Workers’ compensation is a program requiring employers to purchase insurance coverage to provide workplace compensation benefits to employees who become ill or injured on the job. Through this program, workers are provided such benefits as lost wages and medical care. In exchange, employers are protected from personal injury lawsuits by injured employees. While the federal government administers a workers’ compensation program for federal and certain other types of employees, each state has its own laws and programs for workers’ compensation, such as the Pennsylvania Workers’ Compensation Act.
In a workers’ compensation matter, neither the injured worker nor the employer is determined to be at fault. The work injury benefits a worker receives is not decreased by the worker’s carelessness, nor increased by an employer’s negligence. However, an injured employer may lose the right to Workers’ Compensation benefits if the work-related injury results from the worker’s intoxication from drugs or alcohol. Similarly, if the injured employee is hurt by his own actions or inactions intended to cause harm to himself or someone else, the employee may forfeit his right to recover under the Workers’ Compensation laws.
The Pennsylvania workers’ compensation law provides for several types of workplace injury benefits for employees who suffer job-related injuries or illnesses. Injured workers are entitled to the payment of reasonable and necessary medical treatment including surgical and medical services, medicine, supplies, hospital treatment and services, orthopedic appliances, prostheses and rehabilitation. Wage-loss benefits are available if it is determined that an injured worker is totally disabled and unable to work at all, or partially disabled and working in a position earning less than the worker’s pre-injury pay. An injured employee may be entitled to Specific Loss Benefits if the worker has lost the permanent use of all or part of his arm, leg, foot, finger, hand, toe, has experienced sight or hearing loss, or has suffered a serious and permanent disfigurement on his head, face or neck. If the work injury results in death, surviving dependents may be entitled to death benefits. Types of Workers’ Compensation Benefits
The Pennsylvania workers’ compensation law provides for several types of benefits for employees who suffer job-related injuries or illnesses. Injured workers are entitled to the payment of reasonable and necessary medical benefits including surgical and medical services, medicine, supplies, hospital treatment and services, orthopedic appliances, prostheses, and rehabilitation. Wage-loss benefits are available if it is determined that an injured worker is totally disabled and unable to work at all, or partially disabled and working in a position earning less than the worker’s pre-injury pay. An injured employee may be entitled to specific loss benefits if the worker has lost the permanent use of all or part of his arm, leg, foot, finger, hand, toe, has experienced sight or hearing loss, or has suffered a serious and permanent disfigurement on his head, face or neck. If the injury results in death, surviving dependents may be entitled to death benefits.
Under the Pennsylvania Workers’ Compensation laws, workers who are injured in the workplace may be eligible for the following benefits:
Once the injured employee gives the employer notice of his work injuries, the employer or its insurance carrier must agree that the job injury or illness is work-related before injured worker benefits are paid. If the employer or insurance carrier denies the work injury claim, the injured worker must file a Claim Petition to be heard before a Workers’ Compensation law judge who decides which party will prevail.
The Workers’ Compensation claim process can be very complex. Understanding and seeking enforcement of your rights to Work Compensation benefits under the law can be frustrating and overwhelming, especially when your employer or its insurance company seeks to limit or deny those Workplace Compensation benefits. If you think your Workers’ Compensation benefits have been unjustly miscalculated or denied, you need the assistance of a team of Pennsylvania Workers’ Compensation attorneys who can guide you through the process, face off with the experienced work injury attorneys representing your employer or its insurer, and get you the work injury compensation to which you are entitled. Pearson Koutcher Law, is THAT team.
Reporting Your Work Related Injury and Temporary Workers’ Compensation Benefits
When you are injured at work, a successful work injury claim depends on your strict adherence to the requirements of the Pennsylvania Workers’ Compensation Act. Your employer is not obligated to pay Workers’ Compensation benefits until they receive notice of your work-related injury. Therefore, you should immediately report your work related injury to your employer. Time limitations apply so don’t hesitate giving notice for any reason. Upon notice, your employer may accept your job injury claim and voluntarily start paying Workers’ Compensation benefits to you, or they may deny your Workman’s Comp claim.
When you file a claim for wage-loss benefits, your employer or its insurance company has 21 days from the date of notice of your workplace accident claim to accept or deny the claim. During that 21-day period, your employer might choose to start paying you temporary compensation benefits, with the right to deny the Workman’s Comp claim within an additional 90 days. So be aware: although your employer may pay temporary Workmen Compensation benefits during the first 90 days after your workplace accident or injury, these payments will cease if your work related accident claim is denied upon its further review.
Grounds for denial of a Workers’ Compensation claim may include, but are not limited to:
If your workers’ compensation claim is denied, you have no choice but to proceed with litigation. You must file a Claim Petition for Workers’ Compensation benefits in court. Again, time limits for a claim petition strictly apply. You need to move quickly and you don’t want to proceed on your own. The work related injury attorneys at Pearson Koutcher Law have represented countless injured workers in Philadelphia, the Lehigh Valley and the surrounding Pennsylvania areas, fighting for their rights to work injury benefits under the Workers’ Compensation laws. We work hard to prove that our clients suffered workplace injuries or illnesses and are entitled to medical benefits, wage loss compensation, and specific loss benefits.
Your benefits may be terminated if:
Your employer or its insurer may seek to modify your injured worker benefits if your work injury disability status changes. If you are receiving total disability compensation, your employer or insurer can request an impairment rating evaluation (IRE) within 60 days of the 104-week anniversary of the start of your workplace injury benefits. If the evaluation shows that you have an impairment rating of less than 50 percent, your status will change to a partial disability. You will then only be entitled to a maximum of 500 weeks of workers’ compensation benefits.
Your workman’s comp benefits may also be modified if you have recovered from your work injuries or illness enough to return to work in any capacity. The employer may offer an injured worker a job the employer feels is physically and vocationally appropriate for the injured worker to perform. Or, the workers’ compensation insurance carrier can have the injured worker evaluated by a vocational counselor to determine the earning power of the injured worker. In either scenario, the employer and the workers’ compensation insurance carrier will be trying to modify the work-related accident benefits of the injured worker.
If you are contacted by a vocational expert, you can expect that your employer or its insurance carrier will soon be seeking to modify your workers’ compensation benefits. The vocational expert will conduct an earning power evaluation, in conjunction with labor market surveys, to determine if there is a “lighter duty” job that you are capable of performing and if such a position is available to you. If the vocational expert determines that there is a job that you can do, even while your recovery continues, your employer or its insurer will seek to lower or stop workplace accident benefits. You will soon receive a notice of a Petition to Modify or Suspend Compensation Benefits.
Another clear indication your employer or its insurance carrier may be looking to completely cut off your medical and wage-loss benefits is that you are requested to visit a physician chosen by your employer or the insurer for an independent medical exam (IME). The examination is for the purpose of procuring an opinion that you are fully recovered or at least recovered enough to return to some form of employment. Armed with the report of the physician, your employer or its insurer will file a Petition to Terminate your work injury benefits if the IME physician feels you fully recovered from your work injuries.
In lieu of a petition to terminate work injury benefits, an employer or a workers’ compensation insurer may file a Petition for Suspension of Benefits when an injured employee has returned to work, but has not completely healed from a workplace injury. In this case, the worker may need future treatment for the work-related injuries or illness, or at least regular monitoring and periodic check-ups; however, the worker is able to return to his job without loss of income. If your employer or its insurance company is seeking to suspend your workers’ compensation benefits, contact the experienced Pearson Koutcher Law, Pennsylvania workplace injury lawyers to discuss how to ensure that your right to future work-related injury benefits is preserved, as well as your right to challenge the suspension.
A Petition for Suspension of Benefits is an acknowledgment by your employer and its insurance carrier that you have not completely recovered from your workplace injury or illness and, in the future, wage loss and medical treatment may occur as a result of the work injury. A suspension of workplace injury benefits is typical when the injured worker returns to work at no loss of earnings. During the suspension of your Workers’ Compensation benefits, a period lasting 500 weeks, your employer or its insurer must pay any medical bills related to the work injury. A Petition to Reinstate wage-loss benefits during the suspension period is appropriate when your wage loss again occurs, whether a result of a worsening of your condition, the performance of a surgical procedure or a layoff from work.
With the Work Comp Lawyers at Pearson Koutcher law, you’ll always get the help you need. Pearson Koutcher Law only takes workplace accident cases and with over forty years of combined experience, we know how to achieve the best results in the instance of a Workplace Compensation suspension. We can help to get you through a Worker’s Compensation settlement and get you the Workman’s Comp benefits you need most. Consultations are arranged around the client’s schedule and can be set up at the nearest place of convenience, whether that’s in our office or at your place of residence. Contact us for more info about our Workmen Compensation services and how we can help with a Work Comp suspension.
Once you have returned to work, your employer can suspend your Workers’ Compensation benefits upon notification to you and the Department of Labor by mail within seven days of your return to work. You may receive a document called a Notification of Suspension or Modification. If you choose to contest the suspension, you have 20 days to file for a special “supersedeas” hearing challenging the employer’s claims, i.e. you’ve returned to work at earnings equal to or greater than your earnings at the time of the matter. If you do not contest the Notification of Suspension or Modification within the 20 days, you are deemed to have admitted the facts as presented by your employer.
At Pearson Koutcher Law, our seasoned attorneys are here to help you. Below is a list of work injuries we frequently cover. If you have a question about your specific claim, contact us today.
There are many different types of jobs in Pennsylvania. Some jobs have obvious dangers to workers, while others seem relatively safe. However, regardless of your job type, and how safe it may seem, work accidents can happen anytime throughout the day. Our PA workers’ compensation attorneys are proud to represent a wide range of injured workers throughout Philadelphia and surrounding areas, as well as the Lehigh Valley, including the following:
If you are an employee in an industry not listed above and you are injured on the job, please do not hesitate to call the Pennsylvania workers’ compensation attorneys at Pearson Koutcher Law for free information about what steps to take next.
Our Pennsylvania workers’ compensation lawyers represent injured workers in Philadelphia County, Montgomery County, Bucks County, Delaware County, Chester County, Lehigh County (Allentown and Bethlehem), Northampton County (Easton), New Jersey and more.
We will fight for your right to the medical benefits you require to make the best recovery possible from your workplace injuries. Our singular goal is to protect your workmen compensation rights to any and all work comp benefits due to you under the law. For over two decades, our practice has assisted injured workers in the Greater Philadelphia region to successfully obtain their benefits.