Many times when I meet with an injured worker, the first question asked is — how long does it take to receive workers compensation wage loss benefits. I provide that answer here.
There are a few nuances to payment of wage loss benefits in Pennsylvania. First, the Pennsylvania Workers Compensation Act provides employers with a 20 day window to either accept or deny an injury. During that 20 day period, you may or may not be paid benefits. The purpose of the 20 day window is to provide the employer and insurance carrier a frame to investigate the work injury, communicate with the injured worker, and communicate and receive medical documentation regarding the injury. The failure of an employer to report an injury or accept or deny the injury in the statutory time periods opens the employer to potential penalties under the Pennsylvania Workers Compensation Act.
If you have been injured at work and have not heard anything from your employer or insurance carrier within 20 days, call Mooney Law today for an absolutely FREE consultation. Non-compliance happens often. We can and will help.
The 7/14 Day Rules for Wage Loss Benefits
The next question is when does the injured worker become eligible to receive wage loss benefits? You may be told by your employer that they do not have to pay you anything until you miss a certain amount of days due to the work injury. That is fact.
The workers compensation insurance carrier is not responsible for payment of wage loss benefits if the injured worker misses less than 7 days of work due to the work injury. Once the injured worker misses 8 days, then the injured worker become eligible for wage loss benefits. Once the injured worker misses 14 days of work due to the work injury, then the injured worker will be paid for the first 7 days missed from work.
I’ll explain be example. Let’s assume an injured worker has an accepted work injury and misses 5 days of work. Since the injured worker missed less than 7 days, no wage loss benefits are due to the injured worker. Fair? Not really. But, it is the law. Let’s assume the injured worker misses a total of 10 days from work. Since the injured worker had not missed at least 14 days, then he injured worker will not be paid benefits for the first 7 days. In this case, the injured worker would receive wage loss benefits for 3 days only. Now, let’s assume the injured worker misses more than 14 days from work. Now, the injured worker will receive wage loss benefits for the first 7 days missed and ongoing benefits while the injured worker remains out of work.
What happens if the claim is Denied?
If an injured worker’s claim is denied, then the process becomes longer and more complex. First, the injured worker has statutory timelines to submit a Claim Petition alleging a work injury and requesting wage loss and medical benefits. The injured worker has three years from the date of injury to file a Claim Petition. Failure to do file within 3 years bars the work injury claim. Since the injured worker will have to file a Claim Petition, the claim effectively goes into litigation. The burden of proof is on the injured worker to prove all elements of a claim. The litigation process can take anywhere between 8 to 12 months from the start of a Claim Petition until a Workers Comp Judge issues a decision on the claim petition. You can read more about that process right here. Unfortunately, during that litigation process, the insurance carrier does not have to pay benefits. Obviously, that is substantially challenging and puts injured workers in dire financial condition. That is why it is extremely critical to call Mooney Law if you receive a workers compensation denial.
It is important to understand that this article is primarily discussing wage loss benefits. Injured workers are also entitled to medical benefits. There are a few different rules regarding the payment of medical benefits. I will cover those in a subsequent blog article to this one.
If you have been injured on the job, your rights and benefits are extremely important. Do not let your employer bully you. Do not let the insurance carrier dictate to you. Mooney Law has a full workers compensation litigation practice, recognized by Super Lawyers and recognized as a Rising Star in Pennsylvania. Call us today for an absolutely FREE consultation. We represent injured workers throughout Central Pennsylvania AND Maryland. Call us today at 717-200-HELP or 833-MOONEYLAW. You can also visit us on the web at http://www.mooney4law.com.