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Workplace injuries can be more complex, especially if you find yourself dealing with the workers’ compensation process. As with any injury, you want to focus on recovery, so you can get back to your normal life. The last thing you want to deal with is fighting to get the insurance company to pay your bills, or worry about not getting a paycheck. Unfortunately, for many people who suffer a workplace injury, they find themselves stuck dealing with the workers’ compensation system without any help.
Pennsylvania Workers’ Compensation Law
If you are injured on the job, or suffer a work-related illness, the Pennsylvania Workers’ Compensation Act is supposed to protect you. The law is supposed to make sure your medical expenses are covered, and you receive lost wages benefits, until you are able to go back to work. It is also supposed to pay death benefits for an individual who is killed on the job. Unfortunately, the system does not always work the way it is supposed to. This is why you could benefit from a workers’ compensation attorney, to make sure you are fully compensated for your injury.
Almost all employees in the Commonwealth of Pennsylvania are covered by the Workers’ Compensation Act, and almost all employers are required to provide workers’ compensation coverage for their employees. However, some employees may be covered by some other compensation scheme, including federal employees or railroad workers.
Workers’ Compensation Injuries
Workers’ compensation covers most workplace injuries, including an illness or disease related to employment or the workplace. We spend such a large portion of our lives at work, it is not surprising that the workplace is home to so many injuries. Some injuries are the result of a freak accident, others may be the result of an unsafe work environment that is not remedied. Work injuries can also be the result of doing the same actions or motions over and over again, eventually causing serious damage. Some common examples of workplace injuries include:
- Slip and fall
- Electric shock
- Chemical inhalation
- Chemical burns
- Vehicle accident
- Crushing injury
- Repetitive stress injury
- Workplace violence
Some types of employment are more prone to workplace injuries than others. This includes highway workers, firefighters and police officers: jobs that often involve the risk of harm. It also includes nursing careers, where employees do a significant amount of heavy lifting throughout the day, often resulting in injury. Cashiers and secretarial staff may be more likely to suffer from repetitive stress injuries to the hands and wrists. Construction workers often face falling injuries, occasionally due to working in unsafe conditions.
Occupational diseases are disorders caused by working conditions. This includes exposure to hazardous or dangerous chemicals, substances or infections. Examples include cancer from exposure to asbestos, black lung from exposure to coal dust, silicosis from silica dust, occupational asthma, skin cancer, contact dermatitis, or lead poisoning.
Workers’ Compensation Benefits
These workplace injuries can range from requiring a quick trip to the doctor, to permanent disability or even death. No matter how much medical treatment a worker requires, workers’ compensation is supposed to provide medical benefits from the first day of the injury. A worker is immediately supposed to report a work-related injury or illness to their employer, including the date and location of the injury. As soon as the employee misses a shift or day of work, the employer is then required to report the injury to the Bureau of Workers’ Compensation.
The law provides for a variety of workers’ compensation benefits after a claim is approved. This includes payment for lost wages, specific loss benefits, medical care, and death benefits for surviving dependents. After a worker is disabled more than seven (7) calendar days, benefits for lost wages are payable on the 8th day. Once the worker has been unable to work for 14 days, they will receive retroactive payment for the first seven days.
Lost wage benefits will depend on the extent of the injury or disability. Injured workers could be categorized under total disability benefits status, or partial disability benefits status. Benefits for lost wages are approximately two-thirds of your average weekly wage prior to the accident. These benefits can be partially offset by Social Security benefits, unemployment compensation, or retirement pension.
Partial disability benefits are provided for a maximum of 500 weeks. If your physician determines impairment is 50% or greater, you may petition for total disability status. Total disability status applies to workers who are totally disabled or unable to work. The employer can require a medical examination after two years of total disability status, to see if the employee is considered partial or totally disabled.
Denied Workers’ Compensation Claim
Your employer may choose to deny your compensation claim. Some workers’ compensation providers may try and deny claims by alleging the employee intentionally inflicted the injury, or was under the influence of drugs or alcohol at the time. If your claim is denied, you are responsible for filing a claim petition with the Bureau of Workers’ Compensation to request a hearing before a workers’ compensation judge.
If you show up to the hearing, you may find that your employer has brought a team of attorneys, who are prepared to deny your claim. They may have witness statements, photo or video evidence, and argue their case to the judge as to why your claim should be denied. You don’t want to face a workers’ compensation hearing alone. Contact an experienced attorney who will be able to file your petition, and represent you during your hearing.
In some cases, the workers’ compensation judge may recommend an alternative dispute resolution to settle a disputed workers’ compensation claim. This may involve mediation, an informal conference, or a settlement conference. If the employee or employer files a petition with the Office of Adjudication, the judge will usually schedule mediation. Mediation is non-binding, and involves a neutral third-party who attempts to facilitate settlement by having the two sides come to a mutually agreeable decision. If mediation fails, the case may continue with a hearing.
Legal Representation in a Workers’ Compensation Hearing
While you can attempt to represent yourself in a workers’ compensation hearing, these cases can involve complex litigation. Even the Pennsylvania Bureau of Workers’ Compensation suggests having an attorney represent you during these proceedings, “you should be aware that [workers’ compensation] litigation is complex, and your employer or your employer’s insurance carrier will be represented by an experienced attorney.”
If the workers’ compensation judge denies your case, you may still appeal the decision to the Worker’s Compensation Appeal Board, and further appeal to the Commonwealth Court. Before you decide to take on your employer, and the insurance company lawyers, understand what may be at stake. A workers’ compensation denial may cost you hundreds of thousands of dollars, as well as your livelihood. Make sure you have an attorney to fight for you, to make sure you win your case and get the compensation you deserve.
Philadelphia Workers’ Compensation Attorneys
If you were injured on the job, having a lawyer by your side can help you get the compensation you deserve. After all, your employer will probably have a lawyer working for them, so you deserve to have a professional attorney advocating for you. Your employer’s insurance company will try and get away with paying as little as they can. If you or a loved one has been injured while on the job, you will want an attorney who is ready to fight for what you deserve in court. Contact Gilman & Bedigian today for your free consultation.