When a worker suffers an injury on the job, their first concern is typically how they will pay their medical bills on top of their regular expenses while they are out of work. Fortunately, nearly all workers are covered by their employer’s Workers’ Compensation insurance, which provides for their work-injury-related expenses as well as a portion of their lost wages. Workers’ Compensation is governed by a strict set of guidelines, deviation from which can jeopardize an individual’s claim. Injured workers are strongly encouraged to seek an experienced Workers’ Compensation lawyer to handle their case and ensure they receive the full benefits to which they are entitled.
Medical vs Non-Medical Workers’ Compensation Benefits
Payments for medical expenses after a workplace accident are disbursed immediately. The claim does not have to be approved for the worker to receive these benefits. If the claim is later accepted, Workers’ Compensation will continue to pay for medical expenses related to the injury. In some cases, even if the claim is denied, the employer may still cover the initial injury-related costs.
Unlike medical benefits, non-medical benefits, such as compensation for lost wages, can only be disbursed after the claim is approved by the employer and insurance provider. The insurance provider must also receive information about whether the individual can return to work and if there are any restrictions due to the injury. This is also true if the worker needs to receive disability benefits.
In Pennsylvania, the injured worker must miss at least seven calendar days of work to qualify for wage loss benefits. These benefits become payable on the eighth day. If the worker is forced to miss 14 or more days of work, wage loss benefits will be paid retroactively beginning on the first day of missed work. Recipients typically receive weekly or biweekly checks for the duration of their disbursement period.
Requirements for Workers’ Compensation Claimants
Individuals who have suffered an injury at work should notify their supervisor of the accident as soon as possible. In general, notice must be given within 120 days of the date of injury. However, it is best not to wait this long. After a Workers’ Compensation claim has been filed and the employer and their insurance provider have been notified, they have 21 days to accept or deny the claim. The sooner a claim is filed, the sooner the injured worker will begin to receive his or her benefits. If all goes smoothly, the worker may begin receiving checks as early as three weeks after the date of injury.
Sometimes, a claim is denied because the injury was not reported in time or because the claim form was not filled out properly. In other cases, a claim may be denied if the worker did not receive medical treatment or if there is not enough proof to show that the injury was work-related. If a Workers’ Compensation claim is denied, the worker has the right to file an appeal. Appeals are handled by the Pennsylvania Workers’ Compensation board. During an appeal hearing, the court examines the worker’s case to determine if the claim was unfairly denied. If so, the worker can receive benefits and if not, the claim may be denied again. If this is the case, further appeals may be brought to the Commonwealth Court of Pennsylvania.
Philadelphia Workers’ Compensation Lawyers at the Law Offices of Jeffrey S. Gross Help Injured Workers Obtain CompensationIf you have been injured at work, you have the right to file a Workers’ Compensation claim to recover medical and other benefits. To learn more about your rights and how to navigate the complex Workers’ Compensation process, complete our online contact form or call 267-589-0090 to schedule a free consultation with a Philadelphia Workers’ Compensation lawyer at the Law Offices of Jeffrey S. Gross.