How to File a Pennsylvania Workers’ Comp Claim

How to File a Pennsylvania Workers' Comp Claim

The Pennsylvania Workers’ Compensation Act defines an employer’s liability to pay damages for work-related injuries and illness. It also governs all aspects of your workers’ compensation claim. 

Most employers in Pennsylvania are required to carry workers’ compensation. The system provides benefits to injured workers, regardless of whether they contributed to the cause of their injury. However, injured employees cannot sue their employers for work accidents, except in rare instances.

If you sustain an injury at work, it is essential to understand your legal rights and how to file a Pennsylvania workers’ comp claim.

Starting Your Workers’ Compensation Claim in Pennsylvania

You begin a workers’ compensation claim by notifying your employer of an injury or illness. Under Pennsylvania workers’ compensation laws, you have 120 days to report a work injury to your employer. 

If you file your report within 21 days from the injury date, you should receive benefits beginning on the date you were injured. However, if you wait to report your injury, you are only entitled to workers’ comp benefits beginning when you reported the injury or accident to your employer. 

Seek immediate medical treatment for work-related injuries. Go to the emergency room or nearest urgent treatment center for life-threatening or severe injuries. In a non-emergency situation, you will likely need to receive medical treatment from a physician that the workers’ compensation company approves. 

Filing a Pennsylvania Workers’ Compensation Claim 

You must file a formal workers’ compensation claim with the Pennsylvania Department of Labor and Industry to receive workers’ comp benefits. The statute of limitations for filing workers’ compensation claims is three years, but you should seek legal advice as soon as possible to protect your rights. 

Your employer files a First Report of Injury to begin the proceedings. Your employer also notifies its workers’ compensation insurance company of your injury and claim. The insurance company must make a decision to approve or deny your claim within 21 days.

If your workers’ comp claim is approved, you should receive a notice and begin receiving benefits. It is important to understand that the insurance company has the option of paying workers’ comp benefits for up to 90 days while it investigates your claim. It could notify you within those 90 days that it denies your worker’s compensation claim.

If you receive a denial of workers’ compensation benefits, you can appeal the decision. However, you should act quickly to avoid missing deadlines. 

Remember, you have the right to legal representation during your workers’ compensation claim. It can be helpful to hire a workers’ compensation lawyer immediately if your claim is denied. 

Even though you cannot sue your employer for denying your workers’ compensation claim, other legal options exist. You may seek alternative dispute resolution (ADR), which allows a workers’ comp judge to review the case and attempt to resolve the issues. If ADR fails, you can appeal the denial.

What Types of Workers’ Compensations Benefits Can You Expect to Receive in Pennsylvania?

Workers’ compensation provides medical care and wage benefits for injured employees. The types of benefits you could receive after a work injury include:

Medical Care

Your employer is liable for providing reasonable and necessary medical care for a covered work injury or illness. Examples of medical care include, but are not limited to:

  • Emergency medical treatment
  • Cost of doctor’s visits
  • Medications and medical supplies
  • Surgery and hospital stays
  • Physical, occupation, and other therapies
  • Diagnostic testing
  • Second opinions

Your employer may provide a list of six or more approved medical providers. You must visit a provider on that list for initial treatment of a work-related injury or illness. You must continue treatment with an approved physician for at least 90 days after the initial visit. 

However, if the provider recommends invasive surgery, you can seek a second opinion. The employer must pay for the second opinion. However, you must choose a doctor from the approved list to provide treatment for the first 90 days after receiving a second opinion.

During the 90-day period, the insurance company and your employer are not required to pay for medical treatment by a non-approved provider. After the 90-day period ends, you can seek treatment from any physician you choose.

Wage Benefits

If you cannot work because of a workplace injury, you may receive compensation for your lost wages. However, workers’ comp benefits do not compensate you for all loss of income. Generally, injured workers may receive two-thirds of their average weekly wage, subject to state minimum and maximum adjustments

In addition to medical care and payment for lost wages, injured workers may also receive benefits for specific losses, including serious and permanent disfigurement or loss of a body part. 

Consult With a Workers’ Compensation Attorney

Before settling a workers’ compensation claim, you might want to talk with a Philadelphia workers’ compensation lawyer about how much your worker’s compensation claim is worth. An attorney reviews your case free of charge to determine if you could be entitled to additional benefits or compensation after a workplace accident. 

Contact Our Personal Injury Law Firm in Philadelphia Today To Get Help With Your Case

To learn more and get the help you deserve, call Zavodnick & Lasky Personal Injury Lawyers at (215) 875-7030 or contact us online.
You can also visit our law firm at 123 S Broad St #1220, Philadelphia, PA 19109.