Here are twelve basic things injured workers should know about Pennsylvania workers’ compensation.
- Only employees are entitled to workers’ compensation benefits in Pennsylvania. Often times, usually in cases where the employer is uninsured, we litigate the issue of whether the injured worker was an employee or subcontractor. I personally have litigated tons of these employee status issues. If the injured worker is truly an independent contractor, then there is no entitlement workers’ compensation benefits. Disputes over employment status are fact sensitive.
- You cannot typically sue your employer in civil court for work-related injuries sustained in the course and scope of employment. When an individual is injured at work in Pennsylvania, workers’ compensation is the exclusive remedy. There are very limited exceptions. Additionally, it is important to understand that there is NO entitlement to ‘pain and suffering’. Injured workers are entitled to wage loss and medical benefits. That is it.
- It is extremely important to understand that there are statutory time limitations involving the reporting and filing of a workers’ compensation claim in Pennsylvania. An injured worker must report a work injury to the employer within 20 days of the occurrence of the injury to be entitled to workers’ compensation benefits going back to the first day missed from work. If the employee fails to report the injury within 20 days, then the injured worker MUST report the work injury within 120 days of the date of injury. Failure to report a work injury within 120 forever bars the filing of a workers’ compensation claim.
- It is important to understand the difference between filing a claim with the workers’ compensation insurance carrier and filing a workers’ compensation claim with the Pennsylvania Department of Labor and Industry. They are not the same. The three year statute of limitation applies to filing a workers’ compensation claim with the Pennsylvania Department of Labor & Industry.
- Proper calculation of the average weekly wage is critical in a Pennsylvania workers’ compensation claim. At times, the computation of the average weekly wage may inadvertently not include bonuses or overtime. That can effectively lower the average weekly wage, providing the injured worker with less benefits than they should be entitled to. You can read more about that here.
- Medical treatment is critical to a workers’ compensation claim. It is important to seek immediate medical treatment. It is important to tell the medical provider how the injury occurred. It is important to disclose any prior treatment or symptoms in the past regarding the same body part that was injured at work. In most cases that are denied, there are disputes over medical treatment, pre-existing issues, description of injury, and more. Medical treatment is extremely vital component to a workers’ compensation claim.
- Just because an injured worker had a pre-existing condition or prior work injury does not bar a new claim. Employers like to tell injured workers that, but it simply is not accurate at all. However, it is important to disclose it. You can read more here.
- Work restrictions are important in your workers’ compensation claim. Each time an injured worker has an appointment with a medical provider, a current work restriction note from the doctor should be requested. Many times there is a disconnect between the injured worker and the doctor. The doctor does not issue any work restrictions because the injured worker is out of work. Get a work restriction note from every visit with the doctor. You can read more here.
- The insurance adjuster and/or nurse case manager are not advocates for the injured worker. The interests are simply not aligned. The injured worker wants paid benefits while out of work, wants effective medical treatment, and wants that medical treatment paid by the insurance carrier. On the other hand, the insurance carrier wants to simply limit liability and benefits. Many times, the insurance carrier already has an attorney reviewing your claim. That is precisely why you need Mooney Law on your side.
- Being schedule for an Independent Medical Examination (IME) is usually the predecessor to hostile action against the workers’ compensation claim of an injured worker. These exams are not truly ‘independent’. The doctors are paid by the insurance carrier and a letter is sent to the doctor describing what the insurance carrier is looking for out of the examination. The insurance company is CHOOSING the doctor. The insurance company is PAYING the doctor. The insurance carrier usually uses that doctor many times. If you have been scheduled for an IME, call Mooney Law right away. You can read more about IMEs here.
- Other than reporting the work injury to the employer and communicating work restrictions to the employer, injured workers should always avoid talking to people at work about their claim and injury. Injured workers should avoid sending emails and text messages. Believe me, these are saved by the employer. Additionally, injured workers should not just assume a co-worker will be friendly toward them or testify for them. That co-worker is being paid by the employer. Their income comes from the paycheck of the employer. Believe me, I have seen hard lessons learned.
- Finally, and very importantly, injured workers should be well aware that if they choose settle the workers compensation claim, the claim is forever closed. Once a case is settled, it can NEVER be reopened, even if the condition worsens. Additionally, injured workers should never settle the claim with the insurance carrier without an experienced workers’ compensation attorney. Read more about whether settlements are in your best interest.
Pennsylvania workers’ compensation is a very complex area of law that is heavily litigated. It frequently involves complex medical issues, evidentiary burdens, doctor depositions, several hearings, mediations, and more.
Mooney Law has collected tens of millions of dollars on behalf injured workers throughout Pennsylvania and Maryland. We don’t just try and settle your case for a quick fee. Given the fact that Mooney Law practices many areas of law, we look out for the best interests of our clients. Many of our clients use our firm for other matters, such as divorce and custody, criminal defense, estate planning, social security disability, bankruptcy, and more. We value our clients and want to be their boutique law firm no matter the legal needs. That makes us unique from personal injury law firms.
If you have been injured at work, call the proven, trusted, and experienced workers’ compensation attorney at Mooney law. Consultations for workers’ compensation are always free. Call 717-200-HELP or 717-632-4656 to schedule a free in-office or phone consultation.