Starting a PA Workers’ Compensation Claim
Pennsylvania workers’ compensation attorneys are not surprised that oftentimes neither employers nor employees have a good idea of what to do when an injury on the job occurs. Despite the best efforts of the Pennsylvania Workers’ Compensation Bureau and workers comp insurance carriers to educate labor and management, most employees don’t have any clue what their rights are when they are injured, and most employers aren’t quite sure what to do when they are notified of an injury. PA workers comp law can be a trap for the unwary employee, and also for the unwary employer.
A good, handy reference for employers and employees can be found at the website for the Pennsylvania Department of Labor and Industry (www.dli.state.pa.us/landi/). For the brave souls interested in studying the actual language of the law, the official Pennsylvania workers’ compensation regulations can be found at 34 Pa.Code Chapter 121 et seq..
For employees (“claimants” in workers’ comp parlance), it is vitally important to report injuries as soon as they occur. This serves many practical purposes. First, a claimant will not be entitled to any PA workers’ compensation benefits before she gives notice of the work injury. Second, it makes simple common sense that an employee who notifies her supervisor right away is more likely to be believed than one who waits a few days. Third, the act of putting the employer on notice of the injury triggers certain duties on the part of the employer; in other words, after appropriate notice, the employer’s clock is running to respond. It is important to note that the claimant must give notice to a supervisor, not just to a co-worker. The notice cannot be simply that the worker suffered an injury, but must be to the effect that the worker was injured in the course of employment. In all PA workers comp cases, claimants should attempt to give notice within 21 days of their injuries. But beware! A claimant can lose the right to make a claim at all if she fails to give notice of the claim to her employer within 120 days of the injury or the date she has knowledge of a work-related disease.
Employers who are not self-insured are required to post, in a prominent and easily accessible place, at their primary place of business and at their sites of employment, their acceptance of Article III of the Pennsylvania Workers’ Compensation Act, including a statement showing the name of the insurance company carrying compensation insurance and the expiration date of the current policy. 34 Pa.Code § 9.88(1). Employers are also required to post Bureau Form LIBC-500, “Remember: It is important to tell your employer about your injury,” to inform employees of the name, address, and phone number of their workers’ compensation insurance company, their third-party administrator, or their internal workers’ compensation contact person.
Employers are required to immediately report all employee injuries to their insurer. Employers are also required to file with the Bureau a report of injury within 48 hours after every injury resulting in death, and after seven days but within ten days after the date of injury for all other injuries which result in disability lasting more than a day, shift, or turn of work. 34 Pa.Code § 121.5. Within 21 days from the date the employee provides notification of an injury, the employer, or its insurance carrier must either accept liability for the injury, and issue a Notice of Compensation Payable or a Notice of Temporary Compensation Payable, or must issue a Notice of Workers’ Compensation Denial explaining why the claim was denied. If the claim is accepted, the employer, and its insurance carrier must also correctly calculate the employee’s pre-injury average weekly wage and resulting compensation rate, so that the employee can be paid the correct amount of compensation benefits under the Act. If the employer fails to either accept, or deny the injury within 21 days of having notice of the injury, it can be liable for penalties if the employee must file a claim petition with the Bureau.
If a claim is denied, the employee has three years from the date of injury to file a Claim Petition. However, claimants are well-advised to file their petition earlier to give themselves the best chance of being successful in their litigation. Workers’ compensation litigation is an administrative proceeding before a workers’ compensation judge, and in a claim petition proceeding the burden is on the claimant to prove that he was an employee who was injured in the course and scope of his employment, and that his injury has caused him to require medical treatment, or to suffer a loss of earning capacity.
The duties and obligations of employers and employees in Pennsylvania workers’ compensation cases are not to be taken lightly. For an employer, any questions should be referred to their workers’ comp insurance carriers right away so that the employer can be sure to comply with all of the requirements of the Workers’ Compensation Act, and not jeopardize any of its rights under the Act. For employees, it is often wise to consult with an experienced Pennsylvania workers’ compensation attorney even if a claim is being paid, to be sure that the employee is receiving every benefit to which he or she is entitled. If a claimant thinks he is entitled to benefits but is not receiving them, he is well-advised to consult with a PA workers comp lawyer, so that appropriate steps can be taken to ensure that benefits are paid. Take the time to learn your Pennsylvania workers’ compensation rights and duties – the benefits of compliance with the law can save much time and hassle down the road.
The attorneys of Wolf, Baldwin & Associates, P.C. are no strangers to Pennsylvania workers’ compensation courtrooms. We have been practicing in this specific area of the law for over thirty years. Insurance companies will always be represented by workers’ compensation attorneys who are experienced in PA workers comp law. You require, and deserve, expert advice as well. If the insurance company unfairly denies you your rights, we will fight the workers’ comp insurance carrier for your right to receive Workers’ Compensation in Pennsylvania. Please click on the links below to learn more, or click here to contact us now to learn more about your right to PA workers compensation.