If you have been injured in the workplace or developed an occupational illness, 77 Pennsylvania Statutes § 1 et seq offers no-fault protection for your medical care and lost wages. Known as workers’ compensation, this system ensures that injured employees receive protection without having to prove that the employer was negligent.
Understanding the scope of benefits available, eligibility requirements, and the claims process is critical to helping you get the full protections of workers’ compensation benefits in Bensalem. Let a dedicated workers’ comp attorney guide you through the process and help you pursue the payments you need and deserve.
Workers’ compensation provides several benefits to address various needs following workplace injuries or illnesses. To most people, the most pressing immediate need is medical care. Employers and their insurance carriers are responsible for covering all reasonable and necessary medical expenses related to a work injury, including payment for doctor visits, physical therapy, surgery, medications, and even specialized treatments.
Access to medical benefits has some conditions. Employers can require injured workers to seek treatment from employer-designated healthcare providers for the first 90 days after the injury, depending on whether the employer has complied with statutory posting requirements. The employer can only control which medical provider if they obtain the necessary paperwork. If they do not, injured workers are free to treat with whoever they want.
Lost wage benefits are another immediate concern for many Bensalem employees. Workers who are unable to work or are earning reduced wages need compensation to support themselves and their families. There are two main types of wage loss compensation. Temporary total disability (TTD) is for workers who are entirely unable to work and is equal to two-thirds of the worker’s average weekly wage, subject to state minimums and maximums. Temporary partial disability (TPD) is for workers who can perform limited duties or work reduced hours and covers the difference between pre-injury and post-injury earnings, also subject to statutory minimums and maximums.
Specific loss benefits go beyond lost wages and medical expenses. These benefits are for injuries that result in the permanent loss of use of a body part. Some injuries that give rise to specific loss benefits are amputations and vision loss. 77 Pennsylvania Statutes § 513 contains a statutory schedule of benefits for specific losses and lists the amounts for severe disfigurement.
If an employee dies on the job, their surviving dependents may be eligible for death benefits. These benefits, like those paid directly to employees, are limited. They include financial support and reimbursement for burial expenses but no compensation for emotional losses.
Not every injured worker can get workers’ compensation benefits, as certain limitations affect eligibility. For example, the worker must be an employee, not an independent contractor, and they have to demonstrate that the injury or illness arose in the course and scope of employment. Most—but not all—workplace injuries are covered. However, the injury does not have to be in the workplace if it is in the scope of employment.
Traumatic injuries, repetitive stress injuries, and occupational illnesses are the three most common types of compensable injuries. Traumatic injuries are those sustained in severe accidents. Repetitive stress injuries are caused by overuse of a body part—carpal tunnel syndrome is probably the best-known example. Occupational illnesses are illnesses linked to workplace exposure to unhealthy conditions.
People with pre-existing conditions may still qualify for workers’ comp benefits in Bensalem. If the worker’s job duties aggravated a condition beyond its natural progression, then workers’ compensation may cover the condition, or at least the changes from the employee’s starting condition.
While workers’ compensation aims to provide financial security in a no-fault setting, employees may still face obstacles in the claims process. Common challenges include disputes over whether the injury is work-related, disagreements about whether medical treatment is necessary, and conflicts over wage loss calculations.
Insurers of employers may also try to terminate or modify benefits if they believe that the worker is sufficiently recovered to return to work. However, returning to work before they have had an opportunity to heal fully can leave workers vulnerable to more serious injuries. Injured employees in Bensalem have the right to fight challenges that can impact their worker’s compensation benefits.
The Law Office of Kaitlin Files provides skilled legal representation for employees pursuing workers’ compensation benefits in Bensalem. Our seasoned team could help you with any part of the process, from filing claims to challenging denials through appeals. Schedule a consultation to find out more.
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