Oxford Workers’ Compensation Lawyers

What Types of Workers’ Compensation Benefits Are Available in Pennsylvania?

Under the Pennsylvania Workers’ Compensation Act, injured workers are entitled to certain benefits as a result of an accident at work. Pennsylvania is strictly a “wage loss” state, which means the only considerations for workers’ compensation purposes is whether you can perform gainful employment and whether your earnings are impacted by the work injury. Pain and suffering and other losses, such as the ability to enjoy leisure activities, hobbies, relationships, and your previous home life, are not included in workers’ compensation benefits. However, a third party lawsuit may be filed to address those damages with the help of an experienced attorney.

There are four basic categories of Pennsylvania workers’ compensation benefits:

• Indemnity (wage loss) benefits: Injured workers can receive indemnity benefits if they are disabled from work as a result of the work injury. If the injured worker is unable to work at all, they may receive temporary total disability benefits. Partial disability benefits may be available if the injured worker can perform some kind of work but now earns less due to the work injury. This may be a reduction in hourly wage due to a modified job, or a reduction in hours due to the physical limitations related to the work injury.
• Medical benefits: Medical benefits are available for the “reasonable and necessary” medical treatment related to the injury at work. If any party wants to challenge whether a particular treatment is “reasonable and necessary,” a utilization review (UR) must be filed. The employer may be able to limit medical treatment to one of a list of providers that must be posted in a conspicuous location at work.
• Specific loss benefits: As opposed to wage loss, these benefits are to compensate for disfigurement or loss of use of a body part, including amputations, loss of eyesight or hearing, or disfigurement of the head, face, or neck. The affected body part or function does not need to be 100 percent lost, it simply has to be lost for all practical intents and purposes.
• Death benefits: When a work injury results in the death of a worker, there are specific benefits that are generally available to a spouse, children, and other dependents. In Pennsylvania, there is also a set amount which is payable as a funeral allowance.

Our knowledgeable Oxford workers’ compensation lawyers can fight on your behalf to obtain the benefits you need.

Who Is Eligible for Workers’ Compensation in Pennsylvania?

Nearly every employer in Pennsylvania is required to carry insurance to cover costs in case of a work injury or occupational illness. Most workers qualify for workers’ compensation benefits no matter how the accident happened, as long as there is an employer-employee relationship and the resulting injury is work-related. There can be exceptions for businesses with independent contractors or self-employed workers.

The industries that see the most workers’ compensation claims include:

• Construction
• Manufacturing
• Health care
• Transportation
• Warehousing
• Retail
• Farming, fishing, and forestry

How Do I File a Workers’ Compensation Claim in Pennsylvania?

Filing a claim can be a complicated process without the benefit of informed legal guidance. It is common for a worker to think that when they get a claim number from their employer’s workers’ compensation insurer, it means a claim has been filed. However, an official workers’ compensation claim must still be filed by the worker with the state commission. A workers’ Compensation lawyer can help you navigate the claims process from start to finish.

How Long Do I Have to 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 were injured at work and denied either medical benefits or wage loss benefits under workers’ compensation law, you must file a claim petition within three years of the date of injury.

What Should I Do if My Workers’ Compensation Claim Is Denied?

If the facts are not entirely clear whether or not an injury or illness is work-related, it is common for a claim to be denied. If your claim is denied, you have a right to pursue full entitlement to your workers’ compensation benefits. You can further pursue your claim with the help of an experienced lawyer.

A court hearing can be requested through submission of a form setting forth what issues you believe were wrongly decided. Common examples include a denial that an injury or illness was work-related, or a miscalculation of an injured worker’s average weekly wage. In addition, you may also file a Notice of Appeal with the court. If you file both a request for rehearing and a court complaint, and the court rules first, the court’s ruling takes precedence. If the court rules against you, you have a right to appeal with the Pennsylvania appellate courts.

How Can an Oxford Workers’ Compensation Lawyer Help With My Case?

Injured workers are not required to retain an attorney to file or pursue a workers’ compensation claim. However, workers’ compensation is a complex area of the law with many pitfalls. It is advisable to retain an experienced workers’ compensation lawyer if you are an injured Pennsylvania worker.

At Wusinich, Sweeney & Ryan, LLC, we are familiar with the relevant laws and rules in any type of workers’ compensation matter. We can deal with the opposing attorneys and other representatives who may try to invalidate your claim. An workers’ compensation lawyer can also help collect medical evidence to prove your claim, negotiate a settlement, and represent you at your workers’ compensation hearings and appeals.