Chesterbrook Workers’ Compensation Lawyers

What Is Workers’ Compensation Insurance?

Workers’ compensation provides financial benefits to employees suffering work-related injuries or illnesses. Most Pennsylvania employers must carry workers’ compensation insurance for their full-time and part-time employees, with limited exceptions.

Workers’ compensation protects employees by ensuring they receive medical care and other benefits, and employers are protected against large liability claims.

What Is Covered Under Workers’ Compensation?

Workers’ compensation provides financial benefits associated with injuries or illnesses suffered in a work-related accident, such as:

• Medical expenses: Workers’ compensation covers expenses related to your injury or illness, including hospital stays, doctor’s appointments, physical therapy, prescription medications, prosthetic devices, and other related expenses.
• Lost wages: One of the most significant benefits, workers’ compensation, provides a portion of your wages if you cannot work during your recovery, based on your salary before the injury.
• Rehabilitative services: Many injuries require rehabilitative services, such as physical or vocational therapy, as part of your treatment and recovery.
• Disability: If you suffer a partial or totally disabling condition due to your injury or illness, you may be eligible for additional benefits, such as ongoing wages, based on the length of your employment.
• Disfigurement: Some workers’ compensation policies provide disfigurement benefits if your injury or related surgery results in visible disfigurement or scarring.
• Death benefits: In certain circumstances, death benefits for lost wages and funeral expenses can be provided for surviving family dependents if you suffer a fatal work-related injury or illness.

The financial amount of workers’ compensation benefits and the length of time you receive them vary, depending on the circumstances of your employment, the accident, and the severity of your injuries.

How Do I File a Workers’ Compensation Claim?

Filing a claim begins when you are injured by reporting the accident and injuries to your supervisor, employer, or HR representative. Employers must take and submit an accident report to the company’s insurance carrier as soon as possible following an accident so they can begin processing the claim.

If you do not report the accident and your injuries, and no report is taken, any attempt at filing future claims will likely be denied. The same is true if you do not seek medical evaluation and treatment for your injuries.

Can Workers’ Compensation Claims Be Denied?

Workers’ compensation claims are not automatically approved. Insurance companies can deny benefits for several reasons, including:

• The injury did not occur at work.
• The injury was not reported to supervisors within the allotted time.
• Discrepancies between the accident report and documented injuries.
• The employer disputes the claim.
• The injury was caused by illegal drug or alcohol consumption.
• The injury was self-inflicted.
• Medical treatment was not sought.
• Medical providers were outside the certified list.
• Missed filing deadlines.
• Incomplete or incorrect paperwork.

If your claim is denied, you will always receive a letter detailing the reasons your claim is denied.

Can I Appeal a Denied Workers’ Compensation Claim?

If an insurance company has denied your claim, you have the right to appeal, beginning with submitting a formal request for reconsideration. You must also include additional evidence or information supporting your claim for the insurance company to reconsider.

Working with an experienced lawyer familiar with the system will help ensure your appeal paperwork is accurate and thorough.

How Can a Chesterbrook Workers’ Compensation Lawyer Help Me?

Many steps are involved in filing a workers’ compensation claim. An experienced Chesterbrook workers’ compensation lawyer can do the following:

• Determine the cause of your accident.
• Communicate and negotiate with insurance company lawyers.
• Help determine eligibility and type of appropriate settlements.
• Handle third-party claims.
• Appeal denials.
• Modify benefits, if applicable.

Wusinich, Sweeney & Ryan, LLC can advocate on your behalf.