Workers compensation is a system that provides benefits to employees who suffer work-related injuries or illnesses, regardless of fault. In Pennsylvania, most employers are required by law to carry workers compensation insurance for their employees. If you are injured or become ill because of your work, you should know your rights and obligations under the workers compensation law in PA.
Workers’ Compensation: Reporting Injuries and Illnesses, Your Rights, and Obligations
Workers’ compensation is a type of insurance that provides benefits to employees who get injured or sick due to their job. As an employee, it is important to report any injuries or illnesses as soon as possible to your employer in order to ensure that you receive the benefits you are entitled to. Additionally, you have the right to receive medical treatment and time off work to recover, while your employer has the obligation to provide you with a safe working environment and to report the injury or illness to their workers’ compensation insurance carrier.
Reporting your injury or illness
If you are injured or become ill because of your work, you should report it to your employer as soon as possible, preferably within 21 days of the incident. If you wait more than 120 days to report it, you may lose your right to claim benefits. You should also seek medical attention for your condition and follow the doctor’s instructions.
Your employer or its insurance carrier should file a report of injury with the Pennsylvania Department of Labor and Industry within seven days of receiving notice of your injury or illness. You should receive a copy of this report and a notice of compensation payable or a notice of temporary compensation payable within 21 days of reporting your injury or illness. These notices indicate whether your claim has been accepted or denied, and what benefits you are entitled to receive.
Your employer or its insurance carrier should pay for your reasonable and necessary medical expenses related to your work injury or illness. You may have to see a doctor from a list of designated providers posted by your employer for the first 90 days of treatment, unless you have previously notified your employer in writing of your choice of health care provider. After 90 days, you can choose your own doctor, but you must notify your employer within five days of the first visit.
You should keep copies of all medical bills and receipts related to your work injury or illness. You should also keep track of any mileage or transportation costs incurred for medical appointments. You may be reimbursed for these expenses if you submit them to your employer or its insurance carrier.
Wage loss benefits
You may also be eligible for wage loss benefits if you are unable to work for more than seven days because of your work injury or illness. These benefits are based on a percentage of your pre-injury wages, subject to a minimum and a maximum amount set by law each year. For 2024, the minimum is $25 per week and the maximum is $1,200 per week.
The amount and duration of wage loss benefits depend on your degree of disability and the availability of suitable work. You may receive total disability benefits if you are completely unable to work or partially disability benefits if you can work but earn less than before. Total disability benefits can last indefinitely, unless you are found to have an impairment rating of less than 35% after two years of receiving benefits. Partial disability benefits can last up to 500 weeks.
You may be required to undergo periodic medical examinations or vocational evaluations to determine your eligibility for wage loss benefits. You may also be offered a light-duty job by your employer or a job referral by the insurance carrier. You should carefully consider these offers and consult with an attorney before accepting or rejecting them, as they may affect your benefits.
- You have the right to challenge any decision made by your employer or its insurance carrier regarding your workers compensation claim, such as a denial, modification, suspension, or termination of benefits. You can file a petition with the Bureau of Workers’ Compensation and request a hearing before a workers’ compensation judge. You have three years from the date of injury or the last payment of benefits to file a petition.
- You have the right to seek legal representation from a workers’ compensation attorney if you need help with your claim or dispute. An attorney can advise you on your rights and obligations, gather evidence, negotiate with the insurance carrier, and represent you at hearings and appeals. You do not have to pay any fees upfront, as attorneys’ fees are contingent on the outcome of your case and must be approved by a judge.
- You have the obligation to cooperate with your employer and its insurance carrier in the administration of your workers’ compensation claim. This includes reporting your injury or illness promptly, attending medical appointments and evaluations, providing accurate information about your condition and earnings, and complying with treatment recommendations.
- You have the obligation to notify your employer or its insurance carrier of any changes in your status that may affect your benefits, such as returning to work, receiving other income, moving to another address, or settling a third-party claim. You should also keep copies of all documents and correspondence related to your workers’ compensation claim.
- You should act in good faith and avoid any fraud or abuse of the workers’ compensation system. Fraud is a serious offense that can result in criminal prosecution, fines, imprisonment, restitution, and forfeiture of benefits.
Workers’ compensation law in PA is designed to protect workers who are injured or become ill because of their work. However, the system can be complex and confusing, and you may encounter difficulties or disputes with your employer or its insurance carrier. If you need assistance with your workers’ compensation claim, we recommend that you contact a workers’ compensation attorney who can help you understand your rights and obligations, and fight for the benefits you deserve. At our law firm, we understand the importance of having a knowledgeable and skilled attorney on your side during this difficult time. We recommend checking out RG Injury Law, as we have a team of experienced attorneys who can guide you through the legal process and help you get the compensation you deserve.