1. The majority of workers' compensation claims are fraudulent. Approximately 1 to 2 percent of all workers' compensation cases are fraudulent, and some studies, including a Wisconsin study, put the number at about .6 percent.
2. You have to prove that your employer is at fault to collect Pennsylvania workers' compensation benefits. Workers' compensation is a no-fault system. That means that you get to collect benefits regardless of whether anyone is at fault. You are covered by workers' compensation even if the injury is completely your fault.
3. Your employment is protected as long as you're on workers' comp. You may qualify for leave pursuant to the Family and Medical Leave Act, but you are not automatically entitled to get your job back after you recover from a work-related injury. The Family and Medical Leave Act gives you up to 12 weeks of time off for a serious medical condition. Not all employers are obligated to provide this type of leave, and once the leave time expires, your employer does not have the obligation to re-hire you. Accordingly, if you have a serious injury that requires you to be out for longer than 12 weeks, you almost certainly should talk to a lawyer. There are many union contracts that provide additional protection for people who have suffered work injuries. For more information on your rights, click here.
4. You can collect pain and suffering damages for your work injury. In a personal injury lawsuit, you can collect damages for pain and suffering associated with your injuries. In some circumstances, you may also be entitled to punitive damages. In a workers' comp case, you can’t get such damages.
5. You have to do whatever your employer tells you to do after you suffer a work injury. Employees commonly believe that employers have the right to tell them where to go for medical treatment after a work injury. There are circumstances under which you may be required to treat with a medical provider from a list that is provided by the employer, but you have the right to choose the medical provider. Furthermore, so many employers fail to comply with the law and regulations governing this particular rule that as a practical matter, virtually every employee can treat with a doctor of his choice after the work injury occurs. For more information, read this article.
6. If a doctor releases you to return to work light duty, you have to go back to work immediately. Do not assume that you have a legal obligation to return to work following a release by your doctor to light duty. If you have work-related physical restrictions, your employer must provide you with employment consistent with those restrictions or you are entitled to receive workers' compensation benefits. If you wish, contact your employer and ask if light duty work is available, though you have no obligation to do so. If no such work is available, your benefits are not in jeopardy. If you do return to light duty, watch out for “The Seven Most Ugly Tactics Employers Use to Harass Injured Workers.”
7. The insurance company has the right to stop workers' compensation benefits at any time. If the insurance company has issued a Notice of Temporary Compensation Payable following your work injury, it has up to 90 days to stop paying you benefits and force you to go to court to prove you are entitled to benefits. If, however, you continue to receive wage loss benefits for more than 90 days or you are receiving wage loss benefits pursuant to a Notice of Compensation Payable, the insurance company must continue paying those benefits until you return to work at no loss of wage or they obtain a court order stopping your benefits. If you are receiving benefits and the insurance company stops paying them (an unusual occurrence in Pennsylvania) they have a legal obligation to reinstate your benefits immediately under most circumstances.
I hope this page is of assistance to you in understanding frequently disseminated myths about Pennsylvania workers' comp. For more information, download or order a free copy of my book, The Wounded Worker: Inside the Pennsylvania Workers' Comp Maze.