Why You Need a Workers’ Compensation Attorney
May 10, 2023
Workers’ compensation is a no-fault insurance system found in all 50 states that pay medical expenses and lost wages (up to a limit) when an employee is injured or falls ill due to work-related activities or workplace conditions. No fault means that the employee cannot, in most circumstances, sue anyone, including the employer, nor can the employer sue the employee. Generally, the employer will contract with an insurance company to provide workers’ compensation.
Workers' compensation seems like a seamless system. For example, say you fall off a ladder or platform at work, injure your back, seek medical attention, and report the injury to your employer. Your employer contacts the insurer, who pays your medical expenses and compensates you for any lost time at work.
While that sounds like a fairly ideal system, in reality, navigating through the claims process can present problems and challenges you don’t anticipate. Insurers, for instance, are for-profit businesses, so they’re going to look to limit how much they reimburse you. The insurer can doubt your story, require you to get another medical opinion, and even claim your injury resulted from a pre-existing condition.
If you’ve been injured at work or fallen ill due to chemical exposure or something similar in or around Bethlehem or Palmerton, Pennsylvania, contact our workers’ compensation attorneys at the Law Office of Shabbick & Stehle.
We will advise you on how to move forward with your claim and help you with an appeal if you are denied or shortchanged. In some cases, where a lawsuit may be justified, we will help you and represent you in that legal effort. Our legal team also proudly serves clients in Lehigh, Northampton, and Carbon counties, Pennsylvania.
Workers’ Compensation in Pennsylvania
Workers’ compensation covers medical and treatment expenses for your injuries or illness for lost time – and wages – if your condition prevents you from working. However, the Commonwealth of Pennsylvania also caps the weekly wages that can be paid. Generally, the system will pay two-thirds of your weekly wages, but it uses the Statewide Average Weekly Wage to cap what you can receive. That wage average for 2023 is $1,273 a week.
In addition to some of the challenges you may face that were mentioned above, there are also a series of different forms that will be required to be filled out and submitted to qualify for your benefits. For claims beyond something routine like a sprained ankle, and especially for a serious injury or illness, it’s always recommended to consult with a workers’ compensation attorney.
Under the Pennsylvania system, employers can contract with insurance companies, self-insure, participate in a group self-insurance fund, or obtain a policy from the State Workers’ Insurance Fund to cover their workers’ compensation.
Why You Need a Workers’ Compensation Attorney
As mentioned above, just filling out the necessary forms and assembling the supporting medical evidence can be challenging, which can get more difficult if your injury or illness is serious. Then the process itself can pose new and unanticipated challenges for new medical evidence, or the issue of a pre-existing condition can present even more problems.
Say you do fall off a ladder or ledge and hurt your back, and the insurance provider finds out you had previously injured your back while out on a boating vacation. They can then claim that your injury is a result of your pre-existing condition and put your benefits on hold or even deny everything. An attorney can help you challenge this action or denial and also help you file an appeal.
When You Definitely Need an Attorney’s Help
Even what seems like a fairly straightforward claim, it helps to consult with a workers’ compensation attorney, but if you have a serious condition that is impacting your ability to perform your duties at work, then you need an attorney’s assistance. If your claim is challenged or even denied, you definitely should rely on your attorney.
Even before your claim gets to the insurer, your employer may challenge your story and claim you were not injured on the job. In this case, unless you have witnesses to what happened to you, it can be tough to navigate the system. Again, an attorney experienced in workers’ compensation law can help you press your claim.
Another situation is when it comes time for a settlement agreement. Without an attorney to review the terms with you, many challenges will arise. If you are seeking Social Security Disability Benefits because you are going to miss a lengthy period from work, that settlement document becomes even more important.
Finally, you will need an experienced attorney if you do have a case for a lawsuit. A lawsuit generally cannot be filed against your employer unless they deliberately cause your accident, for instance, by tripping you as you walk down some stairs.
Lawsuits are generally reserved for third parties. For instance, if a machine you use at work malfunctions because of a defect and you are injured, you may be able to sue the designer, manufacturer, or even the supplier, depending on the circumstances.
If your employer refuses your workers’ compensation coverage by claiming you are an independent contractor, that maybe reason for litigation as well.
Choose Lawyers Who Care
At the Law of, we are “Lawyers Who Care, Lawyers Who Listen.” If you need to file a workers’ compensation claim in or around Bethlehem or Palmerton, Pennsylvania, contact us immediately for a free consultation. We will help you in all phases of your claim, working with you for the best possible result in terms of benefits and compensation.