If an employee is injured at work, they may be able to file a claim with their employer’s Workers’ Compensation insurance. These benefits may help injured employees make ends meet while they recover from injuries. If you are hurt at work, you should talk to an attorney about how to file a Workers’ Comp claim.
Generally, only those considered “employees” may be eligible for Workers’ Compensation. This typically includes most workers, although certain individuals, such as independent contractors, are excluded. If you are eligible, you must report the injury to your employer right away. The longer you wait, the harder it may become to file a claim. Your employer should notify the insurance company of the injury, and it may determine whether to approve or deny the claim. Potential benefits may include compensation for lost wages, medical costs, and possibly more.
For a free case review to begin your claim, call our Certified Pennsylvania Workers’ Compensation Specialists at Cardamone Law at (267) 651-7945.
Who is Eligible for Workers’ Compensation?
Under the law, Workers’ Comp benefits are available to employees injured on the job. This covers many workers, but certain people, such as independent contracts, may be excluded.
There is sometimes confusion surrounding whether an injured worker is a covered employee or an ineligible independent contractor. In some cases, injured workers file claims believing they are employees, only to discover that their employer has misclassified them as an independent contractor. This could be a mistake or an intentional act meant to help the employer save money on insurance. Either way, you should contact an attorney for help.
Employees are covered by Workers’ Compensation beginning on their first day of work. If your employer tells you that you are ineligible for a certain period of time (e.g., a probationary period), that is incorrect, and you should seek help from a lawyer.
When to Apply for Workers’ Compensation in Upper Saucon Twp
When dealing with a Workers’ Comp claim, it is best to act as fast as possible. You should report your accident and injuries to your employer as soon as possible, preferably immediately. Your employer should then notify the insurance company and begin the claim process.
According to § 311 of The Workers’ Compensation Act, you must notify your employer of your injuries within 21 days of the accident. Otherwise, you cannot begin to receive compensation. If you wait longer than 120 days after the accident, your claims might no longer be valid, and the insurance company might not have to pay any compensation.
If your injury is not related to a progressive disease or illness, the time limit for reporting the accident may be more relaxed. This may come up if you become ill because you were exposed to toxic or hazardous materials at work.
Possible Workers’ Compensation Benefits
Benefits under Workers’ Compensation in Pennsylvania typically include compensation for a portion of your lost earnings and medical costs for your injuries.
Medical Benefits
Medical bills are known for being expensive. Even somewhat minor injuries often require expensive treatment. If your work-related accident is serious, your medical costs might be far more than you can afford.
Workers’ Comp does not limit how much compensation you may claim for medical costs. If your treatment is very expensive, you may claim substantial compensation. However, suppose the insurance company questions whether certain treatments were medically necessary for your recovery. In that case, it may challenge them and request a utilization review, and our Certified Pennsylvania Workers’ Compensation lawyers should be prepared to show that your treatment was medically necessary.
Wage-Loss Benefits
Under the law, eligible employees may receive up to two-thirds of their average weekly wage as compensation if they are not working at all or two-thirds of the difference between their pre- and post-injury average weekly wages if they are working to some extent.
Keep in mind that this compensation is subject to certain caps and limitations. You may not receive more than the statewide average weekly wage, which is adjusted each year. You may not receive less than one-half the statewide maximum or 90% of your average weekly wage, whichever is lower.
Specific Loss Benefits
You may also receive compensation for specific losses and injuries. Benefits may be worth up to two-thirds of your average weekly wage. You must receive no less than one-half of the statewide average weekly wage.
You may receive benefits for conditions including amputations, total loss of a function, significant facial scarring or disfigurement, lost hearing, and lost vision.
When Workers’ Compensation Benefits May Change or End
You may continue to receive compensation for as long as your injuries prevent you from working. However, your benefits might be terminated or your status could change under certain circumstances.
You may continue to receive the benefits mentioned above for as long as you are unable to work. After 2 years of receiving benefits, you may be asked to undergo an Impairment Rating Evaluation (IRE). If the IRE determines that your whole-body impairment rating is under 35%, you may be switched to partial disability benefits. Your rate does not actually change until you return to work. Once on partial disability, you may only receive up to 500 more weeks of benefits.
The Process of Applying for Workers’ Compensation in Upper Saucon Twp
You may be approved for benefits if the insurance company accepts liability for your claim. Alternatively, you might be approved for temporary benefits while the insurance company investigates your case further for up to 90 additional days.
If your claim is denied, you may have to litigate the case until you are approved for benefits. To begin this process, you must file a Claim Petition with a Workers’ Comp Judge.
Do I Need a Lawyer to Apply for Workers’ Compensation?
Legally, you are not required to have a lawyer when you file for Workers’ Comp. However, having a lawyer may significantly help you, especially if the insurance company is hesitant to approve your claims or otherwise pushes back on you.
If your claim is denied, your lawyer may immediately get to work on filing a Claim Petition. They should have the knowledge and experience to determine what information and paperwork are needed to start the appeal as quickly as possible. Additionally, your attorney may cover costs of things you cannot afford on your own, like medical exams and depositions needed as part of your claim.
Your attorney can also try to help you receive all the benefits to which you are entitled.
Can I File an Injury Lawsuit if I Apply for Workers’ Compensation?
Generally, injured employees who are eligible for Workers’ Compensation may not sue their employers, even if their employers are responsible for the accident. Workers’ Comp is the sole legal remedy against an employer, and a personal injury lawsuit is prohibited, barring special situations.
You are, however, free to sue third parties if they were responsible for your accident. For example, if you were injured because of faulty equipment at work, you may sue the manufacturer for producing dangerously defective tools.
You can file a lawsuit after recovering Workers’ Compensation benefits, though you may need to pay back the Workers’ Comp carrier for certain damages so that you do not recover the money twice.
Call Our Upper Saucon Twp Workers’ Compensation Attorneys for Help Today
For a free case review to begin your claim, call our C Workers’ Compensation lawyers at Cardamone Law at (267) 651-7945.
