefits. They will file a petition to terminate or modify your benefits – but they can't suspend them until a hearing is scheduled and a judge reviews your claim. In the meantime, you should contact an experienced Upstate PA workers' compensation lawyer who can begin preparing information to argue your case.
I returned to my employer-designated doctor for a follow-up visit, and two weeks later I received a document in the mail that indicated my benefits would be terminated. Is that legal?
The insurance company cannot actually terminate your benefits without a court order or hearing to review your claim. You should contact an Upstate Pennsylvania workers’ compensation lawyer immediately.
What is the difference between a temporary disability and a permanent one?
Disabilities are classified as temporary or permanent depending on their duration. If a worker suffers a career-ending injury or illness and can no longer work in any capacity, he or she has a permanent disability. A worker with a temporary disability, on the other hand, is prevented from working until cleared by a doctor to do so and can collect workers' compensation benefits during that period of disability.
For more information on the types of disability in Pennsylvania:
If I am found to have total disability status, how much can I expect to receive from workers' compensation benefits?
If you are deemed totally disabled and cannot work, you should receive wage loss benefits in addition to medical benefits. Medical benefits will cover your medical costs for treatment, medication, etc. Wage loss benefits for total disability will be two-thirds of your average weekly wage at the time of your injury, subject to a weekly maximum./p>
I hurt myself at work, but I'm close to retirement and I'm afraid that applying for workers' compensation will affect my pension. Should I just "wait it out" and hope I recover on my own?
The relationship between retirement benefits and workers' compensation is complex, and can vary according to the type of retirement plan you have, and whether your disability is partial – meaning you can perform some light work – or total disability. Some employers may try to avoid paying workers' compensation by asking older injured employees to take early retirement. Whether this is legal depends upon the details of your plan. Your best bet is to contact an experienced PA on the job injury attorney who can review your retirement or pension plan documents and provide you with an informed opinion about your legal options.
I filed a claim for workers' compensation over a month ago. How long do I have to wait before receiving benefits?
The workers' compensation insurance carrier has 21 days from the date you informed your employer of your disability to decide whether to accept or deny your claim. If you have not received any communication regarding your claim past the 21-day mark, contact the insurance company.
What can I do if my claim is denied?
If your claim for workers' compensation is denied, you have three years from the date of your injury to file again. Before you do so, however, contact an Upstate Pennsylvania workplace injury lawyer. An experienced personal injury attorney can evaluate your claim to see if you are missing key documents or information. Some employers attempt to deny claims because they think employees will just "drop it" and the problem will disappear. An injury lawyer may be necessary to enforce the law and make sure your injury is covered.
I’ve been totally disabled for two years. Now my employer wants me to see a physician. Can they do this?
After 104 weeks, your employer can ask that you undergo a physicians’ examination to determine your disability status. If you are determined to be 50% or more disabled according to the most recent edition of the American Medical Association "Guides to the Evaluation of Permanent Impairment,” you remain permanently disabled. If you are less than 50%, you move to “partial disability” status.
I’ve been determined to be partially disabled. What happens now?
You are limited to 500 weeks of compensation and are eligible to return to work at a lower-paying status within your work restrictions. If while partially disabled you obtain a physicians’ certification that you are 50% or more disabled, you can petition to be deemed totally disabled.
I’m partially disabled, and my employer has offered me a job in my area that fits within my work restrictions. What should I do?
If you decline, your employer can petition to end
your benefits. The decision will be rendered by a judge
in an open hearing, after hearing medical evidence about
your suitability for the job.
As you can see, workers’ compensation law is complex.
You don’t want to go it alone. To ensure that your
rights are fully protected, contact the Upstate
Pennsylvania workers’ compensation lawyers of Munley,
Munley & Cartwright at 1-800-318-LAW1 or
contact us
online.
