Frequently Asked Questions
What Benefits Will I Be Awarded If I Get Workers’ Compensation In Pennsylvania?+
If you win your claim or if the employer/insurer accepts your claim without a fight, you will likely receive two-thirds of your pre-injury average weekly wage, plus medical benefits for “reasonable, necessary and related” medical treatment. For low wage earners, the comp rate is 90% of the pre- injury average weekly wage. There is a max rate for weekly comp benefits, for each year. Other benefits are available, called specific loss, for disfigurement, for loss of use of a body part for “all practical purposes and purposes,” or for loss of a limb, fingers, or toes.
Do I Get Full Pay After Getting Hurt At Work?+
No! You generally receive 2/3 of your pre -injury average weekly wage. Some injured workers will get 90%- depending on their gross earnings. There is a statewide maximum weekly comp rate as well. Here is an article on earning power determination according to the Pennsylvania Workers’ Compensation Law. Make sure you know your earning potential before making a claim for workers’ comp benefits.
Can I Get Pain And Suffering For My Work Injury?+
No. There are no damages for pain and suffering in Pennsylvania workers’ compensation. This is because fault is not an issue in workers’ compensation, unlike in a third-party personal injury case.
Can My Health Insurance be Terminated While I am on Workers' Comp?+
Unfortunately, this can happen. The fact that a claim has been accepted or is being paid, does not mean that an Employer has to keep health insurance going. In many cases, it stops soon after the employee stops working, with a COBRA notice going out where applicable. The work comp insurance for the accepted work-related injuries continues until a full recovery is found by a Judge or until a case is settled, but the regular health insurance is not something the Pennsylvania Workers’ Compensation Act covers.
If I Live In Another State, But I Am Injured In Pennsylvania, Can I Get Workers’ Compensation In Pennsylvania?+
Yes. If you are injured while working in Pennsylvania, then you are eligible for Pennsylvania workers’ compensation, even if you reside in another state. Similarly, if you live in Pennsylvania, but are injured in another state, you may still be eligible for Pennsylvania workers’ compensation benefits, if you were hired by a company in Pennsylvania.
Will the IME Doctor Side Against Me?+
Not always. While they tend to be quite biased in many cases, I’ve seen plenty of fair and balanced IME reports which acknowledge a work-related injury and disability. Don’t jump to conclusions.
If I Get Fired, Can I Get Workers' Compensation Benefits?+
If the firing was for willful misconduct, then the insurer/employer will likely argue that any wage loss benefits payable should cease. However, that’s not easy to prove. If an injured worker is laid off and has work-related restrictions, a reinstatement of benefits is due. A termination of employment does NOT end a workers’ compensation case.
Can I Sue My Employer For Negligence For Causing My Work Injury?+
No. Pennsylvania workers’ compensation is your only recourse against your employer for a work-related injury. However, if the injury was caused by a third party, meaning someone other than your employer, then you may have a viable personal injury claim against that third party if you can establish a defective or dangerous product or condition. Or, if you are injured in a car accident while on the job, you will have a Pennsylvania workers’ compensation claim against your employer for lost wages and medical benefits, and a negligence claim against the driver for personal injury.
Will It Be A Workers’ Comp Case If I Get Into A Car Accident While On My Way To Work?+
It depends. Regular commute to/from work doesn’t count. But if you are a traveling employee or were traveling on a specific work assignment, a car accident on your way to work may have grounds for workers’ comp.
How Do I Apply For Pennsylvania Workers’ Compensation If I Was Injured At Work?+
Once you suffer a work-related injury in Pennsylvania, whether from a traumatic accident or from repetitive work activities, you must notify your employer. You should try to give notice within 21 days of the injury, and the sooner the better. Once you give notice of your on-the-job injury, the employer and/or workers’ compensation carrier has 21 days to accept, deny, or temporarily accept your claim by issuing one of three documents: a Notice of Compensation Payable, a Notice of Denial, or a Temporary Notice of Compensation Payable. If 120 days notice is not given, the claim will be barred forever.
Do I Have To Attend An Independent Medical Exam?+
Yes. As long as you haven’t attended one in a six month period, you will have to attend. If you do not attend, the employer/insurer will likely file a Petition to require that a court order be sought requiring your attendance.
Can I Settle My Pennsylvania Work Comp Case For A Lump Sum?+
Yes, if the employer/insurer is interested. The employer/insurer is not required to offer a lump sum settlement. It is a voluntary agreement between the parties. Most employers/insurers are interested in a lump sum settlement, called a “Compromise and Release”. It is highly recommended that you speak with a Pennsylvania workers’ compensation attorney before settling your case.
My Neighbor Got $100,000 for His Settlement, So I Should too, Right?+
No two cases are identical. There are so many factors that distinguish cases. For example, what’s the average weekly wage and comp rate, the age of the claimant, the diagnoses, the accepted injuries in the controlling document, is there is an IME report challenging the treating doctor’s findings, if there is litigation, who is the Judge, has an earning power been established, etc etc etc. It is a waste of time to consider what another person received for their settlement. Talk to your attorney about the value of your case, given the facts of your case.
How long will my case take?+
No. However, there may be legal consequences. If you don’t test work, the employer will likely file a petition to modify or suspend your wage loss benefits, stating that work is available within your restrictions. If your doctor says you can’t do the job, the workers’ compensation judge will ultimately have to determine if the job is something you can handle, after reviewing your testimony, the testimony of witnesses from any employer, and any testimony from your treating physician and/or an independent medical examiner. If you have been offered a job, it is highly recommended that you speak with a Pennsylvania workers’ compensation attorney.
If I Am Receiving Pennsylvania Workers’ Compensation Benefits And My Employer Offers Me A Light Duty Or Modified Duty Job, Do I Have To Accept It?+
It depends as each case is different. Some claims are short-lived, just a few weeks, because the injured worker returns to work. In other cases, the claims last much longer, sometimes even years. In terms of litigation, a petition can take up to a year or more for the workers’ compensation judge to make a final decision. You should talk to your Pennsylvania workers’ compensation attorney about your specific case.
What Do I File if My Claim Was Denied?+
You need to file a Claim Petition, but within three years of the date of injury or the claim is forever barred.
If My Work Comp Claim Is Denied, Can I Get Short Term Disability?+
If work comp denies your claim, and if you have short term disability, you can pursue that. Give the short term disability people your Denial so they know that work comp is not paying. (even if your work comp case is in litigation). If you ultimately end up with work comp benefits, then work comp may be entitled to a credit to the extent the short term disability plan was funded by the employer.
Will My Case be Via Video or In Court?+
Depends on the nature of hearing- some Judges will be going back to in-court for testimony, but may prefer video for status hearings.
Will I have to Attend Hearings?+
Yes, most likely but ask your lawyer as some hearings don’t involve any testimony.
Will My Case be heard by a Jury or Judge?+
A Work Comp Judge will be assigned to your case.
Will I Have To Testify In Court?+
A. Again, it depends on your situation. If a petition is filed, you will likely have to testify before the workers’ compensation judge. Sometimes he testifies at one deposition, or both. Your Pennsylvania workers’ compensation attorney will prepare you for your testimony in terms of what to expect.
How Should I Dress for Court?+
It’s a good idea overall to look respectable but a suit/dress isn’t required.
Will I be spied on?+
It’s possible. Depends on status of case. If your doctor and the IME doctor say you’re totally disabled, they may not waste money on this.
What Medical Evidence Will I Need?+
Depends on many factors- ask your attorney. Sometimes you will need a deposition, sometimes just a report.
Do I Need a Lawyer?+
It’s strongly encouraged. You will likely make a lot more money if you retain a lawyer.
If I Switch Law Firms During My Case, How Does That Work?+
Normally, the new firm will agree to present any litigation costs on behalf of your former law firm, so that they can get reimbursed with a successful outcome or settlement.
In terms of the fee, it depends. There may be a dispute about which firm gets paid, how much, and when. But the injured worker will only pay 20% total, so they don’t need to worry about paying one firm 20% and another firm 20% on top of that. That’s not how it works. The injured worker has a right to be comfortable with his or her lawyer, and sometimes switching firms is necessary to achieve this.
How Does My Lawyer Get Paid?+
Legal fees for injured workers in Pennsylvania are contingent. The injured worker pays nothing out of pocket to get representation — unless the firm charges for litigation costs. The standard Fee Agreement in a Pennsylvania Workers’ Compensation case is 20% of the wage loss benefits. The law does now permit a fee on medical benefits as well, but most firms are not doing this.
When Does My Lawyer Get Paid?+
The award of a legal fee will come via Court Order from the Pennsylvania Workers’ Compensation Judge. This Order can stem from one of many petitions — a Claim Petition, Penalty Petition, Review Petition, Petition to Terminate, Petition to Modify, a Petition to Suspend, and a Death Claim, etc.
Another common petition is a Petition Seeking Approval of a Compromise and Release, which is a settlement in Pennsylvania Workers’ Compensation. Without a Court Order, it’s not proper for the lawyer to get paid.
Can My Attorney Get More Than 20%?+
In most cases the answer is no.
The lawyer would need to make a showing of “good cause” as to why he or she is charging more than the standard 20%. In my 25 years of litigating Pennsylvania Workers’ Compensation cases, I’ve seen it perhaps one time. So it is very rare.
If I Lose My Case, Do I Still Have to Pay My Lawyer?+
No. If you lose, you should not be paying anything to your lawyer unless they have litigation costs that you agreed to pay in the Fee Agreement. My firm, Cardamone Law, has never gone after a client for any litigation costs. Some law firms will do this. This is the nature of a contingent fee system — if you lose, there is no fee. If you win, 20% (typically) of the wage loss benefits go to the firm who was successful for you.
Can I Receive Other Benefits While My Case is in Court?+
Yes, but there may be an offset against the Work Comp that you win/receive later.
Can I Apply for Social Security Disability While On Work Comp?+
Yes, but speak to your lawyer about the timing as that’s important.
My Job Is Protected After A Work Injury, Right?+
Not necessarily! Many people believe that just because they were injured at work, that the Employer must hold their position forever. This is not correct. If you get accepted for FMLA, you can have up to 12 weeks of job protection. But in many cases, according to the PA Workers’ Comp Laws, injured workers lose their job. If the Employer cannot accommodate the restrictions, a worker could be terminated. Or if there is an economic downtown. Or a termination can occur for misconduct, etc. There are some other issues with the ADA- but generally speaking, a work injury doesn’t mean you can’t be terminated. Now this doesn’t mean that the termination is lawful- sometimes, it’s discriminatory- i.e., retaliation for pursuing Work Comp in Pennsylvania. But a Work Injury isn’t an automatic entitlement to job security. To understand the complete extent of PA Workers Compensation Law, consult with a work comp attorney and discuss your options.
If I Receive a Job Offer While Filing or Wile on Workers' Comp, What do I do?+
Ask your attorney. A good faith attempt can help a case. But it depends on many factors.
If I Earn Money While on Work Comp, Do I have to report this?+
Yes. Tell your lawyer right away so he or she can tell the adjustor.
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