Workplace injuries are common, resulting in everything from minor bumps, bruises, and scrapes to catastrophic injuries and even death. The Workers’ Compensation Act, 77, 77 Pennsylvania Statutes § 1 et seq., protects employees by providing benefits for work-related injuries and illnesses.
Understanding the workers’ compensation process is essential in getting the benefits you need. A Bensalem workers’ compensation lawyer from The Law Office of Kaitlin Files can offer the help you need to pursue your claims and meet legal challenges head on.
Workers’ compensation is a no-fault insurance system that provides benefits to employees injured in the course and scope of their employment. Under 77 Pennsylvania Statutes § 501(a), almost all employers must carry workers’ compensation insurance for employees. The no-fault system eliminates the need to prove employer negligence, simplifies the process, and helps workers receive timely medical care, as well as benefits for lost wages.
Qualifying for workers’ compensation requires an injured person to establish that the injury occurred while they were performing work-related duties. The injuries do not have to be the result of an accident at work—repetitive stress injuries, occupational diseases, and aggravation of pre-existing conditions also qualify. A workers’ compensation lawyer in Bensalem could help employees determine if their injuries will qualify.
Injured workers may be entitled to several different types of benefits. While eligibility depends on the nature and severity of the workers’ injuries, most workers will qualify for medical and wage loss benefits if their injuries prevent them from working.
Some workers will be eligible for a specific loss benefit, which compensates for permanent injuries like an amputation or loss of vision. In the case of fatal workplace injuries, surviving dependents may receive benefits to cover funeral expenses and ongoing financial support.
While injured workers do not have to prove liability, they do have to prove the extent of their injuries. Employers—or their insurance carriers—are responsible for paying all reasonable and necessary medical expenses related to the injury. Those expenses include things like doctor’s visits, surgeries, prescriptions, and physical therapy.
Employees may also qualify for benefits for time missed from work if they are unable to work or only able to earn reduced wages. However, because workers’ comp is a no-fault system, workers cannot earn full benefits for lost wages. Instead, wage loss benefits are usually equal to two-thirds of the worker’s average weekly wage. While there are minimum benefit amounts, there are also maximum limits. A Bensalem workers’ compensation attorney could help workers understand their potential benefits.
Under 77 Pennsylvania Statutes § 631, employees must report workplace injuries to their employers within 120 days of the injury occurring. Injured employees who miss the deadline could lose their right to their benefits.
Within 21 days, the employer or their insurer must accept or deny the claim. If they accept the claim, the injured worker starts receiving benefits. If they deny the claim, the worker can file a claim petition with the Bureau of Workers’ Compensation to challenge the decision.
While workers’ compensation is supposed to be an easy, no-fault way to protect workers, insurers and employers may still make it difficult for employees to get the benefits they deserve. Employers or insurers may argue that the injury did not occur at work or, if it did occur at work, that it was from something outside of the employee’s duties. Insurers may question the diagnosis or extent of an injury and, therefore, the need for specific treatments. Another frequent source of disagreement is the wage calculations.
Addressing these challenges may be overwhelming for injured workers. A Bensalem workers’ comp attorney could step in to gather medical evidence, obtain lay statements, and more.
Filing a workers’ compensation claim is supposed to be straightforward for injured workers. However, insurance companies are for-profit entities, and they often try to reduce payouts when possible. The result can be obstacles and hurdles in your way when you try to file a claim.
A Bensalem worker’s compensation lawyer could provide you with comprehensive legal support at every stage of the process. Contact us to schedule a consultation and learn more.
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