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Are all injuries covered by workers’ compensation or are there limits?

In Pennsylvania, nearly all workplace injuries and illness are covered by workers’ compensation, even if you are at fault for your own injury. There are some types of injuries that are not covered, including:

  • Intentional self-inflicted injuries
  • Injuries caused by your intoxication
  • Injuries caused by physical attacks or fights with co-workers
  • Injuries caused by illegal acts
  • Injuries caused during your commute

A worker’s compensation attorney in Philadelphia, PA can help you determine whether your injury is covered.

Can I receive workers’ compensation for repetitive use injuries?

As long as you can prove that an injury is work-related, you can receive compensation for it, even if it resulted from repetitive use of certain body parts.

Who pays for workers’ compensation insurance coverage?

In Pennsylvania and in nearly every state, employers are legally required to provide workers’ compensation insurance coverage to all of their employees. Unfortunately, it is not an uncommon occurrence for employers to break these laws. If you are injured and find out that your employer does not carry this required coverage, contact a Philadelphia work injury attorney right away.

If my employer or co-worker caused my injury or illness, can I sue them instead of using workers’ compensation benefits?

As a part of workers’ compensation legislation, you are not permitted to sue your employer or your co-workers for your work related injury or illness. Your only option is to file for workers’ compensation benefits to cover your medical expenses and your lost wages. There may be exceptions to this rule; if you sustained an injury or an illness through a defective product at work or through physical assault by a co-worker, you may be able to sue either the manufacturer of the product or the co-worker. A Pennsylvania personal injury attorney can advise you of the best route to take in your situation.

What if my condition was pre-existing but was aggravated by work?

If you can prove that your current injury is new and is related to your present employment, you can receive workers’ compensation benefits. If the injury is not new, but is a resurgence of an old injury, then you may not be eligible for benefits. It is recommended to consult with a workers’ compensation attorney in Philadelphia if you are unsure of whether your injury is eligible for compensation.

Are part-time workers covered by workers’ compensation insurance or only fulltime employees?

Part-time workers are covered by the Workers’ Compensation Act, just the same as full time workers are. There is a common misconception that if you are the only employee who is employed by a company, then your employer does not have to offer you workers’ compensation coverage. This is simply not true in Pennsylvania.

What if my job requires travel and I am injured in a related auto accident?

If you are on the job while traveling, you are covered by workers’ compensation. This can include traveling nurses, truckers, delivery drivers, consultants, and traveling sales personnel. It does not, however, include commuting daily to or from work.

If you or someone you know have been injured on the job in Pennsylvania, seek help now!

Pennsylvania Workers’ Compensation law is complex and it can be difficult to overcome the hassles that some insurance companies and employers create. This page contains valuable information about the law and the rights to compensation you are entitled to. Remember, you are not alone. While this page contains many important facts, it is not meant to replace legal advice by a qualified Pennsylvania Workers’ Compensation attorney.

Why is workers compensation so important?

Every year, 3.9 million Americans are injured on the job or traveling for work. When this occurs, the worker is entitled to benefits under Workers’ Compensation Law. If a worker has not been able to perform his or her duty for a period of time, they may be entitled to these benefits.

What should an employee do if they are injured on the job?

There are several steps to take immediately after being injured on the job. First, the worker must make a list of witnesses that saw the accident. Second, a notice or claim should be filed with the employer stating that the injury occurred. In Pennsylvania, if a notice is not filed within 180 days, the case will be nullified and the worker will be unable to receive benefits.

Can I file for workers compensation without an attorney?

Yes – but it is not recommended. Knowing workers compensation rights is important, and while it may feel like a fair settlement, often times the individuals are settling for a smaller reimbursement or not filing for all possible claims.

What types of claims can I file?

When a worker is injured on the job, there are multiple claims that may apply to the case. Workers compensation is an insurance payment that the injured may receive to cover their regular salary. A social security disability claim is a secondary claim that needs to be filed if the worker is unable to work for an extended period of time. A lesser-known claim is one of ‘pain and suffering’, which compensates the victim for their trials and tribulations that have made their lives difficult during the entire injury process. Pennsylvania residents may also be entitled to indemnity, or money lost during the initial time after the accident.

What happens after I file notice of an injury?

After filing notice, the employer will send you to their panel of doctors for an injury report. If the employer doesn’t send the injured worker to a doctor immediately, you need to visit your primary care physician for a report as soon as possible. The statute of limitations in these cases is three years from the date of notice, but seeing a doctor immediately is highly recommended, as insurance companies will often try to use any delay to deny or partially deny your claims.

What if my employer doesn’t file a report?

Some employers don’t have workers compensation insurance or are trying to keep their claims low for the year. Other times employers do not think the employee is injured badly enough to merit workers compensation. In these cases the worker should immediately speak with an attorney. Pennsylvania law requires that all employers insure their workers and that all accidents at work are reported immediately.

What are IME’s?

IME’s are independent medical exams provided by the workers compensation insurance company. These doctors normally side with the insurance company and will try to send the worker back to their job as soon as possible. In some cases the doctor will send the worker to a new job performing ‘Light Duty’.

What are light duty jobs?

A light duty job is often a step towards regular employment. Doctors may send injured workers to easier to perform jobs prior to full reinstatement to lessen the cost of insurance payments. They sometimes send workers back prior to them being healthy enough to perform even light duty tasks. In these cases, the injured worker should speak with their workers compensation attorney immediately. Time is of the essence, and insurance companies can use any delay against you in court.

What if you receive a letter ordering you back to work?

If the insurance company deems an individual fit to work, they must either return to work or speak with an attorney about continuing workers’ compensation insurance. The insurance companies and the employer will want to pay as little as possible and sometimes send injured workers back to their jobs too soon. In these events, speaking with an lawyer is strongly advised.

What is a lump sum settlement?

When an individual is receiving workers compensation payments, the insurance company may approach them in an effort to settle the case. This typically involves one lump sum in lieu of weekly payments. In some situations, this option is beneficial for the injured worker as it may afford them other opportunities. Those who are receiving workers compensation may also approach their insurance company about a lump sum settlement. However, it’s important to keep in mind that settlements are final and once accepted, you may lose your ability to challenge it in court. Insurance companies often prey on people who are in immediate need of cash and offer them settlements that are far lower than what should be reasonably expected. Professional help of a local state workers’ compensation lawyer is highly recommended before signing any such agreements.

Can I really be investigated while I’m injured?

Yes. It is not uncommon for insurance companies to verify the injury status of pending claims. Investigators are tasked with following the injured individual throughout the day to make sure they are as injured as they claim. Social networks are also a common source of injury related investigations. It is important that those who are injured act as they should, according to their injury, during their workers compensation cases. However, there are limits to how intrusive the investigation can be. In Pennsylvania, insurance investigators are not allowed to harass you, enter your property, or call you on the phone without your explicit permission. If any of such behavior happens to you, it is important to collect evidence, that can be presented in court at a later time.

Robert Huber

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