Many Highmark employees are hands-on with patients. That exposes them to a surprisingly high risk of injury, and on-the-job injury claims should be brought against your employer in most cases.
When you get injured at work, get medical care, then notify Highmark of your injuries to start the claims process. Ongoing care may need to be provided by Highmark’s chosen providers within the first 90 days of care. If Highmark denies your initial claim, we can escalate the claim with a Claim Petition filed with the Workers’ Comp Office of Adjudication.
For your free case review, call Cardamone Law’s Certified Pennsylvania Workers’ Compensation Lawyers at (267) 651-7945.
What Highmark Employees Can File for Workers’ Comp?
All employees working for Highmark in Pennsylvania should be covered under their Workers’ Compensation policy. This can include
- Nurses
- Technologists
- Support staff
- Clinical care staff
- Administrators
- Sales
Essentially, anyone who is employed at the company has a risk of injury, and Workers’ Comp should cover it. Jobs like nurses and support staff who actually interact with patients have a higher risk of injury than, say, an in-house accountant, but all are covered.
What Kinds of Injuries Can You File For?
To file your claim, you need a “work-related” injury. This can include any accidental injuries.
Work-Relatedness
Injuries are work-related if either of these is met:
- The injury occurred because of dangerous working conditions.
- The injury occurred in the course of your job duties.
In either case, the accident should be considered work-related and get coverage.
Examples
Common examples of injuries include back injuries from lifting or moving patients, injuries from machinery used at work, or an injury from a slip and fall in your workplace.
Fault
It does not matter who was at fault for the injury, as long as it was accidental. This means you can file a claim if you caused the accident yourself, if your employer caused it, a coworker caused it, or some third party caused it.
Workers’ Comp Filing Process for Highmark Employees
The process of filing a Workers’ Comp claim is as follows. You should, however, always call our Lehigh Valley, PA Workers’ Comp lawyers first to see that you have advice and help throughout the process.
Get Medical Care
First and foremost, get care to treat your injuries. If your injuries go untreated and undocumented, it is harder to show they happened at work, and failing to get care could make you responsible for the worsened condition.
Report Your Injury
Injured employees give notice of their injury to their employers within 21 days to start the claims process. The employer will then file an insurance claim and respond to your claim. You may still file a claim within 120 days of the injury, but this delays things drastically.
Their response must come within 21 days of your filing, at which point they can accept the claim, deny you, or accept it temporarily and extend their investigation.
File a Claim Petition
Once your claim is denied (or if your employer never responded within 21 days), you can file a Claim Petition with the Workers’ Comp Office of Adjudication and get the case assigned to a Workers’ Comp Judge (WCJ).
You should have a lawyer on your side by this point. The Claim Petition is a complex document that involves a lot of information the judge needs to decide your case. Inaccuracies or missing info can be a big problem.
Continue Getting Care
You must keep treating your injuries to remain eligible for your claim. If you stop getting care, it can be seen as rejecting care and hurt your claim.
Settlement
Your claim can be settled at any time if Highmark is willing to pay your claim. Settlement agreements must be approved by the WCJ, and you should always review them with a lawyer and have your lawyer negotiate on your behalf.
Settlements come in different forms, so always work with your lawyer to understand what form is best for you: Should you settle everything or leave the medical costs open? Should you take a lump sum or a structured settlement? Etc.
Workers’ Comp Hearing
If the case is still contested, we can progress through evidence collection (medical reports, witness depositions) and take the case all the way to a hearing. At the hearing, the WCJ will accept all evidence and testimony, then go back to decide the case.
Hearings may last one day or more than one.
FAQs for Highmark Employees Filing for Workers’ Comp
What Benefits Can I Get?
Most injury claims deal with benefits for medical care, lost wages, and sometimes for specific loss injuries. Specific loss covers additional compensation for listed permanent injuries.
Amounts depend on your claim and are subject to caps and floors for wage-loss benefits and specific loss benefits.
Can I Sue for Work Injuries?
Workers’ Compensation is known as the “sole remedy” for work-related injuries, but that is only for claims against your employer. If you have a claim against an outside third party, you can sue them for causing your injury:
- Customers/patients
- Product or equipment manufacturers
- Drivers
- Property owners
However, you need to prove fault when you sue these parties, something you do not have to do in Workers’ Comp claims.
What Damages Are Covered in Lawsuits?
Lawsuits also seek medical bills and lost wages. However, the rate of lost wage coverage can be higher. Lawsuits also cover pain and suffering, something that is not covered in Workers’ Comp.
If you get paid the same damages twice, your employer is allowed to “subrogate” your lawsuit and claim back the money they already paid you. This prevents you from being paid twice and encourages employers to pay Workers’ Comp claims, knowing they can still get paid back if an outside party was at fault.
Call Our Workers’ Comp Lawyers in Pennsylvania Today
For your free case review, call Cardamone Law’s York, PA Workers’ Compensation lawyers at (267) 651-7945.
