Injuries at work can leave you unable to return to work, whether temporarily or permanently. This takes away your income and makes it hard to afford the care you need.
Fortunately, Workers’ Comp is designed to help workers in your exact situation. But getting the compensation you need can be difficult if employers and insurance carriers deny your claims. Our lawyers can stand up for you and fight to get your benefits approved.
Call the Certified Pennsylvania Workers’ Compensation Specialists at Cardamone Law for a free case evaluation at (267) 651-7945 today.
When Can You File for Workers’ Comp?
Workers’ Comp is available to any employees who suffer a work-related injury that leaves them disabled. This gives us three requirements to explore:
Employees
Workers’ Compensation covers employees but not independent contractors. This means your employer has to cover you if your work is controlled on a daily basis (your hours, the manner of work, where you work).
Just because your employer calls you an independent contractor does not mean you are legally a contractor, so always review your case with a Workers’ Compensation attorney instead of relying on your employer’s classification.
Work-Related Injury
An injury that occurs within the scope of your general work duties should qualify as a “work-related injury.” Virtually all work-related injuries should be covered, whether they were from a single accident, repetitive stress/repetitive use, or even an illness obtained over time from work conditions.
There are a few exceptions where intentional injuries and accidents caused by drug use, illegal activity, or alcohol are not covered.
Your work duties might take you on the road, and injuries outside the workplace can also qualify if you were still performing your job, e.g., while driving to a work site, while on a work errand, or while at a lunch meeting.
Disability
An injury is eligible for medical benefits as long as it happened at work, but wage-loss benefits are only paid if the injury leaves you disabled for over 7 days. This covers both partial disabilities and total disabilities, meaning that you can get coverage for a reduction in wages as well as a total inability to work.
Often, whether you are disabled and to what extent will be a core fight in your case.
What is the Process for Filing a Workers’ Compensation Claim in Jenkintown?
If your injury happened at work, you start your case by reporting it and getting medical treatment. Once you report your injury, your employer files a claim with the insurance carrier, but the employer/carrier will usually deny this claim.
Filing a Claim Petition
The medical records and doctor’s reports from your care can help us show your injury was indeed work-related, supplying the evidence to combat your employer’s denial. You can have your case reheard by filing a petition in court.
Collecting Evidence
When you file a Claim Petition with a Workers’ Comp Judge (WCJ), there may be other medical exams and evidence collection to undergo. Our attorneys can help you understand what evidence you need and help obtain it.
Workers’ Comp Hearing
From there, there is a hearing before the WCJ to determine your disability status and whether your injury was indeed work-related. If all goes well, they will grant you benefits.
Settlement
Instead of waiting for a hearing, you can also negotiate a settlement with your employer, where they will pay all benefits at once instead of paying over time. Work on this with your lawyer instead of settling on your own. These settlements usually need approval from the WCJ either way.
Appeals
Lastly, if your case is denied, you can appeal it.
Levels of Appeal for Workers’ Comp Claims
In Pennsylvania’s Workers’ Comp system, the employer makes the initial denial. We can “appeal” this, in a way, by filing a claim petition before a WCJ. If this judge denies your case, there are three potential stages of appeals:
WCAB
The Workers’ Compensation Appeal Board (WCAB) consists of commissioners and lawyers appointed by the Governor as part of the Pennsylvania Department of Labor and Industry. They assign cases to WCJs and decide appeals from those WCJ decisions.
Appeals must be filed within 20 calendar days of the denial.
Commonwealth Court
The Commonwealth Court is a state-wide appeals court that hears appeals about regulatory court decisions, which includes Workers’ Comp claims. At this level, cases are reviewed for legal errors that the WCAB might not have caught, and cases may become precedent for future claims.
Pennsylvania Supreme Court
If the Commonwealth Court still denies your case, you may appeal it to the state Supreme Court, but they do not have to accept the appeal. If they think the case was properly decided or have no legal rulings they think they might make in your case, they can leave the lower court’s decision in place and deny hearing.
When Do I File My Workers’ Comp Claim?
You must report work injuries to your employer within 21 days of the injury, though you can technically wait up to 120 days and still file your claim. However, waiting is never good, as it means more time goes by without getting the benefits you need.
After the claim is denied, you can file your Claim Petition in court within 3 years of the injury.
When Do I Get Benefits Paid?
Employers must decide whether to grant or deny benefits within 21 days of your initial claim. However, they can also grant benefits on a temporary basis, then give themselves 90 days to take them away again without being locked into the initial determination.
After that, benefits typically will not start until the court orders them to pay or the case settles. From the date you file your claim, petitions are often resolved and benefits are started within around 45 days, but some cases are quicker or longer.
When benefits are paid, they usually come as weekly checks or biweekly checks if you got paid that way before your injury.
How Long Can I Get Benefits For?
Total disability benefits can last as long as you remain disabled. However, they do not increase for inflation or cost of living, and staying on flat-rate benefits forever can be a burden.
If you are on partial benefits and can work to some extent, those benefits last for a total of 500 weeks, which do not need to be consecutive.
Call Our Workers’ Comp Lawyers Today
For your free case evaluation in Jenkintown, call Cardamone Law’s Workers’ Compensation lawyers at (267) 651-7945.
