When you get hurt in an accident, you can often sue. If that accident happens while you are working, then a lawsuit may be impossible, or at least more complicated. Fortunately, Workers’ Compensation kicks in in these cases to get you benefits without even needing to prove your employer was at fault.
Our attorneys can represent you in claims against your employer and their insurance provider. We have deep knowledge of Workers’ Comp, and we can help you properly value your claim, settle when possible, or take the case before a judge when the insurance carriers put up a fight.
For your free case evaluation, contact the Certified Pennsylvania Workers’ Compensation Lawyers from Cardamone Law by dialing (267) 651-7945.
Can You Sue for a Work Injury?
Lawsuits for a work injury can be filed, but only in certain situations. You generally cannot sue your employer, and you cannot sue if you were the one who caused your own accident. Otherwise, there are two primary ways to sue:
Un-Covered Workers
Workers’ Compensation only covers – and therefore only restricts lawsuits for – employees. This means if you are an independent contractor, you may retain your right to sue and would not have Workers’ Comp coverage in the first place.
There are also a few types of workers that the Workers’ Comp Act carves out of coverage, such as realtors.
Third-Party Defendants
While employees cannot sue their employers, they can sue other people responsible for accidents, such as these common examples:
- Drivers who crash into them while working, common for roadside construction workers, truckers, and delivery drivers
- Manufacturers of defective tools, machinery, or equipment used at work
- Manufacturers of defective PPE that failed to keep you safe (e.g., helmets, respirators)
- Vendors and suppliers causing injuries
- Contractors and other workers causing injuries.
These lawsuits can supply additional damages beyond what Workers’ Compensation covers, but you have to prove fault and prove damages before you get those damages paid in a lawsuit.
What Damages Does Workers’ Comp Cover?
Workers’ Comp covers three main areas of benefits:
- Medical coverage is paid for all treatment needed for your work-related injury.
- Wage-loss benefits restore a portion (usually 2/3) of the wages you miss while unable to work, or 2/3 of the difference in wages when you do return to part-time work.
- Specific loss payments for permanent injuries like lost function, lost vision, lost hearing, amputation, and serious scars to the face.
Death benefits can also be paid if a loved one died in a work-related accident.
Calculating Benefits for Workers’ Comp
The calculation methods vary depending on the benefit:
- Medical benefits are usually covered in full.
- Wage-loss benefits are capped at the statewide average weekly wage, and you cannot get less than half that value or 90% of your weekly wage (whichever is lower).
- Specific loss is also capped at the statewide average, and the minimum is half the maximum benefit.
How Do I Get Workers’ Comp?
You start your claim by giving your employer notice of your injury, and they start a claim with their insurance carrier. The employer can start paying you benefits if they agree with your claim, or they can start benefits on a temporary basis and take more time to investigate. Either way, they can decide against you in an appropriate time and reject your claim.
Going to Court
From there, you can file a Claim Petition and go to a Workers’ Comp Judge (WCJ). The WCJ will hold hearings and take in evidence to render a decision on two main issues:
- Whether your injury was work-related
- Whether you are disabled and cannot work.
If your injury was work-related, you can get medical benefits. If you also cannot work, you can get wage-loss benefits. They will also decide other issues, too.
Gathering Evidence
Getting the evidence for the WCJ’s hearings often requires medical exams. Your employer can request that you undergo certain exams to see the extent of your injury and disability, as well as what treatment will be needed. You cannot refuse these or else you lose your benefits.
We may also need additional exams, plus we need to hold depositions to gather witness testimony, as the WCJ usually will not have live testimony in court. Our Workers’ Comp lawyers can front these costs and get paid back by the employer when we win your case.
Decisions
Ultimately, the WCJ makes the decision about benefits. You can appeal this decision to the WCAB (Workers’ Compensation Appeal Board) if they rule against you, and you can appeal that to the Commonwealth Court and even the Pennsylvania Supreme Court, if needed. However, the Supreme Court can decide which cases it takes and may reject your appeal.
When Does Coverage Start and End?
Workers’ Comp coverage kicks in on your first day of employment, so you can conceivably file a claim for injuries that happen any time you work for this employer. You may even be able to file some claims after your employment ends.
For example, if you were fired for an accident that injured you, you can still file the claim because you worked for them when the accident happened. Many claims are also filed for occupational illnesses that become apparent well after ending your time with an employer, e.g., for cancer.
When Are Payments Made?
Once the claim is accepted or a WCJ rules in your favor, payments should start quickly. You cannot get wage-loss benefits until you are out of work for more than 7 days, but those back benefits are paid if your injury keeps you out for at least 14 days.
Wage-loss benefits are paid weekly or bi-weekly on your normal pay schedule. Total incapacity benefits can last indefinitely unless you undergo an IRE (Impairment Rating Evaluation) after 104 weeks of benefits that finds you to be under 35% whole body impairment. If that happens, your benefit status is changed to partial disability, and you get 500 more weeks max.
Medical benefits are paid directly to the provider for services in most cases. Specific loss benefits are usually paid weekly after total disability ends.
If you instead settle your case, you usually receive a lump sum payment.
Contact Our Firm’s Collegeville Workers’ Compensation Lawyers
Call Cardamone Law’s Workers’ Compensation lawyers at (267) 651-7945 to get a free case evaluation.
