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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Should I try to settle my claim with the insurance company on my own?
Insurance companies are mainly concerned with their own interests rather than your best interests. The business of the insurance company is to take in as many premiums as possible while paying out as few claims as possible.
Their representatives are trained to minimize or deny your claim, and they employ a variety of tactics to accomplish that. They may well ask you questions that may hurt your claim. At other times, the representative may act as if he or she is on your side and encourage you to resolve your claim quickly for far less than the value of the claim. Consult an attorney before considering settlement, a topic I discuss in more detail here.
What should I do if I am hurt in an accident?
First, get medical attention. At the same time, if you are able to do so, you should create a record that will help you protect your claim. File a police report, either at the scene or as soon as possible afterward. Try to get names and contact information from any witnesses. If you can, write down exactly what happened as soon as possible after the event. Accident scene photographs often provide valuable evidence that can’t be duplicated after the fact.
What is the difference between compensatory and punitive damages, and which can I get in a personal injury case?
Compensatory damages are damages meant to compensate you for your losses. These damages cover actual economic losses, like medical bills and lost income. They can also include compensation for pain and suffering and loss of enjoyment of life. The purpose of compensatory damages is to put you as nearly as possible back in the position where you would have been if the defendant’s negligence had not occurred.
Punitive damages, on the other hand, are intended to punish the defendant and to discourage others from engaging in the kind of negligence. An award of punitive damages requires a showing of something more than mere negligence.
What is a personal injury case?
Personal injury cases arise from a wide range of circumstances. Some of the most common are car accidents, slip and fall injuries, motorcycle accidents, and work injuries. But any time someone is harmed by the negligence of another person or company, there might be a personal injury claim.
What is negligence?
We are required by law to act with “reasonable care.” What constitutes reasonable care varies from situation to situation. When someone fails to act with the reasonable care required by a given circumstance, that is considered negligence. In order for you to recover for most personal injuries, you will have to prove that another person or a business was negligent, and that the negligence caused your injuries.
Is other information available about my rights under Pennsylvania law?
You may download the books described to the left. Print copies of some of the books may be obtained by calling the law offices of The Boles Firm toll-free at (215) 259-5879.
You may download a free copy of "Workers Compensation and the Injured Worker" from:
Contact information for the Bureau of Workers' Compensation:
Bureau of Worker's Compensation
1171 South Cameron St. Room
324 Harrisburg, PA 17104-2501
Email: [email protected]
Toll free in Pennsylvania: 800-482-2383 FREE
Local and outside Pennsylvania: 717-772-4447
For those who are hearing impaired:
Toll free in Pennsylvania TTY: 800-362-4228
Local and outside Pennsylvania TTY: 717-772-4991
Association of Professional Flight Attendants Contact Information:
IOD Representative on Duty: 817-540-0108 x8303
E-mail: [email protected]
IOD National Chair: 817-540-0108 x8293
E-mail: [email protected]
Am I permitted to file a lawsuit in connection with my work injury?
The Workers' Compensation Act provides that the employer and any fellow employee of the injured worker are absolutely protected from suit by the injured employee with one exception. In the event that the injury is at the hand of a fellow employee who has caused an intentional injury to a worker, then the fellow employee (but not the employer) might no longer be immune from suit. Otherwise, as long as the injury arises from the work relationship, workers' compensation benefits are the only recourse of an injured employee against his employer or fellow employee. In a great number of situations, however, the victim has been injured not by a fellow employee or his or her employer, but by a "third party." In this circumstance, the victim is entitled both to compensation benefits and to bring a suit for "pain and suffering" against the negligent third party.
Perhaps the most frequent occasion where the Workers' Compensation Act does not prevent a negligence action arising is when an employee is injured in a car accident during work. Assuming the other driver was negligent, a lawsuit may be brought as long as the other driver was not in the hire of the same employer. An employee whose work takes him or her off the premise of the employer onto the premise of others is exposed to the possibility of defective conditions of those premises, and these defects that might serve as a basis for negligence claims.
These are just a few examples of situations where the Workers' Compensation Act does not prevent an act for pain and suffering. You should not simply assume that suit is prohibited. If you would like to discuss the possibility of a third party claim arising from your work injury, please feel free to call the law office of The Boles Firm (215) 259-5879 for a free consultation.
Should I give a taped statement?
Although you may have to explain your version of the events underlying your claim to an investigator or claims adjuster, there is nothing in the Act that requires you to give a taped statement. You would be perfectly within your rights to refuse to allow your statement to be taped.
If you choose to give a taped statement, be very careful about what you say. You should not give such a statement without first taking some time to think about what occurred. You must be truthful and accurate, and you must be careful not to let anger or frustration affect the statements you make. On the other hand, no matter how friendly the claims examiner may be, you must assume that your statements will be used against you. The adjuster may have medical records or other documents in front of her while questioning you and may attempt to get you to make statements that are contradicted by the documents.
In sum, you must recognize that your livelihood may depend on the words you use during a taped statement, and you must act accordingly. If you have any doubt about the wisdom of giving any statement to a claims investigator, call the lawyers of The Boles Firm for free assistance.
What should I do if my workers' comp claim is denied?
You have the right to appeal a claim denial to a workers' compensation judge. You should gather your medical records so that a claim petition can be filed with the Bureau of Workers' Compensation. It is crucial to have an attorney represent you at this stage of the proceedings because it will be necessary to provide testimony—both your own testimony and the testimony of medical experts who support your benefits.
Through an arrangement with APFA, the attorneys at The Boles Firm have agreed to charge a reduced fee and accept all legitimate claims, no matter how small. Furthermore, the attorneys at The Boles Firm will provide you with a half-hour free consultation concerning your claim and will charge a reduced contingent fee to all American Airline flight attendants who hire the firm.
Under Section 27(C) of your contract, you are entitled to use time in your sick bank while your claim is pending. If you are capable of light duty work, you may be entitled to unemployment compensation benefits because under Section 27(G) of your contract, the company may not require you to work light duty. In the event you are awarded workers' compensation benefits, those benefits will be reduced by any unemployment compensation benefits you received.
Under Section 27(F) of your contract, while your claim is being appealed, you'll be paid sick hours if you have sick hours in your bank. You will also be paid your vacation pay. If you're claiming sick leave and have a scheduled vacation, you must notify the company if you wish to cancel the scheduled vacation. If the workers' compensation judge reverses the denial and the claim is approved, "the amount of sick leave and vacation time claimed, and sick leave and vacation that would have been accrued but for the original denial of the claim during the appeal period will be returned to the flight attendant's sick leave and vacation banks. The amount of sick leave and vacation time reinstated will be limited to the amount of salary continuance the flight attendant would have been eligible for." Furthermore, there may be tax adjustments that must be made because sick and vacation time are taxable and workers' compensation benefits are not. If no tax adjustments are made, you should contact your IOD representative or The Boles Firm at 215-557-5540.
How will my claim be processed?
Once you have provided the company with notice of your injury, the company has 21 days from the date of injury to investigate and make a decision to accept or deny the claim and to make the first payment of compensation due. Your employer or the insurance carrier may make payments of temporary compensation for up to 90 days, even if your claim is not accepted
Upon receiving notice of your claim, the workers’ compensation insurance company will assign an insurance adjuster to investigate your claim, decide whether to accept it, monitor your medical treatment, and perform other tasks. A medical expense claim may be assigned to another department.
Please note that when your claim is assigned to an adjuster, the claim will be given a claim number. If you call or write the adjuster handling your claim, you must be prepared to give your claim number. Any correspondence sent to the insurance company should have the claim number clearly written on the top of the correspondence.