Workers’ Compensation is the core system for getting benefits to workers after an injury at work. Employers are required to cover these injuries regardless of how the accident happened and whether fault can be traced back to the employer.
Our attorneys help get these claims proven by coordinating with your care team, gathering evidence from additional doctors, taking depositions, and arguing your case before a Workers’ Comp Judge. We can fight insurance companies and employers and work toward a settlement that will pay your full benefits.
Call (267) 651-7945 for a free case review with Cardamone Law’s Certified Pennsylvania Workers’ Compensation Lawyers today.
How is Fault Used in a Workers’ Compensation Claim?
You do not need to prove your employer was at fault to hold them responsible for your work injury in Workers’ Compensation claims. Instead, you merely need to prove that the injury was work-related – that it happened during the course of your work duties – to get the injury covered.
This allows for claims when you might not otherwise be able to sue, such as when your employer is at fault (since lawsuits against employers are barred) or when you were at fault.
However, fault is still analyzed in a few situations:
- Intentionally causing your own injuries
- Causing your accident because you were drunk or using drugs
- Injuries caused by illegal activity.
Otherwise, fault does not typically come into the equation. Even so, it can make it more obvious that the injury was work-related if it was caused by an OSHA violation or similar issue.
Who Pays for Workers’ Compensation?
Employees are not required to pay into Workers’ Comp like they are with unemployment taxes or Social Security Disability taxes. Instead, employers must pay for Workers’ Compensation coverage.
When your injury claim is paid, it is usually your employer’s insurance carrier paying. This gives them outsize influence over your employer’s decision to grant you benefits or not, and employers often cannot go against what their insurance carrier decides.
There is one odd situation where other parties might actually cover your Workers’ Comp, and it deals with “statutory employers.” When a company contracts out a portion of its regular business to a third-party company, and that third-party company fails to cover its employees with Workers’ Comp, the larger company is required to pay instead. This merely changes who initially pays you, not your eligibility.
Who is Eligible for Workers’ Comp Coverage in Middletown, PA?
Workers’ Comp is required for all employees who have a chance of being injured in Pennsylvania. This means that nearly all part-time, full-time, and seasonal employees must be covered, regardless of industry. There are a handful of exceptions, such as no coverage for realtors.
The classification as an “employee” as opposed to an “independent contractor” is vital. Contractors often control their own work, might work under a company name, get paid with a 1099, and sometimes get paid a contract price instead of an hourly wage or salary. Employees have their work controlled, work under their own name, get a W-2, and are typically paid hourly or through a salary.
However, many employers try to pass off employees as contractors to avoid paying them, providing benefits, and covering Workers’ Comp, so always consult with a Workers’ Compensation lawyer if you think you might be misclassified.
What Injuries Does Workers’ Comp Pay For?
Workers’ Comp covers all sorts of injuries, including these common ones:
- Falls
- Electrocution
- Broken bones
- Auto accidents during work
- Sprains and repetitive stress injuries
- Back injuries
- Cancer and other illnesses.
As long as your injury happened during your work duties, it must be covered except in intentional injury cases, illegal activity, drug use, and alcohol cases.
Workers’ Comp also pays additional “specific loss” benefits for injuries listed in the statute. These include all kinds of amputation and permanent injuries, including…
- Finger/thumb amputations
- Toe amputations
- Hand, wrist, arm amputations
- Foot, ankle, leg amputations
- Lost eye or lost vision
- Lost hearing
- Serious facial scarring.
These each have a number of weeks assigned to them, during which you get 2/3 of your average wage paid specifically to cover the loss. These benefits come on top of any wage-loss benefits.
Lost Wage Benefits from Workers’ Comp
Your wage-loss benefits differ depending on whether your injury is total or partial.
Total Disability
As long as you are unable to work because of a work-related injury, you receive total disability benefits. These are typically paid weekly or bi-weekly, depending on how you usually got a paycheck before the injury.
Your average weekly wage (AWW) before the accident is multiplied by 2/3 to get your weekly benefit. This is capped at the statewide AWW, and it has a floor of the lower of either 1/2 that statewide AWW or 90% of your AWW.
Partial Disability
For up to 500 weeks where you can still work with reduced wages, tasks, or hours, or with accommodations to deal with your disability, you can get partial replacement wages. Instead of being based on 2/3 of your full AWW, they are paid as 2/3 of the difference between what you make now and what you could make before the accident.
Your disability status can change between partial and total. The 500-week limit applies to the total number of weeks in which you received partial disability benefits; they do not have to be in a row.
When Do Lost Wages Kick in Under Workers’ Comp?
Not every work injury case requires lost wages. If you get hurt at work, they should cover your medical care, but lost wages are only paid if you go at least 7 days without working.
After the first 7 days of disability, you can begin receiving benefits. However, it will usually take longer than that to get your claim granted. Initially, you must report your injury within 21 days. Then, your employer gets 21 days to deny your claim. After that, we will have to take the case to court and start your claim in court, where it can take 2-3 months on average for your benefits to be paid.
If your injury disables you for at least 14 days, you do get the first 7 days paid as well.
Call Our Workers’ Comp Lawyers in Middletown, PA Today
Call Cardamone Law’s Philadelphia, PA Workers’ Comp attorneys at (267) 651-7945 for your free case evaluation.
