The very first thing you should do is report your injury to a supervisor. The Pennsylvania Workers’ Compensation Act requires you to give notice to your employer, such as your boss, supervisor, or HR department. Telling your co-worker is not enough. You may notify your employer verbally, but it always helps your case if you submit something in writing or complete an incident report. It is very important to make it clear to your employer that your injury or disability is a result of your work. Telling a supervisor that your wrist hurts or your low back is achy, without expressing the cause of your pain will be an issue later down the road.
There are specific time limits that must be kept in mind. In order to collect Workers’ Compensation benefits or wage loss benefits from day one of your claim, please be sure to notify your employer of the injury within 21 days of its occurrence. If you do not notify your employer within 21 days, you may still supply notice up to 120 days from the incident. If you give notice after 21 days, but within 120 days, you are entitled to benefits as of the day you supply this notice. If your injury is a repetitive injury – in other words, there was not one single event, but rather the injury occurred over time – then it is in your best interest to notify your employer as soon as you discover (either through your own intuition or from a medical provider) the work-relatedness of your medical condition.
Once you notify your employer, there are a few things that may happen. First, they may tell you that you have to treat with one of their doctors. This is one of the most common misnomers in this area of law. Many employers and insurance companies will dispel the myth to injured workers that they “must” treat with certain doctors (often referred to as panel doctors) for 90 days. There is absolutely no such requirement under Pennsylvania law. In fact, the opposite is true. You are free to choose the doctor that will care for your work injury. There are some very specific laws in terms of payment obligation during the first 90 days. If the employer has adhered to certain rules, then they may only have to pay medical bills for certain providers, but in our experience, these rules are rarely complied with. If the rules are not followed, all medical bills are payable. Even if the employer took necessary steps on their part, there are many medical providers that may still be willing to assist you in the first 90 days. Having control over your own medical care is essential to a healthy recovery and a positive outcome in your case. Unfortunately, some company doctors have inherent bias and will send you back to work before you are ready. Discussing your medical treatment is part of most initial calls and there is no fee for our consultation.
Your employer’s Workers’ Compensation insurance carrier has 21 days from the time you report your injury to notify you in writing whether your claim has been accepted or denied. It is important to note that the 21-day rule is strict and failure to make this decision timely can result in you receiving penalties from the insurance company. No matter what decision they make, it is wise to obtain counsel. They may accept your claim with a Notice of Compensation Payable, accepting responsibility for covering your medical treatment or wage loss benefits, or both. If for instance, you are able to work without suffering a wage loss while undergoing medical treatment for your work-injury, the insurance carrier may accept just the medical portion of your claim and cover your reasonable, necessary and causally-related medical treatment.
The insurance company may choose to temporarily accept your claim by issuing a Notice of Temporary Compensation Payable. This gives the employer and/or the insurance carrier 90 days to investigate your claim. During that time, they will pay your medical bills or wage loss benefits, or both. During this 90-day investigative period, they may accept or deny your claim. Therefore, it would be beneficial to obtain counsel, even if you are temporarily receiving Workers’ Compensation benefits because they can be pulled in the blink of an eye. If the employer does nothing, your claim is automatically accepted after 90 days.
And lastly, your employer may flat out deny your claim by issuing a Notice of Compensation Denial.
Regardless of how your Employer handles your work-injury, it is highly recommended you contact an attorney who specializes in Workers’ Compensation injuries – which is exactly what we do here at Stern & Cohen. If you or a loved one has been involved in a work injury, do not hesitate to contact our office, the consultation is no cost to you.”
Please fill out the form on the right, below, so that we can learn more about your worker compensation needs. We will be in touch with you shortly to discuss your matter in more detail.2001 Market Street, Suite 3400