Workers’ Compensation Frequently Asked Questions
We help clients with workers’ compensation claims receive all possible benefits. Our clients often have questions, such as:
- What is workers’ compensation?
- How do you know if you need an attorney?
- What should a worker do after getting injured on the job?
- What injuries, diseases or illnesses are covered by workers’ compensation?
- Can you be fired by your employer for applying for workers’ compensation?
- Can you choose your own doctor or hospital?
- How do you pay for an attorney to represent you in a workers’ compensation claim?
- What is the statute of limitations regarding the filing of a workers’ compensation claim in Pennsylvania?
- Is it possible for you to receive a lump-sum settlement if you are found to be permanently and totally disabled from further gainful employment?
- Can my employer try to terminate my workers’ compensation benefits?
- Will a pre-existing problem, like arthritis, prevent me from getting workers’ compensation benefits?
- What is an IRE?
- Do I need to attend a Vocational Exam?
Contact us when you need help with a workers’ compensation claim
Find out how we can help with workers’ compensation claims in Philadelphia. Arrange a free consultation for legal help with your claims. Call 215-568-7500 or contact Pond Lehocky Stern Giordano online.
The Pennsylvania Workers’ Compensation Act was created for workers injured on-the-job, or who develop a work-related illness that prevents them from working. Benefits include wage loss compensation and paid medical expenses until workers can return to work. These benefits are generally paid by employers through a private insurance company, the State Workers’ Insurance Fund, or by the employers themselves if they are self-insured. Employers in Pennsylvania are required to maintain workers’ compensation.
Serious work-related injuries or illnesses and the litigation process are all situations that generally require legal representation. If you are injured, or have contracted a work-related illness, or believe you have been treated unfairly, contacting an attorney is in your best interest. You are permitted to represent yourself in court and in front of a judge. However, this is ill-advised because the employer and its insurance company will undoubtedly be represented by an experienced workers’ compensation attorney, putting you at a severe disadvantage. Even if your case is not before a judge, it may be wise to contact an attorney to help you navigate the difficult process of dealing with the insurance company, which often provides you with little, incorrect or conflicting information.
It is extremely important to report your injury to your supervisor or employer IMMEDIATELY. You must include the date, time, and circumstances of your injury. As long as you were not doing anything illegal, your injury is covered, so do not hesitate to report such an injury—even if you feel it may be your fault. Job-related illnesses such as mesothelioma and repetitive trauma injuries such as carpel tunnel syndrome that occur over time must be reported as soon as a diagnosis has been obtained and you learn that the injury or condition is related to your employment.
Generally, injuries, illnesses and diseases caused by your work are covered from the first day of employment. Some time limitations may apply to lung diseases. Not covered are self-inflicted injuries or those caused by intoxication or violation of the law including the use of illegal drugs. Repetitive trauma, or over-use injuries are covered by workers’ compensation.
No. It is against the law for an employer to fire workers simply because they have filed a workers’ compensation claim. However, if you are on disability for an extended period of time, there is a chance you may be replaced and your job will not remain available for you. Employers are not required to hold your job for you while you recover, although some do. In such a case, you may be eligible for unemployment benefits if you are not receiving workers’ compensation benefits.
This depends. If your employer posts the names of at least six doctors in your workplace and requires you to sign a Panel Acknowledgment stating that you will treat with these doctors, you must do so for 90 days. The Panel Acknowledgment must be signed when you were hired and immediately following your injury. Absent these circumstances, you are free to treat with a doctor of your own choice. No matter what, you are always allowed to treat with the doctors of your own choosing beyond 90 days. Aside from the panel doctors, your employer may require you to attend a physical by a company-designated doctor up to two times per year.
Many attorneys handle workers’ compensation cases for a percentage of the lump sum offered to settle the case. Your attorney will not get paid unless you get paid. Whatever the arrangement, your fee agreement with your lawyer must be approved by the judge or Workers’ Compensation Appeal Board handling your case.
You must report your injury to your employer within 120 days. After that, you become ineligible to receive benefits. If you inform your employer of your injury within 21 days, you can be awarded benefits as of the date of your injury. Beyond 21 days, you can only be awarded benefits as of the date you report your injury. Keep in mind that there may be some circumstances where you are not even aware you have an injury, such as carpal tunnel or a serious illness. In these circumstances, it is important to report your condition as soon as your doctor gives you a diagnosis and relates it to your employment. You have three years from the date of an injury to file a Claim Petition if your claim is initially denied.
Yes. Settling your case for a lump sum takes careful consideration and a variety of factors must be analyzed. You and your attorney should and will go over what to consider when contemplating settlement. Retroactive payment after winning a disputed claim may also be in the form of a lump sum, plus interest, and weekly benefits thereafter.
You may be entitled to a specific loss award if you have permanently lost the use of an appendage such as finger, toe, hand, arm or leg, loss of hearing or sight, or disfigurement. A specific loss award is paid in a lump sum.
Yes. Under the Pennsylvania Workers’ Compensation Act, your employer may file a petition to terminate your right to workers’ compensation benefits, if it can show that you are no longer disabled or that any remaining disability is unrelated to the injury. Your employer can win a termination of benefits if its medical expert offers testimony that you are fully recovered, that you can return to work without restrictions, and that there are no medical findings to support your complaints of pain.
No. Under the Pennsylvania Workers’ Compensation Act, even if you had a pre-existing problem, such as arthritis, you may receive benefits if you can show that an aggravation, re-activation or acceleration of the condition occurred as a result of your job duties or the work incident.
If you are receiving workers’ compensation benefits, your employer may require you to attend a medical examination with a doctor of its own choosing. One type of examination is known as an Impairment Rating Evaluation (IRE), which can be requested up to two times within a 12 month period. If you refuse to attend, you may lose your right to receive benefits until you attend.
IREs are guided by the AMA Guides to the Evaluation of Permanent Impairment, which instructs that permanent impairment may only be rated after the status of Maximum Medical Improvement (MMI) is attained. MMI is defined as the point in a the recovery process where no formal medical or surgical intervention is expected to bring about any improvement to the injured worker’s condition.
An employer can hire a vocational counselor to show that you are capable of performing some type of work, although you are injured. Your employer can use the opinions of the vocational counselor to suspend or reduce your workers’ compensation benefits. If you receive a request to meet with a vocational counselor, contact Pond Lehocky Stern Giordano immediately to determine what your rights and obligations are as they relate to this process.