Workers' compensation is a complicated area of law covering everything from employee labor rights to the current work injury compensation act and even the injury compensation for federal employees allotted for under existing laws. A lot of wrong information is given to injured workers about workers' compensation benefits by employers, advocates, and by insurance companies regarding the numerous state and federal laws governing disabled workers, such as the Americans with Disabilities Act ADA. Workers' compensation is a specialized area of law, and only a very small number of attorneys specialize in this kind of law. Workers' compensation cases have their own Court system with their own Judges, procedures, hearings and rules. It is important to find a law firm with experience in workers' compensation cases to make sure that you receive everything you are entitled to. Things happen before you can consult a lawyer. A good lawyer can correct improper things done to your case. This article will detail some of the important factors an injured worker must be aware of following a work-related injury.
In Pennsylvania, workers are entitled to medical benefits for treatment related to the work injury if they are reasonable and necessary. The injured worker is also entitled to receive a portion of his or her lost wages, usually two-thirds of the weekly wage. In exchange for these benefits, Pennsylvania law requires that the injured worker must give up his or her right to sue the company for its negligence in causing the injury. The injured worker does not give up the right to sue any negligent person other than the employer or a co-worker.
Workers' compensation insurance companies can make it very difficult for injured workers to receive their benefits. Below, are some of the things to watch out for.
According to the Pennsylvania Workers' Compensation Act (PDF here), there are a number of time periods and dates that are very important to comply with following an injury or illness on the job. The two most important deadlines are about: 1) giving notice to your employer, and 2) the statute of limitations.
The law requires that an injured worker must give notice of his or her workers' compensation claim to the employer within 120 days following the work-related accident or the claim can be lost completely. Further, if the injured worker gives notice to his or her employer within 21 days following the work-related accident, then the injured worker may receive benefits beginning from the first day out of work. The worker must be out of work for at least seven days before being entitled to receive any workers' compensation benefits. Once the seven day period is over, the injured worker is eligible for benefits from the first day, as long as notice has been given within 21 days. If notice is given after 21 days, but within 120 days, then the injured worker receives benefits from the date of notice instead.
The second important deadline is the three year statute of limitations. This means that an injured worker only has three years to file a claim petition with the Pennsylvania Bureau of Workers' Compensation in Harrisburg. If the workers' compensation insurance company has not issued the appropriate legal documents, formally accepting the claim within that three year period from the date of the accident, then the injured worker who has not filed a petition is legally unable to obtain any workers' compensation benefits. Even though the workers' compensation insurance company may pay the medical bills for a time, this is not legal proof that the insurance company has accepted the claim. It happens often that the insurance company pays some medical bills and still denies the claim! Even if the workers' compensation insurance company writes a letter to the claimant, contacts the claimant, interviews the claimant, communicates with the claimant, or gives the claimant a claim number, none of these actions are proof that the insurance company has accepted the workers' compensation claim. The only way to be sure that the claim is accepted is if the company issues a legal document, filed with the Pennsylvania Bureau of Workers' Compensation in Harrisburg. The most common name for this legal document is a "Notice of Compensation Payable." This legal document can also be called a "Supplemental Agreement" or an "Agreement for Compensation." A trained and experienced workers' compensation lawyer will know if the workers' compensation claim has been properly accepted by the workers' compensation insurance company. If not, after three years the claim is lost.
Another trick insurance companies try is to get an injured worker to sign documents in exchange for benefits, but the documents are not appropriate and may harm your case. Also, the employer or insurance company may tell the injured worker that they must treat with the employer's physician without giving them a choice of doctors. The law states that the employer may control the injured worker's medical treatment for the first 90 days following the work accident, only if the employer has given the worker a valid list of at least six different doctors in six different practices. This list must be posted at the place of employment and must be given to the injured worker as soon as the work injury is reported. The injured worker is then required to go to one or more of the six doctors on the list. If there is no valid list of at least six different doctors, then the injured worker is free to go to any doctor of his or her choosing, and the workers' compensation insurance company must pay all related medical bills which are reasonable and necessary. The injured worker does not have to go to the employer's company doctor, or to the employer's occupational health center, such as WorkNet, Occupational Health, NovaCare, or Concentra. The injured worker must be given a choice of at least six different doctors, and otherwise, is free to go to any doctor that he or she chooses.
Often employers pressure the injured worker to return to work earlier than advisable, or even safe. If the injured worker returns too early, there could be additional injury and may even harm their right to receive workers' compensation benefits.