Find the Answers to Your Pennsylvania Workers’ Compensation and Disability Benefits Questions
Most people navigating the workers’ compensation and disability benefits application processes come to us with questions and confusion. Here, we share some of the questions that we answer most about the disability and workers’ compensation application and appeals processes. If you have a question for us, check out this page to see if we have answered this question for others!
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What else should I expect from my employer or its insurance company after I have notified them of my injury?
After receiving notice of a work injury, your employer will ordinarily refer the claim to the insurance company that handles its workers’ compensation claims. . The name, address, and telephone number of the workers' compensation insurance company is supposed to be posted on the employer's premises. Once the employer notifies the insurance company of the claim, the insurance company will assign a claims representative or adjuster to handle your claim, and that person should be in contact with you.
How much time does an employer have to make a decision on whether they will accept my claim?
An employer has 21 days from the date you give notice to investigate a claim and decide whether to accept responsibility for it. Often employers claim that it takes them longer than 21 days. Most commonly, the employer or its insurance company claim that they have not received the written medical records or that the medical records did not say that the condition is work-related. Therefore, if your injury is causing you to miss time from work, you should take it on yourself to make sure that your treating physician verifies, in writing, that your condition is work-related and that you are disabled from performing your regular job as a result of the injury.
What constitutes "notice"?
You have the obligation to notify your employer of your condition and its relationship to your employment. This notice may be oral, but written notice is preferred. Notice should be given to a supervisor, foreman, or other agent of the employer.
What should my employer do after I notify them of my injury?
Employers are obligated to keep records of all on-the-job injuries. If an injury results in any lost time. your employer should complete an Employer's Report of Occupational Injury or Disease (Form LIBC-344). This report must be completed even if the employer disputes its responsibility for your injury. You are entitled to receive a copy of the report.
Do I need to notify my employer of my injury?
Yes. Unless notice of the injury is given to your employer within 21 days, you are not entitled to receive compensation. If notice is not given within 120 days, you will forfeit the right to receive any benefits at all.
There are circumstances in which the notice period does not begin to run until you know or should have known that your disability was caused by a work injury or disease. If your employer or its insurance company tells you that you are not entitled to receive benefits because you gave late notice, contact an attorney who may be able to help.
Are other benefits available to me after I’ve been injured?
I wrote Battered & Broke to give injured workers a comprehensive guide to available cash and assistance while their benefit claims are pending. Here's a quick list of benefits:
Sickness and Accident, Short Term and Long Term Disability
Your employer may have sickness and accident insurance. If you are unable to work due to your injury, it is worthwhile at least to inquire as to whether or not you are covered by a short-term or long-term disability policy.
Welfare, veterans’ benefits, or pension benefits.
If you are totally disabled from all forms of employment, you may seek recovery of Social Security disability benefits. Before you apply for such benefits, you should consult an attorney.
An application for unemployment compensation benefits is not inconsistent with an application for workers' compensation benefits. If you are disabled from your pre-injury position but are capable of performing sedentary or light work, you will qualify for unemployment compensation benefits if your employer refuses to supply such work to you. Your employer or its workers' compensation insurance company will be entitled to a credit for any unemployment compensation benefits you receive while the petition is pending.
Social Security Disability
You are entitled to Social Security disability benefits only if you are suffering from a physical or medical condition that prevents performance of any substantial gainful work, and the condition is expected to last or has lasted for at least 12 months, or is expected to result in death. The Social Security Administration will consider all medical or psychiatric problems that you may have in determining your eligibility for these benefits. Once you receive these benefits for two years, you are entitled to purchase Medicare coverage for your medical expenses. If you have only minimal liquid assets, you may qualify for Supplemental Social Security. This benefit is available to very low income persons who have not made sufficient contributions to the Social Security system to qualify for disability benefits. The same disability test is applicable as for Social Security disability benefits.
Can my employer fire me while I am receiving workers’ compensation benefits?
While there is nothing in the Workers' Compensation Act that forbids employers from firing employees who are out of work due to work injuries, there may be remedies under other federal and state statutes. Some of those laws are the following:
1. The common law of wrongful discharge. If your employment is terminated because you filed a workers' compensation claim, you may have the right to pursue a wrongful discharge lawsuit.
2. Collective bargaining agreements. If you are a union member, your collective bargaining unit may contain provisions that limit your employer's right to terminate you.
3. The Family and Medical Leave Act (FMLA). The FMLA is a federal statute that grants you the right to 12 weeks of unpaid leave time per year if you are suffering from a serious medical condition. This protection is available only if you have worked a sufficient number of hours in the year preceding the first day of leave.
4. The Americans with Disabilities Act (ADA). The ADA is a federal statute that prohibits employers from discriminating against qualified individuals with permanent disabilities, regardless of whether the impairment arose from a work-related or non-work-related event. The ADA imposes on employers the obligation to make reasonable accommodations provided the person can perform the essential functions of the job.
If I suspect that my injury resulted from a defective product, is there any action that I should take?
If you believe that your injury resulted from a defective product, it is essential that the accident scene be preserved. You should request that co-workers or your union take steps to ensure that the product causing the injury is not lost or destroyed. Your employer may be willing to cooperate in preserving the accident scene because they stand to recover monies paid to you as workers’ compensation benefits if you are successful in your lawsuit against the manufacturer of the product.
Can I bring a lawsuit against anyone in connection with my work injuries?
Under Pennsylvania law, you are not permitted to bring a lawsuit against your employer, though there are some significant exceptions, except to recover workers’ compensation benefits. However, you are permitted to bring a lawsuit against persons and companies other than your employer who can be held responsible for your work injury. For example, if you are injured in an automobile accident as a result of the negligence of a driver other than a co-worker, you may sue the other driver.
Am I still entitled to workers’ compensation benefits if I am working but not on my employer's premises?
As long as you are engaged in activities that further the business interests of your employer, you are entitled to workers’ compensation benefits. For example, if you are injured while running an errand for your employer or while participating in a company-sponsored athletic event, you are entitled to benefits. On the other hand, injuries occurring while commuting to or from work often are not covered by the Workers’ Compensation Act, depending on the premise circumstances. Since there are many circumstances where even such injuries may be covered, it is essential that you notify your employer of the injury.