Getting hurt at work can be a frightening experience. Workers may not know their next steps or how to take advantage of the rights guaranteed by Pennsylvania law.
At Shor & Levin, P.C., our PA workers’ compensation lawyers help workers in Philadelphia and surrounding areas take the right action after a work injury. We want to make sure they get all of the benefits they are entitled to receive.
Because we know that it is important for injured workers to know what will happen in their case, we have prepared a guide that discusses the first 90 days after your injury – a crucial time period.
What You Need To Do
Follow these step-by-step instructions to accurately and efficiently file your claim.
1. Tell your employer you got hurt.
You need to let your employer know immediately that you suffered an on-the-job injury. If you cannot do so immediately, make sure you do it within 21 days of the injury. Giving notice gets the workers’ comp claims process started.
If your workers’ comp claim is based on a condition that developed over time, like carpal tunnel syndrome or cancer from toxic exposure, let your employer know within 21 days of your diagnosis.
2. Get medical help.
When seeking medical help, you need to make sure your injuries are documented, so make sure that you get a diagnosis on record. Under PA law, you may need to see a doctor that is on a list that your employer provides, you could be referred for physio if your injury requires, with companies like Burleigh Physio. For more information on which doctor to see, read our Common Questions section below. As soon as you are physically able, get legal help.
3. Keep records regarding the time you miss from work.
If you have missed at least seven days of work, you are entitled to receive lost wages benefits equal to two-thirds of your lost income. These benefits may not arrive for about three weeks after your injury. So, keep track of exactly how much work you missed. This keeps you from losing out on any money you are entitled to receive. Many people are concerned for their welfare once an injury occurs causing them to need time off work. Unfortunately, sometimes these incidents cause long term damage and even disabilities, which need to be addressed in terms of insurance. For example, if your line of work is majorly physical, such as if you are a vet, you will need to look into disability insurance for veterinarians to research into what they are entitled to in terms of benefits and money.
4. Keep a detailed account of your medical treatment and recovery process.
Workers’ comp benefits should provide disability income if you cannot work or if your ability to work is limited. Sometimes, employers try to push you back to work before you are ready. They may try to say you aren’t that badly hurt. A record of your medical treatments, doctor visits, and things like physical therapy sessions during recovery will help you to prove the state of your condition.
5. Follow up on your claim.
You should hear quickly whether your claim is approved. You should start receiving benefits within just weeks of the injury. If you do not receive a letter promptly letting you know whether your benefits have been approved, you need to follow up with your employer to find out why. This may also be a good time to call in a PA workers’ compensation lawyer to move your case forward and protect your rights. If you get a denial letter, then you need to call an attorney immediately. You will have only a limited time to respond to this letter.
What Your Employer Should Do
If you follow the steps above, you’ve done your part. Read on to make sure your employer does theirs.
1. Notify their workers’ compensation insurer
You employer must notify their workman’s comp insurer so that they may begin processing the claim.
2. File A First Report of Injury
Employers must file this report with the Pennsylvania Workers’ Compensation Bureau within 48 hours of a work accident that causes death and within seven days of an injury that causes a worker to miss more than a day, shift or turn of work. Filing this report will keep the workers’ compensation process moving along at the rate that it should.
3. Approve or deny a claim.
The employer or insurer has 21 days to approve or deny the claim. If they deny responsibility, it must issue a Notice of Workers’ Compensation Denial to you. If the insurer accepts that the injury was work-related, an Agreement of Compensation is sent out within 21 days from the time the injury was reported.
If the employer/insurer does not deny responsibility outright but isn’t sure if the claim is covered, a Notice of Temporary Compensation Payable must be issued. This must be filed with the state bureau as well. If this Notice of Temporary Compensation is filed, then this gives the employer 90 days to investigate the claim before accepting or denying full responsibility for your work injury.
Your employer can pay for medical bills and wage-loss payments during this 90-day investigation period without accepting responsibility or admitting the accident was work-related.
Below are some insider tips on how to stay ahead of the curve when navigating the workers’ compensation process.
1. Be careful what you say and sign.
You do not want to volunteer information to your employer or insurer that could hurt your benefits claim. You also don’t want to sign something that gives up any of your legal rights. Before you sign any statements other than basic medical admission forms, you need to have a lawyer protecting your interests.
2. Get an experienced Pennsylvania workers’ comp lawyer on your side.
The insurance company and employer have professionals looking out for them. You need a lawyer looking out for you. At Shor & Levin, P.C., our workers’ compensation lawyers are known as the Bulldog Lawyers because we aggressively fight for injured workers in Philadelphia and throughout PA. We have more than four decades of experience. We can handle all of your legal issues after your work injury.
Don’t wait. Get started today. Call (866) 462-8553 or submit our online form to schedule a FREE case evaluation.
The workman’s compensation process can be complicated, and chances are you have some questions. Read through the ones below to see if you can find some answers. If your question is not below, please contact us. We’d love to help.
What Does Workers’ Compensation Cover?
Workers’ comp can reimburse workers for the costs incurred for medical bills and for part of the wages the employee lost from missing work due to the injury. It does not cover the costs of pain and suffering.
However, personal injury or 3rd party claims, do. If you were injured at work by someone or something other than your employer, this is a 3rd party, and you may be able to file a personal injury or 3rd party claim against this negligent party. Visit our Personal Injury page to learn more about this option. Alternatively, you can research a california personal injury law firm if you are closer to this area, however, there are many other firms around that can be contacted to discuss personal injury accidents.
How Long Does The Whole Process Take?
You should get a final answer on whether your claim is covered within 90 days of the initial injury. The benefits can stop if the insurer decides your claim should not be covered. The benefits can continue indefinitely until you recover or until you have received the maximum of 500 weeks of partial disability benefits and must change to permanent disability compensation.
Can My Employer Fire Me If I File A Claim?
No. This is illegal according to Workers’ Compensation law. If you are fired after you have filed a workmans’ comp claim, and if you feel that it was because you filed said claim, you may be able to take legal action against your employer.
Can I Choose My Own Doctor?
You can choose your own doctor to treat your condition unless your employer accepts your workers’ compensation claim and has a posted list of six or more doctors in your workplace.
If your employer has this list and has provided it to you at the time of your injury, you must visit a doctor on the employer’s list for your initial treatment. You must keep seeing a provider on the list for at least 90 days from the time of your first visit.
If invasive surgery is recommended within the first 90 days of your injury, you can get a second opinion. However, you then have to see the doctor who provided that second opinion for at least 90 days.
After 90 days has passed from your injury (or from your second opinion), you can switch to seeing any doctor you want. Your employer has to cover it as long as your employer is notified.
What If My Employer Or The Insurance Company Denies My Claim?
If you receive a denial, you need to contact a lawyer about how to appeal.