Workers’ Compensation Attorney
When you’re injured at work, your company should have a worker’s compensation plan in place that covers your lost wages and medical expenses. It is important to understand what worker’s comp covers to make sure you are fairly compensated.
In some instances, workers’ are denied workers’ comp, sometimes for reasons that aren’t fair. If you are denied workers’ comp, Bloomsburg, PA law firm Luschas, Naparsteck & Crane, LLP will review your case to determine what you’re entitled to.
This article will outline what worker’s comp should cover and provide advice on what you should do if your claim is denied.
What Does Workers’ Comp Cover In Pennsylvania?
If you are injured on the job in the state of Pennsylvania, here’s a list of what your company’s workers’ comp should be covering.
- Medical expenses
- Temporary and permanent total and partial disability benefits
- Specific loss benefits- provides compensation for the specific loss which may be the use of an extremity, vision or hearing loss or disfigurement
- Death benefits
What Injuries are Covered Under Pennsylvania Workers’ Comp?
Any injuries incurred at work should be covered by workers’ comp unless they are self-inflicted or a result of illegal or careless behavior or behavior resulting from intoxication. Here are some injuries that are commonly incurred in the line of work.
- Carpal tunnel syndrome
- Neck injury
- Back injury
- Asbestos exposure
- Traumatic brain injury
- Joint injuries
How Do I Get Pennsylvania Worker’s Comp Benefits?
In order to get your workers’ comp benefits, you must report your injury within 120 of its occurrence. You must also file a worker’s comp claim.
Filing a claim is not easy and any incomplete or incorrect information may affect your ability to get the compensation you deserve. It’s a good idea to enlist an attorney to make sure your claim is completed properly.
Who Decides if I’m Eligible for Benefits?
Your employer will get the final word on whether or not you’re eligible for benefits. However, the insurance company and medical providers will weigh in on the decision and could drastically affect the outcome.
Your doctor will diagnose your condition and decide on a method of treatment. This may include seeing a specialist, going for physical therapy and more. He or she will determine how much time you will need to take off work and whether or not your condition is permanent.
This will come into play in the final decision as to whether you are eligible and how much you should be compensated for.
The insurance company will also weigh in when it comes to figuring out how much you are owed and if any additional information is needed to prove your claim.
Can I Choose the Doctor?
Yes and no.
You can not choose the doctor you see for your initial visit. The doctor you see first will be the one chosen by your employer and you must see the doctor within 90 days from the time the injury was sustained.
However, once a follow up treatment is recommended, you can get that treatment from the doctor of your choice.
How Much Can I Get In Workers’ Comp Benefits in the State Of Pennsylvania?
Under Pennsylvania law, workers’ are entitled to two thirds of their average weekly pay. Medical expenses are covered as well.
How Long do My Workers’ Comp Benefits Last?
According to Pennsylvania law, your benefits will last until you go back to work or sign an agreement suspending your benefits. If you lose a case before a Worker’s Compensation judge, that could also end your benefits.
Does Workers’ Comp Cover Permanent Disability?
At some point during your treatment your doctor will determine if your condition has improved and whether they think it will continue improving. If they don’t think you will continue to get better, you will have reached MMI or maximum medical improvement.
Once you have reached MMI, you doctor will determine whether your injury has left you with any permanent restrictions. If it is determined that you have lasting restrictions, you will get a disability rating which is a percentage that represents your degree of limitations.
From there, your doctor decides whether you have a permanent total disability or a permanent partial disability.
A permanent total disability will keep you from working for the rest of your life. If this is the case, you will continue getting workers’ comp benefits for as long as you live.
If you are diagnosed as a permanent partial disability, your compensation will be based on a system of scheduled or unscheduled loss.
A scheduled loss is listed on a state’s schedule and will tell you exactly how many weeks you will be compensated according to your injury. If your injury is not scheduled, your disability rating will be used to determine how long you’re eligible to receive benefits for.
Who is Eligible for Workers’ Comp?
Most employers are required to carry workers comp. You will be eligible for workers comp as long as you were an employee who sustained a work-related injury and filed in accordance with your work deadlines.
However, there are some workers that employees are not required to cover in their insurance policies. These include the following.
- Domestic workers such as nannies and housecleaners
- Agriculture and farm workers working on small farms
- Leased or loaned employees such as temp workers
- Casual or seasonal employees
- Undocumented Workers
What If I’m Denied Workers’ Comp Coverage?
Workers comp coverage is not always approved. Here are some common reasons you might get turned down.
- Your injury didn’t occur in the workplace while doing your job: Your injury must be at least 50% due to work activity and must have occurred in the workplace. If you were on break when injuries occurred, you may not be eligible.
- Your injury isn’t covered: For example, mental health is not covered by workers comp. If you are suffering anxiety due to work related incidents, you will not be eligible for worker’s comp.
- Waiting too long: You must meet the reporting and filing deadlines to receive workers comp. Waiting too long can ruin your chances of becoming compensated.
- No witnesses: If no one witnessed the incident causing the injury, you may have trouble proving your case.
- Discrepancies on your report: Your report must be in line with the doctor’s findings or your claim may be considered fraudulent.
- Pre-existing condition: If you have a pre-existing condition that you believe worsened while you were on the job, you may not be eligible for workers comp, especially if your employers provided tools to keep you from exacerbating your injury.
- Lack of cooperation: If you do not cooperate with your employers and insurance company in giving them all the information they need such as recorded statements, etc., your claim may be denied.
- Injuries that May Have Been Your Fault: If you incurred injuries due to being intoxicated, being the aggressor in a fight, not complying with workplace safety rules or fooling around on the job, you may not be compensated for your injuries.
It’s Important to Have a Good Lawyer on Your Side
If you believe that you were unfairly denied workers compensation benefits, it is best to seek the help of a workers comp lawyer. Your lawyer will help you in the following ways.
Collecting Evidence: Your lawyer will collect relevant evidence including medical records, testimonies from medical experts, family and friends and any proof as to why your workplace may be unsafe.
Negotiating Settlements: A good lawyer will make sure you get the money you deserve. They will assess the extent of your injuries and tally up your medical expenses to make sure you are fully compensated.
Represent You at a Hearing or Trial: If your lawyer is unable to reach a settlement agreement with your employer, the case may be taken to trial. Your lawyer will represent you in front of a judge, arrange all witness testimony and make sure all documents are correctly filled out and submitted on time.
Advice You on Third Party Claims: In some instances, you may be able to get additional compensation through third party claims. For example, if you were using faulty equipment while you were injured, you may be able to sue the company that manufactured that equipment as well as your employer to get additional coverage for your damages.
Why Luschas, Naparsteck & Crane, LLP
If you are looking for an attorney to represent you in your Pennsylvania workers comp claim, Luschas, Naparsteck & Crane, LLP is highly recommended. We have years of experience in the field of personal injury and workers comp law. We will leave no stone unturned when it comes to building a strong case and getting you the compensation you deserve.
A work-related injury can be devastating. If your company is responsible, don’t let them get away with it. Call Luschas, Naparsteck & Crane, LLP to make sure your losses and expenses are covered.