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9 Important Facts Abo­­­ut Workers’ Compensation

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By Dennis Plank, Workers’ Compensation Attorney

Whether you work in an office, a factory, or a construction site, in a warehouse, outdoors, or elsewhere, your employer is responsible under Pennsylvania Law for providing insurance benefits to compensate injured workers for lost wages and medical expenses under the terms of The Pennsylvania Workers Compensation Act. The workers’ compensation program was started over 100 years ago to provide employees with compensation for lost wages and payment of medical expenses arising from work-related injuries and work-related medical conditions, regardless of fault. The Act also protects employers from direct lawsuits by employees.

Although the vast majority of employers in Pennsylvania are required by law to carry workers’ compensation insurance coverage for their employees, there are a few exceptions. However, the majority of employed Pennsylvanians are covered under the law and have well-defined rights and recourse under the Act.  Most people don’t think much about workers’ compensation until they find themselves injured.  The law can be confusing.  That’s why we are offering this list of nine important facts you need to know about workers’ compensation in Pennsylvania.

Fact: Not all Types of Injuries are Covered by Worker’s Compensation

While it’s true that Pennsylvania law covers most types of injuries and illnesses encountered as a part of your employment, not all injuries are included.

  • Self-Inflicted Injuries: If your injuries are intentionally self-inflicted, you are not covered for benefits under the terms of the Act. Any attempt by an employee to intentionally harm himself in order to obtain workers’ compensation benefits is both fraudulent and not covered under the Act.
  • Physical Attacks: If you are physically attacked by a co-worker for personal reasons, or if you are physically attacked by a person not associated with your workplace, you are not covered under Workers’ Compensation. However, such physical attacks are illegal and should be reported to your employer and the police immediately.
  • Alcohol and Drug Abuse: If your injuries were caused as a result of alcohol or drug use, you are not covered. It is your responsibility to conduct your work soberly and without drug use.
  • Breaking the Law: If you are injured while breaking the law, or as a result of breaking the law, you are not covered.
  • Commuting: Generally, if you are injured commuting to and from work, you are not covered. However, if you are in the course of traveling as part of the performance of your work duties such as driving to a remote work site after reporting to work, making deliveries for your employer, traveling for business, or you are injured while driving or making deliveries for your employer, you may be covered.

Fact: Workers’ Compensation Covers Injuries That Occur Over Time.

Not all work injuries happen in a moment. Some occur slowly over time from repetitive motion, like back pain or carpal tunnel syndrome.  Your employer should not require you to repeatedly work in awkward or uncomfortable positions or require you to work repetitively without breaks or variety, nor should your employer subject you repeatedly to physical force, weight, impact, or vibration.

Additionally, your employer should make sure they are using the right tools and equipment optimally placed for your physical requirements. Extreme temperatures and poor work organization are also factors in repetitive injuries. If you’re not sure if your injury is covered, please set up a free consultation at Going and Plank, and we’ll help you determine your rights.

Fact: Part-time Employees are Covered by Workers’ Compensation in Pennsylvania

Workers’ Compensation is not reserved for full-time and salaried employees. In Pennsylvania, both full-time and part-time employees are covered under the Workers’ Compensation Act.

Fact: Your Injury may be Covered, Even if it Didn’t Happen on Employer Property

PA law does not require that your injury occurs on the work premises to be covered under the Act. If you were injured while doing work requested by your employer, you may be covered. While commuting is usually not covered, if you were injured in an accident while running an errand for your employer, you may be covered.  While commuting is not covered, you may be covered if you fell in your employer’s parking lot. If you travel for work or drive for a living, accidents that occur while you are working, regardless of location, are covered. Request a free consultation at Going and Plank to find out if your injury is covered.

Fact: There are Time Limits on Workers’ Compensation Claim

If you are injured on the job or realize that you have acquired a work-related medical condition over time, report it to your employer as soon as possible. Your report should include when and where the injury occurred, and you should describe the type of injury. While verbal reports are acceptable, written reports are preferred. You should make a copy of your written report and keep it for your records.

Additionally, you must report your injury within 120 of the date or injury to receive Workers’ Compensation benefit, or, in the case of conditions incurred over time, with 120 days of the date of your diagnosis. However, it’s much better to report the injury within 21 days to ensure you get the maximum compensation for medical bills and lost income. If you’re not sure you’ve met the time limits, contact us at Going and Plank for a free consultation.

Fact: If you Have Contracted a Condition or Disease as a Result of the Environment at Your Workplace, You may be Eligible for Workers’ Compensation

If you have contracted a medical condition or disease as a result of exposure to unsafe working conditions or unsafe activities, you may be eligible for Workers’ Compensation. Occupational diseases can be caused by repeated exposure to asbestos, dust and air-borne particles, fungicides, gas, infectious agents, metals, noise, pesticides, herbicides, pressure, radiation, solvents, temperature, and vibrations. Many conditions and diseases can be classified as occupational diseases, including:

  • cardiovascular system disease
  • central nervous system disease
  • hearing loss
  • heart disease
  • liver disease
  • lung disease
  • mental health issues
  • mesothelioma
  • musculoskeletal disease
  • psychiatric diseases
  • renal disease
  • reproductive system disease
  • skin disease
  • vision loss

Fact: Workers’ Compensation is Usually Paid in Addition to Sick Pay

Worker’s Compensation claims are rarely paid quickly. If you need to take time off work because of a work injury, use your sick time and make sure your employer is notified in writing that you are taking sick time to recover from a work-related injury. (And keep a copy of that written notification.) In most cases, your Worker’s Compensation will be paid in addition to sick time taken. Union members may have alternate agreements in places, so if you’re part of a union, check with your union boss for details. If your employer is forcing you to take sick time instead of filing for Workers’ Compensation, contact the team at Going and Plank to ensure your rights are being protected.

Fact: Your Employer has a Worker’s Compensation Attorney Working for Them. You Should Too.

When Workers’ Compensation claims are filed, your employer’s insurance company uses an experienced Workers’ Compensation attorney to protect the company’s rights and their financial interests. To make sure you aren’t deprived of your rights, and to ensure receipt of all wage loss and medical expense benefits you deserve, you should also hire a Workers’ Compensation attorney.

Workers’ Compensation cases can be complex, and the insurance company’s goal is to avoid payment of claims if possible. With an experienced workers’ compensation attorney on your side, you’ll be able to fight for the maximum compensation you deserve.

Going and Plank has over 35 years of experience representing Workers’ Compensation clients. Contact us today to schedule a free consultation on your case.

Fact: The Law Offices of Going and Plank Only Gets Paid if You do

Many people are scared to incur additional costs when they’re dealing with Workers’ Compensation issues. However, Going and Plank won’t charge you upfront fees for a Workers Compensation case. In fact, we don’t charge you anything unless you receive your benefits, compensation, or settlement. That means we’re interested in getting you the best settlement possible. Contact us to schedule your free consultation today.

Why are Workers’ Compensation Claims Denied in Pennsylvania?

What is Workers’ Compensation?

Workers’ compensation is actually a type of insurance. Employers are required by Pennsylvania law to carry workers’ compensation insurance, often called workers’ comp. When employees are hurt on the job, they may incur medical expenses, miss work, or suffer long-term consequences. Employees who are injured or disabled in connection with their job are usually eligible to receive workers’ compensation benefits which may include recovering lost income, payment of medical bills and, in some cases, a lump sum settlement.

Workers’ Compensation in Pennsylvania

Each state has a slightly different plan. In our state, The Pennsylvania Workers’ Compensation Act requires most employers to compensate employees for lost income and medical expenses. If you’ve been hurt on the job, you may also qualify for potential lump sum settlements. Until 2011, small businesses were exempt from carrying workers’ compensation insurance. In 2011, a measure was signed that expanded the availability of workers’ compensation coverage to all types of small businesses, including sole proprietors, partners in partnerships, and members of limited liability corporations.

However, many workers’ compensation claims in Pennsylvania are denied. While not all denials can be successfully overturned, scheduling a free consultation with an attorney from Going and Plank may be your first step towards getting the compensation you deserve.

Why are Workers’ Compensation Claims Denied?

There are many reasons workers’ compensation claims are denied in Pennsylvania. Each case is different, and no one policy covers all situations. However, there are some circumstances that are especially problematic for employees and insurance companies. In these cases, insurance companies are more likely to deny your claim. An experienced workers’ compensation attorney can help you navigate complicated situations. Here’s a list of some of the common reasons workers’ comp claims are denied.

Denied Because of Lack of Witnesses

Without a witness, it’s easier for insurance companies to claim your accident never happened, or to claim it happened elsewhere. If you make a claim without the proof of an eyewitness, insurance companies will question your claim, and many such claims get denied. If you’ve been hurt at work, but no one saw your injury, Going and Plank may be able to build a case, especially if you told co-workers or supervisors about your injury when it happened, if there are witnesses who saw you before or after the accident, or if you left work that day to seek medical attention. Contact us for a free workers’ comp consultation.

Denied Because You Didn’t Report Your Injury Immediately

Sometimes employees get hurt at work and consider it a minor injury. You may put off reporting your injury until you realize it’s a larger issue. Whenever you experience any type of seemingly minor injury at work, such as a bumped head or a sore joint, report it immediately even if you feel it’s a minor mishap. Often small injuries develop into major medical issues, so cover your bases and report all incidents, big or small. Even if you waited to report your injury, you may still be entitled to workers’ comp. Contact us at Going and Plank for a free consultation.

Denied Because of Inconsistent Accounts

If your version of your injury if different from the accounts given by witnesses, co-workers, supervisors or medical professionals, your workers’ comp claim may be denied. If you feel others are deliberately misrepresenting your injury, or that you are being treated unfairly, contact us at Going and Plank to schedule a free consultation.

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Denied Because You Filed a Claim After You Were let go or Fired

Even small injuries at work can quickly escalate into bad situations. It’s important to report work injuries immediately. If you miss working for a few days after your injury to rest up, even if you take sick days, your employer may decide to fire you in the interim. In fact, some employers will fire you because you were hurt on the job, to avoid a claim. Insurance companies often think that if you waited to file a claim until after the termination, it’s an attempt at revenge. If this is your situation, contact us at Going and Plank to discuss your choices.

Denied Because a Medical Exam Detects Illegal Drug use in Your System

After a work-related accident, some employers require a test for illegal substances. Your workers’ comp claim can be denied if drug use led to an increased chance of an accident. However, certain exceptions may apply. Schedule a free consultation with a workers’ comp attorney to weigh your options.

Denied Because You Refuse to Issue a Recorded Statement

Employees may be asked to make a recorded statement for the insurance company, but you are not legally required to make this statement. Since recorded statements can be used against you, it’s smart to consult a workers’ comp lawyer at this point.

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When you retain Going and Plank to represent your interests, we will take the time to thoroughly analyze your claim in order to ensure that lost income is recovered, medical bills are paid, and a lump sum settlement is fully and expertly considered. Click here to schedule a free consultation. 

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