What Is Workers Compensation?
Workers’ compensation is an insurance program that provides benefits to workers who were injured or became ill on the job to make up for medical costs and lost wages while they were out of work.
What You Need to Know
It is Required In Pennsylvania
Much like other states, workers’ compensation insurance coverage is mandatory for all employers in Pennsylvania with one or more employees. This is the case regardless of the number of hours per week the employee works, the employee’s relation to you (family businesses), or the employee’s status. According to the Pennsylvania Department of Labor & Industry, there are a few exceptions:
- Coverage for sole proprietors, partners, and corporate officers is optional.
- Licensed real estate salespeople or brokers and licensed insurance agents who work on a commission-only basis are exempt
- Domestic or casual laborers, outworkers, and farmers with one employee who works less than 30 days a year or earns less than $1,200 a year are exempt.
- A spouse or child who is employed by a farmer and is under eighteen years of age is exempt.
Read more here!
Fault is Generally Not An Issue
Neither the employee’s own negligence in causing the accident nor your complete lack of fault are factors in deciding whether the worker gets benefits.
Employees Give Up the Right to Sue the Company….With Exceptions
In exchange for the assured benefits, employees give up their right to sue you for any injury covered by workers’ compensation laws. However, employees retain the right to sue negligent third parties if their negligence helped cause the accident.
If, however, your injury was intentionally caused by your employer, you may still be able to sue. For example, if you slip and fall during your job, you won’t be able to sue, but if your employer pushes the ladder while you’re on it, there’s a good chance you can file a lawsuit.
Contact us if you have questions or believe you have a case to sue.
What to Do When You’re Injured
Report the Injury or Illness!
Always report any work injury or illness you may believe is due to your job. Telling your work colleague or friends isn’t enough. Report the injury or illness to the HR department, your supervisor, or the risk-management department when it occurs.
Your employer should have you fill out an incident report and direct you to where to obtain medical treatment. Make sure to keep the lines of communication open and follow up with your supervisor if you do not get any paperwork or documentation.
Visit the Right Medical Provider
Obviously, if your injury is an emergency, you’ll go where the ambulance takes you. However, if your injury or illness is not an emergency, your employer may direct you to find treatment at a particular hospital or clinic.
In Pennsylvania, your employer can have a list of healthcare providers that you are required to go to if you want your bills to be covered by workers’ compensation. If you don’t go to one of the approved treatment facilities, you run the risk of not qualifying for workers’ compensation coverage.
Tell the Doctor or Hospital Employees You Were Injured on the Job
While you need to tell your employer you were injured on the job, you also need to tell your doctor. When you’re filling out the paperwork wherever you are getting treated, check the box that asks if your injury or illness was work-related.
That ensures your medical bills will be sent either to the workers’ compensation insurance company or your employer, not you.
Why Was Your Workers’ Compensation Claim Denied?
There are many reasons as to why your workers’ compensation claim may have been denied. Common reasons include:
- Not reporting the injury or filing the claim in the required time period
- Your employer might accuse you of not having been injured on the job
- Your injury was the result of your doing something on the job that you shouldn’t have been doing
- If you were under the influence of drugs or alcohol during the accident
Trust Casale & Bonner P.C.
Have you been injured on the job? Confused about the process of submitting a claim? Has your compensation claim been denied? Maybe we can help. Our lawyers will make sure you receive the compensation you need and deserve so you can focus on a successful recovery!
Want to Learn More?
If you are interested in learning more about workers’ compensation, specifically workers’ compensation in Pennsylvania, browse the following links:
- The Workers Compensation Act
- The Pennsylvania Department of Labor & Industry (for businesses)
- The Pennsylvania Department of Labor & Industry (for individuals)
Believe you have a right to workers’ compensation? Call Casale & Bonner P.C. at 570-326-7044 to speak with a lawyer.