Worried About Losing Your PA Work Compensation Payments?

work comp If you suffer a workplace injury or illness in Pennsylvania, you may be entitled to workers’ compensation. This step-by-step guide explains how to file a claim and how to appeal if your claim is denied.

You report your injury.  If you are injured at work or suffer a work-related illness, you must report that injury or illness to your direct supervisor or employer within 21 days. Claims made after 120 days will be denied, except for claims involving progressive diseases, such as occupational lung disease, mesothelioma, and certain cancers.

Your employer reports the injury to the insurer. Once you’ve filed your report, your employer must report the injury or illness to its workers’ compensation insurance carrier. The employer has 48 hours to report a fatality and seven days to report an illness or injury.

The employer makes a decision about compensation. Your employer has 21 days from your report of injury to make a decision about your case. There are four possible options:

  1. Your employer accepts liability for your illness or injury and issues an Agreement for Compensation.
  2. Your employer accepts liability for your illness or injury and issues a Notice for Compensation Payable.
  3. Your employer determines that more information is needed before a decision can be made about your case and issues a Notice of Temporary Compensation Payable. This gives your employer an additional 90 days to make a final decision. You will receive benefits during that time.
  4. Your employer denies liability and issues a Notice of Workers’ Compensation Denial.

If Your Claim is Approved

Your employer calculates your compensation. Your employer must use the Statement of Wages to calculate your compensation. Your employer sends to his insurance carrier with the Agreement for Compensation, Notice for Compensation Payable, or Notice of Temporary Compensation Payable.

You receive compensation. You will receive compensation until you are well enough to return to employment. If your condition changes, the insurer may file a Supplemental Agreement for Compensation in order to alter your benefits.

You return to work. When you return to work, you will receive a Notice of Suspension or Modification. Once you receive your final check, your employer must file a Final Statement of Account Compensation Paid. You will be issued an Agreement to Stop Weekly Workers’ Compensation Payments. You have three years from the date of your last check to petition the termination of benefits.

If Your Claim is Denied

If your claim is denied, you can file a Claim Petition.  You have three years from the date of injury to file a Claim Petition. However, if you are unable to work and need money to pay the bills, this claim should be filed immediately. This is what happens once you file the claim.

File a Claim Petition. The form should be sent to the Pennsylvania Workers’ Compensation Bureau in Harrisburg.

A Workers’ Compensation judge is assigned to your case. Once the judge is assigned, all parties involved in the case will be notified of the date and time of the Workers’ Compensation hearing.

A hearing is held.  Both sides are given an opportunity to present evidence in front of the workers’ compensation judge.

The judge assigns the claim to mediation. In most cases, the judge assigns the case to mediation.  Mediation gives the parties an opportunity to agree on a settlement. If mediation does not lead to a resolution of your case, either you or your employer may ask for a conference with the judge.

The judge makes a decision. The workers’ compensation judge renders a written decision approving or denying your claim. If your claim is denied, you have 20 days to appeal the judge’s decision to the Workers’ Compensation Appeal Board.

You may appeal the judge’s decision to Workers’ Compensation Appeal Board. If your claim is denied, you may appeal the judge’s decision to the Workers’ Compensation Appeal Board. The appeal must be made within 20 days.

You may appeal to the Commonwealth Court. Either party has 30 days to appeal the decision of the Appeal Board to the Commonwealth Court.

Appeal to Pennsylvania Supreme Court. Either party has 30 days to appeal the decision of the Commonwealth Court to the Pennsylvania Supreme Court.

Although the workers’ compensation system is intended to protect injured workers and their families, it can be difficult to navigate. This is especially true if your initial claim is denied. The Bulldog Lawyers at Shor & Levin can help you get the compensation you and your family deserve.

If you have questions or concerns about your legal rights to compensation for a Pennsylvania workplace injury or illness, contact us at 855-631-2013 or through our online contact form.