Workers' Compensation

Philadelphia Workers’ Compensation Lawyer

Workers’ Comp Settlement for a Back Injury

Work injury is all too common. When someone is injured they need a PA workers compensation attorney. Some work injury, such as slips, falls, and accidents involving faulty equipment are a result of negligence on the part of the employer and a Philadelphia workers compensation attorney can help get the injured person compensated for their loss. The PA work injury lawyers at our Philadelphia office help those who have been injured make a recovery.

We all need to make a living, and we expect that our employers will make our places of work as safe and pleasant as possible. Other types of injuries, such as carpal tunnel syndrome or the development of back and neck problems, come about because of the nature of the work and are not the employer’s fault. Employees who can no longer do their jobs because of a workplace injury worry how they are going to be able to support themselves and their families.

If you are injured while on the job, regardless of whether or not the injury was the result of your employer’s negligence, you are entitled to workers’ compensation benefits. Much like wages, these benefits are paid to employees who are out of work on a periodic (weekly, bi-weekly, or monthly) basis. These benefits are intended to compensate the worker for lost income and medical expenses incurred. Damages such as pain and suffering, as well as punitive damages that punish an employer for negligence, are not available in workers’ compensation claims. In exchange for receiving workers’ compensation benefits, you give up the right to sue your employer over your injury, even if it was your employer’s fault.

Most employees qualify for workers’ compensation, but some do not. For example, independent contractors and “casual employees” are not entitled to receive workers’ compensation benefits. Also, your employer could attempt to suspend your benefits, reduce your benefits, or demand that you undergo a physical examination at any time. You should hire an attorney as soon as possible to determine what your rights are to receive workers’ compensation, and so that you have someone on your side if your employer tries to take your benefits away in the future.

At The Levin Firm Personal Injury Lawyers, we understand that representing workers’ compensation claimants requires particular types of skills and knowledge, as well as ability to understand your rights as an employee. We understand these issues, and work with our clients, their friends and family, as well as their doctors, psychologists, long-term care planners, and others – to ensure that our clients receive not only the finest legal representation, but also the finest support and medical care.
Workers’ compensation claims are complex, and require attorneys who understand how to navigate the system, and who are willing to explain the status of your case to you every step of the way. At The Levin Firm Personal Injury Lawyers, we investigate every claim so that we may aggressively and zealously represent our clients and obtain the best possible results.

Philadelphia Workers’ Compensation FAQs

If you or your partner have contracted an occupational illness or suffered injuries in a workplace accident, you are likely facing an array of physical, emotional, and financial challenges related to your injuries and filing a workers’ compensation claim. In addition to the physical pain and discomfort of illness or injury, injured workers often need to miss work for a period of time. This can result in a loss of income that can have a large impact on households.

Federal law mandates all states to administer a workers’ compensation insurance program that requires this insurance to provide benefits to workers who suffer on-the-job injuries or illnesses. Whether you have begun the workers’ compensation claims process or not, you likely have questions and might be uncertain about what comes next.

It’s in your best interest to at least consult us to find out the best course of action for your circumstances. Involving a lawyer early on in the workers’ compensation claims process can help ensure you do not make common missteps that could potentially jeopardize your benefits.

Were you injured in a workplace accident in Philadelphia? If so, then you may have the right to obtain compensation for your injuries through the state’s Workers’ Compensation program.

We have developed this guide of some answers to frequently asked questions about workers’ compensation claims in Philadelphia. The information below could help get you started until you have the chance to meet with a Philadelphia workers’ compensation lawyer at the Levin Firm.

What is workers’ compensation insurance?

Workers’ compensation is a mandatory insurance program that provides workers with compensation for the costs of medical treatment and lost wages if they sustain an injury at work or contract an occupational illness. If an employee suffers a fatal injury or illness, workers’ compensation provides death benefits for eligible surviving family members. Although workers’ compensation is nationally mandated, private insurance carriers and third-party administrators provide benefits to those with approved claims.

Employers purchase workers comp to provides benefits to employees who have suffered an injury or illness at the workplace. Pennsylvania’s Workers’ Compensation Act is the law that defines how claims are made, what benefits are available, and who is eligible to receive compensation. Under this Act, all private employers in Pennsylvania must purchase workers’ compensation insurance for their employees, whether the employees are full-time, part-time, or seasonal, even if the business is a non-profit corporation, is an unincorporated business, or has only one employee.

The Act contains just a few exceptions to this rule, including:

  • Employees covered under other workers’ compensation-type programs, such as federal civilian employees, railroad workers, and longshoremen.
  • Volunteer workers, provided they receive no compensation for their work, including monetary compensation as well as other forms of compensation such as products or services.
  • Agricultural workers who work for less than 30 days or receive less than $1,200 from one employer per calendar year.
  • Corporate executive officers.
  • Employers who have filed for, and have obtained, an exception from workers’ compensation obligations due to religious beliefs.

Some of the benefits provided to injured employees through Pennsylvania workers’ compensation insurance include:

  • Payment of lost wages, which may begin after seven calendar days of disability. If the worker still cannot return to work after 14 days, he or she will be retroactively paid for the first seven days. Lost wage benefits are approximately two-thirds of the wage the employee was earning before the injury occurred, up to the weekly maximum.
  • Death benefits, provided to the family if the worker dies due to his or her injuries.
  • Specific loss benefits, designed to recover the loss of certain body parts or the loss of function in those parts, including thumb, finger, hand, arm, toe, foot, leg; or the loss of hearing or vision as a result of the injury.
  • Medical care, including reasonable surgical or medical services provided as a result of the injury, such as medicine, supplies, hospital treatment or services, orthopedic appliances, and prostheses.

Workers’ compensation insurance can be purchased by the employer from an insurer who is licensed to work in Pennsylvania or through the state-funded workers’ compensation insurance provider. Some companies may self-insure by providing proof of the ability to pay for the benefits that would be required if their employee became injured.

Is workers’ compensation a federal program, or is it something provided by the state?

Neither, really. Workers’ compensation is a form of insurance that employers purchase or provide. However, the rules governing what a workers’ compensation insurance policy must cover are, for the most part, set forth in state law, and a state agency oversees workers’ compensation compliance and disputes.

Federal employees and those working in certain industries, however, such as railroad workers and longshoremen, are covered through different workers’ compensation insurance overseen by the federal government. For example, the U.S. Department of Labor oversees four workplace disability programs, including the Energy Employees’ Occupational Illness Compensation Program, the Federal Employees’ Compensation Program, the Longshore and Harbor Workers’ Compensation Program, and the Black Lung Benefits Program.

What do I need to do to obtain workers’ compensation benefits?

The first thing you need to do is to seek medical treatment if necessary for your injury or illness. Keep in mind that if your employer has a list of at least six providers for you to choose to seek initial treatment from, then you must seek care from one of the providers on the list. You must also notify your employer of your injury. Pennsylvania workers’ compensation law requires you to give this notification within 120 days; failure to do so can result in you losing benefits. For occupational illness or disease, you have a time limit of 300 weeks after the last date of occupation in the occupation where you were exposed to the hazard, and you must file a petition for benefits no later than three years after the illness occurs.

How do I know if I am covered under workers’ comp?

The Pennsylvania Workers’ Compensation Act covers almost all workers. Employers need to comply and provide coverage for all seasonal, part-time, and full-time workers. Pennsylvania also forces nonprofits, unincorporated businesses, and organizations with only one employee to comply with the Workers’ Compensation Act.

Other laws protect some groups of employees including employees for the federal government, railroad workers, longshoremen, shipyard employees, and harbor workers.

Some groups that exempt from the law:

  • Volunteers
  • Farm laborers
  • Casual employees
  • Domestic workers

Call us if your employer tries to classify you as an independent contractor to exclude you from workers’ comp benefits.

What should I do if my employer is uninsured?

If you do not fall into one of the exceptions listed above, your employer is supposed to have workers’ compensation coverage unless they elect to be self-insured. If your employer has chosen to self-insure, they can directly pay you for your medical expenses and lost wages. If your employer is not self-insured, or they have not purchased the required workers’ compensation coverage, you might be eligible for benefits from Pennsylvania’s Uninsured Employer Guaranty Fund.

You must file a claim within 45 days from the date you found out your employer was uninsured. If your claim is approved, you could receive the same or similar benefits typically provided by workers’ compensation coverage.

Bottom line: Call our Philadelphia workers’ compensation lawyers today if you were injured working for an uninsured employer.

How long do I have to file a workers’ compensation claim in Philadelphia?

You must notify your employer of your workplace injury within 21 days. Your employer may know immediately if you suffer an injury, but sometimes employers are not on-premises. Under Pennsylvania law, you have 120 days to file a workers’ compensation claim. If you do not report your injury or file a claim in time, you risk delaying your benefits or having your claim denied.

If your employer disputes your claim or your employer’s insurance carrier denies your claim, you have three years from the date of your injury to file a petition and have your case reviewed. Occupational illnesses work a little differently than injuries. Typically, illness in the workplace occurs as a result of hazardous exposure; which in most cases, happens over time. You must have contracted your occupational disease or illness within 300 weeks from the last date you worked in the location where you had exposure to the hazard that caused your condition.

What benefits could I receive if my Philadelphia workers’ compensation claim is approved?

Pennsylvania law provides a wide array of workers’ compensation benefits to those with approved claims. Benefits can include:

  • Lost wage benefits. Workers who suffer a total disability or partial disability as a result of a workplace injury can receive payments to replace some income they lose for missing work.
  • Death benefits. Fatal workplace injuries sometimes entitle surviving dependents to receive benefits.
  • Specific loss benefits. Some types of injuries entitle employees to additional compensation. Examples include the permanent loss of all or part of a thumb, finger, hand, arm, foot, leg, or toe. Injuries that cause damage to vision or hearing, or cause permanent scars on the head, face, or neck also may also qualify injured workers for special loss benefits.
  • Medical benefits. Workers who suffer injuries or illness would be eligible for benefits that cover related necessary surgical and medical services including medicine, supplies, hospitalization, and assistive devices. Your medical treatment would be covered if your workers’ compensation claim is approved, even if you do not have to take time off work.

Are other insurance benefits available to me aside from workers’ compensation?

If your injury is serious and you can’t work for at least a year or more, you may have legal rights to receive certain types of disability benefits, such as Social Security Disability payments. Go here for more information about this type of payment. An experienced Philadelphia workers’ compensation attorney can help you evaluate your eligibility for any such benefits.

Can I also file a lawsuit against my employer due to my injuries?

Generally, no. The workers’ compensation program is designed to provide a simpler process for collecting compensation for workplace injuries and illness than suing an employer.

Still, in some limited circumstances, a worker may have the right to sue an employer for a work-related injury or illness, such as:

  • Cases where the employer has not purchased workers’ compensation insurance for its employees in spite of being required to do so.
  • Cases where the employer intentionally injures an employee.
  • Cases where a third-party caused the workplace injury or illness.

Speak with an experienced Philadelphia workers’ compensation lawyer to determine your eligibility to take legal action against your employer.

Keep in mind, too, that even though you cannot sue your employer for a work-related injury or illness in most cases, you may have the right to take legal action against a third party (someone other than your employer or a co-worker) for causing you harm. A lawyer can help you evaluate your right to take this sort of action as well.

Will my employer fire me if I file a workers’ compensation claim?

It is against the law for an employer to fire an employee simply for filing a workers’ compensation claim. It is also illegal for an employer to retaliate against you in any other way for filing your claim, such as by threatening you, increasing surveillance of your activities on the job, giving you a negative job review, or giving negative job references. If you feel that this has happened, then you may have legal rights to sue for damages. Speak with a Philadelphia workers’ compensation attorney right away.

Does my employer decide when I am recovered enough to return to work?

No, that is a decision made by your doctor. You will be allowed to return to work when your doctor provides you a release to do so. Often, doctors release the employee to return to work before treatment ends, but with restrictions. Once you have provided the release to the employer, it then becomes the employer’s decision as to whether you can return to work.

My employer stated that I’m not actually an employee but an independent contractor. Do I still qualify for workers’ compensation?

With the growing popularity of rideshare services such as Lyft and Uber, in which the drivers who drive for the company are classified as independent contractors, there is increasing attention being given to the misclassification of workers here in Pennsylvania and elsewhere. In addition to depriving workers of their right to obtain benefits through the workers’ compensation program, misclassifying an employee as an independent contractor also interferes with a worker’s ability to obtain other benefits, such as unemployment insurance, health insurance, retirement benefits, and paid vacations.

If you feel that you were wrongly classified as an independent contractor instead of an employee, speak with an attorney right away. You can also file a worker misclassification survey on this page or call 1-866-403-6163 (option 3), weekdays from 8 a.m. to 4:30 p.m. We encourage you, however, to speak with an attorney first. We can help you determine if you need to file that paperwork and if so we can help you do it.

My benefits were terminated and I would like them reinstated. How do I do this?

If your employer’s insurer terminated your benefits, you may file a petition with the Office of Adjudication for a reinstatement hearing within three years after the date of your last workers’ compensation check. The judge overseeing your case will generally require mediation with all interested parties unless there is reason to believe that mediation efforts would be futile. Decisions of the Office of Adjudication can be appealed to the Workers’ Compensation Appeal Board as well as the Commonwealth Court.

Do not attempt to navigate the reinstatement process alone. Speak with an experienced Philadelphia workers’ compensation attorney right away.

Do I have to pay a deductible for medical treatment through workers’ compensation?

No. Your employer and your employer’s insurer are responsible for paying the full amount of benefits for reasonable medical treatments that are owed to you. However, the insurer may decline to make payments if you failed to seek treatment from the employer’s list of providers for at least 90 days after the injury or your treatments were deemed to be unnecessary.

My son hurt himself at school and I missed work to take him to doctor’s appointments. Does this injury qualify for workers’ compensation?

No, the injuries of your family members are not covered through workers’ compensation, even if you miss work to obtain treatment and provide care. An employer’s responsibility to provide workers’ compensation insurance only extends to employees who have become injured during the normal scope of their employment or have acquired a workplace illness due to exposure to a toxic substance while at work.

I am 17 years old and just suffered an injury at my part-time job. Am I eligible to receive benefits even though I am not of age?

Yes, the workers’ compensation law requires that employers provide this coverage for all employees, regardless of how old they are or how many hours they work.

I am a sole proprietor with no employees. Am I required to have workers’ compensation insurance?

No, sole proprietors are not required to carry workers’ compensation insurance. However, if you pay anyone as an independent contractor who performs work-related services for your business, you should check to ensure that the worker is properly classified.

Why would workers’ comp deny my claim?

There are several reasons why the insurer might choose to deny your claim, including:

  • The belief that your injury was self-inflicted or was caused by illegal behavior, such as being under the influence of alcohol or drugs.
  • The belief that your injury was pre-existing or that it didn’t happen at work, or that the illness you acquired was not occupational.
  • If you fail to notify your employer of your injury or illness within the required time period.
  • There were no witnesses to your injury who can verify that it occurred at work.

If you have received a claim denial, speak with an experienced Philadelphia workers’ compensation attorney right away to discuss your rights.

Can my regular doctor treat me for my work-related injury or illness?

It depends on the situation. If your employer wants you to visit a specific doctor or healthcare provider for your injury or illness, they must provide you with six or more options. You then must visit this provider for your initial treatment and continued treatment for the first 90 days. If a provider from the list recommends a major surgery, you would have the right to seek out a second opinion, which is covered by your benefits.

If you choose to visit a physician who is not on your employer’s list of providers, they might refuse to pay for treatment. If your employer does not provide a list, provides an incomplete list, or 90 days has passed, you could seek treatment with any doctor you choose. You, however, must notify your employer of your choice. If you begin workers’ compensation benefits, your employer’s insurance carrier also has the right to send you to a doctor of their choice for an exam. If you do not go to the exam, you risk losing your benefits.

How long do I have to wait for workers’ compensation benefits?

Once you have missed one shift or day of work as a result of a workplace injury or illness, the law requires your employer to file a first report of injury with the Pennsylvania Bureau of Workers’ Compensation. Your employer can choose to accept or deny your claim.

Upon acceptance, you cannot receive disability payments to cover lost wages until you have missed at least seven calendars of work. Your benefits would then be payable on the eighth day after your injury. Once you have missed 14 days of work, you will receive payment for the first seven days you missed work.

How much could I receive for lost wages?

The benefits you receive for lost wages will generally be approximately two-thirds of your average weekly wage, up to the maximum amount allowed under Pennsylvania law. Your claim’s administrator can use a variety of methods to calculate your average weekly wage under the Pennsylvania Workers’ Compensation Act. However, the minimum compensation rate is the lesser of 90 percent of your average weekly wage or 50 percent of the statewide average weekly wage.

How long can I receive workers’ compensation benefits for lost wages?

Whether or not your insurer approves your claim, you may be granted temporary compensation benefits for up to 90 days. These benefits may stop at any time during the 90 days if your employer’s insurer chooses to deny your claim. Once you have been approved to receive compensation, your wage-loss benefits may continue until your employer and insurer have evidence to show that you are back to work at wages that are equal to or more than what you were making before the injury. Benefits may also stop if a judge determines that you are not eligible to receive them. Additionally, if you receive partial disability benefits, those benefits will expire after 500 weeks.

In addition, the length of time you can receive payments for lost wages depends on whether you have a total or partial disability benefits status.

  • Total disability benefits. Total disability status applies to employees who have been injured to such an extent that they cannot work for a period of time because of a disability. After you have received total disability benefits for 104 weeks, your employer’s insurance carrier has the right to request a medical exam. During the exam, a physician will assess if you are at least 35 percent disabled as defined by American Medical Association (AMA) standards. If you are less than 35 percent impaired, your employer’s insurance company can change your benefits status to partial disability.
  • Partial disability benefits. Any injury that leaves you less than 35 percent impaired falls under the umbrella of partial disability. You can receive partial disability benefits for up to 500 weeks. If you visit a doctor during this time, and he or she determines you meet the 35 percent threshold, you can petition workers’ compensation for total disability status. You could also receive 500 weeks of partial disability benefits if you return to work and make less money as a result of injury-related restrictions.

Do I have to take a light-duty position if my employer offers one to me?

If you are receiving workers’ compensation benefits and your employer offers you a local position within your medical restrictions, you would still have a right to decline the job offer. However, your employer would also have the right to petition a workers’ compensation judge to reduce or terminate your lost wages benefits. The insurance carrier must continue to pay your benefits throughout the petition process and beyond, unless a judge orders something different.

I reported my injury to my employer, filed a claim, and I have not received a response. Now what?

If you should be receiving benefits, you need to contact your employer or their workers’ compensation insurance provider as soon as possible. The insurance provider has 21 days from the day you notified your employer of your injury to decide whether to approve or deny your workers’ compensation claim or make temporary payments to you for up to 90 days while they gather more information.

If you find that the carrier denied your claim, you have the right to contest their decision. First, you must file a petition with the Office of Adjudication, which assigns cases to special workers’ compensation judges. A judge would hold a hearing, listen to evidence, and render a judgment. If you are unhappy with the judge’s decision about your claim, you would also have the right to appeal to the Workers’ Compensation Appeal Board and Commonwealth Court.

Could I sue a third party for damages related to my work injury or illness?

Yes, if the third party’s negligence led to your workplace injury or occupational illness. In fact, it can be imperative that you evaluate your case to find out if any third parties might be liable. As mentioned above, workers’ compensation benefits do not fully replace your wages. Also, you cannot receive compensation for pain and suffering, loss of consortium, or other possible non-economic damages, from workers’ compensation, but you could from a third-party liability claim.

Some examples where a third party might be liable for damages include:

  • Property owners, business owners, or contractors responsible for a job site where an accident occurs.
  • Companies that manufacture dangerous or toxic chemicals that led to an occupational illness after exposure.
  • Companies that manufacture or distribute defective products or equipment when a defect leads to injury, illness, or death.
  • Negligent drivers who cause a traffic accident with employees who are driving or riding in a company vehicle.

Do I need a Philadelphia workers’ compensation attorney?

Workers’ compensation litigation is complex and your employer and/or their insurance provider will have an experienced lawyer or legal team in their corner. You will want a Philadelphia workers’ comp lawyer of your own who has your best interests at heart.

Some ways in which our experienced Philadelphia workers’ compensation lawyer could help you include:

  • Investigating the event(s) that led to your injury or illness.
  • Investigating safety practices in your workplace.
  • Interviewing witnesses.
  • Gathering relevant documents like medical records, police reports, and safety records to help support your claim.
  • Holding your employer financially liable for damages if they are uninsured.
  • Holding your employer financially liable if they try to retaliate against you for filing a workers’ compensation claim.
  • Identifying third parties that might be liable for damages related to your workplace injury or occupational illness.

When you need a Philadelphia, Pennsylvania or New Jersey personal injury attorney to represent you, a family member or friend who has been injured at work, contact The Levin Firm Personal Injury Lawyers, who represent every client zealously in order to obtain the best results possible in each case.

Philadelphia Office
Attorneys Gabriel Levin and John Mattiacci at The Levin Firm welcome the opportunity to meet and work with you.
Toll Free: 877.825.8542