Workers’ compensation is the insurance that provides financial benefits and medical treatment to employees that sustain injuries at work. An injured employee relinquishes their right to sue their employer for negligence if they seek treatment through workers’ compensation.
Workers who become ill due to their job may qualify for these benefits. Employers usually pay for the insurance and may not require an employee to contribute.
Which entity regulates workers’ compensation benefits in Pennsylvania?
The Pennsylvania Department of Labor and Industry is responsible for the administration of worker’s compensation law. State Workers Insurance Fund, a private insurance carrier, offers workers’ compensation insurance policies. In other cases, employers may be self-insured.
What are the rules of workers’ compensation in Pennsylvania?
Workers’ compensation coverage is compulsory by most employers according to Pennsylvania law. Employers who do not possess workers’ compensation coverage may experience employee lawsuits. Moreover, they may also face criminal prosecution by the Commonwealth. In some cases, however, employers are exempt from worker’s compensation coverage.
How do you file a workers’ compensation insurance claim process in Pennsylvania?
The workers’ compensation coverage claim process begins with reporting your injury to your employer. In Pennsylvania, you have 120 days to report to the employer from the day when you sustained the injury. Failing to file within this time may nullify your right to seek compensation.
When can you sue for a workplace injury?
There are two fundamental scenarios when you can sue your employer for a workplace injury: (i) if an employer wrongfully denied workers’ compensation benefits and (ii) if an employer would not provide workers’ compensation coverage.
Long-term injury or illness related from workplace accidents can profoundly affect quality of life. Unfortunately, workers’ comp does not cover the pain and suffering associated with sustaining injuries in the workplace.
However, you are allowed to file a lawsuit in exceptional circumstances that lead to pain and suffering. Before you decide whether to file a lawsuit against your employer, evaluate the situation to determine who is at fault for the injury. In certain cases a product manufacturer or even a third party at the workplace may be responsible.
What are some reasons to file a workplace lawsuit?
Some reasons to sue an employer are wrongful termination, misclassification, improper pay, improper discipline, or retaliation for filing a complaint. Sexual harassment and other violations can also lead to workplace lawsuits.
- Defective Products: Manufacturers may be aware of a dangerous defect in their products. If a manufacturer fails to warn businesses about this defect, they may be responsible when a worker is injured on the job. For example, a known malfunction that could trap a worker’s arm in a machine would allow the injured employee to file a lawsuit against the manufacturer.
- Toxic Substances: Toxic substances that are used in the workplace could cause acute or latent injuries. Acute injuries appear shortly after exposure to the substance and are typically short-term. Latent injuries could take years to develop but can last a lifetime.
- Employer Liability: Employers are typically protected from lawsuits when workers’ compensation is involved, but an employer may be held liable when their actions are reckless, negligent, or malicious. For instance, employees in most states can sue employers that injure them during an argument.
- Third Parties: Third parties could injure a person while the injured party is acting as an employee. For example, employees who deliver goods for a living may be injured in an accident while working. The driver of the other vehicle may be liable for the injuries sustained by the employee.
Traits such as disability, marital status, color, creed, military status, national origin, and others are protected by law. These anti-discrimination laws such as Title VII of the Civil Rights Act protect the interests of workers.
Who is eligible for workers’ compensation benefits?
Workers who perform casual labor can only qualify for workers’ compensation in the case of death or accident. In these cases, a worker can obtain reimbursement for major or minor injuries that led to disability.
Workers’ compensation aims to help employees cover medical bills and other workplace injury expenses. Even if an employee is responsible for the situation resulting in a work injury, most employees can collect workers’ comp. However, some basic requirements determine whether or not an employee is eligible for these benefits.
The employer may provide workers’ compensation coverage
State laws dictate whether or not an employer must carry workers’ compensation insurance. Small employers are often exempt from this requirement. Other employers’ industries may have a very low risk of workplace injury.
Non-profit companies are also occasionally exempt from needing workers’ compensation insurance coverage. However, employers who are not required to have coverage often choose to carry this insurance anyway.
While some employers are exempt, most employers must offer the insurance. Each state determines whether self-insuring is allowed. If an employer opts to self-insure, the employer uses their own company funds to pay for medical expenses and other costs related to workman compensation claims.
The workers’ compensation insurance process protects both the employee and the employer. Accidents happen, so an employer that chooses to carry it can often avoid a number of lawsuits over time.
You must be an employee of the company
Even if you perform work tasks for an employer regularly, you may not be taken into consideration as an employee of the company. For instance, workers’ compensation does not cover independent contractors.
Workers’ compensation also does not cover volunteers, with few exceptions. One such exception is the municipal sector. For example, a volunteer police officer that directs traffic at a parade could typically collect workers’ comp if they were injured in an accident in this scenario.
Types Of Workers’ Compensation Benefits
Knowing your rights when it comes to workers’ compensation benefits is a must when it comes to obtaining needed compensation. Following are the primary types of workers’ compensation benefits:
- Medical care
- Rehabilitative
- Disability
- Death
Many people end up in the hospital as a result of workplace accidents every year. Although workplace accidents may result in a minor injury, it is not uncommon for workers to get a long-term illness or injury on the job.
Medical Care Benefits
Workers’ compensation covers primary medical care after a workplace injury. For instance, a worker who suffers from back pain due to work activities can receive compensation for visits to a doctor’s office or chiropractor to have the condition diagnosed and treated. Emergency medical care and surgeries are also covered under workers’ comp.
Rehab Benefits
If a workplace accident results in a long-term injury requiring rehabilitation, these services are covered. Employees who cannot perform their current job because of a workplace injury may be eligible for job training for a new position, tuition reimbursement, or retraining. This is aimed at helping the employee learn how to complete tasks related to their current position while living with a long-term injury.
Disability Benefits
Some injuries or illnesses related to a workplace incident are so severe that an employee can no longer work at all. Disabilities resulting from workplace accidents can be temporary or permanent, and the disability can be partial or total.
Partial disabilities allow a person to complete a limited number of job tasks. A person with a partial disability will work, but such a disability will likely require them to work part-time or in a different position.
Total disabilities make it impossible for a person to work at all. If a total disability is temporary, the employee can someday return to work. However, permanent full disabilities sometimes occur in which the employee cannot ever work again.
Death Benefits
One type of workers’ compensation benefits involves the death of a worker. The family members can receive workers’ compensation in the case of wrongful death. However, in some cases, only spouses and children can collect benefits. The amount of compensation varies, but the calculation usually factors the deceased worker’s wages.
What is Covered Under Workers’ Compensation?
The workers’ compensation system allows employees to collect compensation when they are injured on the job. Understanding what exactly is covered by the insurance is a critical piece to seeking benefits.
- Injuries
Many employees believe that workers’ compensation only covers work-related injuries if they are sudden and unexpected. While accidents such as falls are covered, gradual damages resulting from the regular completion of work tasks are also covered.
- Illness
Workers’ compensation may cover long-term illnesses that develop as a result of job tasks. However, an employee must be able to prove that their job was responsible for the illness. Lifestyle factors, including a family history of illness, hobbies, and health risks may be used to determine whether or not an employee’s illness resulted from their job.
- Death
Legal dependents of an employee that dies in a workplace accident may be eligible for workers’ compensation. However, most states have strict laws that dictate which family members can collect the benefits. Spouses and children can usually collect benefits, but other dependents may not be eligible.
Which of the following is not covered under workers’ compensation?
If there is any health risk caused by the worker being under the influence of alcohol or drugs, this is not covered under workers’ compensation. Moreover, if the employee committed an act of misconduct or inflicted the injury themselves, this is not covered and may be punishable by law.
To protect your rights when it comes to workplace injuries, it’s best to hire an experienced Philadelphia workers’ compensation lawyer to represent you.