Settling a workers’ compensation case can be very frightening for an injured worker. When is the right time? What happens to my medical benefits? What if my condition worsens? What about outstanding medical bills?
Another question frequently asked centers around unemployment compensation. Can an injured worker who settles his/her workers compensation claim receive unemployment compensation after settlement. The answer is — possibly. Workers compensation settlements and eligibility for unemployment compensation benefits usually revolve around two specific questions.
First hurdle applies to injured workers who have been off of work due to injury for a period of one or more years. The issue that usually triggers a denial is the fact that after being off a year or more, unemployment compensation may have very little or no wage information to determine eligibility. Since no or little wage information exists, unemployment compensation finds you to be financially ineligible. The Pennsylvania Workers Compensation Act addresses this issue in Section 204(b). The provision allows injured workers who have been out of work due to the work injury to elect to have their ‘base year’ consist of the four calendar quarters that immediately preceded the work injury work absence. However, the issue must be raised on Appeal on the the Notice of Financial Determination. It is best to have legal counsel represent you in your unemployment compensation appeal to raise appropriate issues to fight for your benefits. Along with workers compensation, we here at Mooney & Associates also represent individuals in unemployment compensation appeals.
Just because you were off work due to injury does not mean you do not have the work credits to be eligible for unemployment compensation. The Pennsylvania Workers Compensation Act (WCA) has addressed this issue in Section 204(b) which provides that an employee who does not meet the monetary and credit week requirements under section 401(a) of the Unemployment Compensation Law due to a work related injury compensable under the Pennsylvania Workers’ Compensation Act may elect to have his base year consist of the four complete quarters immediately preceding the date of the work related injury. This request should be raised within the appeal period identified on the Notice of Financial Determination.
The second trap usually involves the employment status of the injured worker at the time the workers compensation settlement occurs. It is likely with most insurance carriers that an injured worker will be required to sign a resignation letter or general release when they settle their case. When an employee resigns from employment, the burden to prove eligibility for unemployment falls to the employee to prove a necessitous and compelling reason for resignation. Specifically, in Lee v. UCBR, The Commonwealth Court made it quite difficult to meet that burden when voluntarily resigning as part of a workers compensation settlement. The simplest way to protect right to unemployment compensation is to have the appropriate language in the settlement agreement as to not bar unemployment compensation benefits. That is one reason, among many others, why it is absolutely imperative to seek legal counsel before agreeing to any workers compensation settlement. For your FREE consultation, please contact our firm at 877-632-4656.
