Legal Toolkit Pennsylvania Workers' Compensation

What to Know About Workers' Compensation

a

Pennsylvania Workers' Compensation laws

are designed to financially aid workers injured while on the job by replacing lost wages and paying medical expenses because injuries without forcing the employee to show negligence on the part of the employer. Employees can not sue their employer in civil court unless the employer does not have insurance. The employee's exclusive remedy is the Workers' Compensation system. Injuries that can qualify for Workers' Compensation benefits can include accident injuries experienced by workers in the scope of their employment; repetitive motion injuries like carpal tunnel or back problems; and occupational diseases like asbestosis or black lung disease that were contracted after on-the-job exposure to toxic materials. Workers' Compensation benefits may not cover on-the-job injuries taht were caused when an employee was intoxicated, engaging in horseplay, or committing a crime.

b

Employer requirements:

All employers in Pennsylvania must carry Workers' Compensation coverage through a private carrier, through the State Workers' Compensation Fund (SWIF), or be granted self-insured status Even if your employer has failed to obtain the proper coverage, you may still be able to recover benefits from the Uninsured Employee Guarantee Fund.

c

Workplace injury:

As soon as a workplace injury has occurred, an employee should immediately inform their employer of the accident or injury and seek medical attention. Ignoring a workplace injury is unwise because of the possibility of longer term medical issues related to the injury. Your employer should then submit a First Report of Occupational Injury form to its insurer and the state bureau. Employees are required to be treated by a panel physician for the first 90 days, as long as a list of 6 providers is offered to the employee. If the employee is not given a list to choose from they may seek treatment from a medical professional of their choice. Speaking to a Worker’s Compensation attorney immediately about your injury can clarify appropriate courses of action and the experienced attorney can clarify the appropriate course of action.

d

Federal Workers' Compensation:

The United States Department of Labor Office of Workers' Compensation Program (OWCP) administers Workers' Compensation benefits to certain types of workers and their dependents. The Division of Federal Employees' Compensation provides coverage and benefits to certain federal and postal employees. The OWCP's other programs include the Division of Energy Employees Occupational Illness Compensation, the Division of Longshore and Harbor Workers' Compensation, and the Division of Coal Mine Workers' Compensation, which provide coverage to certain employees in those industries. Not all Workers' Compensation attorneys handle federal cases. Railroad Workers' coverage comes from a different program, FELA (Federal Employers Liability Act) with different rules. A Workers' Compensation attorney can advise you of options regarding your particular situation.

e

OSHA:

The U.S. Department of Labor has developed regulations to insure workplace safety. Collectively, these regulations are referred to as the Occupational Safety and Health Act (OSHA). The government has the power to investigate and cite employers who violate these regulations, and it may also pursue claims on behalf of employees who are injured or die as a result of violations or who are retaliated against for participating in an investigation. OSHA citations can be steep, and, as a result, employers should fully understand the implications before paying a fine or negotiating what they think appears to be a fair settlement. Companies should consult with employment attorneys experienced in OSHA cases.

f

Time to file a claim:

The rule of thumb is to file Worker’s Compensation claims as soon as possible. While it is advisable to inform your employer in a timely manner, you must do so within 120 days or you will be denied coverage. In cases where your employer denies your request for benefits, the statute of limitatios for filing a claim due to a workplace injury is three years from the date the injury occurs. The time limits for claims relating to repetitive occupational disease depend on when the injury is legally recognized and date of last exposure. A worker’s compensation attorney can assess your case, timing of the injury, and advise you about the best course of action.

g

Compromise and Release Payments:

At some point during your case, you may be offered or desire a lump sum payment from the insurer. An experienced Workers' Compensation attorney can review your situation and assist you in determinig if this course of action is beneficial to you.