After a work injury, you could need expensive medical care. Getting these bills covered through Workers’ Comp can help you move forward with your life, all without having to prove who was at fault for your injury.
Workers’ Comp also covers 2/3 of your lost wages, extra benefits for certain permanent injuries and – for those who lost a loved one in a work accident – death benefits. Getting these benefits, however, is not always simple. Insurance carriers and employers often deny claims, meaning the only option is to turn to the courts.
For a free case evaluation, contact our Certified Pennsylvania Workers’ Compensation Lawyers at Cardamone Law at (267) 651-7945 today.
Do I Qualify for Workers’ Compensation in Perkasie?
Our lawyers cannot determine whether you qualify, personally, without examining the facts of your case. Many cases involve specific issues about the employee or how the accident happened that might cut off benefits. However, we can say that you generally qualify if you meet these three criteria:
Employee
If you are an employee – not an independent contractor – then you can typically claim Workers’ Comp benefits from your employer. Employers have to cover all workers who could be injured while employed in Pennsylvania.
However, independent contractors are essentially self-employed, and properly classified contractors have no “employer” to file a claim with.
Work-Related Injury
If your injury happened within the scope of your work, it should qualify. It does not have to have happened during the core duties, and accidents at your workplace or other environmental injuries often count as well.
Injuries during a commute or after work hours often do not count. However, injuries during required work trips, trainings, or meetings outside of “normal hours” should still qualify.
Disability
If your injury did not cause a disability, then medical care should still be covered. However, if it makes you unable to work for more than 7 days, you can get replacement wages.
These are typically paid at a rate of 2/3 the average weekly wage (AWW) you made before the injury. If you are partially disabled, they subtract your current AWW from the pre-injury AWW before giving you 2/3.
Are There Caps on Workers’ Comp Payments?
Workers’ Comp pays three areas of compensation, each with different rules about maximums:
Medical Bills
Medical bills are not “capped,” but you cannot get anything beyond the actual values of expenses you faced. If you are settling your case, you will also include the estimated future bills you will face.
Wage-Loss
Wage-loss benefits are capped at the statewide AWW. Each year, the government sets this amount. For 2025, it is $1,347/week, meaning you hit that cap if 2/3 of your AWW is over that amount (i.e., if you make over $2,020.50/week).
With that, there is also a minimum. Workers with lower wages get a minimum of either half the statewide AWW or 90% of their lost wages, whichever is lower.
Partial disability benefits are also capped at 500 weeks. However, your status can switch between total and partial disability and back again, so the 500 weeks will not necessarily be in a row.
Total disability benefits last as long as your total disability does.
Specific Loss
Specific loss benefits are specific to the injury. Rather than being labeled in a dollar amount, you get 2/3 of your AWW for a number of weeks listed for each injury. These injuries include things like amputation, lost function, lost sight/hearing, and facial scars.
A lost big toe, for example, pays 2/3 your AWW for 40 weeks, while a lost eye pays 275 weeks.
How Does a Settlement Work for Workers’ Comp?
When you settle a Work Comp claim, the goal is to include all benefits you would have received over time in the settlement. This requires some estimates and projections our lawyers often need to work with experts to obtain.
For example, your wage-loss benefits would pay total disability for as long as you would be disabled. So, we need to estimate how long that will be. If your injury is permanent, that would replace wages through retirement age; if your injury will improve after 9 months, then you might return to partial disability for a few weeks before full-time work.
These estimates can be complex and need close attention. Things are even more complicated when your recovery might not be a straight line, such as with work-acquired cancers, heart conditions, or other ongoing illnesses.
In some cases, we cannot accurately predict your benefits, and it is better to stay on ongoing benefits so you can get additional medical care as the need arises.
For a settlement to be approved, a Workers’ Comp Judge needs to ensure you understand your rights and sign off on the settlement.
Can I Handle a Workers’ Comp Claim Without a Lawyer?
Technically, you can file a Work Comp claim without a lawyer. If your employer accepts your initial claim, you might get ongoing benefits without a lawyer’s intervention. However, if they deny your claim, it is almost impossible to proceed without a lawyer.
You would have to file a Claim Petition on your own, pay for any medical exams and evidence collection (e.g., depositions), and act as your own attorney. Given the fact that most disability claims involve physical disabilities that stop people from working, this might be physically as well as economically impossible.
Our Workers’ Comp lawyers have certifications that show we have the experience and training necessary to help with your claim, stand up for you in hearings, negotiate settlements, and fight for you in your case.
Your focus should be on recovery while we focus on getting your benefits.
When Should I Bring My Workers’ Comp Claim?
You must file your initial notice of injury with your employer within 21 days in most cases, but your claim is blocked if you do not give notice within 120 days. From the date of denial, you have 2 years to file a Claim Petition, but you need your medical care and lost wages now.
That means you should call a lawyer as soon as you can and get us on your side from the beginning.
Call Our Workers’ Comp Lawyers in Perkasie Today
For your free case evaluation, call Cardamone Law’s Workers’ Compensation lawyers at (267) 651-7945.
