Frequently Asked Workers' Compensation Questions

Do you know the first step you should take when you’re injured at work?

Workers' compensation laws protect people who are injured on the job. In the legal world, understanding the complexity of legal jargon and terminology can really throw you through a loophole, especially when faced in a legal predicament. Whether you’re just looking to educate yourself on your rights as a working American or stuck in a tricky legal battle, you shouldn’t have to face the stresses of learning a whole dictionary of workers’ compensations terms which could make or break your case.

As a citizen, it is imperative to familiarize yourself with the system of workers' compensation. As an employee in the United States, you probably have some questions pertaining to whether or not you’re eligible to receive workers’ compensation and which situations would entail you to receive compensation. If you thought a pre-existing condition, or any injury where you were the one at fault, would prevent you from receiving workers' compensation, read on!

What is Workers' Compensation?

Workers’ compensation is a state-mandated insurance program that provides compensation to employees who suffer job-related injuries and illnesses. While the federal government administers a workers’ compensation program for federal and certain other types of employees, each state has its own laws and programs for workers’ comp.

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.

In general, an employee with a work-related injury or illness can get workers’ compensation benefits regardless of who was the one at fault, whether the employee, the employer, a customer, or a third party.

Are all on-the-job injuries covered by workers’ compensation?

Workers' compensation covers most, but not all, on-the-job injuries. The workers' compensation system is designed to provide benefits to injured workers, no matter the circumstance. Generally, injuries that happen because an employee is intoxicated or using illegal drugs are not covered by workers' compensation and coverage may also be denied in situations involving:

  • Self-inflicted injuries (including those caused by a person who starts a fight)
  • Injuries suffered while a worker was committing a crime 
  • Injuries suffered while an employee was not on the job

Does workers’ compensation cover long-term problems?

Your injury does not need to be caused by an accident (such as a slip or fall) to be covered by workers' compensation. Many workers receive compensation for injuries that are caused by overuse or misuse over a long period of time (for example, repetitive stress injuries that can result over time from excessive sitting or computer work).

You may also be compensated for some illnesses and diseases that are the gradual result of work conditions, such as heart conditions, lung disease, and stress-related problems.

Can I still sue my employer for my injury?

Employees cannot sue their employers in the event of a work-related injury. When Pennsylvania workers' compensation was established in 1915, Pennsylvanians gave up the constitutional right to sue for damages after a work injury. In return, they were guaranteed payment for lost wages and medical expenses, while their employers were freed from the ramifications of varying settlement amounts.

Are there any circumstances in which I couldn’t receive workers' compensation?

Generally, if you are injured either on your way to or coming home from work, you are not covered by the Workers’ Compensation Act. However, if your job requires you to travel, you have no fixed place of employment, or you are under a contract that covers you while on your way to and from work, you may be covered.

Are Workers’ Compensation Benefits Taxable?

Workers' compensation benefits in Pennsylvania are not considered taxable income. For federal income tax purposes, workers’ compensation awarded under a workers’ compensation act or statute due to work-related sickness or injury are fully exempt from tax. A workers’ compensation attorney can help you throughout every step of the process. As soon as an injury occurs, you should contact a workers’ compensation attorney. 

Is there an exception to the tax-exempt status? 

If the injured worker receives Social Security Disability Insurance (SSDI) in addition to workers’ compensation, he or she may end up paying taxes. If your workers' comp and SSDI benefits exceed 80 percent of your average current earnings before you became disabled, then you would experience an offset.

The taxable amount of your workers' comp benefits would be equivalent to the amount that Social Security reduces your SSDI payments. For example, if your SSDI benefits were reduced by $300, then $300 of your workers' comp benefits are now taxable.

Most people who receive both workers' comp and SSDI benefits do not have enough to owe federal taxes. 

What are average current earnings?

Your average current earnings are determined using a formula from the Social Security Administration. The sum is typically calculated as:

  • the average monthly wage used to calculate your benefits, OR
  • one-sixtieth of your total wages for your highest-earning five consecutive years, OR
  • one-twelfth of your total wages from your highest-earning year out of the preceding five 

The formula the Social Security Administration will use to determine your average current earnings depends on your individual circumstances.

Examples of a workers' comp offset

Susan’s average current earnings amount to $3,000. She qualifies for $2,000 in SSDI benefits and receives $800 per month in workers’ compensation. Her total benefits equal $2800 per month.

She would experience an offset because her total monthly benefits exceed 80 percent of her average current earnings (80 percent of $3,000 = $2,400). In most states, Susan’s SSDI benefits would be reduced by $400 so that she does not exceed 80 percent of her average current earnings ($2,800-$2,400= $400).

Susan would be taxed on $400 of her $800 per month workers’ comp benefits because her SSDI benefits were reduced by $400. Her final totals would be $800 in workers’ comp ($400 of which would be taxable) and $1600 in SSDI benefits.

Returning to work and taxation 

Some injured workers have the ability to return to work on a light duty job. For example, if a police officer broke his leg and suffered severe bruising while on patrol, he may be able to return to work at a desk job. The police officer can still collect workers’ compensation benefits and wages while performing light duty. Any wages received from the job would be taxable. The workers’ compensation benefits would not be taxed.

Can a workers' compensation attorney help me reduce my taxable income?

An experienced workers' compensation attorney can structure your workers' comp settlement in a way that minimizes any offsets to your benefits and reduces your taxable income. Most people do not have to pay taxes on their workers' compensation payments, but other forms of income may impact your taxable income.

It can beneficial to contact an attorney to see how SSDI or other benefits could affect your workers' compensation payments. 

Can A Workers’ Compensation Attorney Help Me Reduce My Taxable Income? 

Yes, and a workers’ compensation attorney can help you throughout every step of the process. Moreover, an experienced workers' compensation attorney may be able to structure your workers' compensation settlement in a way that minimizes the offset and reduces your taxable income. Thus, while a portion of your workers' comp may considered taxable income, in practice the taxes paid on workers' comp are usually small or non-existent.

As soon as an injury occurs, you should contact a workers’ compensation attorney. There may be a lot of confusing and misleading information provided by the insurance company, and an attorney can ensure that your rights are protected. There is no fee unless your case is won. All fees must be approved by a judge.

You can also contact an attorney if your employer/insurance company attempts to stop or modify your workers’ compensation benefits.

What is an IRE?

If you are receiving PA workers’ compensation benefits, your employer or its insurance company may require you to attend a medical examination with a doctor of its own choosing. One type of special medical examination is known as an Impairment Rating Evaluation (IRE), which can be requested up to two times within a 12 month period after you've been receiving benefits for 104. This exam is similar to an Independent Medical Examination, but its purpose is to try and limit your workers' compensation benefits. 

According to a recent decision in workers' compensation law, the IRE process was deemed unconstitutional. As a result of this ruling we are denying ALL IRE requests. Injured workers should not be subjected to unlawful exams that may negatively affect their workers' compensation benefits. 

What happens during an IRE?

During an IRE, a doctor applies the American Medical Association's (AMA) guidelines to determine if the injured worker is more than 50 percent disabled. If the doctor concludes that the worker is less than 50 percent disabled, then the injured worker's benefits are capped at 50 weeks. 

Doctors have been using the current 6th addition of the AMA's guidelines for evaluation. The recent court case determined that use of the 6th edition is unconstitutional because the guidelines were developed by a private company (the AMA) and not by a state agency, and because the guidelines haven't been reviewed in nearly two decades. It is a violation of the constitution to give a private company the authority to determine how injured workers are evaluated under the law with no government oversight.

What Should A Worker Do After Getting Injured on the Job?

It is extremely important to report your injury to your supervisor or employer IMMEDIATELY after your injury, even if it doesn’t cause you to miss work or seem that bad. When reporting, 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 your injury—even if you feel it may be your fault. Job-related illnesses such as mesothelioma and repetitive trauma injuries like carpal 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.

It is suggested that you give notice be given writing, as you must report that you were injured and that your injury was caused by your job. If you develop an occupational illness over time that can be related to your job, you should report it as soon as you receive a doctor's diagnosis. Injuries must be reported to your supervisor or the person whose job it is to prepare injury reports. 

How much time do I have to report an injury?

You must report your injury within 120 days; after this time is up, you become ineligible to receive benefits. If you do inform your employer of your injury within 21 days, you can be awarded benefits as of the date of your injury, but beyond 21 days, you can only be awarded benefits as of the date you report your injury.

What happens if my injury is gradual? 

There may be some circumstances where you are not even aware you have an injury, such as carpal tunnel or even an injury with no initial symptoms. 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.

Can I choose my own doctor for treatment?

You are ALWAYS free to treat with your own doctor, and we recommend it. The only instance in which you must see an employer-provided doctor is if specific conditions are met. Majority of the time, employers do not meet these conditions. They must have had you sign a document called a panel acknowledgement when you were hired, if any changes were made, and immediately after your injury. They also need to provide a list of physicians. It must contain at least six providers and three of these six providers must be physicians. After the 90 days though, you are free to treat exclusively with your doctor. 

Even if your employer did meet the conditions above, you can still treat with your own doctor, but you may have to pay out-of-pocket for their service. 

Will A Pre-Existing Condition Prevent Me From Getting Workers’ Compensation Benefits in PA?

A pre-existing condition will not prevent you from getting workers’ compensation benefits in Pennsylvania. 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. As soon as you receive a written diagnosis from your doctor, report your work injury.

The Workers’ Compensation Act applies to ALL injuries or occupational diseases occurring during the course and scope of employment and which are related to that employment. The Act applies to all Pennsylvania injuries and even injuries occurring outside of Pennsylvania under certain circumstances (such as travel).

What if your employer refuses to file an accident or incident report for your injury?

If your employer refuses to complete an injury report on your behalf, you may file a claim petition for workers' compensation payments. You will need to go to a series of hearings with a workers' compensation judge.

While you are not required to have an attorney with you at the hearing, it is highly recommended. The workers' compensation process can be very confusing, with opportunities to be mistaken at every turn. 

What if my claim was denied?

If you were denied workers' compensation benefits even though you know that you're too hurt to work, you need to contact a lawyer right away.

There are many situations in which your workers' compensation claim may be denied even though you're still too hurt to go back to your job. If you were denied workers' compensation benefits even though you know that you're too hurt to work, you should contact a workers' compensation attorney immediately.

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?

Most minor to moderate injury cases are settled with a lump-sum payment to the injured party, or a type of settlement that offers one large amount rather than weekly payments for lost wages. You can also negotiate a lump sum settlement rather than continuing to receive weekly permanent disability payments. In addition to future amounts, the insurance company will owe you for permanent disability payments and medical care. You can also settle any disputed amounts, past-due temporary disability payments, and unreimbursed medical expenses.

You can also negotiate an agreement for a structured settlement in which you’ll receive payments over a period of time. In these cases, you don’t need to give up all of your future rights to medical care.

Estimating the value of a settlement is more complicated if you are on permanent total disability. This is because, if you are on permanent total disability, your weekly benefits might continue for decades. Thus, estimating the settlement value has to take into account the present value of your future entitlement to benefits.

Why would I want a lump-sum settlement? 

Some people prefer to settle their workers’ compensation claims for one large payment rather than weekly checks. It’s also crucial to have an attorney when trying to settle your case for a lump sum so you know you’re getting the true amount your case is worth. If you are on permanent total disability and do not have a lawyer, you shouldn’t settle your case without speaking with a lawyer.

Settling your case for a lump sum takes careful consideration and a variety of factors must be analyzed. You and your attorney 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.

What if the injury does permanent damage? 

You may be entitled to a specific loss award if you have permanently lost the use of an appendage. Loss of hearing or sight are compensable, as well as disfigurement.

Specific loss benefits are payable if you suffer an amputation or loss of use of various body parts, such as fingers, hands and toes. If you suffer a loss of hearing or vision, you are entitled to be paid specific loss benefits also. Any permanent or serious disfigurement (scars) of your head, neck or face, entitles you to receive specific loss or scarring benefits. Payment for specific loss benefits are equal to your total disability benefit rate for the time period and the healing periods.

Can You Choose Your Own Doctor/Hospital?

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 have been 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.

What’s the Selection of Healthcare Providers Like?

During the 90 days, you may select any of the choices provided by your employer. The list of healthcare providers must have no more than four coordinated care organizations and no fewer than three physicians, and if there are no chiropractors on the list, the employee can see a chiropractor of their choosing.

Following your first visit, you must continue treatment with a doctor or a combination of doctors on the employer provided list for a period of 90 days, and once that time is up, you can see whichever doctor you’d like to see.

Are There Any Special Circumstances?

There is one special circumstance during the 90 day period you should also be aware of. If you are seeing one of the employer-listed doctors and he or she recommends invasive surgery, you have the right to obtain a second opinion by a physician of your choice. However, any treatment recommended as a result of a second opinion must be provided by one of the six or more employer-listed care providers if it takes place within the 90 day window.

Do I Have to Go Back to Work if the Doctor Says I’m Able to Work?

You do have to listen to the doctor, but you most likely won’t be thrown back into work full-time, as you’ll normally be told you’re able to perform “light-duty work.”

Partial disability benefits are payable up to 500 weeks (9.6 years) when your partial disability status is determined from an IRE or if an insurance carrier’s doctor feels that you are able to perform light-duty work. This means that you have the ability to earn some wages, but you have not completely recovered from your work injury. As before, you were receiving total disability benefits because you weren’t capable of working at all.

If the new job pays less than the pre-injury job, you are entitled to be paid two-thirds of the difference between average weekly wage of your old job and your new job up to the maximum rate for the year of your injury.

Talking to A Workers’ Compensation Attorney

The Pennsylvania Workers' Compensation system is very complex; figuring out which doctor you can go to for treatment of your work-related injury is just one small part of an intricate process. If you have been injured on the job, get in touch with a Pennsylvania workers' compensation attorney and learn more about how to make a successful claim for benefits.

How do you know if you need a Pennsylvania workers’ compensation attorney?

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 a Pennsylvania workers’ compensation attorney is in your best interest. Even if you think you’re able to handle a situation on your own, a lawyer is there to help you 100% through your case and receives no payment until your case is won.

Can you represent yourself in court?

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 lawyer in Pennsylvania, putting you at a severe disadvantage. Also, insurance companies can be very unhelpful at times because they may provide you with wrong or conflicting information so having a knowledgeable lawyer will put you at an advantage.

Can You Sue Your Employer?

No. In exchange for receiving workers' compensation benefits, an injured worker gives up the right to sue his or her employer for pain and suffering. There are very few exceptions to this rule, and this does not mean that you cannot sue other parties that may have been responsible for your injuries. For example, if you are involved in a work-related motor vehicle accident and sustained injuries as a result of the negligence of a third party, you may be able to file a personal injury action against the third party seeking pain and suffering for your injuries.

Why Should You Get a Lawyer?

When you have a lawyer, you do not speak to the insurance company, as the lawyer handles all that for you. This claims adjuster will probably set up an independent medical exam for you, which will be a doctor paid for by the insurance company. This doctor may downplay your injury or offer an alternate explanation for how it occurred. These appointments are mandatory and the failure to attend could mean a loss of benefits. A workers' compensation lawyer attorney will walk you through the whole process and inform you of any important developments so that all your attention can be on recuperating.

The workers' compensation system may have been intended to provide prompt and fair compensation for injured workers, but it now appears to work mostly to the benefit of employers and insurers.

Even if your case is not before a judge, it may be wise to contact a Pennsylvania workers’ compensation lawyer to help you navigate the difficult process of dealing with the insurance company and your employer.

Can I post on my social media accounts?

We encourage all clients to be mindful of what they post on their social media accounts. The information posted on social media sites it not always private or privileged. Pictures and comments can be taken out of context and can turn a perfectly fine situation on its head. Photos that you are tagged in may be visible publicly, and all your social networking sites should be set to private. Of course, it is encouraged that you not post anything about your case on your social media accounts.

Is My Private Information Really Private?

Despite customizable settings on popular social networking sites, concerns about the privacy of posted material have continued to persist, with users wary of third-party advertisers and employers alike having access to their profile’s information. Now, recent rulings in Pennsylvania workers' compensation cases could potentially add forensic computer experts to that list.

An emerging trend in Pennsylvania workers' compensation claims has involved courts generally granting limited discovery requests for access to claimants' Facebook pages where certain public postings on these accounts suggest that more private posts might be relevant to the contested issues in specific cases. However, this access is normally only allowed after a showing of facts which suggest that the discovery of the claimant’s private profile will yield information relevant to the case. Without this, such discovery is not likely to be permitted.

How Can You Ensure Total Privacy?

Nevertheless, in light of these recent decisions, injured workers in Pennsylvania need be aware of what is present and posted on their social media sites, ensuring that their personal profiles are free of material that could damage their workers' compensation claims.

If you're unsure of what constitutes such material, contact a workers’ compensation attorney. To be sure, the ever-increasing prominence of online social networking in today’s world promises that social media will continue to impact workers’ compensation litigation in the days to come.

Can my employer try to terminate my workers’ compensation benefits in Pennsylvania?

Unfortunately, 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.

How will I know if a request to end my benefits has been filed?

If a request to terminate your work comp benefits has been filed, you will receive a "Petition to Modify, Suspend, or Terminate." It's important to contact an attorney as soon as you receive this petition. Oftentimes there are strict deadlines to respond, and you should have an attorney inform you of your legal rights and represent you before a judge.

My employer sent me a petition saying my workers' compensation payments should stop on the day I examined by my employer's doctor. Will my payments stop?

This petition you received is called a "Petition to Terminate Compensation Benefits,” and your employer filed the petition because they believe that you have recovered from your injury and can now return to work.

A workers' compensation judge will decide if your payments will stop. Until those hearings take place, you should still receive your workers' compensation benefits and payments. If you've received one of these petitions, you should speak with an attorney immediately if you believe you're still too injured to work, or if your personal doctor hasn't released you to work.

What if I personally believe I’m still unable to start working again?

If you feel that your employer is trying to force you back to work even though the company doctor doesn't think you're ready, chances are that your company will stop pressuring you.

However, if the company doctor says you're ready to return but your own personal doctor disagrees, you can refuse to return to work. Though your employer may file a "Petition to Terminate, Modify, or Suspend Benefits," your payments won't change until a judge reviews your case and determines the result of your case.

If your own doctor feels you're ready to return to work, but you disagree and refuse to return to your job, you may lose your workers' compensation coverage. A lawyer can help you figure out if it's in your best interest to return to work.

If you think you're in danger of losing your workers' compensation benefits and you don't already have an attorney, you should contact one right away.

Can you be fired by your employer for applying for workers’ compensation in Pennsylvania?

No you cannot. It is against the law for an employer to fire workers simply because they have filed a Pennsylvania workers’ compensation claim. It is rare for an employer to make the mistake of telling an employee that they are being fired due to a workers’ compensation claim, because most employers are aware that this would likely lead to an employment discrimination lawsuit. However, if your employer terminates your employment and you suspect it is due to your workers’ compensation claim, you should try to gather evidence to prove your suspicion.

Can You Lose Your Job if You’re Permanently Injured?

Nonetheless, 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. Unfortunately, unless you are a union member or have an employment contract your receipt of workers' compensation benefits does not necessarily protect your job or other employee benefits such as health insurance. As a result, if you are out of work and receiving workers' compensation benefits, your employer may be able to fire you or lay you off if they cannot reasonable accommodate your physical restrictions. However, an employer cannot fire you or lay you off solely because you made a workers' compensation claim.

What If My Doctor Says I Have Permanent Work Restrictions?

If you have fully recovered from your workplace injury or occupational disease, or have reached maximum medical improvement, you should discuss with your doctor whether you have any permanent work restrictions. If you have fully recovered, it is highly unlikely that you have any permanent work restrictions due to your work-related injury. To the extent you have any permanent work restrictions, you must discuss these restrictions with your employer. Your employer is required to make reasonable efforts to accommodate your new work restrictions so that you can perform your job. If your employer can reasonably accommodate you, your employer must accommodate you.

What Happens if I Can’t Return to My Job?

If your employer cannot accommodate your work restrictions after you have reached Maximum Medical Improvement (MMI), your employer is allowed to terminate your employment. This is typically the case where the nature of the job is such that someone with your restrictions simply cannot perform the job. If you physically cannot return to your job, your employer may terminate your employment.

Your employer has the option of offering you alternative, light duty work. Most often, this occurs when an employer offers you a different position in the company with less vigorous physical requirements.

In many cases, if you cannot return to your job, you are eligible for additional workers’ compensation benefits. This could include vocational retraining or potentially a pension through permanent and total disability benefits.

In addition, an employer does not have to maintain your health insurance or other benefits while you are receiving workers' compensation benefits. You may, for example, receive what is called a COBRA Notice, allowing you to pay for medical insurance at your own expense. If you do, you should discuss this with your attorney.

What injuries, diseases or illnesses are covered by workers’ compensation in Pennsylvania?

Generally, injuries, illnesses and diseases caused by your work are covered from the first day of employment. Any employee who was injured in the state of Pennsylvania is covered under the Pennsylvania Workers’ Compensation Act, and it doesn’t matter if your job is part-time or seasonal in nature. The majority of all injuries and illnesses caused by a work-related accident or a condition are covered under Pennsylvania workers' compensation. You may request workers' compensation payments even if you are at fault for your work injury.

If you feel skeptical about your injury or illness, do not think twice. The Workers’ Compensation Act applies to ALL injuries or occupational diseases occurring during the course and scope of employment and which are related to that employment.

What if I have a pre-existing condition?

The Act applies even if you have a pre-existing condition, such as a bad bad or heart condition which you aggravate, accelerate, or make worse over the course of your employment. You are entitled to collect workers’ compensation benefits from your present employer even if your employer tries to debate it. If you can prove that your injury is work-related, you could request workers' compensation payments. Jobs that require repetitive motions to perform them can cause carpal tunnel syndrome and other disorders.

Who is responsible for providing workers’ compensation benefits?

Your employer is required by law to provide workers' compensation coverage to their employees. Those who are self-employed may be rare exceptions to this law. Just as it's required by law to have car insurance yet many drivers are still uninsured, employers are required to have workers' compensation coverage yet some neglect to carry it.

When Does My Employer Have to Start Paying My Workers' Comp Benefits?

Under the Workers' Compensation Act, an employer and its insurance company have 21 days after they receive notice of the injury to either agree that an injury is work-related (and issue a Notice of Compensation Payable or Notice of Temporary Compensation Payable) or to deny the claim (and issue a Notice of Compensation Denial). Before you can receive wage losses, there must be medical proof from a doctor confirming your injuries and whether you can return to work or there are any restrictions on the type of work you can do. Most insurance companies mail checks every other week to injured workers, although a few pay wage loss benefits weekly.

What isn’t covered under workers’ compensation in Pennsylvania?

Sometimes, limitations may apply to lung diseases. Self-inflicted injuries or those caused by intoxication or violation of the law including the use of illegal drugs are not covered under workers’ compensation in Pennsylvania. However, repetitive trauma or overuse injuries (such as carpal tunnel from excessive computer use) are covered by workers’ compensation. Can I receive payments if a previous injury was aggravated on my current job?

It depends on whether the aggravation is a new injury or a recurrence of the old injury. If your medical records show that you have a new injury and that it was related to your current job, you would be able to receive workers' compensation payments.

Do I need to attend a Vocational Exam?

Vocational rehabilitation is a process which impairments or health disabilities to overcome barriers to accessing, maintaining or returning to employment or other useful occupation. Vocational rehabilitation can require input from a range of health care professionals and other non-medical disciplines such as disability employment advisers, and techniques can include the following: goal setting and intervention planning, provision of health advice and promotion, in support of returning to work, and case management.

Who would hire a vocational counselor while I’m undergoing workers’ compensation?

An employer can hire a vocational counselor to show that you are capable of performing some type of work even though you are injured. Your employer can use the opinions of the vocational counselor to suspend or reduce your workers’ compensation benefits.

What is considered vocational rehabilitation?

Some services are designed to help you overcome or lessen your disability, while others can directly help you prepare for a career. The services include:

Diagnostic Services: Medical, psychological, and audiological examinations and tests used to better understand your disability and your needs for specific types of services.

Vocational Evaluation: Aptitude, interest, general ability, academic exams, work tolerance, and "hands-on" job experience used to understand your vocational potential.

Counseling: Vocational counseling will help you to better understand your potential, to rely on your abilities, to set realistic vocational goals, to change them when necessary, to develop successful work habits, and to work again.

Restoration Services: Medical services and equipment such as physical and occupational therapy, wheelchairs, and automobile hand controls can be provided to enable you to pursue and achieve employment.

What if I’m still injured and I have to undergo vocational rehabilitation?

Unfortunately, some employers and insurance companies use vocational rehabilitation to reduce or stop wage loss benefits — instead of trying to help you find other work, and the insurance company may want you to simply accept any job so that wage loss benefits can be stopped.

While the true purpose of a vocational counselor is to help you find suitable employment after an at-work injury, vocational counselors are sometimes hired by insurance companies for the sole purpose of cutting your wage loss benefits. A poor vocational counselor can make your situation worse by ignoring work restrictions and by suggesting demeaning jobs. If it is found that you did not cooperate with a vocational counselor, you could lose entitlement to wage loss benefits.

You might also be sent to a vocational counselor for a “transferable skills analysis.” You may find that your wage loss benefits have been cut based upon a job that does not actually exist. This is not vocational rehabilitation and you should call an experienced workers' compensation lawyer immediately if this happens.

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.

How do you pay for a Pennsylvania workers’ compensation attorney to represent you in a workers’ compensation claim in PA?

If you've been injured on the job and are considering hiring a workers' compensation attorney, it's important for you to understand the costs involved before you start worrying about money. If you think a workers’ compensation lawyer is out of budget, not hiring one is going to be more out of budget.

Workers' compensation cases, like most personal injury cases, are generally handled on a contingency fee basis, which means that 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.

What is a contingency fee?

Contingency fee arrangements allow all injured workers, even those with limited financial resources, the chance to receive quality legal representation by eliminating the need for substantial up-front payments.

When you need the services of one of our attorneys, the workers' compensation law states that workers' comp cases be handled on a contingency fee basis. A contingent fee means that the attorney's fees are contingent or payable only if you receive benefits. There is never an out-of-pocket cost to you for attorney fees.

Legal fees generally must be approved by a workers' compensation judge or appeals board before the attorney collects a fee.

When would you need a lawyer?

  • You are not receiving benefits even when you were injured on the job
  • You received benefits for your injury that were discontinued, and you need to have them reinstated
  • You've been receiving benefits but are currently faced with having them terminated or modified
  • You have been asked to submit to a medical examination in order to determine an impairment rating
  • Your employer has talked to you about resolving your claim
  • Your employer has filed a request for compromise and release

What is the statute of limitations regarding the filing of a workers’ compensation claim in Pennsylvania?

In addition to helping your lawyer gather evidence and get ahead of the workers' compensation insurer, prompt action can help you stay within the statute of limitations. The statute of limitations refers to the length of time you have to formally file a workers' compensation claim.

In Pennsylvania, the statute of limitations for workers' compensation claims is three years from the date of injury. If you have been injured at work and denied either medical benefits or wage loss benefits under the workers' compensation law, you must file a Claim Petition within three years of the date of injury. If you do not file your petition within that time, your claim will be barred forever, preventing you from collecting any workers' compensation benefits for your injuries.

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.

What are some other time limitations?

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.

Another example, for a loss of use of hearing from the long-term exposure to hazardous noise, a claim must be brought within three years of the last exposure to hazardous noise. On the other hand, with regard to an occupational disease contracted from exposure to a workplace hazard, disability (lost wages) must occur as a result of the occupational disease within 300 weeks (about six years) of the last exposure to the hazardous toxin.

When should you report your injury?

As soon as you are injured on the job, you should report the injury to your employer, even if the injury does not cause you to miss time from work. It is suggested that the notice be given in writing, but if that’s not possible, remember that you, or someone acting on your behalf, must report that you were injured and that your injury was caused by your job.

Also, even if you only suspect that you may have an occupational illness, you should report it. The injury must be reported to your supervisor or the person whose job it is to prepare injury reports.

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