Getting The Workers’ Compensation You Deserve
If you were injured on the job, you have at least two large concerns right away: How will you recover as well as possible from your injuries, and how will you cope financially if you lose the income you depend on? You may need emergency treatment, follow-up medical care, and time to rest and heal. Your family may depend on the earnings you bring home. How will you get along without regular paychecks from your employer?
Workers’ Compensation has attempted to answer questions like these for countless injured workers over many years. What many people do not realize is the critical role a lawyer can play in a successful Workers’ Compensation case. Do not be surprised if your employer and/or their insurer puts up roadblocks as you seek the help you deserve.
Shabbick & Associates, PC, welcomes inquiries from injured employees or their family members. Let us explain how we can help with your claim or with an appeal after a denial. Meanwhile, see our questions and answers below on various aspects of Workers’ Compensation.
What Is Workers’ Compensation?
The Pennsylvania Workers’ Compensation Act (the Act) provides coverage for injured workers. The employer is required to secure insurance, either through private insurance, the State Workers’ Insurance Fund, or self-insurance. There may be serious consequences if the employer fails to obtain proper insurance. Some employers may require workers to agree in advance that they are not employees or otherwise classify the workers as “independent contractors”; however, the worker is not bound by such an agreement, and it may be necessary to initiate litigation in order to determine whether the injured worker is entitled to coverage under the Act.
The Act provides for certain benefits to the injured worker. The injured worker may obtain wage loss benefits, medical expenses benefits, and, in the case of fatal injuries, funeral benefits and survivors benefits payable to certain dependents.
If you are injured, the injury should be reported to management even though initially there may be no lost time. The employer is obligated to report the claim to its insurance company, and the insurance company is obligated to issue a written decision within 21 days of the report, indicating whether the claim is accepted or denied. There are specific forms required by the Bureau of Workers’ Compensation (BWC) that must be filed in Harrisburg to document the handling of each claim. The insurance company will require verification by medical record to substantiate the injured worker’s claim. If the injured worker is incapable of any type of employment, they may be entitled to temporary total disability benefits. If the injured worker is capable of modified employment, but at reduced wages, the injured worker may be entitled to temporary partial disability benefits.
Disputes over entitlement, amount and duration of benefits are resolved by filing petitions to the Bureau of Workers’ Compensation. BWC assigns the dispute for hearings conducted at the local level. The individual presiding over the hearing is a Workers’ Compensation Judge (WCJ). The WCJ will schedule hearings. The hearing procedure is conducted with a certain degree of formality with witnesses, both factual and medical or vocational expert witnesses, testifying under oath. Typically, the WCJ will require briefs from the parties’ attorneys before issuing the written decision.
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Do I Need An Attorney?
The injured worker is at a serious disadvantage unless he/she retains counsel. The employer will be represented by its insurance company. The insurance company will have lawyers available to represent the interests of the employer and the insurance company. The insurance company may initially deny your claim such that litigation cannot be avoided.
Once the injured worker begins receiving disability benefits, the employer, through its insurer, may take advantage of certain procedures authorized by the Act to modify, suspend or terminate benefits. The Act provides certain rights but also imposes certain obligations upon the injured worker. You will be bound by the rules even if you do not have an attorney.
The Workers’ Compensation insurer may propose a partial or full settlement of the injured worker’s claim. There are many factors to consider when determining whether the proposal is fair. An experienced attorney will help you get the settlement you deserve.
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How Much Will My Attorney Charge?
All counsel fees are typically limited to 20% of the amount awarded and must be approved by a Workers’ Compensation Judge. When circumstances warrant, the WCJ may order the insurance company to pay the injured worker’s attorneys fees, though unfortunately, such an award is not customary.
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I Have Concerns. What Should I do?
You should contact an attorney experienced in Pennsylvania Workers’ Compensation matters to understand your rights and obligations. Our attorneys give individual attention to each case. You may contact us by calling any of our offices to schedule a brief telephone conference to discuss your case. Later, an office appointment will be scheduled by mutual agreement.
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