Nearly every Pennsylvania worker is entitled to coverage under the state Workers’ Compensation Act for job-related injuries and illnesses. Unfortunately, employers and insurance companies sometimes try to prevent workers from obtaining the benefits they deserve.
All Pennsylvania workers – even those who have never been injured – could benefit from understanding the basics of the state’s workers’ comp law. Here are the answers to some frequently asked questions:
Who is covered? Nearly every employee is covered, even those who work for part-time or for very small employers. However, some workers, like railroad employees, longshoremen, agricultural workers and domestic employees, are covered under other laws.
What injuries are covered? Workers are entitled to coverage for injuries, illnesses or diseases related to their employment. It is not necessary for the injury to be caused by the employer’s negligence.
Are there any injuries that are not covered? Intentionally self-inflicted injuries are not covered, nor are injuries that result from an employee’s violation of the law or use of illegal drugs. In some cases, injuries related to an employee’s intoxication may also not be covered.
Is there a waiting period for coverage? No. Workers’ compensation coverage starts on the first day of employment.
Do I have to make an injury report? Yes. Report an injury or illness to your employer or supervisor as soon as possible. In your notice, you must state the date of injury and you must state that your injury or illness is work related. Once you miss a day of work, your employer will turn in a report to the state.
What if my employer denies my claim? You have a right to appeal your employer’s denial. If you haven’t already talked with a Workers’ Comp attorney, do so as soon as possible after your denial.
What benefits can I recover? You are entitled to coverage for all reasonable surgical and medical services related to your injury, as well as medicine, orthopedic appliances and other supplies for as long as they are needed. In addition, you are entitled to wage-replacement coverage if you have to miss work or take a lower-paying job.
Can I choose my own doctor? Sometimes. An employer does have the option to post a list of six or more physicians and require employees to choose from that list for the first 90 days. Your employer cannot direct you to a specific provider. If your employer does not provide a list, you are free to choose your own doctor.
What are the wage loss benefits? You are entitled to approximately two-thirds of your average weekly wage, subject to a statewide cap on wage loss benefits. For 2012, the maximum weekly compensation rate is $888.000. Workers who receive relatively low pay may be entitled to more than two-thirds of their average weekly wage. You must be off work for seven days before you become eligible for wage loss benefits.
When do I have to go back to work? If your doctor clears you to return to work, you must go back. Further, if your employer offers you light-duty work within your restrictions, you must accept that work or risk losing your benefits. You do have a right to appeal a determination that you should return to work.
Philadelphia Workers’ Compensation Lawyers: Advocating for the Rights of Injured Workers in Pennsylvania
This is only a broad overview of the issues that may arise in a Pennsylvania Workers’ Compensation case. If you have been injured in an on-the-job accident or stricken with a work-related illness or disease, talk to a Philadelphia Workers’ Compensation lawyer who can help you understand your rights. Call McCann Dillon Jaffe & Lamb, LLC today at 215-569-8488 or 302-888-1221, or contact us online.