Frequently Asked Questions About Workers’ Compensation
Here are answers to some of the most common questions we hear about workers’ compensation law in Pennsylvania. If your questions are not answered on this page, feel free to call our office at 570-391-0199 to speak to an attorney in a free consultation.
Q: I have limited money, can I hire you?
Q: What about the court costs?
Q: I just hurt myself at work. What should I do?
Q: I told my employer about my work injury, but they have done nothing. Is this legal?
Q: I was hurt at work and the insurance company denied my claim. What should I do?
Q: I hurt my back at work, but I had a bad back before my work injury. Am I covered?
Q: The workers’ compensation insurance carrier acknowledged my claim and I continue to work. What should I do?
Q: I heard workers’ compensation insurance companies sometimes videotape injured workers when they are out in public. Is this true?
Q: The insurance company’s doctor says I am fully recovered, but I do not feel recovered. What should I do?
Q: What about my medical bills?
Q: The insurance company hired a nurse to come to my appointments with me. Is this legal?
Q: The insurance carrier hired a vocational expert to meet with me. Must I go?
Q: What about settlement?
Q: I want to settle my case, but what about my medical treatment?
Q: The insurance carrier wants me to go to their doctor for an evaluation. Must I go?
Q: How much will my weekly workers’ compensation check be?
Q: I am out of work and receiving workers’ compensation. Do I need an attorney?
Q: What is workers’ compensation?
Q: Who is covered?
Q: What are the benefits?
Q: Should I be concerned with time limits?
A: YES. Our advice is free. Our consultation is free. There is no attorney’s fee to take your case. We only get paid when we win, and we proudly offer reduced fees. All Pennsylvania workers’ compensation cases are taken on a contingent fee basis. This means a workers’ compensation attorney gets a percentage of the money they recover for you. Typically, workers’ compensation attorneys take 20% of your recovery. We reduce this percentage for our clients. We also offer special rates for Union members.
A: Litigating a workers’ compensation case can get very expensive. Typically, doctors must testify to win a case. They often charge several thousand dollars to do this. Some law firms ask you to pay for your doctor’s testimony. Even if a law firm pays for the deposition, they sometimes ask you to pay them back later. Not us. We pay all costs for you. We never ask our clients to pay for anything – ever.
A: Tell your employer about your injury immediately. You have only four months from your date of injury to tell your employer about it. You must treat with a doctor chosen by your employer for the first 90 days if there is a written list of doctors properly posted at your place of employment. After 90 days, you are free to treat with any doctor you would like, so long as you give your employer five days notice.
A: No. Your employer and the workers’ compensation insurance carrier have only 21 days to act after you report your work injury. By law, they must choose to accept or deny your claim within 21 days or they are in violation of the Pennsylvania Workers’ Compensation Act. If you injured yourself and you have not received any paperwork – call us now because your employer may be violating your rights.
A: Many times insurance carriers deny legitimate workers’ compensation claims. Once your claim is denied, it places the burden directly on you to file an appropriate Petition within three years within your date of injury. Your claim will be forever lost if you do not file it within three years of your date of injury.
A: Yes. To win your case, you must prove an injury occurred while you worked. This can be a new injury or an aggravation of a pre-existing condition. The Pennsylvania Workers’ Compensation Act treats an aggravation exactly the same as a new injury. Of course, your doctor must be willing to say your pre-existing condition became worse due to your work.
A: Don’t quit. Don’t get fired. Don’t retire. Voluntarily ending your employment could have a negative impact on your right to wage loss benefits. If you are working under medical restrictions, always have a copy of your medical restrictions with you. The Pennsylvania Workers’ Compensation Act requires injured workers to exercise “good faith” when they are injured. This means you should always tell your employer “you are available to work within your restrictions.” If you encounter difficulty on the job, never take yourself out of work without a doctor’s advice. You should immediately go to your treating physician and have your doctor examine you to reevaluate your restrictions. If your doctor takes you out of the workforce, you should immediately provide your employer with your new restrictions.
A: Yes. In Pennsylvania, an insurance company may legally hire an investigator to spy on you. While an investigator may not commit trespass or violate the law, they may follow you, speak with your friends and neighbors and take videotapes of you conducting your normal activities in public. The best advice is to always know your medical restrictions and live your life within your doctor’s restrictions. ALWAYS follow your medical restrictions – at home, in public and at the workplace. This is good advice from a legal and medical standpoint.
A: Get prepared. The insurance company will file a Petition against you. The Petition will ask a Workers’ Compensation Judge to immediately cut off your benefits. The Judge will typically rule on this request within 14 days of the first hearing. It is very important to be well-prepared for the first hearing to protect your wage loss benefits.
A: Your employer is responsible to pay for reasonable, necessary and causally related bills related to your work injury.
A: Many times the insurance company or employer will assign a nurse to medically manage your claim. The Pennsylvania Workers’ Compensation Act does not address medical management. Therefore, an injured worker and his or her doctor may chose not to speak with a nurse manager.
A: YES. Often times, insurance carriers hire a vocational expert to meet with an injured worker to evaluate their education and employment skills. The vocational expert will then survey your general area for employment opportunities within your medical restrictions and vocational/employment abilities. This is called a Labor Market Survey. The vocational expert will estimate how much money you could make if you return to the workforce. The insurance company would then file a Petition and try to cut off or reduce your benefits. Again, they will ask to cut off or reduce your benefits at the very first hearing. Therefore, it is very important to be well-prepared.
A: Many times workers’ compensation cases result in lump sum settlements. The amount of settlement varies from case to case and depends on many factors including your age, your pre-injury rate of pay, the severity of your injury, the amount of medical bills paid due to your work injury, etc. There is no set or fixed value to any workers’ compensation case. We have a great deal of experience negotiating lump sum settlements for our clients and we never settle a case unless our client wants to and is satisfied with the amount. Call now for a free evaluation.
A: This is a legitimate concern for any injured worker. Most times the insurance carrier will push very hard to get an injured worker to fully settle his or her case and give up any future right to medical treatment. Sometimes they will even offer additional money to get this type of settlement. On the other hand, the Pennsylvania Workers’ Compensation Act allows injured workers to settle the wage loss portion of their case only. That means reasonable, necessary and causally related medical treatment can remain payable even if you settle your workers’ compensation case.
A:YES. The Pennsylvania Workers’ Compensation Act requires workers to attend such medical evaluations by doctors chosen by the insurance carriers as often as two times per year. You could refuse to attend such an evaluation for very limited reasons. If transportation is an issue, the workers’ compensation insurance carrier will provide door-to-door transportation for you. They will pick you up at your home, take you to your evaluation and bring you back home when you are done. This transportation should be requested as early as possible. Additionally, you can ask the insurance carrier to pay for your mileage if you drive yourself.
A: Wage loss varies from case to case. Usually, your workers’ compensation wage loss rate will be determined by the wages you earned one year prior to your work injury. Most injured workers receive 2/3 of their pre-injury average gross paycheck. All wage loss benefits, including settlements, are tax-free. If you worked for your employer for less than 13 weeks, your wage loss benefits will typically be calculated by your hourly rate of pay and the hours you were expected to work at the time you were hired. In Pennsylvania, workers’ compensation wage loss benefits are fixed. This means they will not increase over time.
A: You are not required to have an attorney for your workers’ compensation case. Keep in mind, our firm never takes a fee unless we recover wages for you or we prevent the compensation company from taking wage loss benefits from you. Therefore, if you are currently receiving compensation and you hire us, we will advise you and keep the workers’ compensation insurance company off your back without charging any fees. There will never be a fee unless we settle your case for you or the workers’ compensation carrier takes you to court. Until this happens, hiring us would give you the peace of mind needed to recover. More importantly, you will have an attorney up-to-date on your case and ready to go to court at a moment’s notice. This is very important when an insurance carrier takes you to court and asks the Judge to stop paying you at the very first hearing. You need someone informed and ready to fight for you. We are ready.
A: The Pennsylvania Workers’ Compensation Act pays for your medical expenses and wage loss when you are unable to work due to a job injury or work related illness. Additionally, it pays for death benefits to an injured worker’s dependent survivors for work related death.
A: Almost all Pennsylvania workers are covered by the Workers’ Compensation Act. In fact, employers must provide workers’ compensation coverage for all employees even if they are seasonal and part time. Even an employer with only one employee must comply with the Act.
A: Payments for loss of wages, medical benefits, death benefits (if the job injury or disease caused the death) and specific loss benefits. Specific loss benefits pay injured workers who have lost the permanent use of a body part or those who have sustained serious and permanent scarring or disfigurement to the head face or neck.
A: YES. An injured worker must tell his/her employer about the work injury within 120 days after the injury for compensation to be paid. If workers’ compensation benefits are denied by the employer or insurance carrier you have only three years from the date of injury to file a Claim Petition. By failing to file a petition in time, you may forfeit your right to benefits. If you were on workers’ compensation benefits and they are currently suspended, you may file a petition to reinstate your benefits within 500 weeks from the date your benefits were suspended. If your benefits were terminated, you may file a Petition to Reinstate within 3 years after the date of your most recent workers’ compensation check. Please remember that payment of medical benefits by your employer does NOT always mean that your claim has been accepted. You must still comply with the above time restrictions.
The information contained in the Frequently Asked Questions portion of our website contains general information only. Workers’ Compensation cases are fact specific and you should contact an attorney for specific legal advice regarding the facts of your case.